Grey areas

In his previous series, Dark States, Louis Theroux painted a bleak portrait of the US, focusing on murder rates, heroin addiction and those exploited within the illegal sex industry. For his latest, he returned to America, this time exploring the most fundamental aspects of people's lives: birth, love and death.

Altered States began with the lightest episode, on polyamory. In what set the tone for the series, the concept seemed unusual (at very least) at the outset, but Theroux's sensitive approach helped to make the motivations of those involved more comprehensible to the extent that by the end it no longer seemed so outlandish. The programme was a bit of a throwback to the Weird Weekends days, though, in that at one point he made the move from objective observer to active participant by joining in with the activities at a party celebrating the sensuality of touch.

The other two episodes, on choosing to die and open adoption, were more difficult to watch. The former, in particular, was proper lump-in-throat stuff. It asked a provocative question: is it not better to have control over your own death than to leave it to natural causes? Allowing the terminally ill to choose a "good" death as a way of avoiding unnecessary suffering (both their own and that of their family) came to seem less controversial and more a matter of human dignity. However, having that option was also shown to bring its own personal, ethical and familial complications, and the almost evangelical zeal of those who advised about and assisted the suicides was deeply troubling.

Likewise, the final episode considered the complexities of open adoption: the fact that it offers pregnant women who are unwilling to have an abortion but who also feel incapable of or unprepared for motherhood the opportunity to give their children a better life, while at the same time giving hope to couples or individuals desperate for kids. As is so often the case, the complicating factor was shown to be money: such adoptions are financial transactions. The way the US system is set up feels instinctively problematic, on both sides: on the one hand, it seems wrong that the wealthy have the luxury of being able to buy babies from the poor, while on the other, women are able to exploit the system by getting pregnant, rinsing prospective adoptive parents for thousands of dollars and then claiming they've changed their mind about giving up the newborn child. And then, of course, there are the agencies making money as the go-betweens.

We live in a time when opinions on all manner of issues seem increasingly divided and indeed polarised, when people are often entrenched in their views and instantly dismissive of any alternative perspectives. So Theroux's customary approach to what are highly charged topics - careful, thoughtful, balanced, dispassionate - was invaluable in showing that not everything (or perhaps not anything) is black and white. In fact, there's a lot of grey inbetween.