In this post, guest contributor Laura Specker Sullivan discusses the cross-cultural ethics at the heart of the recent film, The Farewell.
Lulu Wang’s 2019 film The Farewell revolves around an actual lie: when Wang’s grandmother was diagnosed with stage four lung cancer, her family agreed that she ought not be told. For Wang, who grew in the United States but had been born and lived in China for several years, this came as a shock. As the character representing Wang, Billi, says at one point, what if her grandmother has things she wants to do? What if she needs to make plans?
Many members of an American audience will likely feel the same way as Wang did upon hearing her family’s plan. Informed consent is the cornerstone of American medicine, a bulwark protecting patients against physicians’ paternalistic infractions. The story of the rise of informed consent as a means of ensuring patients’ right to make their own medical decisions is well-known, and arguably celebrated, history here. While bioethicists and others occasionally lament the central focus on patient autonomy in medicine to the detriment of well-being, few would choose to replace it with the kind of benevolent lies that Wang’s film depicts.
This is not the case in much of Asia, and Wang’s film is not the first to highlight this practice. Akira Kurosawa’s 1952 film Ikiru tells the story of a Japanese businessman, Kenji Watanabe, who has cancer, but is not told by his doctor – he finds out thanks to a fellow patient who knows what the doctor’s diagnosis of benign stomach pain really means. Yet where Kurosawa’s film highlights the benefits to the main character of knowing his diagnosis, as he reevaluates his humdrum life as a salaryman and reconnects with the people around him, Wang’s film is less quick to embrace the benefits of disclosure. This reflects her experience that, in her words, “What my family did was kind, and it worked…maybe” (This American Life). Yet it also reflects the current moment in social understanding of how to justify particular practices that from one perspective might seem wrong, but from another angle seem right. While moral relativism has been a maligned term in philosophy, appreciation for the diversity of practices across cultural and other borders has led to increased interest in the resources for justifying practices within their own context.
Indeed, the kinds of nondisclosures Wang depicts are not outliers in East Asia. In Japan when Hirohito, the Emperor Showa, was diagnosed with cancer, he was not told, and media reports were carefully controlled so that the truth would not get back to him (until it was determined that he was likely no longer able to read the newspaper). It is unclear whether he knew of his diagnosis at the time of his death.
A Los Angeles Times report from 1988 is telling of the rhetoric that surrounded the decision to shield the Emperor from his diagnosis. Japan’s nondisclosure policy is described as “decades behind the times,” a practice that would be an “anachronism in most other developed countries.” The moral is clear – people ought to be told their diagnoses, and the nondisclosure to the Emperor may just be the last gasp of a cultural practice that can no longer be justified according to modern ethical norms.
This is why Wang’s The Farewell is so welcome. Her film assiduously resists easy moralization. The family’s decision not to tell Wang’s grandmother isn’t good, but it isn’t bad, either. While the strength of tradition is clear, it is not naïve – alongside scenes of Billi and others expressing nostalgia for a past China are those where she glimpses women who do not have the options that she does, party girls accompanying men who stay up all night gambling. No country is perfect, Wang seems to be saying, and there are benefits and drawbacks to both. While her character Billi may be surrounded by family in China and may have been living alone in New York, lonely and broke, Wang acknowledges both the burden of family expectations and the freedom of self-invention that nevertheless accompany each of these experiences.
If there is a moral to Wang’s film, it is that lies happen all the time, for all sorts of reasons. In the opening scene, Wang tells her grandmother that she is wearing a hat and not earrings, while her grandmother says she is visiting her sister. None of these things are true, but neither wants the other to worry about her well-being. Yet not all lies are equally good – their justification depends on the purpose with which they are told. The management of the truth to care for each other (as Billi’s uncle says at one point, “it’s our duty to carry the emotional burden for her”) is contrasted with lies for the sake of appearances, as when the grandmother encourages everyone to say that the couple about to be married have been dating for a year, when really they have only been together for three months. While the family’s actual lie to the grandmother is intended to be a caring lie, Wang does not exclude the possibility that it is a lie for appearances – that the family feels it must lie, because that is what Chinese families do.
It is in this context that the ending (spoilers ahead) is particularly poignant. I and my fellow movie-goers, a group of ethicists, physicians, and philosophers, all watched the film expecting the moment where the family finally tells the grandmother. This scene does not come. Rather, we watch as Billi leaves her grandmother for her flight back to the United States. Before doing so, she shares a different lie – she did not get the Guggenheim fellowship that she had been hoping for and about which she had told everyone she had not yet heard. In this ending, The Farewell affirms something that her grandmother says to Billi in this penultimate scene – life is more about how you do it, than what you do. Revealing her own lie strengthened Billi’s bond with her grandmother, rather than threatening it.
The ethical question in diagnosis disclosure may not be what to say, but how to say it. Ethics is not one-size-fits-all and the choices we make come with rich backgrounds and contextual considerations that cannot be swept away. The biggest life decisions – what career to pursue, whom to marry, where to raise one’s kids, how to engage with one’s family, and ultimately, how one wishes to die – are not dichotomous ethical dilemmas but emotionally rich choices with branching paths. Ought Wang’s family have told their grandmother? The answer, Wang seems to be telling us, doesn’t matter if we’ve approached the situation in the right way.