Article
Comment
Education
6 min read

Shouldn’t you be in school?

Beyond headlines about school refusers and ghost children, lies a challenge to adult notions of schooling. Henna Cundill unpacks the issue, inspired, in part, by fish.
A school of tropical fish swims to the right, while one swims to the left.
A school of tropical fish off the Maldives.

The squeaky black shoes are back in the hall, and by now all the white polo-shirts in the land (except aged 4-5, slim-fit) have been snaffled by harassed mums and dads. Yes, it is that time of year again – the time for newspaper editors to dredge up some statistics about the rising number of “school refusers” – anxious young people whose squeaky shoes and white polo shirts are looking set to never leave the house.  

The numbers are “spiralling” frets the Guardian, and the Daily Mail asks “Are you raising a ‘ghost child’?” Forth come the stock images of a sulky teenage girl pulling the duvet over her face, or a young boy with an oversized backpack and hands clamped firmly over his ears. A parent, frowning, is quoted as saying that the school isn’t doing enough. A headteacher, eyebrows knitted, says how difficult it is without the support and cooperation of the parents. Then everybody shakes their heads and blames the pandemic. 

In my time as a School Chaplain, before the pandemic, I saw how truly awful school refusal is – for everyone involved. Beneath the covers, underneath the backpack, there is actually no “refusal” of anything – in fact, there is a campaign to get rid of this term, which I heartily support. Refusal implies there is a choice, but when a young person feels so overwhelmingly anxious and afraid, there is no choice for them, other than fight, flight, or freeze. Parents and caregivers feel judged, teachers are largely helpless. Social workers, when they get involved, quickly feel like they are the enemy of absolutely everyone involved. Surrounding any long-term school refuser there is often a hot mess of frustrated adults, and underneath the frustration, sadness.  

No Scouts, no community choir, not even traipsing down to the park to hang out informally with their peers. Instead, anxiety traps them into the perceived safety of home. 

Why sadness? Because we know that, regardless of our views on the importance of cookie-cutter educational attainments, no young person should be isolated. Even families who are committed and evangelistic about home-schooling will also schedule social activities for their children, be it membership of various clubs and organisations or group sessions of learning with other home-schooled kids. But the school refusers I have known have typically also refused anything like that. No Scouts, no community choir, not even traipsing down to the park to hang out informally with their peers. Instead, anxiety traps them into the perceived safety of home, that one tiny corner of the world where they have a sure sense of belonging and some modicum of control.  

With the idea of “belonging” in mind, perhaps it is helpful to think about what a school actually is. The word school is multi-faceted in meaning. In nature, it denotes a group of fish, all swimming together. Such behaviour would seem counter-intuitive, since it means that all the fish are then competing for the same food or other resources. But ask any fish and it will tell you that being part of the group is itself a resource, enhancing their ability to find food and to protect themselves from predators. We could put this a more familiar way: a school is where the whole is greater than the sum of its parts.  

There’s also another meaning to the word school – groups of creatives or philosophical thinkers whose styles and methods influence and complement each other, e.g., “His paintings are those of the Impressionist school.” We can see how, in these schools, people spark off one another, constantly developing and refining their own work in response to the work of others. Those with greater skill and experience mentor those who are just beginning. In this respect, we could say that a school is where people can push the boundaries of human creativity and knowledge.   

Since the ancient days, when learners gathered around the Greek philosophers, first to listen, then to discuss, and then to refine ideas, we have gathered our young people into schools for the purpose of educating them. We have long acknowledged that the best learning is a group activity which takes place over time. This is why home schoolers also schedule the clubs and activities – not just because children need friends (although that is important) but because there is a particular “other” kind of human progress that happens when we have to rub along with other people. When learners are placed in groups, ideas can be tested, boundaries can be overcome, creativity meets with critique - the whole quickly becomes greater than the sum of its parts.  

