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Posted on October 1, 2019 at 12:30 PM

“Based on an Actual Lie”—thus begins The Farewell, a film that follows 30-year-old Billi from her New York City home to Changchun, China, where she and her family visit her dying grandmother Nai-Nai.  Billi’s family arrives in Changchun under the guise of a wedding celebration for Nai-Nai’s grandson, but they have really come together to all be with Nai-Nai before she dies of stage IV lunch cancer. The ‘actual lie’ on which the story is based concerns the withholding of grim health information from the family’s matriarch; but this very substantial lie coexists with myriad other well-intentioned lies that various family members tell one another throughout the movie.

The Farewell is a good reminder that disease often affects an entire network, and that medical ethics is, much to the chagrin of many analytic philosophers, embedded in a highly complex web of cultural and sociological forces.  Billi’s father admits to Billi that their strategy of lying to Nai-Nai about her condition wouldn’t fly in the United States; yet the viewer discovers, along with Billi, that norms in China dictate against medical honesty when that honesty brings with it bad news.  

This cultural clash is most stark when we witness the bilingual Billi speak to Nai-Nai’s doctor in English right in front of Nai-Nai, who speaks only Mandarin.  Billi interrogates the physician about whether lying to Nai-Nai is the right thing to do, and he affirms that Nai-Nai has advanced lung cancer and reassures Billi that “it’s a good lie.”  Here, the truth is right in front of Nai-Nai, but just out of reach.

The central tension of the film concerns the interplay between informational disclosure, harm, and autonomy.  Nai-Nai’s family is deeply concerned about the harm that disclosure of her disease status would cause, and this concern appears to be the main driver of their decision to withhold information.  But I have to wonder whether there are other factors in play—e.g. avoidance or denial—that are also contributing to their decision.  And in focusing so much on harm, the family ignores Nai-Nai’s autonomy—and with it, her vibrant, hilarious personality—as worthy of consideration and respect.  When, if ever, does information cause the type of harm that the bioethical principle of nonmaleficence dictates against?  And when, if ever, does this type of harm justify a disregard for autonomy?  These are hard questions to answer.

In the film’s coda, we learn that Nai-Nai is still alive six years later.  As a viewer, I was not sure how to take this information: is it evidence that Nai-Nai’s family did the right thing by lying to her, therefore giving Nai-Nai the opportunity to live six more years in blissful ignorance?  Or does her unexpected longevity make the lie all the more nefarious, since it robbed Nai-Nai of the chance to view each one of those nearly 2200 days as an especially precious gift?  

The most likely answer is that it depends—it depends on what Nai-Nai herself would have wanted.  And with the exception of Billi, Nai-Nai’s family members do not give this question any thought when deciding on what they think is best for Nai-Nai.  We do learn that Nai-Nai lied to her late husband when he was terminally ill, which Nai-Nai’s children seem to think justifies their doing the same to Nai-Nai.  But we also witness the sting of humiliation when Nai-Nai learns that her husband lied to her for years about his smoking habit.  We see throughout the film, from several different angles, how we often don’t really know the people whom we believe we know best of all.

As for me?  Well, I’d want to be told the truth.  But I’d also want the opportunity to leave that truth by the wayside, should I deem it too much of a nuisance, and walk away no worse for the wear.  If only that were a real possibility—for Nai-Nai, for Nai-Nai’s family, and for the rest of us.

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