Article
Comment
Politics
7 min read

What’s up with activism and what it is missing

As local elections occur in England, Councillor Elizabeth Wainwright is stepping down. Finding herself increasingly distant from activism, she asks if there’s any room for love.

Elizabeth Wainwright is a writer, coach and walking guide. She's a former district councillor and has a background in international development.

A protestor hold a megaphone up at a demonstration outside a building
A 2017 protest against London Fashion Week.

During my term as a Green Party District Councillor, I was once publicly congratulated by the local Extinction Rebellion (XR) group for taking on the new role of ‘Cabinet Member for Climate Change’.  

A week or two later, I was questioned at a Council meeting about whether I was part of XR – opposition Councillors wanted to know if I’d be using their “extreme rent-a-mob tactics” in my role.  

The local XR group are kind and knowledgeable and are making things happen. But to my Council questioners, this seemed to matter less than the fear of the ‘other’ – in this case, what they perceived to be a mob of environmental extremists that might do harm to the Council. It works both ways – I’ve also seen activist groups paint all elected Councillors with the same brush, assuming none of us care. It feels like there is little grace and a lot of judgement going round.  

I’ve been curious why local non-activist residents and Councillors might not be keen to engage with activist groups (the term ‘activist’ is a broad one, and this article isn’t long enough to analyse it, but activist groups are generally engaged in activities to bring about social, environmental or political change).

Some tell me that they’re put off by what they perceive to be self-righteousness, judgement, anger, and the ‘hippy’ identity. I am put off by some of these things too, however much the media might falsely amplify these qualities – but still, perceptions close down relationship and possibility, and this is one of the things that keeps me at arm’s length from the ‘activist’ label, particularly when it gets caught up in group identity and expectation too. At a time when we need to see change in so many things – the state of the environment, politics, social equality – I’ve been wondering why I feel a distance from the ‘activist’ identity.  

As well as getting elected, I’ve taken part in marches, signed petitions, joined social and environmental action groups. I want to walk alongside others who are doing something about the things that matter. But I have struggled to find the in-between of ‘slacktivism’ on the one hand (supporting causes largely online with little commitment), and intense commitment to a particular group or tribe on the other. And I am tired, because despite the protests, volunteering, and organising, the challenges seem bigger than ever. These efforts are important, but protesting the status quo isn’t enough.  

I look at the NGOs, political groups, roles, funding proposals, slogans, meetings and glossy branding that are often part of activism and civil society more broadly – and are tools I’ve used myself – and I find myself doubting that these things can really bring about the change we need in our relationship with each other and the planet. We need more than better branding, or more funding, or more campaigns. As Audre Lorde said, the “master’s tools will never dismantle the master’s house.” I find myself distancing from the urgency of activism, volunteerism, and campaigning in their current forms.  

I’ve felt public discourse and action become less patient, more certain, more fragmented, with little room for curiosity and open conversations.

As well as form, I also feel a disconnection from engagement with and discussion of the issues of our time. In my involvement in social and environmental action over 20 years, I’ve sensed the shift brought about by rapidly evolving technology and media, which mean social and moral norms are evolving too. I’ve felt public discourse and action become less patient, more certain, more fragmented, with little room for curiosity and open conversations – sometimes explicitly through cancel culture or more subtly through othering and unintentional judgement. I think of a song by Sam Fender called White Privilege which includes the lines  

“Everybody's offended… I'm not entirely sure the nitpicking can count as progression… Nobody talks to each other for fear of different opinions…”  

Perhaps that closing down of conversation is in part down to social media and its algorithms which respond well to noise, performance, and oversimplification – it is not a space designed to help us relate across difference and understand each other, yet this is vital if we are to create the change needed in ourselves and in the world.  

I want to be part of meaningfully and wisely addressing the world’s sickness, not desperately and loudly treating its symptoms. I have been wondering if there’s another way I might think about creating change. 

Author, educator and social critic bell hooks (who prefers her name written in lowercase) wrote her book All About Love because she was 

“thinking about how we love and what is needed for ours to become a culture where love’s sacred presence can be felt everywhere”. 

She laments the lovelessness that is pervasive in our society. She goes on to say,  

“profound changes in the way we think and act must take place if we are to create a loving culture”.  

Sometimes, the issues at stake demand that we weep, raise our voices, get angry. Jesus turned over trading tables in the temple when he saw the sacred space had been turned into a marketplace – he got angry. But ultimately, he asks that we love our neighbours, including our enemies.   

And yet sometimes I wonder whether we know how to love in the world as it is today. hooks says,  

“In the realm of the political, amongst the religious, in our families, and in our romantic lives, we see little indication that love informs decisions, strengthens our understanding of community, or keeps us together.”  

In her lectures on ending racism and sexism, she notices that her audiences, especially the young,  

“become agitated when I speak about the place of love in any movement for social justice” 

despite the great movements for social justice having emphasised love. Her listeners seem 

“reluctant to embrace the idea of love as a transformative force.”  

We need to see love as a transformative force though. We say we believe in it; we make films and write poetry about it, we see it guide communities during collective experiences like global pandemics, we turn our faces towards it, we seem to want it. Perhaps this is where the hope is – that we want love in its various forms, even if we are embarrassed to say so. Love is not naïve, it does not ask us to be nice and polite, or eternally optimistic. Its presence does not remove negativity, disagreement, people who let us down. But I think it gives us the eyes and tools to work together, and to stand in compassion before judgement. 

If we take love and affection for our neighbour and places seriously, understanding what it looks like in practice, then movements for change can begin right where we are – in our language, in our community, in relationships that ripple out. In a placeless and disconnected age, perhaps this is the kind of activism that would help us heal ourselves as well as the world. Author Simone Weil said that  

“the gospel makes no distinction between the love of neighbour and justice.”  

I am becoming drawn to a love-led activism, an activism that is made from the hard day-to-day work of listening, and patience, and loving what’s sometimes hard to love. It might mean taking time to build relationships with people who aren’t like us. It might mean breaking out of our institutions and tribal groups, hearing each other across difference, and imagining new possibilities together rather than form ever-tighter clubs. It might mean getting soil not screens between our fingers, rooting in relationship, slowing down, paying attention. Whatever it looks like, it must appeal to both activists and non-activists, because we must all be involved in calling forth new worlds.  

The Bible is full of calls to love justice, to defend the weak, to provide for the poor and hungry, to defy the authorities when we need to – but to do all this, as Paul says, “rooted and grounded in love”. Micah says,  

“what does the Lord require of you but to do justice, and to love kindness, and to walk humbly with your God?”  

As bell hooks knew, justice goes hand-in-hand with love. It is hard for one to exist without the other.  

We can choose to open up conversations or shut them down, to walk with others or retreat behind ideological lines, to stand in judgement or relationship, fear or love.

Perhaps it doesn’t matter whether we’re catalysed by anger, indignation, love, or care – but it matters what we go on to do with that spark. We can choose to open up conversations or shut them down, to walk with others or retreat behind ideological lines, to stand in judgement or relationship, fear or love. I think about what might come next when I stand down as a District Councillor at the next election, following a pull to do justice, and to love kindness more than belong to a political tribe. If we choose, we could build a loving culture, weaving a social fabric where activists and non-activists can see past current paradigms and feel able to work together, holding each other up as neighbours whilst nurturing beauty, hope and the becoming world. It may have no clear identity, it may not suit the noise of social media, but this is work that I want to be a part of.

Article
Assisted dying
Comment
Politics
7 min read

Assisted dying hasn’t resolved Swiss end of life debates

Despite attempts to normalise it, new challenges still arise.

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.