Column

Comment

1 December 2023

9 min read

From the barber’s chair: the friendships that open us up

Adrian and Neal recall and recount tales of friendships and what made them work so well.

Adrian Urquidez and Neal Presa

Adrian Urquidez is a Californian barber and theologian Neal Presa is a regular client.

Three men walk down a path, the middle one talking and gesturing while the others listen.

Centre for Ageing Better on Unsplash.

Adrian

As life moves on, I began to realize how important my friendships are. Half the people that I grew up with are now married with kids and the other half are still living their life independently. We all have our own paths in life, and I believe whichever path you take, those whom you consider friends will support you and your decisions no matter what.

As I went through my issues in 2019, I had nothing but support from my family and

friends. It wasn't easy for me to be open with my struggles because I felt that everyone would look at me differently. I received nothing but support from everyone then and when I returned to work. They were all there, waiting to book their next cuts with me. From the beginning of my return I knew, then, how important my clients were to me. I wasn't just their barber; I was their friend whom they continued to support even during one of the craziest times in my life.

Trying to stay afloat during a global pandemic was not easy; honestly it was one of the hardest things I’ve had to deal with. I knew I had to be as strong as I could be so I could help my loved ones stay positive and their heads held high.

During these times, I worked as much as possible. At every appointment with a client, they showed support and always checked in with how I was. I used all these opportunities to help myself by speaking what was on my mind. Sometimes they would even open up to me and share what was going on in their lives, positive or negative. These times were much needed therapy sessions at every appointment. Being vulnerable helped me so much and it also helped my friends share what was on their minds; they opened up to me.

When I finally felt right to open up about this incident it was with people who shared the same struggles. They understood and never once judged me.

Growing up we were taught never to show any fear or emotion. I grew up in a rough area where if you showed weakness, you could be the next target to get bullied. I didn't realize until about four years ago how that way of living was wrong. That way of living haunted me for years.

Going back to my childhood, there was an incident that shaped my teens and early

adulthood. I was touched inappropriately by a member of my family and thankfully someone came home so it didn't go further than it did. I never spoke about this incident because I didn't realize the severity of the situation as a young boy and how it would affect me in my later life. You would never think a family member would do anything to put you or harm you in any way. Even as an adult I never said anything because I did not want to get judged or have people put a label on me that wasn't true. When I finally felt right to open up about this incident it was with people who shared the same struggles. They understood and never once judged me.

These were people who I just met but I felt like I had known them for years. I opened up to them more than I had opened up to my childhood friends and family.

This is where I discovered the meaning of friendship. I was never judged and looked at differently. I was the same person to them, and I was accepted no matter what. What a great feeling. I began to hold my friendships close as I had the confidence to share so much with everyone. One of the first clients whom I felt comfortable with opening up with was my friend Neal. I remember going over to cut Neal’s and his sons’ hair and I always left feeling purified. I can honestly say that Neal is one-of-a-kind and I'm so lucky to have him by my side. Neal has seen me at my lowest and never once has he ever judged me.

He and his family have shown nothing but support and just truly care for our friendship. This is where I discovered the meaning of friendship. To me, the meaning of friendship is endless love no matter what the person or persons are going through. You never judge but try to point your friend or loved one in the right direction. Always support and be there when you can. We can take for granted those friendships and lose sight that they are the ones that would be there with a simple phone call or text.

Today I cherish all my friendships and I'm there for those who were there for me when I was at my lowest. I will do anything in my power because I know my friends and family would do the same for me.

Neal

Thirty years ago, there were a little over 600 websites, two years after the World Wide Web debuted on the global stage. Today, there are a little over two billion websites. Yet, with all of our connectivity, loneliness is endemic. The social isolation that ensued during COVID-19 only exacerbated what was latent in our body politic. Yet, whether pre-, peri-, or post-COVID, the level and depth of loneliness is staggering. While many people have social media accounts, and the ubiquity of smart devices keep us all connected 24/7, one’s number of “likes,” “friends,” “followers” belie what is experienced in silence: we live, and move, and have our being in lonesome existence. We seek to be known and loved, but our career pursuits and dreams of having families leave us feeling alone.

They desired someone or a few who could understand them, who desired to understand them, to love them. And to love them not for a quid pro quo, but just to love them for who they are.

