Article

Culture

Music

24 July 2023

6 min read

What was I made for?

Caught up in the Barbie moment, Belle Tindall ponders the haunting depths of the anthem that Billie Eilish has penned for the influential movie.

Belle Tindall

Belle is the staff writer at Seen & Unseen.

Barbie stands on a balcony and waves while looking out over her city.

Barbie in Barbieland.

Warner Bros.

I urge you to take the Barbie movie completely seriously - the film itself, the press-tour, the reactions and reviews, the watch-parties, the soundtrack, the costumes. All of it.

This is not a film to be shrugged at. Love it or hate it, Greta Gerwig’s re-imagining of the Barbie universe is a tool with which we can read this cultural moment. This film, fronted by Margot Robbie and Ryan Gosling (to name just two of an astonishingly expansive A-list cast), is already something of a cultural artefact in that it binds together decades worth of individual memories and experiences with a toy whose impact is truly unfathomable. These micro-stories have fed into what is now a macro-narrative. In binding together such experiences, the Barbie movie will attempt to speak into what has been, what is, and what may be.

You may think that I am being dramatic, but if you’re unaware of the term ‘Barbenheimer’, then I’m afraid that culture is already speaking a language that you’re unfamiliar with. While it's hard to know how this film will age, it's not hard to see how it is a real moment. One that should be given our full attention.

As Lauren Windle has provided a masterful analysis of the movie itself, this article will turn its attention to Billie Eilish’s hauntingly good musical accompaniment.

What is particularly interesting to explore, is who Billie is asking this question on behalf of, and who she’s asking it to.

Anticipation has been building as certain songs have mysteriously been left off the movie soundtrack’s track list: what are these mystery songs? Who is giving them to us? Why are they being kept hidden?

Rumours began to swirl, the most traction being given to the theory that Billie Eilish, the 21-year-old musical prodigy, had something particularly special up her sleeve. And the rumours were right. A week before Barbie’s release date, Eilish released What Was I Made For?, a song written just for this movie. And perhaps, just for this moment. The last time Billie turned her hand to writing a song for a film, she wrote an Oscar-winning anthem for James Bond, so this Barbie offering was always going to be special.

This song, written with her older brother (Finneas) in their childhood home, has already been streamed around twenty-million times. We can therefore assume that it is already residing in Gen-Z’s public consciousness. Simplicity seems to have been the key choice when it came to the production of this ballad; aside from a soft piano accompaniment and a hint of harp in the middle, Billie’s vocals have nothing to hide behind. In fact, her clean and soft voice sounds as though it reaches out of the song, the echo and layered harmonies giving it a truly 3D feel.

The result is ethereal.

But this song is more than beautiful. It is more than its (wonderous) sound. The lyrics are, quite literally, haunting. The title of the song is also the question that ties it together, as repeatedly Billie asks the question: ‘what was I made for?’ This question, and its implications, is where this song becomes more than a song. As so many of the great ones do, it becomes a three-minute-long existential pondering. What is particularly interesting to explore, is who Billie is asking this question on behalf of, and who she’s asking it to.

Of course, this song was written for the purpose of featuring in a film, its primary job being to tell the same story as the film itself (or at least an aspect of it).

Over a billion Barbie dolls have been sold since 1959. Over the years, Barbie has had over 250 professions, she has evolved through the decades to best personify the evolving beauty ideals of the age, she is, to quote herself, everything. But in being everything, is she also nothing? Time recently wrote that:

‘Barbie has no inner life or purpose; children are supposed to project their hopes and dreams onto her blank canvas.’

Considering this, it’s obvious how lines such as -

‘Takin' a drive, I was an ideal. Looked so alive, turns out I'm not real, just something you paid for. What was I made for?’

– hit the brief perfectly. If the song was intended to be a seeking out of Barbie’s more fragile side, it is a job tremendously well done.

But there’s more to it.

Billie Eilish has been under culture’s magnifying glass since she was fifteen years old. Many of her most formative years have been spent in our gaze as she’s become an adult in front of our very eyes. Whether it’s been the ever-changing colour of her hair, the romanticism of her homegrown talent, the fact that her sense of style so satisfyingly defies all the rules of the moment, or that her voice is so delicate it almost feels as though it needs protecting, she’s had us utterly captivated. And of course, such captivation has taken quite the toll. It always does.

Taking a moment to imagine how the world looks from Billie’s viewpoint, it becomes obvious that a song which was written for a toy is also profoundly autobiographical. She too is an ideal, she is something we’ve paid for. Through writing this song, Billie offered us her profound vulnerability. And what’s fascinating is that she did so without even realising it. When speaking about the song, Billie recalls how,

‘I was purely inspired by this movie and this character, and the way I thought she would feel, and I wrote about that. And then, over the next couple of days, I was listening… and I do this thing where I’m writing for myself, and I don’t even know it… this is exactly how I feel, and I didn’t even mean to be singing it.’

So, this song has two profound levels to it. And yet, I can’t help but feel as if it has even more to offer. The chances are that neither you nor I are a twenty-one-year-old mega-star, and we’re certainly not a sixty-four-year-old doll, but I wonder if this song was written about us too.

It hints at a belief that she was made with some kind of purpose and intentionality weaved into her existence.

This cultural moment is asking a pertinent question, it’s certainly not a new one, in fact, I would guess that it’s as old as time itself. But every now and again it is as if the volume gets turned up and this question rings out above all others: what does it mean to be human? Or, to borrow Billie’s phrasing: what were we made for?

The interesting, albeit obvious, thing about Billie’s particular wording, is that it implies a kind of faith that is hidden in plain sight (for, as far as I know, Billie has no religious faith). It hints at a belief that she was made with some kind of purpose and intentionality weaved into her existence. This is one of the most faith-filled things one could think, and naturally, Christians would heartily agree. Of course, it’s perfectly possible that this is simply emotive wording that Billie has crafted, for the sole purpose of getting people to listen to her song. However, I would argue that this question is asked all day every day, by people who have an intuition that there is more to their presence in the here and now than mere chance. And I’m willing to bet that the Barbie movie is going to have a lot to say about it.

Are we in a cultural moment where we’re wanting to re-find our humanity in its truest form? So much so, that we’re willing to shirk falsehoods, pretences, and presumptions? Are we disillusioned by anything less than our most authentic selves? It is interesting to ponder where such questions are prompting us to look for answers: inward? Outward? Upward, even?

What Was I Made For? is a soundtrack for a movie, a particularly interesting movie at that. But I would suggest that it’s also the soundtrack of an existential yearning, a song of a human working out what it means to be such. And I suppose that makes it a song that tells our story, as well as Barbie and Billie’s.

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

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.