Article

Comment

Sustainability

28 November 2024

6 min read

Does COP make any difference?

When climate deal makers and justice seekers meet.

Julia Kendal

Juila is a writer and social justice advocate.

A speaker holds two fingers up while sitting in front of a backdrop reading 'United Nations Climate Change.

Brazilian politician Geraldo Alckmin addresses COP29.

Vice-Presidência da República, CC BY 2.0, via Wikimedia Commons.

This year’s UN climate talks have come to an end with a headline-grabbing figure, reports of deep divisions and cries of failure. How do we understand the legacy of these negotiations for us now and for the generations to come?

COPs bring together negotiators from almost 200 nations, along with tens of thousands of people from across business, civil society and local communities. They gather to make decisions about this crisis that touches every community and part of our lives and our world, though not equally (which is part of the issue). The annual negotiations are the culmination of months of action and diplomacy. The negotiators pore over draft texts to understand the implications of a new set of brackets, they search for sources of free coffee to power them through the increasingly sleepless fortnight, and scrabble at the end to land on a consensus.

At COP29 this year, the key things at stake were a new finance deal that was three years in the making and a wave of 2035 national climate targets. Lurking amongst discussions were the implications of the US election results. The pressure was on to land strong decisions before Donald Trump – who withdrew the USA from the landmark Paris Agreement on climate last time he was in office and has stated his intention to do so again – returns to the White House.

What did we get at the end of all of this?

Finance in the spotlight

The new finance goal of at least $300 billion per year by 2035 for lower-income countries seems like a big number, but is around a quarter of what is needed, $1.3 trillion. For what was dubbed 'the finance COP', wealthier nations came with a distinct lack of actual money, despite their obligations towards those countries least responsible and hardest hit by climate change. The $300 billion could be spun as a tripling of the previous commitment of $100 billion a year – but taking into account inflation, it’s nowhere near that in real terms. And it’s not just about the quantity; much of that money is likely to be loans, driving already strapped countries even further into debt.

When lower-income countries argued for that $1.3 trillion, this wasn’t them trading Pokemon cards in the playground. It was about the very existence of people and whole communities. Climate Action Network, a global network of over 1,900 civil society organisations, labelled the outcome a betrayal, while India's delegate Chandni Raina called the final text “little more than an optical illusion”.

To build meaningfully from this, the last-minute addition about using the next 12 months to develop a roadmap towards that $1.3 trillion needs to be a priority. This finance could come from sources such as taxes on shipping, aviation and the wealthiest in society. This money would be an investment in the world we need – more secure and stable in the face of growing climate chaos and more frequent flooding and storms.

Emissions reductions left in the dark

The other key test of this COP was meant to be the countries’ national climate commitments which are due to be updated and strengthened by February next year at the latest. Despite this, the UK was one of just a few countries to come with a new target. In Baku, nations had the opportunity to collectively agree how they will implement the commitments from last year to transition away from fossil fuels – but kicked those decisions to next year. This is in the context of plateauing action to curb warming; since 2021 we have been on a path toward 2.7°C by the end of this century. (This analysis suggests the recent election of Donald Trump could add 0.04 °C of warming due to rolling back US climate policies; not good, but not the derailing some feared. The potential impact on collective action is as yet unquantified.)

A mirror to the world

Questions are inevitably being asked about these COP events: are they “no longer fit for purpose”? Is it time for something else to deliver the scale and urgency of action required?

I was struck by the words of Alden Meyer, with his 40 plus years of experience in climate policy:

“COPs are where the world holds a mirror up to itself to see how well it is doing in the fight against climate change; when the image in the mirror is ugly, it does little good to blame the mirror.”

We do not like what we are seeing. Two weeks of tough negotiations culminating in imperfect outcomes expose our frustration with the rate of our change. They magnify our longing for COP to solve this crisis that frightens and overwhelms us.

But COPs are only as good as the governments, businesses and people that will turn the agreements into lived reality. That’s why those national climate plans due next year matter so much. This mirror indicates that climate seems to have slipped a little down the priority list, despite the growing urgency.

The mirror analogy is a good one – but we also need to recognise where there are vested interests who would obfuscate what we see and what is decided. Among the thousands who descended on Baku were 1,773 fossil fuel lobbyists — more than all delegates from the ten most climate-vulnerable countries. This is part of a recent trend of outsized influence by those who would invest against our collective future for the profit of burning more fossil fuels.

Weeks like last one remind us of the flaws in the COP process – but the answer is not to ditch the whole thing. COPs are the only forum where every country is heard on this global issue. Existing power imbalances are reflected and needed to be addressed; a concrete finance figure only appeared on the last scheduled day of negotiations, putting lower-income nations were under pressure to accept it as clock ran down. In the final hours, several delegations walked out of a meeting to express their frustration with what was on offer.