You may notice that many schools promote themselves as being a “learning community” or a “family.” It’s not just about being twee – research shows that promoting a sense of belonging reduces the amount of school refusal and non-attendance. We know that belonging matters, as Belle Tindall has recently discussed, and that a sense of belonging can impact our health and even our mortality. (“Well, I told you so!” says the fish.)  

This was something the early Christians knew too. In the first few decades after Jesus’s life and ministry they gathered in groups to pray and to discuss, just like those earlier followers of Plato and Aristotle had done. There was an eagerness to learn from those who had heard Jesus’ teaching first hand, and to develop and refine their understanding of what that teaching could mean in practice. It was a school, although they called it a church – or strictly speaking an ecclesia in the Greek, which just means a gathering of people.  

In the ecclesia there was good natured debate, but also some spicy disputes and arguments, along with a lot of discussion about who was “in” and who was “out” - something which is also a hot topic in the school playgrounds of today. Into that context, Paul (one of the first leaders of the ecclesia) wrote that the church was a bit like a human body, in which:  

The eye cannot say to the hand, “I don’t need you!” And the head cannot say to the feet, “I don’t need you!” 

His point was that belonging is about knowing not just that you belong but that you are needed. In a human body, different parts have different roles, and Paul also asks his readers to consider this point:  

“If the whole body were an eye, where would the sense of hearing be? If the whole body were an ear, where would the sense of smell be?”  

I have seen that schools do often try very, very hard to communicate to young people that they belong. But, shackled to the syllabi and never more than a few short months away from the next round of exams or individualised assessments, it’s much harder for schools to show young people that they are needed. With our present system, how can we show young people that, even if they are not predicted to be the student in the class who gets straight A’s, their presence there in the group and their role in the learning process is vital, and contributes to the learning of others? 

When it comes to the presence of absence among our young people, schools have often gone as far as they can practicably go, as have parents, as have social workers. And the young people themselves? Well, they are stuck – biologically their only options are fight, flight, or freeze.  

So that leaves us, the society that over-emphasises individualised achievement, that glorifies celebrity and individual success. In adulthood we so quickly forget how to “do” school, how to model it to our young people, swimming all together in a way designed to promote human knowledge, protect each other from danger or even just to ensure that everyone gets fed. No wonder our young people absorb a sense that their presence isn’t needed, when in so many areas of life it’s every fish for themselves. 

As adults, perhaps we should be asking ourselves the question: why aren’t we in school?          

Explainer
Assisted dying
Comment
9 min read

Assisted dying's language points to all our futures

Translating ‘lethal injection’ from Dutch releases the strange power of words.
A vial and syringe lie on a blue backdrop.
Markus Spiske on Unsplash.

In the coming weeks and months, MPs at Westminster will debate a draft bill which proposes a change in the law with regards to assisted dying in the UK. They will scrutinise every word of that bill. Language matters. 

Reading the coverage, with a particular interest in how such changes to the law have been operationalised in other countries, I was struck to discover that the term in Dutch for dying by means of a fatal injection of drugs is “de verlossende injectie.” This, when put through the rather clunky hands of Google translate, comes out literally as either “the redeeming injection” or “the releasing injection.” Of course, in English the term in more common parlance is “lethal injection”, which at first glance seems to carry neither of the possible Dutch meanings. But read on, and you will find out (as I did) that sometimes our words mean much more than we realise.   

Writing for Seen & Unseen readers, I explained a quirk of the brain that tricked them into thinking that the word car meant bicycle. Such is the mysterious world of neuroplasticity, but such also is the mysterious world of spoken language, where certain combinations of orally produced ‘sounds’ are designated to be ‘words’ which are assumed to be indicators of ‘meaning’. Such meanings are slippery things.  

This slipperiness has long been a preoccupation for philosophers of language. How do words come to indicate or delineate particular things? How come words can change their meanings? How is it that, if a friend tells you that they got hammered on Friday night, you instinctively know it had nothing to do with street violence or DIY? Why is it that in the eighteenth century it was a compliment to be called ‘silly’, but now it is an insult?  

