Weekend essay

Art

Culture

20 January 2024

9 min read

Wonder walls: will Manchester’s creativity save the city?

Manchester newcomer, and new bishop, Matthew Porter is bowled over by the city’s enrichening creativity.

Matthew Porter

Matthew Porter is Bishop of Bolton, in the diocese of Manchester.

Looking down on a man walking across a grid of large black and white portrait photographs of people's faces

The 'Inside Out: This is Manchester’ installation.

Manchester is the place to be. So thinks fashion house Chanel. It recently hosted its renowned annual Métiers d’Art show in the British city, billing it as ‘one of the most effervescent cities of pop culture and an avant-garde one, whose bands, spanning all genres, have changed the history of music.’ So thinks the English National Opera, who have just announced that Manchester is to be its new home. And so, think the investors who have pumped £242mn into Aviva Studios, a stunning new arts centre, billed as the most important arts venue in the UK since London’s Tate Modern gallery.

Cultural mix

Having recently started as new bishop in the Diocese of Manchester, I feel like I’ve arrived at a time of exploding artistic vibrancy, with the city and region rising to new cultural heights. The mix is rich and potent, edgy and interesting, young and confident, strong and loud. And yet not far from the coolness and affluence it brings there are still many areas of urban dreariness and scruffy social housing, often linked with deprivation and deep poverty, telling a different story of those who feel they’re being left behind, deficient in ambition and lacking in hope. Manchester is a real cultural mix.

Despite these contrasts, you can’t ignore the fact that much of Manchester is humming. The symbol of the city, the ‘Manchester Bee,’ feels apt and has rightly been revived, for it represents hard-work and industry, something the area is becoming known for again. But it’s a new kind of industry. It’s not the hard factories of the cotton mills but the softer artistic endeavours that are reclaiming the spaces and setting the tone. Astute and celebrated, the Mayor of Manchester Andy Burnham recognises and champions this, declaring recently that it’s the creative industries that are now the fastest growing sector in the city.

As a newcomer to the region, I’ve been wondering what I should make of all this artistic entrepreneurship. Is it good? Is it important? Is it helpful? To help answer these questions I decided I needed to see what all the fuss was about and so I visited the newly opened Aviva Studios.

Nestling in the heart of the city, on a riverbank, the venue is located in the renovated Granada TV studios building and provides a vast space for creativity. It’s already the home of the Factory International music label and the Manchester International Festival. I was keen to understand the vision and understand why so much time and energy and money has been invested in such a space. I wanted to know if it really is a landmark space for contemporary arts in the UK, especially in the North of England, and whether I’d be back.

So, I visited on the first day of the venue’s official ‘Welcome’ to the general public. There’d been a series of soft launch events which included Free Your Mind, a large-scale, interactive hip-hop dance reimagining of The Matrix, directed by Oscar-winning film-maker Danny Boyle. But this was now ‘open to the world’ time. I turned up with grown-up members of my family who work in various creative sectors and who were keen to explore, aware that the warm-up events had already garnered great acclaim from The Times to Aesthetica magazine. We entered and took in the aroma of fresh coffee and the bustle of noise, as a small crowd of diverse ages gathered round a pop-up stage enjoying the creative reading of a children’s story. The foyer stage was transformed every hour into something new: first a space for musicians, then actors, then artists and dancers, all entertaining and encouraging participation. It was fun and vibrant, with an intriguing and inviting family-feel, drawing people in.

Connective art

Good art does that. It attracts. It reels you in, not just to observe, but to get involved. I experienced something of that as we stepped outside and enjoyed an installation called ‘Inside Out: This is Manchester’. It was a simple black and white portrait-display of two hundred Mancunians. The large photos were set out in a group on a concrete floor, creating what looked rather like a giant board game. The idea was you walked over them, standing on them, in and among them. So, into the photos I walked, and to my surprise I soon discovered the experience to be visually arresting and intriguingly immersive. After a few minutes of wandering among the faces I stood to one side for a breather. I asked my family which face they found most interesting, and I pointed out the one that had stood out for me. At that very moment, I noticed that a woman walking among the pictures had stopped at the one I’d chosen and was crouching down. As I looked again, she appeared rather like the woman in the photo. ‘Hi. Is this your photo?’ I asked. ‘Yes, it is’ she replied. ‘I’m Carmen. I’m just here for a short time today and wanted to see it.’ ‘It’s my favourite’ I said, ‘It’s a really great photo. I love the way it’s captured you pulling such a strong face!’ ‘Thanks’ she smiled, going on to explain how the shoot had been taken, but that this was the first time she’d actually seen it. I was thrilled: the person behind one face out of two hundred that had caught my attention, happened to turn up at the exact moment I was there! It made me feel strangely connected to the installation and with the people of Manchester they represented. Such is the connective power of art!

Such art does what cathedrals of old have done, enabling us to look out and look up and see beyond ourselves into a greater vista. They are deeply valuable and enchanting spaces.

