Review
Belief
Culture
Film & TV
1 min read

Heretic: Hugh Grant’s brilliance wrestles this tranquilized take on holy horror

If not original, a dissection of belief needs to be sincere and agile.
A man looks scarily upwards.
Hugh Grant prepares to eviscerate the script.

Halloween night: the perfect setting for a horror film. Religious horror: the perfect horror sub-genre. The supernatural invading the natural, darkness swallowing the light, tension and suspense assaulting the placidity we all crave, and doubt gnawing away at faith. All these reversals of the order we try to live in are on offer in Heretic. This is a ghoulish and ghastly offering from writer/directors Scott Beck and Bryan Woods, who are no strangers to the genre. In Heretic they bring the best that horror cinema has to offer: simplicity.  

The plot and script are lean enough to effortlessly perform the twists and contortions needed to keep the viewer off-guard and on the edge of their seat. The script is tight, with some wonderful opportunities to soliloquise and dialogue that is deliciously awkward and painful. The camera work is almost cruel in its relentlessness. This is not a film of jump scares. Here the camera lingers, and lingers…and lingers. Tight close ups on frightened faces and sinister smiles. Slow pans round a room, promising a sudden shock of relief that never comes – only more anxiety.  

The camera refuses to make the experience easy, but insists on letting the atmosphere and semiotics drive the audience to the point of tears. Such a focused and aggressive camera needs performers who won’t shy away but will grab it and wrestle with it! Thankfully, the performances are superb across the board. It's basically a three-hander, carried by Sophie East, Chloe Thatcher, and the indominable Hugh Grant (more about him later).  

East and Thatcher play two young Mormon missionaries – Sister Paxton and Sister Barnes - who spend their days walking the streets of a small American town in the mountains. In between dispiriting attempts to communicate their faith with an apathetic and even derisive public, they wile away the hours discussing their faith, their hopes and dreams, the perception of Mormonism in the popular culture, and the marketing of ‘magnum condoms’. Sister Paxton is earnest and zealous, desperate to prove herself as a missionary by converting at least one person. Sister Barnes is a little more reserved, almost cynical. There is less fervour, a hint of weariness, even the lurking sense of doubt? 

The two young ladies end an exhausting day with a visit to an isolated mountain-top cottage where they believe the seemingly kindly and bumbling English gent, Mr. Reed, is a prospective convert. Who else bumbles like Hugh Grant? It’s a joy to watch. What they hope will be a pleasant chat about their faith slowly descends into a horrifying and twisted psychological torture session, where the concepts of faith, doubt, religion, prophesy, and institutional thinking are all examined.  

I dare not say much more. This is a film which hides its twists well and uses the mundanities of blueberry pie and Monopoly to chillingly hilarious effect.  

However… 

Having heaped praise upon praise, I must admit that I left the cinema feeling slightly disappointed. I love horror cinema. I love religion – so much so that I’ve made it my day job. I love them in combination that appears pretty frequently, from the giddy heights of The Exorcist to the drudgery that is The Exorcist: Believer. This means that most of the themes that can be explored have been explored. Originality is nearly impossible, and not really necessary – but exploring the themes with sincerity and agility would be nice. The script might be acrobatic, but the thematic exposition is about as plodding as a tranquilised elephant with a limp. 

It is bad. 

Again, I don’t want to give the twists and turns away, but quite quickly a dissonance between the brilliance of the dialogue and the turgidity of the theme appears, and it doesn’t…go…away! What is faith and what is doubt? Good. What is belief and what is disbelief? Good. No. Scrap that. ‘RELIGION IS ALL JUST MAN MADE!’ Okay, we could explore that. ‘NO. JESUS IS BASICALLY HORUS.’ Right, but let’s tease out the nuance. ‘NO! RELIGION IS JUST A SYSTEM OF CONTROL!’  

Mr Reed suddenly morphs into the most tiresome bore. A cross between the theological illiteracy of Dawkins and the pathological obsession with power of Foucault. It is possible that this is part of the point – that this was intended to be a witty and incisive invective against institutionalism (especially institutionalised misogyny), and the ladies do land some philosophical counterpunches which expose the emptiness of Mr Reed’s rantings – but it just wasn’t done subtly or adeptly enough. What promises to be a thematic exposition of the nature of belief turns into a fairly lumbering and ponderous lecture on how belief full-stop is a ‘system of control’. We get it. We’ve been hearing this for centuries, and at a new fever pitch since the early noughties. Again…originality isn’t essential if the same old theme is explored well. I just didn’t feel it was. I felt it was a chore. 

Yet (another twist coming!), Mr Reed is still compelling. However boring the thematic content, I was never bored. Hugh Grant is superlative as the sinister, fanatical, hateful, charming, charismatic, hilarious Mr Reed. He delivers lines filled with acid yet dipped in honey. He smiles that singular smile as both wolf and lamb at once. His eyes twinkle with light that is both warm and yet dead and cold. He delivers laugh out loud speeches with absolute relish. The theme might be being butchered, but when the butcher is Hugh Grant you sort of forgive it all.  

I would advise you see this film. It's excellent on every technical level and an almost perfect tension builder. It's not perfect, and those who are genuinely interested in the theme are likely to roll their eyes as the early promise of interesting study devolves into something sub-Sam Harris. But ignore that and just enjoy the twists and turns. Ignore it and focus on Hugh Grant. He’s never been better. 

 

**** Stars. 

Article
Assisted dying
Care
Culture
Death & life
8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan is a physician practising in Toronto, Canada. 

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception. 

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate. 

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.  

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it. 

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.  

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us. 

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it. 

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die. 

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents. 

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory. 

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem. 

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception. 

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception. 

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods. 

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.  

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering. 

 It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it. 

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.