Some words are so pregnant with possible meaning, they almost cease to have a meaning. What does “God” mean when you hear someone shout “Oh my God!”? Probably nothing at all, or very little. It is just a sound, surely? And yet no other sound has ever succeeded in fully replacing it. We are using the term “God”, as theologian Rowan Williams points out in his book The Edge of Words, as a “one-word folk poem” to refer to whatever we feel is out of our control.     

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next. 

This idea of an injection being verlossende seems to me to be the opposite. I find myself hearing it in four different (and not mutually exclusive) ways, each to do with taking control of this very uncertain question of dying. The first, releasing, sounds to me like an echo of the neo-platonic ideas that still infuse public consciousness about what it means to be dead. As we slimily carve our pumpkins for Halloween and the children clamour to cut eyeholes into perfectly good bedsheets, we see a demonstration of society’s latent belief that humans are made up of body and soul, and that at death the soul somehow leaves the body and floats into some unknown realm (or else remains, disembodied yet haunting). If we translate verlossende as releasing then we capture that idea – that of the soul, which longs to be at peace, trapped inside suffering, mortal flesh. 

Google’s second suggestion for verlossende was redeeming. This could be heard theologically. Christians believe in eternal life, that the death of this earthly body is only the start of something new – a life where there will be no crying or pain, and people will live forever in the glorious presence of God. In the bible, the apostle Paul encourages those who follow Christ to trust that they have been marked with a ‘seal’, meaning that they are like goods which have been purchased for a price, and that God will ‘redeem’ this purchase at the appointed time. Death, therefore, is not a fearful entering into the unknown, but a faithful entering into God’s promises.  

Both of these first two interpretations look at death, in some sense, ‘from the other side’ – evaluating the end of someone’s life in terms of speculation over what will happen next. But there is the view from this ‘side’ also. We do not need to speculate about what death means for some of those who experience acute suffering due to terminal illness, and who wish to hasten the end of their lives because of it. They too might want to speak of a releasing injection or a redeeming injection – given that both terms hint at the metaphor of life as a prison sentence. To be in prison is to have one’s rights and freedoms severely limited or entirely taken away. It is not uncommon to hear a sufferer refer to incapacitating illness as being ‘like a prison sentence’, and one can empathise with the desire to have the release date set, back within the sufferer’s control.  

This is the strange power and pregnancy of words – verlossende is able to carry all these meanings or none of them. Until I began researching this article, I had always assumed that the English term, lethal injection, simply meant an injection of some substance that is deadly. This is how the term is commonly understood, therefore, in a sense, this is its meaning. Yet, when I came to consider the possible origins of the word, I realised its likely etymology is from the Greek word lēthē, meaning ‘to forget’. In the Middle Ages, if something was lethal it caused not just death, but spiritual death, placing one beyond the prospect of everlasting life. By contrast, something could be fatal, meaning only that it brought one to one’s destiny or fate.  

With this in mind, as we try to speak clearly in the assisted dying debate, the term fatal injection might be a more precise way to describe this pathway to death that is in want of a name. After all, whether you believe in an afterlife or not, dying is everybody’s fate, and I can see that choosing to take control of one’s fate is, for anyone, an act of faith with regards to what comes next.  

  

This article was part-inspired by Theo Boer’s original article Euthanasia of young psychiatric patients cannot be carried out carefully enough, in Dutch newspaper Nederlands Dagblad.  Theo is a professor of health ethics at the Protestant Theology University, Utrecht. 

Read the original article in Dutch or an English translation below. Reproduced by permission.

 

 

Euthanasia of young psychiatric patients cannot be carried out carefully enough 

Theo Boer 

How is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’, wonders Theo Boer. It also conflicts with perhaps the most important task of psychiatrists: ‘offering hope.’  

The patients we are talking about now are not physically ill and therefore do not have the ‘comfort’ of an impending natural death. 

A letter was recently leaked in which leading psychiatrists ask the Public Prosecution Service to investigate the course of events surrounding euthanasia of young psychiatric patients.  

