Literature and Medicine

Abstract:

The usefulness and limitations of dignity as a guide to clinical end-of-life decision-making lie in the challenge it poses to the bioethical principle of autonomy, individualist self-determination that can resist others’ expectations. I propose understanding dignity as performative and thus mutual rather than autonomous, requiring witnesses and a feedback loop of representation, reception, and reinterpretation that, crucially, persists after the death of the central subject in order to establish the meaning of a death as either “dignified” or “horrible.” Taking Erving Goffman’s theatrical model of self-presentation as an invitation to apply to dying the criteria of dramatic genre and the rules of decorum prescribed by the genres of tragedy and horror, I use the representation of assisted suicide in the 2019 film Midsommar, and that film’s foregrounding of the face, to develop an account of dignity as the witnessing and reading of a communal and embodied performance of self-governance in the face of dissolution.