Fictional Plotlines and Real Assisted Suicide

Popular depictions of assisted dying can be a bellwether for changing views on the controversial topic.

On the season finale of HBO’s Girls on Sunday, an ailing photographer named Beadie, played by the inimitable Louise Lasser in a wheelchair, asked Jessa to help her die. “So let me get this straight,” says Jessa, a recovering addict played by Jemima Kirke. “You hired me because you knew I could get you drugs.”

No, says Beadie. “I hired you because I thought you were the only person who would see how necessary this was.”

It was daring of Lena Dunham, the show’s writer and creator, to introduce this particular plot twist. Assisted suicide is one of the subjects that American television shows steadily avoid.

Four years ago, the sitcom veteran Bob Kushell tried to get a black comedy about assisted suicide, titled Way to Go, into production. “I was told everybody very much liked the script,” said Kushell, but the TV executives passed on it anyway, his agent told him, because “the subject matter was just too dark.”

In Kushell's mind, the darkness was sort of the point. Giving a controversial topic the comedic treatment makes it less scary and more palatable, he said—and maybe something people would take more seriously because of the laughter. Suddenly, the subject is not so threatening to look at head-on. Kushell, whose credits include Third Rock From the SunSamantha Who? and Anger Management, took the Way to Go script to a producer he knew at the BBC. They loved it there. The show's six episodes aired for its first season in early 2013.

The introduction of complex issues into television plots is both a driver and a reflection of cultural shifts. Once a subject gets widespread treatment in scripts, the popular conversation can take on a new urgency, giving people a common vocabulary and a common set of feelings about the characters they’ve come to care about. Now when we talk about aid in dying for those with unbearable suffering—which is legal, with certain restrictions, in five states, with legislation pending in seven more—we can think of Beadie on Girls.

“I wake up every day disappointed that I didn’t die in the night,” she says as she pleads her case. “I’m tired. My body is gone. … I’m in so much pain, Jessa.”

Advocacy groups have long known the power of TV plot lines. Back in the 1980s, the Harvard School of Public Health mounted a campaign to normalize the idea of a “designated driver” to reduce drunk driving. Jay Winsten of Harvard spent weeks in Hollywood, meeting with 250 executive producers and head writers, asking them to work the concept of a designated driver into their TV scripts. Many agreed. In one typical placement, an episode of the police show Hunter from 1989 has four detectives sitting at a bar. The waitress arrives with their drinks.

“So who had the soda and water?” she asks.

“I did,” says one of the macho guys.

“Well,” she smiles, “someone’s gotta drive.”

During the next four seasons, Winsten counted 160 programs that dealt with drunk driving or designated drivers, either in passing or for an entire episode. And it helped: By the early 1990s it was hard to find anyone who hadn’t heard of the designated driver. Something similar might be happening now with assisted dying—first in Great Britain and soon, if last weekend’s Girls is any indication, in the U.S. as well.

In the British series Way to Go, three bumbling young men use a cobbled-together “McFlurry of Death” suicide machine to help very sick neighbors and acquaintances end their lives. They have stumbled into the assisted dying business by circumstance.

Each of them needs cash—the leader, Scott, so he can leave his dead-end job as a veterinarian’s receptionist and get back to med school; his half-brother Joey so he can pay off his gambling debts before his bookie breaks any more of his fingers; and their friend Cozzo, a soda machine repairman, so he can support the baby his wife is expecting.

When Scott’s next-door neighbor, who’s dying of ALS, offers to pay handsomely if Scott will help him die, the three grab the opportunity to make some serious money. Scott has access to the drugs, the same ones used to euthanize dogs at the clinic, and Cozzo has the technical know-how, and the spare parts, to assemble a portable suicide machine.

“Why should I let life dictate what happens to me?” says the first client before he pulls the lever. “This way I dictate what happens to my life.”

Scott has qualms about it every time they use the Rube Goldberg-like contraption on a new client—which is one way Kushell has given the show some moral gravitas. The people who want to die—a nursing home resident with an unspecified degenerative brain disease, a bitter woman in her forties who’s had cancer half her life—are treated with respect. All the humor, some of it quite funny, comes at the expense of the three blokes, not the people dying.

“You rarely get the opportunity in situation comedy to deal with such a dramatic hot-button issue,” said Kushell. “I really felt it was important to be able to talk about both sides of the issue throughout the course of the series, and have a really emotional struggle with the topic.”

That’s what the Scott character is for. Each time the guys get a new client, he wonders all over again whether they are doing the right thing. And when he meets and falls for the daughter of the first client, the neighbor with ALS, he can’t bring himself to tell her that he was the one who helped her father die.

Mark Pritchard, a Tory member of Parliament, blasted the show for treating a somber subject as “a matter of fun.” But objections to Way to Go were generally muted, partly because the show aired on BBC-3, the rebellious younger cousin of the BBC empire.

“We knew if you put it on primetime to a big wide audience it might have been more incendiary than on a younger-steering channel,” Jon Plowman, the series producer, told me.

That’s partly why Lena Dunham was able to introduce the topic on HBO, where she’s a known entity and a celebrated rule-breaker. It’s a reminder of an earlier golden age of American sitcoms, the 1970s, when Norman Lear mastered the art of mixing the very funny with the very, very serious. Back then, it was possible to have Edith Bunker get sexually assaulted on All in the Family, or to have the title character in Maude have an abortion. Even assisted dying made a cameo appearance, when one of the quartet on Golden Girls was asked by a friend to keep her company while she took a lethal dose of pills.

But at the time of the Golden Girls episode, American comedy had already taken a step back from the edge. The show aired in 1989, and at the end of the half-hour, the drama got tied up neatly in true sitcom style: The friend who wanted to die was convinced that she still had much to live for. Big hugs.

As taboo-busting as Girls has been over the course of its three seasons, Dunham also pulled her punches a bit the other night. The Beadie-Jessa storyline ended in a way not that different from the Golden Girls plot resolution of 25 years ago.

After Jessa helps Beadie swallow a handful of pills (telling her that if she chokes on them it’s okay, “it’s just a different route to the same thing”), she sits at the bedside holding her hand. The minutes pass. “Now I guess we just wait,” Jessa says awkwardly, twice. The camera cuts to scenes with all the other main characters—this is, after all, the season finale—and when we return to Jessa she’s still sitting at the bedside, stroking Beadie’s hair in a surprisingly maternal gesture.

Then Beadie’s eyes spring open. “Call 911,” she says. “I don’t want to die.” She repeats it, yelling now. “Call 911! I don’t want to die!”

The last we see of these two is Jessa scrambling over Beadie to get to the phone, stunned and slightly annoyed. She takes a deep breath, and starts dialing.