On Wednesday, legislation that allows terminally ill New Yorkers to opt for an assisted suicide is set to come into effect. The state’s Medical Aid in Dying Act is the culmination of work by many — and a work of art may have paved the way.
Released in the U.S. in 2025, Pedro Almodóvar’s film “The Room Next Door” tells the story of how Martha (Tilda Swinton), who has terminal cancer, enlists her friend Ingrid (Julianne Moore) to help her die. Set in a fictional New York prior to the legalization of medical aid in dying, assisted death is framed positively, with Martha’s decision to die an act of dignity and self-determination. Ingrid is an honorable and moral friend who facilitates her death while staying in a neighboring room.
Our cross-cultural research shows that films, short videos, and other media dealing with assisted dying circulate in predictable patterns. At moments when public opinion is shifting in favor of legalization, cultural resources that foreground physical suffering and valorize choice and control often dominate public discourse, while also narrowing the frame of debate.
For instance, when Brittany Maynard — a 29-year-old white, upper-middle-class woman from California — was diagnosed with terminal brain cancer in 2014, she left her family and friends and moved to Oregon to have the option of an assisted death, which wasn’t legal in her home state. Maynard partnered with the advocacy group Compassion & Choices to make a short video, “The Brittany Maynard Story,” which provoked an outpouring of empathy for her situation and helped trigger legislative change in California — where assisted suicide became legal in 2016 — and beyond. The story was cited in legislative discussions in the U.K., Canada, Australia, Germany, and Austria. In Chile in 2015, 14-year-old Valentina Maureira, inspired by Maynard’s case, recorded a YouTube video pleading with President Michelle Bachelet to authorize her assisted death, stating she was tired of living with cystic fibrosis. The video went viral, prompting a presidential hospital visit and igniting right-to-die debates in the country.
But there are dangers when framing aid in dying in relation to a single life story, particularly when that story’s main character is an attractive and articulate newlywed who suffered a tragic illness. Film portrayals, even or perhaps especially powerful ones that change the legal landscape, often leave out the background socioeconomic considerations that shape individual decisions. “The Room Next Door” is no exception.
“The Room Next Door” is the first English language film of Spain’s most celebrated contemporary director, aimed at an American audience, and it won the Golden Lion at the 2024 Venice Film Festival. Both Almodóvar and Swinton have spoken publicly about their desire to see assisted dying become legal. The film itself is an adaptation of Sigrid Nunez’s widely acclaimed 2020 novel, “What Are You Going Through?”
Advocacy groups quickly seized on the film. Compassion & Choices, which campaigned for legalization in New York, hosted screenings; Death with Dignity praised it as evidence of the “need for the existence” of legalization. Mary Beth Quaranta Morrissey, chair of the New York State Bar Association Task Force on Medical Aid in Dying, cited the film during deliberations. Shortly thereafter, the association endorsed the task force’s recommendation to support legalization.
New York isn’t the only place where the film influenced policymaking. It even surfaced in legislative debates in Uruguay during parliamentary discussions that ultimately legalized assisted dying in that country in October 2025.
Almodóvar sets up its ethical framing through specific aesthetic choices. In the film, his signature use of colors— blazing red, forest green, deep blue, golden yellow, lavender pink — and intimate chamber-drama staging transform domestic interiors into spaces of moral clarity. The sound design — marked by silences, ambient natural sounds such as snowfall and birdsong, the unhurried rhythm of speech, and an original score built on tranquil orchestral elements — amplifies the film’s contemplative tone. In this mise-en-scène, assisted dying is portrayed as a relational, dignified, and visually pleasing act. Viewers, including any lawmakers who may have seen it, are invited into an idealized and privileged environment, where the complexity of the choice to die is aesthetically contained and emotionally distilled.
Almodóvar’s film focuses on the suffering caused by a terminal diagnosis, and the additional anguish incurred by not having the option of aid in dying. Securing an extrajudicial assisted death is difficult and risky for Martha, forcing her into elaborate arrangements and causing fears about legal consequences for her friend. But beyond what it depicts, the film is revelatory for what it lacks.
Set in a rarefied world, “The Room Next Door”makes no mention of hospice or palliative care in its extended meditation on what constitutes a good death. Neither does it delve into systemic barriers to adequate care for people with disabilities and/or terminal diagnoses. Other films do that work but don’t get picked up by the media in the same way, or function as successfully as ethically charged soundbites around the right to die. Reid Davenport’s recent documentary “Life After” (2025) tells a story of how ableist prejudices inform how society debates and regulates assisted dying. He discusses the case of 39-year-old Canadian Michal Kaliszan, a software developer with spinal muscular atrophy, who considers a medically assisted death to avoid entering an institution for the rest of his life. By exploring questions of social exclusion and care, Davenport does not portray the quest for a legal assisted death as glamorous or admirable, asking instead what it might look like in practice.
Social conditions and health care options influence the ability to make freely determined end-of-life choices; the documentary “How to Die in Oregon” (2011) paints assisted dying in a largely positive light, focusing on the stories of more or less affluent, white, nondisabled people. The one underprivileged person interviewed describes how his insurance refused to pay for his cancer treatment, offering instead to fund palliative care including an assisted death. “The Room Next Door,” on the other hand, offers only a brief nod to the U.S.’ “teetering health care system,” while Martha enjoys a private hospital room overlooking Manhattan and chooses to die in a luxurious house upstate.
In Almodóvar’s native Spain, Alejandro Amenábar’s film “Mar adentro” (“The Sea Inside”) starring Javier Bardem dramatized the life of Ramón Sampedro, a sailor who became quadriplegic following an accident and had an assisted suicide outside the law. That film too depicted the suffering of an individual who struggled to come to terms with his condition, without delving into widespread but difficult-to-resolve issues that may have influenced Sampedro’s choice, including ableist premises and gender stereotypes around manhood.
Amenábar’s film became a key force driving the legalization of assisted dying in Spain, and perhaps Almodóvar has just achieved something similar in New York. If so, it is time to reflect more carefully on the political and medical implications of positive portrayals of assisted suicide in artworks.
Anna Magdalena Elsner is associate professor of medical humanities at the University of St. Gallen, Switzerland. She is the principal investigator of Assisted Lab, a European Research Council research project on the aesthetics, laws, and ethics of assisted dying. Vanessa Rampton is a senior researcher within Assisted Lab at the University of St. Gallen, Switzerland, and an affiliate member of the Department of Equity, Ethics, and Policy at McGill University in Montreal. Their book “Assisted Dying: Law, Ethics, and Aesthetics” will be published by Cambridge University Press later this year. This research was supported by a European Research Council grant funded by the Swiss State Secretariat for Education, Research and Innovation.