The latest instalment in Louis Theroux's new documentary miniseries aired on BBC Two on Sunday night and it was an intense, emotionally charged watch that divided viewers on social media. In Choosing Death, the second film in the three-part Altered States series, Theroux explores assisted dying in California, where it's legal for terminally ill people to end their lives.
Being such a sensitive and controversial topic, the film was bound to stir debate on social media and it did just that, with viewers debating the issue of assisted dying itself – should we have the right to end our own lives? – and the way in which the BBC told the subjects' stories. Choosing Death is a far cry from the frivolity of last week's Love Without Limits, which saw him delve into the awkward world of polyamory.
California is one of the six US states where it's legal for people to take a lethal overdose if they meet certain conditions: they must be terminally ill, of sound mind and strong enough to administer their own prescribed dose. Theroux visits the family homes of people who want control over ending their own lives, and finds that choosing the right time is far from easy.
Many praised the film for giving a voice to the terminally ill people whose wishes are so often overlooked in the ethical and moral debates about assisted dying, and for handling the issue with such sensitivity.
Louis Theroux's Altered States: Choosing Death documentary last night was thought-provoking, incredibly emotional and a vital watch to understand why choosing when to end your life is an important subject. Beautifully filmed too. @louistheroux #AlteredStates #LouisTheroux— bethan elizabeth (@_bethwithanf) November 19, 2018
Louis Theroux #alteredstates tonight was a beautifully, sensitively made exploration through 3 personal stories of issues around assisted dying in terminally ill people. He is so skilled you don't realise it. TV documentary making at its very best and so much food for thought— david oliver (@mancunianmedic) November 18, 2018
Louis Theroux is just incredible. Compassionate, empathetic, gentle, and yet somehow gets right to the heart of every question, no matter how difficult. And you can see just how comfortable he makes the people that are opening up their souls to him. #AlteredStates @louistheroux— 𝗖𝗵𝗮𝗿𝗹𝗼𝘁𝘁𝗲 (@charlottevm85) November 19, 2018
But there was less consensus in the reaction to one particular storyline. Theroux meets the controversial Final Exit Network, a group of volunteers that goes further than the state's existing laws by offering technical advice to people who wish to die but aren't necessarily terminally ill. The group believes people in psychological pain, not just those in physical pain, should be able to take their own lives, and as such they operate in a legal and ethical grey area. They've had a felony conviction and other prosecutions in the past, the film notes.
Theroux meets Debra, who was left with physical ailments after a serious car crash, including dementia-like symptoms, and is heartbroken by her husband's recent death. She wants to end her life long before what would appear to be her natural time, and seeks the Final Exit Network's help. The segment stirred up complex moral and legal questions about how much control we should have over our own deaths.
I wasn’t quite sure what to make of those exit guides, it’s a very tricky line of right and wrong but when he answered Louis’ question of “Will there be any evidence of ‘Final Exit’ at her home?” and he answered “I hope not” slightly suspicious #LouisTheroux #alteredstates— Scott (@Scott81792652) November 18, 2018
Final Exit Network have a duty to seek help for those who approach them for advice, who are not terminal. They said Deborah had no one to live for, but at the same time mentioned her friend. I'd love to know how much they charge the vulnerable for their "service" #AlteredStates— Daisy (@DaisyKirkwood14) November 18, 2018
I found #AlteredStates deeply moving, especially having lost my dad to terminal cancer when he was 59, but I fear lots of people in the US will be driven to end their lives to spare their families from huge medical bills. This is the health system the Tories want for us.— Chelley Ryan 🖐️ #RJCOB (@chelleryn99) November 18, 2018
Perhaps the most moving moment in Choosing Death, though, is when the life of Gus, a retired respiratory therapist with stage four pancreatic cancer, ends on screen. Gus has a full life by anyone's standards, with a wife, twin daughters and a new grandson, and he wants to end it himself before the disease does it for him. He dies with his family, Theroux and the film crew by his side.
The BBC's decision to show his death on screen caused a schism between viewers on Twitter, with many arguing that the BBC's editorial choice felt "intrusive" and "like a step too far".
But the overwhelming reaction to his story was heartbreak. Countless viewers said how moved they were by Gus' story, with many describing themselves as grieving. Regardless of whether or not it was ethical for Theroux to be present as he died (although presumably Gus' family will have consented), there's no doubt that airing his story helped to humanise the issue of euthanasia.
Absolutely broken into pieces after watching #AlteredStates @louistheroux had tremendous sensitivity and compassion. I loved Lori's attitude to it all, such strength. Deborah admitting it was a decision through heartbreak 💔 Gus & his family tipped me over the edge 😢 #lovetoall— Rhiannon Wilson (@JaffleLady) November 19, 2018
Never grieved a person I don’t know like I feel I am now - Gus on @louistheroux #AlteredStates, what an absolutely heartbreaking story to watch. Glad he fulfilled his wishes surrounded by loved ones, but what a sad thing for the world to lose such a beautiful soul. 💔— Beth McCarthy (@bethmaymccarthy) November 19, 2018
Assisted dying is legal for terminally ill people in just a few countries and US states, including Oregon and Washington, Canada and Switzerland. Assisting a suicide remains a crime in England, Wales and Northern Ireland and is punishable by up to 14 years in prison.