Earlier this month, Colorado voters approved a ballot that made it the fifth US state to legalise physician-assisted suicide (excluding Montana, which allows it via court ruling). Discussions around this issue are understandably fraught.

At a time when legalisation is becoming more common, it’s now even more important that we consider how the debate around assisted dying is framed – not only the news, but also documentaries and fictional entertainment such as novels and films contribute towards the public understanding of euthanasia. And in the main, such fictional depictions and documentaries are largely in support of assisted suicide. Unless handled carefully, such media could work to stifle the debate.

A musical attempting to highlight this dynamic was staged last weekend at Liverpool’s Unity Theatre as part of DaDa Fest – an arts festival that stages events based around disability.

Assisted Suicide: The Musical was created by Liz Carr, a well-known disability activist, comedian and actress who has spent a lot of time campaigning against the legalisation of assisted dying. The musical finds Carr, alongside a small cast of actors, singing a collection of catchy tunes that draw attention to various issues surrounding the debate, including the contested notion of choice and the various social barriers faced by those living with disabilities.

Liz Carr (centre) says it’s rare to see people with disabilities being shown to lead happy and fulfilling lives

The musical is refreshing for many reasons – not least because it addresses the bias of creative work exploring this contentious issue. As Carr points out, it’s very rare to see people with disabilities being shown to lead happy and fulfilling lives. It’s the stories in which individuals request to end their life that receive most attention.

A film released this year called Me Before You played a large role in highlighting this bias. Carr and other campaigners from the group Not Dead Yet protested against what they saw as the film’s romanticisation of euthanasia at its premiere this year.

The movue ‘Me Before You’ has attracted criticism from Carr and others over its perceived romanticisation of euthanasia

Based on a 2012 novel by Jojo Moyes, Me Before You tells the story of Will, a young man who is left quadriplegic after being hit by a motorcycle. On realising that his paralysis is permanent, Will requests to travel to Switzerland where he can be helped to end his life. Much of the novel is concerned with the romance that develops between Will and his carer, Louisa. Despite their feelings for one another, Will maintains that he will not change his mind about ending his life. Louisa struggles to understand how their relationship is not enough for him to want to live.

Criticism of Me Before You was certainly justified – the film doesn’t do enough to criticise the social barriers Will faces, nor does it delve into the mental health side of things. And yet there are people living with disabilities who agree with the way in which the film raised the issue of assisted suicide. The dialogue that emerged in response to Me Before You raised questions over the way entertainment explores these issues and its role as a means of engaging the public with the ethical debates around euthanasia.

The assisted suicide clinic Dignitas, in Pfäffikon near Zurich (Getty) (Getty Images)

Documentaries also have an important role in setting the agenda of these debates. Assisted Suicide: The Musical pokes fun at these, too. Carr believes such documentaries are intended to pull at audiences’ heartstrings by showing disabled people as pitiable – and euthanasia as a suitably compassionate response. No specific examples are mentioned, but documentaries such as the BBC’s How to Die and Terry Pratchett: Choosing to Die undoubtedly fit the bill here.

Once again, the issue is representation. It’s not so much that these portrayals are maliciously insincere, only that so few documentaries consider how disabled individuals should be assisted to live, not simply to die.

There do exist books and films which are, at least to my mind, more adept at handling the topic of euthanasia and disability.

You’re Not You is both a novel and a film that centres on the life of Kate, a classical pianist who is diagnosed with ALS. Kate employs a carer – Bec, a college student desperate for money, who applies for the job despite a lack of experience. The narrative ends with Kate being taken off life support. Or there’s the 2011 French film The Intouchables, loosely based on a true story in which a wealthy aristocrat hires a young man from the projects to be his caregiver. The film ends with Philippe marrying the love of his life.

The difference with these narratives is their capacity to reflect nuance – to show the characters as indecisive, to show the realities of their condition while also showing them enjoying life. The key point here is uncertainty. Disability rights groups who reject physician-assisted suicide focus on the idea that it’s understandable to want to end one’s life but also that this is never permanent, just a phase.

Whether you agree with this perspective or not, the high book sales of Me Before You and Carr’s sold-out musical demonstrate that the arts are a prominent platform for engaging people with social and bio-ethical issues. They may not always be successful in terms of appropriate representation, but they still promote reflection on how they participate in and frame these discussions.

And such reflection is to be promoted. It encourages future books, plays, films and documentaries to acknowledge the complexity of this issue and avoid attempting to provide a blueprint that must be followed in order to achieve clearly defined positive or moral outcomes.