For eight years I served an affluent congregation in one of America’s most affluent ZIP codes. Business acumen, political gravitas, excellence in duty, and elegance in program execution were the values and expectations of the community and congregational context. It was a wonderful ministry, where I learned much and where I had to engage my gifts and skills in deeper ways. God opened up spaces for me to minister within, love and be loved by people who were successful in their industry.

When that ministry concluded, two separate congregants asked to meet for a meal. Each of them shared that they appreciated my season of pastoral ministry and they hoped that we would continue staying in touch, perhaps become close friends. They realized that they had spent decades forging business relationships, raising a family (for one of them, navigating a divorce of a second failed marriage), and having careers. Now in their mid-/late fifties they looked around and saw the absence of relationships of any meaningful depth. Sure, there were the business lunches, dinners with friends and cocktails with other couples. But in their mid-life, they sought authentic friendships. They desired someone or a few who could understand them, who desired to understand them, to love them. And to love them not for a quid pro quo, but just to love them for who they are. They said that they experienced a semblance of that in my eight-year ministry with the congregation.

What was I to do with their request? I had already left the employment of the church by then. They and I had to part ways as I was no longer their pastor. If anything, we were friends, and would remain so, but I could not commit to the level of depth they desired. I told each of them, gently and pastorally, that two decades ago, when I was newly married and starting my pastoral vocation, I intentionally forged a wide network of friendships. Not just for my work but for emotional and spiritual support. But among this network, there was that small few whom I can count on one hand who are the A-Team of friendships. Those friendships were cultivated over many years – a couple of them over two decades – as we have been intentional about being in each other’s lives. We would stay in touch and would find opportunities to see each other, carving out precious times wherever we were in the world and whatever demands were on our plate. That intentional commitment meant being willing to be vulnerable. It meant taking the risk early on to open up my heart with guys I deeply trusted and who entrusted their hearts to me.

The Message version of the Old Testament wisdom sayings of Proverbs says: “Friends come and friends go, but a true friend sticks by you like family.”

I didn’t want to deflate the spirits of my two former congregants. But neither did I want to over-promise, to commit myself to investing the time and energy in cultivating the depth of friendship they sought. I told them let’s stay in touch and we left it that. It’s been over a year since those sacred conversations and there’s radio silence.

In reflecting upon those conversations, and in similar conversations with many pastor colleagues and fellow dads who are not pastors, loneliness is, indeed, endemic. It’s tragic and it’s sad. As we can’t be deep friends with everyone, there is a yearning and longing for the depth of friendships that my former congregants sought. People seek that authentic depth of desiring to be known, of being listened to, of being received and welcomed into one’s heart without having to prove anything.

As Jesus was nearing the end of his time with his friends (his disciples), he emphasized how important it is to love one another. He even washes their feet to demonstrate that even the Son of God will humble himself because he loves his friends. He teaches them what he means when he calls them friends, when he regards us as his friends, and not as servants. This is what Jesus our friend said,

“I do not call you servants any longer, because the servant does not know what the master is doing, but I have called you friends, because I have made known to you everything that I have heard from my Father”

The late Earl Palmer, an American Presbyterian pastor, taught from this passage. Palmer observed that Jesus regards us as his friend by virtue of the fact that Jesus allows us to be in the company of him and the heavenly Father as they have a conversation about the secrets of God’s heart. In other words, only to his friends will Jesus whisper the Father’s heart because to do so is to entrust the treasure of the One who loves him into our own heart. That by doing so, we are let into the heart of God.

It’s that quality of friendship that is most needed more than ever. It’s the God-shaped heart that takes the risk to love and be loved. It’s the kind where you can whisper to your friend the sacred longings, hopes, dreams, and fears of your heart. It’s, likewise, receiving from your friend the same: being entrusted with the treasure of their heart. And it’s also experiencing joy and delight in being with each other, even through online technology, whether it be for a 15-minute coffee or for a whole day at the tennis courts or sharing corny jokes that no one else appreciates but they do.

Friendships are gifts of God and gifts from God. The ability to open up our hearts and lives to others is a gift of and from God as well. In doing so, we reflect a bit on what Jesus shows us what love is about, what it takes to love, and what it means to be loved.

The wise words of philosopher and poet, Henri-Frédéric Amiel, encapsulate well what is needed more than ever:

“Life is short. We have but little time to gladden the hearts of those who walk this way with us. So we swift to love, make haste to be kind.”

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.