Review

Culture

Film & TV

Romance

13 May 2023

6 min read

What’s love got to do with it?

Watching Lovesick, a surprisingly profound comedy about chlamydia, prompts Beatrice Scudeler to consider permanence in relationships.

Beatrice Scudeler

Beatrice writes on literature, religion, the arts, and the family. Her published work can be found here.

A row of young people stand and talk to each other

Lovesick's cast.

Netflix.

This article contains spoilers for those who have not seen Lovesick.

I was working on my English MA in 2019, just before the start of the pandemic, when a friend first told me about a Netflix show that had just aired its final season, Lovesick. The premise, I will grant, was not the most inspiring one for an unmarried, socially conservative graduate student whose only experience of dating had been an unfortunate three-day courtship with her at-the-time best male university friend.

In Lovesick, Dylan Witter is the usual twenty-something-year-old: out of university, sort of purposeless, dating a string of women he thinks he’s deeply in love with, but breaking up with each of them no later than at the four-month mark. Unsurprisingly, he is diagnosed with chlamydia; shaken by the realisation that eleven years of sex out of marriage has left him with little more than sadness and a disease, he decides to meet with all of his ex-girlfriends, both to warn them that he may have given them chlamydia, but most importantly to try and figure out why he can’t find permanence in his relationships.

From this point, Lovesick spends three seasons going back and forth between Dylan’s past and his present, building towards the final confrontation, at the end of season three, with his best friend Evie, with whom, he eventually realises, he has been in love for seven years. Along the way, we meet Dylan and Evie’s other best friend, Luke, who proposed to his girlfriend while still at university, was rejected, and now lives a sexually reckless lifestyle, as well as Angus, the kind-of-forgotten friend, who married a woman he didn’t really love, had sex with a maths student turned one-time stripper, divorced his wife Helen, and is now having a child with ex-stripper Holly.

By the time we are out of university or school, it is unsurprising that our sense of certainty and purpose should crumble, when suddenly the burden of finding meaning is solely on our shoulders.

Based on this description alone, you’d be forgiven if you thought this show quite a depressing drama, and certainly not one worth your time. In fact, it is a surprisingly profound, honest comedy about our generation’s struggle with the false promise of freedom, and our deep-seated desire for permanence, for a more sacramental view of reality. Dylan’s trials in his youth all point him towards the realisation that making commitments (whether that’s sticking to a career and becoming actually good at your job or finding permanence in a romantic relationship) is ultimately the one thing that makes life worth living. The writers of Lovesick would perhaps not put it this way, but this truly is a show about people who desperately need God, and fail without His guidance.

The same applies to all of us, to those who are not Christians, but also to those of us who profess Christianity, but live as though we are atomised and self-sufficient (which we can all be tempted to do). When we are children, we have our parents to guide us; they are not a replacement for God, but they provide some guidance. Later, at school and university, it’s our teachers. By the time we are out of university or school, it is unsurprising that our sense of certainty and purpose should crumble, when suddenly the burden of finding meaning is solely on our shoulders.

If we go to church, if we have a community in Christ to support us, the burden is somewhat lifted. But Dylan, Evie, Luke, and Angus have no such thing. They rely on each other alone, and, since they are lost, all they can do is commiserate each other about how difficult adult life is.

Even so, the suggestion is there in Lovesick that there are moral standards external to our conscience, that there is something sacred and greater than us. In the very first episode of the show, Angus begins his ill-fated marriage to Helen. They get married in what is presumably an Anglican church, and Dylan makes a curious remark that, even though he’s ‘not religious’, a wedding in a church seems more appropriate. He laughs it off by suggesting that you have to sit somewhere hard and cold to really enjoy the ceremony, but it’s clear that he’s talking about more than this.

What he’s experiencing is an intuition which I would guess is still in so many of us even in our post-Christian society, that is, the intuition that there is something sacred about promising to love and care for another person for the rest of your life, that it’s not merely a contract. It is a duty to uphold such a promise, and this is a kind of promise that ties us in love to what some people may call ‘the universe’, though what we really mean, who we really mean, is Christ.

They have chosen to make an attempt at permanence, not to dismiss adult life as a senseless heap of broken people.

Sure enough, the rest of the show is about our protagonists watching all their significant relationships fall apart, and trying to rebuild them. I will have to spoil the ending for you, but that does not really matter, as it’s fairly obvious which direction the show is building towards from the very first episode. Angus is left alone as Holly leaves him, but vows to find a new job in order to provide for his unborn child. Luke stops engaging in promiscuous behaviour (sort of, he has seven years of trauma to deal with, after all) and begins a precarious, but genuinely caring relationship. After being hurt and hurting many people, Dylan and Evie decide that, in spite of all the heartbreak, and after a broken engagement, it is still valuable to make ourselves vulnerable to suffering for the sake of loving another person.

The show ends with Dylan telling Evie that he loves her for the first time, and you can tell it’s the first time in his life that he has really meant it. They are not married yet, but we can guess that’s what will happen next. They have chosen to make an attempt at permanence, not to dismiss adult life as a senseless heap of broken people, but rather to decide to take away some of the brokenness by growing up, making a commitment, and standing firm.

To marry during a pandemic, in the wake of my parents’ divorce, and uncertain about our future, was at once the maddest, and the best decision we ever made.

Something I have not yet told you is that the first time I watched this show was when I first started dating my husband. Although I could not relate to the endless dating, I could relate to the fear, the uncertainty of whether the other person wants to care for you in the way we want to care for them.

Not long after, I told my now husband that, if he didn’t think our relationship would lead to marriage, I’d much rather we break up and move on. I did not want Dylan and Evie’s seven years of suffering. I wanted marriage, I wanted commitment, I wanted a family. We did get married, around a year later, and after a year of marriage I watched Lovesick again. Now as a married woman, and having gone through the hardships of moving country twice, having a child after a difficult delivery, and facing problems in our extended family, I appreciated more deeply what a sacred and courageous thing it is to commit to sticking by one person, no matter what.

To marry and have children, knowing how ruthless and un-beauteous the world can be, is exactly the act of bravery our society so desperately needs. I watched Lovesick for the third time just recently, leading up to our second wedding anniversary. It was my husband’s first time watching, and we could not help but reminisce about our courtship, and how, to marry during a pandemic, in the wake of my parents’ divorce, and uncertain about our future, was at once the maddest, and the best decision we ever made

So, yes, watch Lovesick, even though it’s technically just a comedy about chlamydia. It may spur you to reflect on the real meaning of love: the fearless and unconditional caring for the other, regardless of their brokenness, but rather because of it. After all, that is how God loves us.

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.