Article

Comment

Politics

Trauma

War & peace

9 December 2024

6 min read

So, what are the prospects for peace and good will?

2025 will need the reconcilers, and their pain.

Emerson Csorba

Emerson writes on geopolitics. He is also a business executive and holds a doctorate in theology.

Two people down a table turn and listen to someone closer talk, against a wall mural.

Reconciliation event, Northern Ireland.

Telos Group.

As we approach 2025, a series of skirmishes are erupting that warn us of impending danger. In Syria, Turkish-backed rebel forces have overtaken Aleppo, taking advantage of Russia’s focus on Ukraine. Pro-Europe protestors in Georgia demonstrate at the country’s parliament in Tbilisi. And South Korea declares martial law in response to purported North Korean threats. President-elect Trump jokes – with much truth in jest – about Canada becoming the 51st state.

As the world awaits the inauguration of President-elect Trump on January 20, 2025, we are in an in-between state. But there is more feeling of foreboding than of future peace. A ceasefire has been agreed between Israel and Hezbollah, but with rocket fire continuing to be exchanged and Israel yet to respond to Iran’s October missile barrage while Iran pursues nuclear capability. In the United States, Ambassador to Japan Rahm Emmanuel warns of Chinese ambitions to take Taiwan not in 2027 – as commonly believed – but rather in 2025.

Even if only temporarily, there will be a pause in early 2025 from the conflicts we have been accustomed to over recent years. The inauguration of President-elected Trump will, in all likelihood, put an end to Russia’s war in Ukraine. Russian agreement for peace will be secured, however, only in exchange for Ukrainian territorial concessions. Israel will maintain a ceasefire with Hezbollah while American support helps to remove the remnants of Hamas in Gaza. With American backing, Israel and Saudi Arabia will restart the historic Abraham Accords process as we enter the Spring.

Yet this pause and these short-term successes will be ephemeral and deceiving, an interlude prior to the much greater threats in store. Antonio Gramsci’s ‘The old world is dying, and the new world struggles to be born: now is the time of monsters” is often quoted with a tinge of optimism, as if the monsters are here for a moment, but soon to be overcome. Unfortunately, the monsters of our times are well-entrenched, and they are gathering energy for their next acts. And they appear from all sides, as the lesser rather than greater aspects of men and women take centre stage in our politics, whether in the political West or Global East.

In this world of monsters, division and difference is the default approach to human relationships. We have become numb to these words, but what division and difference signify is a profound weakness in modern men and women bereft of love. Too many men and women prefer basking in their own and others’ flaws, to a striving to overcome these in favour of what we may individually and collectively achieve – if only we tried. We are living in a period of darkness seeking to dampen the light and diminish the spirit of those pursuing the good.

Division is easy. It is natural. It is emotional. Its focus is the lowest element of ourselves and of others. In comparison, togetherness is faith. It sees the hidden potential of another. Togetherness is unnatural. Togetherness flows from faith and is the unseen-become-reality. It recognises the seeds of good in another, understanding that each person is composed of many contrasting sides, some bad, some good, but the good the more powerful of the two. Togetherness is a choice. It is a choice to water the seeds of faith with patience, to see what these seeds might become with time, consistency, and effort (while maintaining balance of personal space and social connections, as both are vital for emotional wellbeing).

There is no bridging of divides, no reduction of division, no togetherness, without pain. This is a lesson for the world’s current and future reconcilers across all walks of life.

In an age of growing division and conflict, togetherness is barely visible. Yet reconciliation remains possible. In fact, it is precisely in these times, when the odds are against the peace of togetherness, that reconcilers in politics, business, academic, non-profit and community sectors are called to step forward with purpose. It is precisely when there is little faith or hope in the future that reconciliation – an act of love – is demanded.

Reconciliation is the restoration of a favourable relationship between oneself and others. It is achieved through sacrifice. The reconciler experiences pain in order to restore relationships. Reconciliation is built on love for other persons, in spite of their flaws and their continuous resistance, as well as their lack of faith, love and hope at many times. It requires a healthy self-love, in which we seek the fulfilment of our own good as a basis for doing so for others.

Next to love, the main ingredient of reconciliation is pain, because those who have become estranged fight, they resist, they go back on what they said they would do, they vacillate between good and evil, and they contest the reconciler. The reconciler will die, or come close to dying, at certain points in the reconciliation process. And yet the reconciler is raised following death, defeat only a stepping-stone to the triumph of togetherness.

The reconciler turns the pain involved in bringing together otherwise conflicting groups, peoples or nations into something much more positive. They internalise pain, incorporating it into their being. This is achieved through love, which enables patience, always seeing the bigger picture and the potential of people. Love is the basis for action to bring others together and keep them together, appealing to their better sides, despite the human tendency to corrupt the good.

People talk nowadays about the need to ‘bridge divides’ and that we are ‘better together.’ We need, for instance, to bridge divides between regions and capitals, such as between Alberta and Canada, or Québec and Canada in the Canadian context, or between the North East and London, or with Northern Irish reconciliation, in the United Kingdom. But these are easy things to say. More difficult is realising that the process of reconciliation is painful and that leaders seeking reconciliation – at local, regional or national levels – must first become experienced in suffering.

This experience can only be the result of a prior education in the value of pain, knowing that the joy of togetherness is most profound when preceded by a patient and humble suffering. There is no bridging of divides, no reduction of division, no togetherness, without pain. This is a lesson for the world’s current and future reconcilers across all walks of life, as we enter a world even more replete with conflict. And in reconciliation, it is always unclear what the outcome is going to be. A person’s efforts could be all for naught, faithful efforts then a matter of failure and bitterness, rather than of sweet accomplishment.

Anyone seeking reconciliation in a more dangerous world must first die to their previous lives of division. They must leave this self in the past, shedding it. They must become new persons, imbued with love, believing in human potential, who want others to succeed and who are ready to fight to achieve this success. But reconcilers must always fight with love as the foundation of their efforts, and with faith that they will win in their fight, that their efforts will be successful. This faith goes against what is seen – the odds are rarely if ever in reconcilers’ favour.

We need reconcilers in our day and age. These individuals are in short supply, but they are key to the futures of nations and to the health of our geopolitics. They are the politicians - elected and those behind the scenes - the businesspeople, and the local community leaders who can see the bigger picture and articulate it, keep focused on the potential of those around them, and bear the suffering involved in fulfilling potential.

The present wars and skirmishes as we enter 2025 will temporarily lessen. They will even pause. We should not be surprised when these re-emerge with more intensity over the next year. This is precisely when many will be called to strive for togetherness in the face of division, knowing that reconciliation is strength in the face of the reality of human weakness. Reconciliation is always a possibility.

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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.