Wed, Apr 17, 2019 - Page 13 News List

Movie review: A Decision

Maso Chen follows 2017’s ‘The Silent Teacher’ with another skillful documentary asking uncomfortable questions about death

By Han Cheung  /  Staff reporter

Wu Yu-cheng chats with his 24-year-old patient Jing-yu, who was paralyzed in a car accident when he was 17 and relies on a ventilator to stay alive.

Photo courtesy of

A Decision’s opening sets the grim and philosophical tone for this documentary, with a upbeat doctor asking his paralyzed 24-year-old patient: “For those who rely on a ventilator just to live, is it worse to be conscious or unconscious?” The young man looks at him and says, “If I really had a choice, I’d prefer to die. I don’t want to be a burden.”

This doctor is Wu Yu-cheng (吳育政), an anesthesiologist at Dalin Tzuchi General Hospital (大林慈濟醫院) who was once attending physician at the intensive care unit at Changhua Christian Hospital (彰化基督教醫院). Appalled by patients who were essentially forced to stay alive with no hope of recovery and the financial and emotional burden on their loved ones, Wu started advocating against futile medical care. Wu believes that Taiwan’s excellent healthcare system has actually exacerbated the situation as more people could afford such life sustaining treatment whereas in other countries, financial concerns may overshadow ethics and feelings. After submitting numerous articles and op-eds, he reached out to director Maso Chen (陳志漢) to make a documentary for more impact.

It’s a timely subject — suffering from terminal pancreatic cancer, renowned sports anchor Fu Da-ren (傅達仁) underwent voluntary euthanasia in Switzerland last year, while Taiwan just implemented in January the Patient Autonomy Act (病人自主權利法), which allows people under certain conditions who have made an advance decision to ask doctors to terminate their life sustaining treatments.

There are about 4,000 patients per year in Taiwan who are on ventilators with little hope of recovery, and while not all of them want to die, Wu believes that they should have the choice. Despite the new law, the emotional and moral struggles of the doctors and loved ones do not just disappear. The film’s title is apt, as it often boils down to a decision — without the ventilator, the patient will die in a few hours and there’s no turning back.

The film has two storylines: Wu regularly visits the paralyzed young man and tries to improve his quality of life while finding a way to let him breathe on his own, while at Wu’s former intensive care unit another young man struggles whether to keep his suffering mother — who prefers to die peacefully — on life support while trying to balance his personal life. The mother is lucid and even able to walk sometimes, adding to the difficulty of the decision and returning to the question: is it better to be conscious or unconscious?

This is Chen’s second full-length documentary revolving around death. His 2017 work, The Silent Teacher (那個靜默陽光午後), is a heart-wrenching tale about a man and his late wife who had donated her body for students to dissect at Fu Jen Catholic University’s medical school. Chen had a complex and likable protagonist and a rather surreal topic, as traditional belief in keeping the corpse whole after death has made people reluctant to donate.

A Decision doesn’t have such a unique story nor is it much of a tearjerker, but rather it cuts straight to the heart. Caring for a bedridden or dying loved one is something most people will inevitably face one day, a fact so unbearably real that Chen edited the entire film in black and white to make it less realistic. While it works, the resulting grim tone makes the film even bleaker, matching the despair and silent anguish of the patients and their loved ones.

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