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Louis Theroux raises questions on quality of life and dignity in death

Dominic Lyons looks at how this tactful and touching documentary can be used to support teaching in Philosophy and Religious Studies

Louis Theroux takes the same nonchalant approach whatever the subject of his investigation. Effortlessly coaxing his interviewees into opening up, the broadcaster’s programmes are always enlightening however much they vary in tone – from kooky, to awkward, to unsettling. Theroux’s latest three-part series, Altered States, is a tribute to his versatility. While the first instalment on polyamory, Love Without Limits, emphasises his gawky charm and offers plenty of meme-worthy content for the Instagram generation, the second, Choosing Death, sees the filmmaker front a sobering examination of euthanasia, morality and the law. In Altered States: Choosing Death, the presenter combines humanity with objectivity as he investigates legal voluntary suicide in the USA. This one-hour programme is prime-time TV par excellence, and also raises ethical questions on quality of life and dignity in death that can spur debate in the classroom for Religious Studies or Philosophy.


Theroux meets three individuals who, at various stages of dying, have chosen to end their own lives. We are introduced to Gus, who is aged seventy-four and suffering stage four pancreatic cancer. Gus has bought a lethal drug cocktail online for $350 to be self-administered – a procedure legal in seven U.S states. A retired respiratory therapist, he has seen countless people sapped of their spirit while waiting to die, and speaks of his terminal illness in combative terms: “It’s going to kill me. Why should I wait for it to do that? I should kill it.” Vowing to leave earth on his own terms, Gus provides Theroux with a strong argument in favour of voluntary euthanasia. Nonetheless, the documentarian highlights the gravity of his decision, meeting the family who first have to let him go.

Embracing the inevitable with one last act of free will, Gus’ decision can be read as strength of character. But if his case is relatively clear-cut, the debate becomes cloudy when Theroux meets Debra. The 65-year-old is in mourning after the recent death of her husband, and her misery is made worse by signs of dementia following a car crash. Without family for either emotional or financial support, she turns to the Final Exit Network, a non-profit, pro-assisted suicide group steeped in controversy. As an interviewee, Debra is a remarkably sparky woman, which is jarring given that she has apparently abandoned her will to live. Theroux comments that she appears “a vibrant, attractive, humorous person who, I would assume, has lots to live for – so what am I missing?” Debra responds that, without her husband, of whom she speaks adoringly, and fearing the erosion of her identity by oncoming dementia, she is merely “existing… with no quality of life.” Present also are two of the Network’s “Exit Guides” who, when pressed by Theroux, say they feel gratified to permit the ultimate pain relief. It is disquieting that, instead of learning to cope with life and loneliness through therapy, this warm, intelligent woman has her suicidal thoughts indulged and facilitated by an outside organisation, uninvested in her survival.


In Altered States: Choosing Death, Louis Theroux presents the euthanasia question through the lens of unique personal circumstance. The result is a programme that draws on the grey areas clouding the conversation: When does counsel become coercion? Should free will overrule family? And does suffering outweigh the sanctity of life? Altered States: Choosing Death can slot into the Religious Studies and Philosophy curricula to frame the discussion in an accessible and engaging context. Theroux’s programme questions what makes life worth living and the idea of a right to a dignified death. A master devil’s advocate, the filmmaker’s sensitivity never wavers in this look at an unimaginable choice.