How to Plan Your Own Death

Canada’s Supreme Court legalized medical assistance in dying (MAID) in 2016, and there has been no end to debate and controversy over the end-of-life process: how it should be approached, what conditions it applies to and who should be allowed to make the choice to end their own life with a doctor’s assistance. Now, Canadian filmmaker Sophie Deraspe has arrived with the documentary “The Final Act,” an intimate portrait of people who have, in the face of terminal illness and other significant health burdens, decided to bring their lives to a close on their terms, surrounded by the people they love. But rather than delve into the politics of MAID or any controversy surrounding it, Deraspe has chosen what is almost a more radical approach to the topic, focusing squarely on the simple fact of death, and what it means to decide on welcoming it on one’s own terms.

“The Final Act” is a film about coming to terms with and acknowledging mortality. It’s also about breaking taboos around death, and in particular around witnessing it. Multiple scenes in the film take the audience right into the room when, with family and friends around them, the patients are injected with drugs to bring about their final rest. In a sense, she says, it is not really a film about assisted dying so much as a film about dying, period. Facing its reality so that we might embrace life, as the patients in the film do in sharing their final act. It’s a subject Deraspe has tackled before, in her 2009 feature “Vital Signs,” about a woman who goes to work at a palliative care facility.

“The Final Act” had its world premiere at the 2026 Toronto International Film Festival, where I spoke with Deraspe about bringing her interest in the subject to the world of documentary, what it was like to make the film — including the beauty she found being in the room with cameras to witness people’s final moments. This conversation has been edited for clarity and brevity.

Truthdig: What brought you to the idea of making a film about MAID?

Sophie Deraspe: I’ve been in contact with palliative care workers before, and one of my first films took place in a palliative care ward. Even if it’s fiction, I took my inspiration from real people. I was interested in end-of-life since a very early age, actually. I knew how full of light it can be, full of love, even if it’s very sad to let someone go. But then I did a film that was here in Toronto, “Antigone,” in 2019, and a Quebecois doctor wrote to me after having seen the film. He wrote beautifully about the film, and it just felt like, “Oh I want to know who that man is.” His name was Pierre Viens, M.D. I Googled him and I saw how he was involved in making MAID possible in Canada. So I wrote back telling him, “Are you aware that I did a film before called ‘Vital Signs’?” He replied, “I am quite aware. Of course.” And then he said, “Why don’t we meet?” I realized at the time he was 81 years old. He was with us today for the premiere. He’s 87 now.

“I took my inspiration from real people.”

So in 2020, 81 years old, he took the bus from Quebec City to Montreal to meet with me. At the end of this lunch we had together, we made this promise that we would do something together as a testimony. At his age, he had accompanied many people through the process of dying or choosing their own death, with MAID, and he felt he wanted a tribute to those people and their courage and how they teach us about life, and about ending life. I just felt I connected with this, and I also felt there’s a film to be done.

I didn’t know at that time, are people going to be willing to let us enter the room? But I knew from personal experiences that it’s OK to talk about death. It’s OK to acknowledge the fact that we are finite, that we’re part of nature, so we have some sort of a beginning and an end, and we’re part of a cycle. I knew right from the beginning that there’s a film, and I wanted a film for theatrical release. Not about the law specifically, not about all the very important social and ethical issues that are discussed in our society, but just the fact of dying and of being there. I knew I didn’t want to just close the door and leave the room for the moment.

Was that part of the motivation for making the film? Being in the room?

Yes, because I thought if we want to speak about death, why not stay until the end and acknowledge the fact that life will leave this body.

It was very striking. But also filming it at all feels like breaking a taboo. I was curious about your relationship to that taboo, and asking an audience to sit through it, confronting them a bit with that.

At first, I was wondering, would people allow me in the room? And of course, not everybody would, but some people not only allowed me, but welcomed me in the room. It’s a final act, but it’s also final words. They want to share something. They want to, for whatever reason, contribute in a way until the very end.

That goes to the opening lines of the film. There’s a conversation about the strangeness of scheduling and deciding on a time, but continuing to live.

But the fact is, we have a schedule. We know there’s an end. We don’t know exactly when it’s going to happen. The more we’re aware of this, I think the more we can enjoy the fact that the sun is rising and we may enjoy big things, like me being here showing a film at TIFF, but also like waking up in the morning and feeling the light, or sharing very mundane moments with my loved ones.

And in that final act, as you were saying, the idea of sharing it makes it about connection to other people. That can sound corny, but it’s what life is about, and a lot of people don’t get that opportunity on their final day. Can you talk about including the people surrounding the person who’s making that choice, the family and friends, and even the doctors and doulas, and what was it like talking to them and bringing them into the film?

How I worked was first with Dr. Pierre Viens, and then with some of his colleagues in other places than Montreal, and then through them, when they felt, “Oh, I think this patient is communicating something about sharing. I think this person is a good candidate for the film.” But even Pierre, it took him many years before he felt he could ask one of his patients, because he puts it this way: He has such a strong connection with them because he’s going to be the doctor that will help them end their life, so he didn’t want his patients to say yes to a film just to please him. He wanted to make sure that it was their decision.

Which, of course, reflects the intended process for MAID.

Yes, and that’s also why it took many years. I started filming with other of his colleagues, some of them he knows personally. And in that time, I’d say, like, four years, we had those people that you see on screen sharing their death. Most of them also agreed because their family would agree to that. Sometimes they weren’t sure about it, but once they met with me, I think they felt OK. Because most of them aren’t used to cameras. It’s not part of their lives. Once they had met with me, I took the camera out and we started just speaking about stuff that for them was so relevant, because they’re going through the process of, let’s say, “It’s our last two weeks. So what do we speak about?”