COPs provide a space for civil society, youth activists, faith and community leaders to speak into global decisions and shape the world and our future. Getting the agreement we got is in part testament to the advocates who kept finance solutions on the agenda.

The COP processes need to be made fairer and more accountable, to steer a clearer way forward for climate action of the scale and speed we need. But if we scrapped them, we’d only need to create a different space for international diplomacy in their place – and we certainly don’t have time for that.

We see only in part

Ultimately, our disappointment with COP shines a light on our longing for a more hopeful future. It would be easy to let weeks like the last one harden or discourage us. But legacies are hard to see in the moment. Prior to the 2015 Paris Agreement, we were headed for at least 3.5℃ of warming by the end of this century; a catastrophic change to our world and inheritance for future generations. COPs have played a key role in shaving almost a degree from that trajectory. It still isn’t enough, but it isn’t nothing.

COPs show us something of the world as it is – messy, broken and yet suffused with people devoting themselves to justice again and again. For many, there’ll be some much needed rest to catch up on, because this is a race for the long haul. We live and act and speak for justice knowing that legacies don't fit nearly into a headline or media quote. They are slower to be realised and understood. The challenge to us all is to keep sowing faithfully, knowing we may not be the ones to reap in our lifetime. To keep acting in love and hope – even when the end is not in sight.

One of the early church leaders, Paul, wrote in a reflection on love: “For now we see only a reflection as in a mirror; then we shall see face to face.”

Article

Assisted dying

Comment

Politics

25 November 2024

7 min read

Assisted dying hasn’t resolved Swiss end of life debates

Despite attempts to normalise it, new challenges still arise.

Markus Zimmerman

Markus is Professor of Moral Theology and Ethics at the University of Fribourg, Switzerland.

A single bed, wiith an unmade colourful duvet stands in the corner of a room. A hoist reaches over it from the corner.

The dying room, Dignitas Clinic, Zurich.

Dignitas.

While countries such as Germany, France or the UK are currently struggling to find a suitable regulation for assisted suicide, their peers in the Netherlands, Canada and Switzerland have years of experience with the controversial medical practice. Even if each state must explore its own ways of dealing with these ethically controversial issues, it is obvious that international experience should not be ignored as they try to find a way forward.

In Switzerland the discussions and challenges surrounding assisted suicide are increasing rather than decreasing. Contrary to the idea that a liberalisation of assisted suicide would lead to fewer debate, tensions and difficulties are increasing. My observation, and thesis, indicates that practices such as assisted suicide cannot be “normalised”, even in the medium and long term.

Developments

In recent years, one to two per cent of all deaths in Switzerland were due to assisted suicide. From an overall perspective, this practice is therefore still a marginal phenomenon. However, a look at the total number of assisted suicides per year gives a different impression, as this has increased more than fivefold in the years between 2008 and 2020, from an initial 253 to 1,251 deaths per year, a rising trend. The cause of death statistics for Switzerland only include those cases of assisted suicide in which persons resident in Switzerland were involved and the death was reported to the authorities. According to the Swiss Federal Statistical Office, in 2020, it was mainly people over the age of 64 who made use of assisted suicide. Detailed information on the underlying illnesses of the people affected in 2018 shows that about 40 per cent were affected by cancer, just under 12 per cent by diseases of the nervous system, a further 12 per cent by cardiovascular diseases and just over a third by other illnesses, including dementia and depression. There are currently seven right-to-die organisations in Switzerland which play a leading role in a typical assisted suicide procedure. They work closely with doctors who are prepared to prescribe a lethal drug, generally Pentobarbital. The data reflects an ambivalent picture: on the one hand, the proportion of assisted suicide cases is relatively low in relation to all deaths and, for example, in comparison to the large number of people who die in Switzerland in a state of deep sedation until death; on the other hand, the number of assisted suicides in Switzerland has risen sharply in recent years.

Perceptions and assessments

Since the 1990s, the public perception and assessment of assisted suicide in Swiss society has changed from an initially cautious and sceptical attitude towards broad acceptance. While the debates in other countries are characterised by relatively sharp controversies between those in favour and those against, public discourse in Switzerland has been less polarised. There are indications of a certain normalisation of the situation, the strongest sign is that Switzerland has so far refrained from regulating assisted suicide in a separate law. The results of a recently-published study on the opinions of Swiss people over the age of 55 regarding assisted suicide confirm these impressions.: The survey showed that over four-fifths of respondents support legal assisted suicide, almost two-thirds can imagine asking for assisted suicide themselves at some point, and that almost one-third are considering becoming members of an right-to-die organisation in the near future, with one-twentieth of respondents already being members at the time of the survey in 2015. Among people with a higher level of education and older people aged between 65 and 74, approval of assisted suicide and corresponding practices was higher than among less educated, younger and very old people; approval was also significantly lower among religious practitioners.