Quality design

From there we went on an architectural tour. The stairwells, the corridors, the foyers, and the meeting spaces were cleanly and elegantly designed, using strong but simple materials, emphasising curves and city views, encouraging you to walk on and see more. We were told how many spaces, especially the foyers, worked really hard, being multi-functional and could be transformed for different uses. The two main venues were impressive and huge: the Hall is a 1600-seat concert venue, and the Warehouse space could host 5,000, thanks to vast walls that can be opened to create one massive space. The quality, the design, the versatility and the technology was hugely impressive, all set up and ready to be a northern centre of artistic excellence.

Enchanting spaces

So what did I make of it? And should such creativity be funded in Manchester? In short, I liked it. In fact, I absolutely loved it. It made me realise how much we need good art, good artists and good artistic spaces. They enrich us and our environment. They touch us deeply not just in our minds but in our souls and cause us to ponder and wonder. Such art does what cathedrals of old have done, enabling us to look out and look up and see beyond ourselves into a greater vista. They are deeply valuable and enchanting spaces.

The experience was significant for me, and extremely positive. Not only do I want to go back but since visiting I’ve mentioned it to quite a lot of people and am finding myself to be a bit of an evangelist for the place! I didn’t expect that. It reminds me that good spaces produce good conversations. The fact that it cost so much might be controversial to some, but it’s hard to put a price on stunning. If it inspires people to great visionary endeavours and lifts people, especially those lacking in hope, to see beyond their horizons, then it’s money well spent. If it causes children and women and men to dream dreams and imagine new futures, then I’m behind it. If it helps people see beyond their present dilemmas and laugh heartily and cry deeply and love compassionately, then I’m a supporter.

I believe passionately in encouraging artistry and innovation whenever and wherever I can. For the God I serve is the great Creator and the inspiration behind all true creativity.

Deeper understanding

My visit to Aviva Studios must have been good, as it’s made me want to support and encourage the team working there. I found myself thanking everyone, and even took a leaflet about becoming a member. As a bishop, I feel on behalf of the church and city that I want to cheer on Aviva Studios, commending it and its boldness to the Greater Manchester area, for I believe passionately in encouraging artistry and innovation whenever and wherever I can. For the God I serve is the great Creator and the inspiration behind all true creativity. Not only has he made the universe and planet Earth on which we reside, but throughout history he has given artistic gifts for human beings to foster and share.

I agree with Japanese artist Makoto Fujimura, that ‘Art is fundamental to the human search for deeper understanding. Art, by extension of this reasoning, is fundamental to understanding the Bible,’ which itself is a beautifully and uniquely-crafted literary work combining human artistry and divine inspiration. Creativity then, is at the heart of God, and of his human creation. We need to express this creativity in all sorts of places, including our workplaces. Artist and crafts pioneer William Morris rightly says that ‘without dignified, creative human occupation people become disconnected from life.' But surely this is true not just of our jobs but of our homes, and especially of designated creative spaces. Without such creative places, like gothic cathedrals, beautiful parks, art galleries and now Aviva Studios, we can easily become disassociated from the wonder and joy of life. We need good spaces to stir us and send us.

Innovative leadership

As a bishop who wants to see our churches growing and communities thriving, I welcome the new Aviva Studios as part of the cultural landscape of Greater Manchester. I want to enjoy it, visit it and share it. I also want the church to learn from it, for churches are meant to be places of Christ-centred worship and mission that are indigenous, reflecting the good things of their cultural environment. Manchester’s burgeoning creative culture is a good challenge to the church to be similarly creative, and not just in a reactive, but proactive way.

Churches have often been centres of creative excellence in the past, which is often when they have been most vibrant. They tried new things and become breeding grounds for creative people and innovative leaders. Interestingly, despite many churches struggling in the UK today, I see more signs of vitality and pioneering cultural leadership now than I did ten years ago. Most days I come across entrepreneurial church leaders who are brimming with fresh thoughts and renewed vision for their communities. Some even have bold and brash ideas that are being turned into reality, like purchasing, at considerable cost, an old army barracks in the centre of Manchester. Once renovated it will be a stunningly creative space for young adults, to serve the city and from which many new churches will be planted in the future. I’m all for it. Let creativity arise!

Creative people

Aviva Studios is an impressive building, designed to be a modern cathedral of contemporary cultural creativity in Manchester. It confidently declares a positive future for the arts, shouting loudly and proudly that Manchester is the cutting-edge city for creativity in the region and, should anyone be unsure, it really is the premier metropolis of the North. But perhaps more importantly I hope its impact will not just be the vast and impressive multi-million pound building, but the greater creative legacy it leaves in people, in those who are shaped by its art.

Rabbi Jonathan Sacks, who was Chief Rabbi from 1991 to 2013 expressed something of this when he said:

'We are shaped by our environment, but we can also shape our environment as well. We are created, but also creative.’

My prayer is that Aviva Studios and the other new artistic ventures will release more creativity across the city and region, across all ages, social sectors, and ethnic groups. Not only will this lift our sights, but it will stir our souls, and cause us to wonder at the Most Creative One, the God and Father of our Lord Jesus Christ.

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.