A Terminal Trust (Tsui No Shintaku): Montreal Review

Japanese drama about end-of-life medical choices will test American attention spans.

Masayuki Suo reunites for a third film with his "Shall We Dance?" star Kôji Yakusho.

MONTREAL -- Investigating moral and ethical issues around "death with dignity" from a variety of angles, some more productive than others, Masayuki Suo's A Terminal Trust (based on a novel by Tatsuki Saku) centers on a doctor whose own personal life informs how she handles the grave request of a terminally ill man. More slow-moving and drawn-out than its somber subject requires, the film would be more appealing to arthouse distribs if trimmed far back from its current runtime of almost two and a half hours.

Internist Ayano Orii (Tamiyo Kusakari), having made a failed suicide attempt after a romantic breakup, finds herself unusually sensitive to the pain of her patient Shinzo Egi (Kôji Yakusho), whose severe asthma attacks will soon threaten to kill him. It helps that Egi, stoic about his own pain, finds indirect ways to assuage hers. The two have long, heart-to-heart visits that may look like fantasy to anyone who's ever fought for two more minutes of a busy doctor's time.

Coming to feel that he can trust her more than his own family, Egi asks Dr. Orii to promise she will end his life once things get bad enough that his body can only breathe and be nourished through tubes. (The film includes so many shots of architectural ductwork that one suspects Suo thinks a building's respiration has something to say about that of an ICU patient.) Orii sadly agrees, and some time later -- in a scene suggesting that "pulling the plug" can be a violent, terrifying thing even when done lovingly -- she helps him die.

We see all this in flashback, as Orii sits, three years later, in the waiting room of a prosecutor investigating her actions. That prosecutor (Takao Osawa) is drawn as such an officious, manipulative man that we're pushed into identifying even more strongly with Orii. When, very late in the film, he questions her choices, what should be a legitimate debate -- one that would cause viewers to think harder about these issues as they play out in the real world -- the film has all but forced us to dismiss his accusations as heartless persecution.

It's easy to imagine a version of this story that would need to run over two hours, but A Terminal Trust isn't it. Suo's script spends so much time upfront on the relationship between doctor and patient that, without becoming a miniseries, it can't fully explore the issues raised by his incapacitation and death. It's understandable Suo would want to give so much screen time to the highly sympathetic Yakusho, but doing so doesn't serve the dramatic structure of a film that might've been much more provocative than it is.

Production company: Altamira Pictures
Cast: Tamiyo Kusakari, Kôji Yakusho, Taka Osawa, Tadanobu Asano
Director-Screenwriter: Masayuki Suo, based on the novel by Tatsuki Saku
Producers: Ken Tsuchiya, Naoto Inaba, Takao Tsuchimoto, Shinyato Horikawa
Executive producers: Chihiro Kameyama, Shôji Masui
Director of photography: Rokuro Terada
Production designer: Norihiro Isoda        
Music: Yoshikazu Suo   
Editor: Junichi Kikuchi
No rating, 144 minutes