Sensitive topics

The fact that assisted suicide enjoys broad support in Swiss society as a whole does not mean that there are not difficult and controversial aspects relating to its practice. Relevant topics include, in particular, places of death, authorisation criteria and procedures.

Places of death: Assisted suicide is permitted also for mentally ill persons in psychiatric clinics, but the federal court recommends great caution here and requires two psychiatric expert opinions to ensure that the person willing to die is capable of judgement with regard to the desire to commit suicide. Although assisted suicide for children and adolescents has hardly been an issue in Switzerland to date, the corresponding debates are currently being held in Canada and elsewhere. The question of whether people in prison also have a right to make use of assisted suicide, has been the subject of intense debate in Switzerland for years, with a generally positive response. The question of whether right-to-die organisations should be given access to acute hospitals and nursing homes is still the subject of controversial debate, with regulations varying from hospital to hospital, nursing home to nursing home

Authorisation criteria: With regard to the admission criteria for persons willing to die, the capacity for judgement is at the centre of attention: while the importance of the criterion is undisputed in itself, there is a struggle for reliable standards and procedures to reliably test this criterion. Since the publication of the SAMS ethical guidelines Management of Dying and Death in 2018, the criterion for end of life and, depending on this, that of unbearable suffering have received new attention due to an objection by the Swiss Medical AssociationFMH. While the guidelines are based on the criterion of unbearable suffering, the FMH wants to stick to the near end of life. It is certainly difficult to diagnose the existence of unbearable suffering, as the international debate on the significance and assessment of existential (neither physical nor psychological) suffering shows. This difficulty is illustrated by the debate that has been going on for several years in Switzerland about so-called old-age suicide and the inherent criterion of tiredness of life. At the centre of the dispute is the legally difficult question of whether a doctor is also allowed to prescribe a lethal drug to a healthy person.

Procedures: Here the role of the medical profession and right to die organisations is by far the most important issue. In contrast to the physician-centred models in Belgium, Canada and the Netherlands, the Swiss model of assisted suicide is based on the idea that every person has the right to end their life and may call on the help of any other person to do so. Although the medical profession is usually involved in the process, the management of the procedure is normally the responsibility of a right-to-die organisation. This division of responsibilities is always up for debate when legal regulations are being considered, in which doctors should tend to take the lead in the process due to their professional background. There is also a debate about how and by whom compliance with the authorisation criteria should or could be monitored, whereby it remains to be decided whether this should be carried out before or after the death. At present, a certain amount of monitoring takes place following a suicide, insofar as the authorities investigate the cases afterwards. There is also debate as to whether Pentobarbital is a suitable means of suicide, especially if this barbiturate is not administered intravenously but taken orally; there is no knowledge of how many cases are currently administered intravenously and by whom an infusion is then set up. Last but not least, consideration has already been given to the use of lethal drugs, such as helium gas, which can be obtained over the counter.

Attempts at regulation

Political efforts to regulate assisted suicide in Switzerland in a more nuanced way than today have been made since the 1990s but have remain largely without consequences to date. In relevant judgements by the Federal Supreme Court or in statements by the Federal Department of Justice and Police, reference is regularly made to the ethical guidelines of the SAMS. These are classified as soft law and are therefore not legally binding, even though their content has become the subject of dispute. The National Advisory Commission on Biomedical Ethics (NCE) had already recommended more far-reaching legal regulation in 2005 as part of a detailed opinion on the subject; in the opinion of the NCE at the time, the review of authorisation criteria, a justifiable regulation of assisted suicide for the mentally ill, children and adolescents and state supervision of right-to-die organisations, should be ensured by law. The question is what form a legal regulation can take that grants the medical profession far-reaching powers but at the same time prevents medical paternalism (in favour of or against assisted suicide). From the perspective of Swiss experience, this is “a square circle”: either the doctors retain the final decision on who receives the barbiturate, or official access rules are established, the review of which does not generally require medical expertise.

The outlook

In the short and medium term, it can be assumed that the number of assisted suicides in Switzerland will continue to rise. The coronavirus pandemic and the particular difficulties faced by nursing homes during this time are likely to exacerbate this increase. In view of these expectations and the legislative processes in other European countries, pressure is likely to increase in Switzerland to create a legal regulation. Overall, I think politically it will be important to create a legal regulation, in order to ensure legal equality and legal certainty on the one hand and prevention of abuse and expansion on the other. At the centre of social-ethical reflection is the challenge of learning to deal with the pluralism of different ideas of a good death and to develop and establish alternative models to medically assisted dying. The thesis I mentioned at the beginning is confirmed today: assisted suicide in Switzerland can hardly be normalised; new problems, challenges and demands are constantly arising. Suicide, whether with or without the help of another person, always means an existential transgression that defies normalisation.