One death mentioned by name concerns seventeen-year-old Milou Verhoof, who received the redeeming injection from psychiatrist Menno Oosterhoff at the end of 2023. It will not have escaped many people's attention how much publicity the topic has received in the past year or so. Together with a colleague and a patient (who later also received euthanasia), Oosterhoff wrote the book Let me go.  

The tenor was: it is good that euthanasia is possible for this group of patients, the taboo must be removed, their suffering is often terrible, they have already had to undergo countless 'therapies' without effect - can one time be enough?  

Or would we rather have these patients end their lives in a gruesome way? And who really thinks that psychiatrists make hasty decisions when they decide to comply with a euthanasia request?  

To be clear: we are talking about something completely different than what has been called 'traditional euthanasia' for years: euthanasia for physically ill patients with a life expectancy of weeks or months. Given the excellent palliative care that has become available, such euthanasia will actually be less and less necessary in 2024.  

Panic  

No, the patients we are talking about now are panicky, anxious, confused, depressed, lonely, often unemployed, poorly housed, without prospects. But they are not physically ill and therefore do not have the 'comfort' of an impending natural death.  

I have heard several of them say: if only I were terminal, then euthanasia would not be necessary. The fact that there is now attention for this group of patients, with whom we in our hurried and solution-oriented society know so little how to deal, is a gain. At the same time, I am happy with the leaked letter. You can criticize Oosterhoff's procedural approach ('why not an ethical discussion instead of a legal one?'), the lack of collegiality, this perhaps underhanded action ('why did you go straight to the Public Prosecution Service?'). But in my opinion, the letter writers are definitely hitting the mark with this crooked stick. Firstly: how is it possible to determine that patients who have suffered from psychiatric disorders for five or ten years and who are between the ages of 17 and 30 have ‘completed their treatment options’ (a criterion from the Euthanasia Act)?  

Review Committee  

Nobody disputes that their suffering is unbearable. At the same time, I know from my time on a Regional Euthanasia Review Committee that an illness becomes unbearable when all hope is gone.  

A psychiatrist who gives euthanasia to a young adult is also undeniably sending the signal that, like his patient, he has given up all hope of improvement. That is actually risky, because even patients who have suffered for years sometimes recover and, moreover, our brains are not fully developed until we are 25. But it also conflicts with perhaps the most important task of psychiatrists: offering hope. In their training, the risk of transference-counter-transference is consistently pointed out: a patient takes his therapist with him into despair, the psychiatrist transfers those feelings to this and other patients: ‘this kind of suffering is untreatable and cannot be lived with’.  

In the recent NPO television documentary A Good Death we see an embrace between a psychiatrist and her emotional patient. In doing so, this psychiatrist offers a unique form of involvement. But does she provide sufficient resistance to the cynicism, despair and negative vision of the future that is also widespread outside psychiatry?  

Sensible decisions?  

That brings me to a second objection: is it sufficiently recognised how much a psychiatric illness can affect someone’s ability to make sensible decisions? The hallmark of many psychiatric illnesses is a deep desire to die and an inability to think about it in a relative way. As a result, many are unable to think in terms of a ‘possibly successful therapy’.  

Boudewijn Chabot 

The main character in the book Zelf heeft by Boudewijn Chabot, Netty Boomsma, responds to Chabot's suggestion that there might be a life after depression: 'Yes, but then I won't be it anymore.' She wants to go down with her depression. I know differences. The people with a death wish who remark about a possible therapy: ‘I hope it is not effective, because then I will have to go through it again.’ 

 Another hurdle 

If a second psychiatrist is consulted and, for example, suggests trying one or two more therapies, many patients see this as yet another hurdle on the road to euthanasia. They do not see it as a serious opportunity to be able to cope with life again. There are no easy answers here. Nor are pillories appropriate. But let euthanasia remain complicated here, and let us continue to look for hope. 

 

Reproduced by kind permission