Art makes life worth living

Why society, and churches, need the Arts.

Jonathan Evens

Jonathan is Team Rector for Wickford and Runwell. He is co-author of The Secret Chord, and writes on the arts.

A choir sing at the front of a church while an audience looks on.

St Martin-in-the-Fields choir performance.

Arguing for the significance and role of the arts and culture during an election in an era where a cost-of-living crisis has followed austerity and a pandemic, may seem to be a hard task. The Arts being thought of often as frivolous and unimportant in comparison with the basics of survival. Yet it is essentially a task that the current government has attempted, as in June 2023, a ‘Creative industries sector vision’ was published which included a commitment to an additional £77 million in funding.

At that time, the government estimated that creative industries generated £126bn in gross value added to the economy and employed 2.4 million people in 2022. A range of research has also been examining the way in which creative industries and the arts can positively impact wellbeing, for example through public health interventions.

The foreword to ‘Creative industries sector vision’ stated:

“Our creative industries are world-leading, an engine of our economic growth and at the heart of our increasingly digital world. From 2010 to 2019 they grew more than one and a half times faster than the wider economy and in 2021 they generated £108bn in economic value. In 2021, they employed 2.3 million people, a 49% increase since 2011. Their impact reaches beyond their borders to other sectors, with advertising, marketing and creative digital innovation supporting sectors across our economy.

The importance of the creative industries also goes well beyond the economy. They provide the news that informs our democracy, the designs that shape our cities and the content and performances that enrich our lives and strengthen our global image. The sector has proved that it is an essential positive force for society, bringing joy, inspiration and opportunity to our lives. The creative industries form the national conversation through which we define our shared values.”

The arts and culture help tackle social injustice as theatres, museums, galleries and libraries are the beating heart of our towns and cities bringing communities together and making life worth living.

This positive view of the creative industries was echoed in a report ‘The arts in the UK: Seeing the big picture’ published in November 2023 by management consulting firm McKinsey. The report described the UK as a “cultural powerhouse” with a globally recognised arts sector and 91 per cent of UK adults engaging with the arts in the previous 12 months.

The Arts Council estimates that art and culture contribute £10.6 billion to the UK economy as the UK has a creative economy worth £27bn and culture brings £850m to UK, through tourism, each year. They also contend that the arts and culture help tackle social injustice as theatres, museums, galleries and libraries are the beating heart of our towns and cities bringing communities together and making life worth living. In addition, our creative industries are successful throughout the world - our leading cultural institutions are a calling card worldwide and have important trading links from the US or Germany to China and South Korea. Last year our National Portfolio Organisations earned £57m abroad.

Churches feature within these arguments because they often host or organise cultural events, exhibitions, installations and performances which contribute towards the economic, social, wellbeing and tourism impacts achieved by the arts and culture. The Arts are actually central to church life because, as well as being places to enjoy cultural programmes such as concerts and exhibitions and also being places to see art and architecture, many of the activities of churches take place within beautiful buildings while services combine drama, literature, music, poetry and visuals.

The artist Makoto Fujimura has suggested the creation of cultural estuaries in churches, schools and informal associations as a strategy for enhancing culture. Estuaries are where salt-water mixes with fresh in a confluence of river and tidal waters. They are environments not of protection but of preparation as critical nursery areas for fish that come downstream after hatching.

This suggestion has been taken up by Sam Wells, Vicar of St Martin-in-the-Fields, who advocates for churches to minister in and through the 4Cs; commerce, culture, compassion and congregation. He writes in ‘A Future that’s Bigger than the Past’ that:

“… the image of an estuary is helpful for a church regarding itself as a meeting place of human and divine, gospel and culture, timeless truth and embodied experience, word and world.

Churches work hard to make themselves inspiring locations where people are drawn into a sense of the presence of God; but they can work equally hard to make themselves hospitable locations where people of varied backgrounds may gather in a spirit or mutual appreciation, generous regard and constructive challenge. The two purposes of church need not be mutually exclusive.”

The arts, he suggests, provide a perfect example of how such an estuary space may flourish with participatory, aspirational and commercial activities all taking place in the same space. In a short time, he suggests, “a secluded, secretive space may be opened out to become a centre of community activity, energy, and creativity.” All that’s needed “is for a church to let go of the need for direct outcomes and linear trajectories and to let the Holy Spirit govern the interactions and catalyse its own surprises.”

The Bible adds to this missional assessment of the importance of the arts. At the point we are told of human beings as having been made in the image of God the one thing we know for certain of God is his creativity, making our own creativity central to our understanding of how we live in his image. Later, the very first people to be spoken of in terms of being filled with the Spirit of God are the artists and craftspeople who make the Tent of Meeting for the people of Israel as they journey through the wilderness. The Bible, itself, is a library of various genres of literature with many of its texts having been preserved through oral performance, whether spoken or sung.

Given these theological, missional, social and economic reasons for seeing the arts and culture as central to personal wellbeing and to national life, in this election period it surely makes sense to check the commitment of politicians in all parties to maintaining and developing the cultural industries and the vital place that the arts and culture have in the life of our nation.

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.