“It also allowed them to ultimately say the things that they were afraid to ask.”

Sometimes I think because the camera was in the room, it also allowed them to ultimately say the things that they were afraid to ask. Because sometimes with the camera, it just feels like, “OK, this is the moment.” Or even me trying to be respectful all the time, but at the same time, not shying away from asking, “Are you afraid of what’s coming?” or “Do you have regrets?” Or sometimes questions like, “What do you believe comes after death?” I think those simple questions, even sometimes within the family, they didn’t dare to ask.

You can see that in the film. There are moments where you get the sense that they haven’t talked about certain things, or not in the important way.

Yes, and it just felt like because the camera is there, and there’s this space for an ongoing conversation, they could talk about it. And I believe it felt good.

Obviously Dr. Viens was instigating it, so you know how he felt in a way. But how did the other other doctors feel about being included in the film? Particularly because it’s a controversial subject, and to have their faces public in this way is a real choice.

Those in the film are quite comfortable with the service they provide to a person who asks for it. But then one of them, Dr. [Danièle] Michaud, she’s the one who’s says, “I don’t believe in any god or whatever or there’s life after death, but I was surprised telling my patients, ‘Wait for me on the other side, we’ll play cards together.’” She’s quite emotional when she says that. I didn’t film her while giving MAID to a patient because for her it felt it’s not something she could do with a camera in the room. But she wanted to have a talk with me and speak about that. For another one, it’s not him [the patient] or his partner that felt uncomfortable with the camera, it’s his teenage daughter, and of course, it’s their moment, so I won’t insist. She doesn’t know me, and I never interviewed her, so if she’s not comfortable, it’s more important that she’s in the room with her father than me. So it depended on the circumstances of each of them.

In terms of the editing, structurally speaking, it takes a bit before you get one of those death scenes, and you see it quite at length. Then you kind of leave that for a while, but come back to it near the end of the film, showing several death scenes. Was that for the sake of the audience?

What I was thinking is that I don’t want to shy away from death itself, from a body, the fact of the body. So quite early in the editing, it felt like, “OK, let’s show what it is.” Also we have conversations with a social psychologist. We have a conversation with an Indigenous doula. So we have conversations with people who are into this. Their work involves being comfortable with the fact of dying, and so I just thought, “OK, let’s show one. Let’s get rid of this.”

Right. Yeah.

And for the others it just felt like, it’s OK to be uncomfortable, it’s OK to be extremely emotional, it’s OK. For some of them, it’s beautiful to see how the people around them, how the family, relatives, loved ones, share the moment. It felt OK for the other ones that it’s not about them — or not about only them dying — but also the sacred moment that is shared.

It brought to mind when my grandfather died. My sisters and I made a trip out, he was in the hospital, and we were there in the room, you know. The difference is he wasn’t really awake. That’s a different kind of experience. I was curious, though. It is a decision. It is a form of suicide. And obviously that’s controversial. Do you see the film having any political message?

I didn’t want the film to be about the law because it’s changing. I wanted the film to be about acknowledging the fact that we’re going to die and see what it can do to us as individuals and as a society if we get rid of this denial of death. Death is in the media everywhere, in the news, the body counts. It’s in the entertainment industry a lot, so we’re fascinated by it. But when it comes to seeing a real body, it’s supposed to be shocking or taboo.

Those scenes are quite bracing, especially the first scene. It was interesting watching it, because it’s beautiful in a way, but also I was really having to take it in for a moment. It’s quite a lot.

“Being alive means that it’s going to end at a certain point.”

To me, I would have attended the deaths of people, like natural death, not MAID or medically assisted death, but then it’s not the same. I cannot have an appointment with death, and even with our close relatives, we want to be there, and sometimes it’s just tough to be there the moment they actually leave. So to me it’s not a film so much about MAID. It’s a film about acknowledging the fact that being alive means that it’s going to end at a certain point, and better enjoy it now, better make the most of it while we can and maybe leave something after we’re gone, be it memories or whatever.

Or other people, I guess. Just the feeling that’s there between people.

Yeah, so that’s more the point. I know there’s going to be a talk about MAID, and also the fact that it’s not the end of the law. Some people want to extend it to more cases, or restrict it, and it’s not the same in every country.

Usually a documentary like this would be a bit more directly political. It was just interesting how that was not the concept.

It’s more philosophical. Existential. It’s a film about love. It’s a film about life and the fact that we’re part of nature.

Somebody in the film brings up the idea that part of what makes us human is that we know that we’re going to die. It’s about taking control over that.

That’s the taboo for some people or religions. You know, many of the people that I filmed, they do believe in God.

Interesting.

Yeah, and one of them has the cross behind him. The old lady, the 101-year-old lady, she believes in God, but she told me, “I believe in him up there, but I don’t believe in all the men who decide for us what it is,” because she’s seen enough of them just being men doing manly things. But she believes it’s quite OK, that God accepts absolutely the way she conducted her life, and the way she leaves.

Most religions deal with the idea of free will and the gifting of free will, and it feels like that’s the ultimate expression of it in a way. I found it very, very moving. I cried a lot.

I still do cry.

How do you do that actually? Just continuing working on it, while crying that much?

It’s OK to cry, and it’s OK to cry with other people sometimes. The first time I filmed one of the women in the film dying, the first person I talked to was my son. He was 9 years old at the time. I drove for one hour, and I was so aware of the light, the people, watching people walking, the pedestrians and the cars and people honking and others just having a good time, and I felt like life was so vivid in a way. So when I saw him, I just felt like I had to tell him what I just did. I filmed a woman dying, and the first thing he said was, “I want to see it.”

Sharing it with your son speaks to the very end of the film. The process of new birth.

Yeah. Some are leaving, others are coming, and that’s the beauty of it.

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