Essay

Culture

Music

28 March 2023

5 min read

Strangers and the sound of belonging

Utterly captivated by a clip of a Jacob Collier concert, and then immediately intrigued by said captivation, Belle Tindall wonders why thousands of strangers singing together has been eliciting such a powerful reaction.

Belle Tindall

Belle is the staff writer at Seen & Unseen.

A muscian plays a keyboard on a concert stage surrounded by instruments, while multiple images of his face are projected behind him.

Jacob Collier in concert.

Jon Tilkin, CC BY-SA 4.0, via Wikimedia Commons.

I had an empty couple of minutes to play with; so, mostly due to muscle memory, I found myself opening my Instagram app. Habitually, I do this multiple times a day, and mostly to no profound avail. But this one day, something caught my eye and sent me down a spiral of curiosity (and judging by how astronomically viral it went, it seems I was not spiralling alone).

It was footage of Jacob Collier performing in Rome. Jacob is a singer, songwriter, jazz instrumentalist and general music prodigy. But that’s not the most captivating thing about him. The Collier phenomena has erupted because of the way he turns his audience of strangers into a perfectly tuned, beautifully united, choir. And this particular night in Rome, he managed to steer this audience to sing beyond the major scale and onto the far more complex chromatic scale, something he has been working towards for years.

The most striking thing about this minute-long clip is not the beautifully raw sound (although, it really is something to behold), but what this sound is communicating - a tangible sense of belonging.

Watch Jacob Collier in Rome

Our need to belong

We each know how it feels to belong, and we are also acutely aware of the inverse, how it feels when a sense of belonging is lacking, and feelings of isolation creep in and make themselves at home in its absence. But for the sake of clarity, perhaps a working definition would be helpful at this point, and for that, I turn to the Psychology Dictionary. The PD defines ‘belonging’ as ‘a feeling of being taken in and accepted as part of a group, thus, fostering a sense of belonging. It also relates to being approved of and accepted by society in general. Also called belongingness.’ 

The notion of ‘belonging,’ or ‘belongingness,’ has been well studied. And still, its intrinsic power is staggering to consider.

According to research published by the Australian Journal of Psychology, belonging is a universal and fundamental human need, one that ‘may just be as important as food, shelter, and physical safety’. So intrinsic is it, that the lack of belonging, resulting in acute loneliness, is attributed to a 26% increase in the risk of premature mortality. This has led the World Health Organisation to officially recognise isolation as a determinant of health, placing it in the same category as smoking, physical inactivity, and excessive alcohol consumption.

Further research suggests that our brains perceive, and subsequently react to, social pain in the same way they are designed to react to physical pain. Releasing opioids and other instinctive painkillers when encountering a lack of belonging, our brains are detecting literal pain within us. As humans, we are susceptible to suffering social injuries, and it seems that the subconscious parts of our brains take those injuries much more seriously than their conscious counterparts.

The necessity of belonging is woven into our make-up.

Subsequently, when we speak of a person’s need to belong, we’re speaking of a need that has significant mental, emotional, spiritual, behavioural, and physical repercussions; a need that is intersectional, if you will. It is a central construct at the core of our humanity and a defining variable in how we perceive reality.

It could be suggested, considering all of this, that human beings were simply made to belong. The necessity of belonging is woven into our make-up.

Surrounded by people versus belonging with people

Over the final scene of the 2009 film World’s Greatest Dad, Robin Williams’ voice delivers a line that is so profound it lingers in your mind long after the end-credits have finished rolling. He says ‘I used to think the worst thing in life would be to end up all alone. It’s not. The worst thing in life is to end up with people who make you feel alone.’

There’s a staggering wisdom in that.

Namely, that belonging is not the inevitable outcome of simply getting people into one room. That’s the difference between the Collier concert - where the audience are truly belonging to each other, if only for an evening - and the coffee shop where I’m sitting right now, filled with people using laptops and headphones as a form of defence against the threat of small talk. Each of us belonging only to ourselves.

If it were the case that proximity equated to belonging, urbanization and the subsequent squeezing of populations into close quarters would have surely deterred the epidemic of loneliness that the West currently finds itself in. And yet, it is not uncommon for ‘neighbour’ and ‘stranger’ to be identities that co-exist. And what about the role of social media? Access to one another has never been so readily available. The world has never been so small, and its population so ‘close.’ And yet, what social media so often provides is the affirmation and amplification of feelings of isolation.

No. Proximity alone is not the answer.

Will Van Der Hart writes that ‘People don’t just want to be with other people they want to belong with them’.

The tuning fork

Christianity has a lot to say on the subject of belonging/belongingness.

The anonymous author of the creation literature (the chapters which act as the start-line for the Biblical narrative) notes how the only thing that was unsatisfactory about our freshly created world was the initial isolation of humanity. Such solitude was at odds with the blueprint for human flourishing and defied our design as intrinsically relational beings. The Christian faith therefore offers an explanation to humanity’s fundamental need to belong, It presents a spiritual why behind the afore-mentioned neurological findings.

The biblical narratives, the psychological research – they are united (if you pardon the pun) in their assessment of the human condition. Namely, that belonging is simply a non-negotiable, it’s buried inside our biology.

So, perhaps it’s no wonder Jacob Collier has caught the world’s attention, he’s providing a simple soundtrack to one of our most engrained needs. It seems that what has long been communicated through ancient spiritual texts and more recently affirmed through endless psychological theories, can also be communicated with a simple harmonious sound.

To watch that clip is to watch thousands of strangers belong: belong to the room, belong to the moment, belong to the sound.

In 1948, author and theologian, A.W Tozer pondered the nature of unity and human connection. He asked, ‘has it ever occurred to you that one hundred pianos all tuned to the same fork are automatically tuned to each other?’

If ever we were looking for an answer to this profound question, we need look no further than Jacob Collier’s audience and their sound of belonging.

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.