It is based on the real-life story of Ramón Sampedro (played by Javier Bardem), who was left quadriplegic after a diving accident, and his 28-year campaign in support of euthanasia and the right to end his life.

The film explores Ramón's relationships with two women: Julia, a lawyer suffering from Cadasil syndrome who supports his cause, and Rosa, a local woman who wants to convince him that his life is worth living.

He is unable to end his life by himself and does not wish to implicate his family or friends, as by Spanish law, they would be charged with murder or assisting a suicide.

As she seeks to learn more about him and his situation in order to fight for his cause, he recounts his past and his reasons for wanting to die: He says that there is no dignity in living paralysed.

Rosa, in tears, appears at his house and Ramón admits that he has planned a way to commit suicide without the direct and obvious involvement of anyone else.

Ramón refuses to be carried downstairs and so the two men converse through the help of a church boy, who runs up and down to share their arguments.

Its consensus summary states: "Held aloft by a transfixing performance from Javier Bardem as a terminally ill man who chooses to die, The Sea Inside transcends its melodramatic story with tenderness and grace.

"[2] Metacritic assigned the film a weighted average score of 74 out of 100, based on 38 critics, indicating "generally favorable reviews".