Column

Comment

Community

22 September 2023

8 min read

From the barber’s chair: what makes a whole community

Cutting hair during COVID taught Californian barber Adrian and long-time client Neal some lessons about relationships. A new column.

Adrian Urquidez and Neal Presa

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

A barber stands between two clients, a father and son, a neon sign shines behind.

Adrian and the Presas.

This monthly column features reflections from two Americans: Adrian Urquidez, owner/barber of Cutman & Co, a Barbershop in Solana Beach, California, and Neal Presa, a longtime client who is a Presbyterian minister. Both Adrian and Neal have been friends for almost a decade.

Adrian

From being behind the barber's chair for 15 years now, I've learned so much about myself and others. From their life experiences as well as my own, when you put the two together, you have so much input to bring to the table.

At the start of 2020 I just resurfaced back into my workspace after taking a leave of absence. I was struggling with some alcohol issues, and I needed to step away from the chair to figure myself out and get the clarity I need to move on with my life. At the start of COVID, three months sober at the time the world shut down, I could no longer go to Alcoholics Anonymous (AA) meetings, I had to shelter-in-place and figure out how I was going to take care of my family. I applied to numerous jobs and had no luck. Finally, long time clients of mine began to text me saying “they need cuts”. That’s when the house calls began! Work began to flow in and before you know it word started to spread.

Going to people’s houses, cutting hair outside, masked up, I began to realize that no matter what the circumstance, people want to feel good, they want to look good and that's where I came in the picture. Outside of my everyday work I started going to school for alcohol and drug counseling. I enjoyed every second of it; it kept me in the world of recovery. So, with school and Zoom meetings I was able to stay strong and continue to be sober. I learned so much in those two years as my clients, who became my friends, helped keep me afloat financially and ZOOM helped me attend those AA meetings.

Looking back now, I see how important it was for me to go through COVID. I spent more time than ever with my family, understanding what I valued most and learned how important community is. I realized that the people I saw monthly were more than just clients; they were pretty much family. They cared about me, my family and my well-being, which helped me strive to be the best version of myself.

Almost four years sober, I opened my first barbershop, grew my family by one and now get to do what I love every day in a shop of my own. I get to talk to people each of those days and listen to their life adventures. Barbering has evolved so much, when you step in, the vibes are welcoming. At the shop it is more than just “getting a haircut.” You get a beverage of your choice and sit back and relax and enjoy your experience. For 45 minutes or so my ears are theirs and whatever the case may be, my clients/friends get to share about whatever is going on: personal lives, sports talk and just everyday issues we all struggle with. I love what I do, as it opened so many doors and gave me the opportunity to meet so many people - corporate CEOs, professional athletes, doctors, military personnel, fathers, mothers and kids..

At the end of the day, barbering has changed my life, and I can honestly say that I helped change the lives of others and myself by being vulnerable, personable and just really being present in my everyday life.

Neal

The old saying “misery loves company” is true in so many ways. On the difficult journey of life, trying to figure out the twists and turns of what makes it both beautiful and gratifying – and the same time a source of frustration, anguish, and all the mixed emotions of what it means to be human, we need companions along the way. We are human and we can’t do life alone. It’s miserable to do so, and we need neighbors and strangers alike to share in our joys, to comfort and commiserate with when the going gets rough, and to learn from one another.

As with any company we keep - whether it be family, friendships, your neighborhood, or even the traffic on Highway 5, there’s bound to be some sort of conflict. Hopefully, the risk of being in relationship with others doesn’t discourage you and me from being a part of community, of joining new ones, and learning about other people.

COVID-19 was one of the biggest disruptors of such community. Remember the social isolation, the shelter-in-place directives? Recall everyone around us masking up, only seeing each other’s eyeballs, walking on sidewalks socially distanced from each other? Or trying to live and work with endless online meetings and only seeing a few inches of the other person’s existence?

And, in the midst of all of this upheaval, there was a wide swath of community here in the United States and around the world, who amplified their voices on the streets and social media refusing to get vaccinated or to listen to medical professionals. The herd mentality that overtook logic and healthy action to benefit everyone else was a community-response in itself, granted not a healthy and not a helpful one.

It’s good that this inaugural column of “From the Barber’s Chair” is starting on the subject of community. Adrian’s not just my barber, but a friend of mine and of our family. Adrian and I have come to know, respect, and love one another as I have sat in his chair for countless haircuts and conversations about all sorts of topics. He, like a pastor and a bartender, has heard it all. He, like so many artisans in his craft, has the comforting demeanor and listening posture that encourages you to share about your life, be vulnerable about your fears and celebrate your child’s achievements. You also find the joy of a reciprocal relationship in receiving his life’s story as he lives it out between each monthly appointment. Ours is not so much a vendor-client relationship - though of course there is still a fee and gratuity to pay and a service to be rendered - as it is about two erstwhile strangers who are friends, who are figuring out this thing called life. We have this give-and-take; a give-and-take not so much about goods and services, instead it’s about a mutuality of reflecting upon the craziness and wonders of being husbands, fathers, professionals, citizens of the world, trying to be good human beings to neighbor and stranger alike, and make what positive impact we can on the world in our slice of God’s creation.

So, when COVID-19 arrived, like a monster truck barrelling down a storefront, disorienting life as we all knew it, it was such a gift and a blessing for Adrian to have continued his business by making house calls. There we were, in the backyard of our home, every month, my two sons and I would meet Adrian as we all donned our masks. It was two years of those house calls that that helped bring our family and Adrian through COVID.

Adrian was part of another barber shop at the time and that shop was going through a management transition. I knew from years back that Adrian had dreamt of having his own barber shop one day. He had disappeared from the scene for a year. It was on one of these COVID-period house calls that Adrian shared of his ongoing journey towards sobriety. He shared of the strain that alcoholism took on him, his health, his marriage, and family, and how his slow walk to recovery was unfolding and that was life-giving for him and all those with whom he loved and who loved him.

The road to recovery came at a right time when the onset of COVID drove many people into addictions and depression because of social isolation. To receive Adrian’s story and to be invited into the sacred space of his life was a precious gift.

Adrian and our time with him were a source of community, a source of life.

During this period, I was working with church colleagues remotely as we tried to creatively figure out how to serve a large congregation when the name of the game ought to be face-to-face community. This was not to happen, and not anytime soon. Also, our sons who were, at the time, both in high school, grew weary physically and mentally having to take their classes via Google video. I could see their energy level waning and melting. My wife and I grew concerned about them and about their classmates. This was not a healthy situation at all, but this is the best we all could do at the time, to just manage the frustrations, the anxieties, and the stresses of it all.

Our haircut appointments with Adrian were monthly punctuations for human contact outside of our family unit, outside the Zoom contacts with church colleagues, outside the video classrooms. It was like those proverbial apocalyptic movies of emerging from the underground bunker to see who was alive, or like the mythical Noah’s flood surviving on the ark and sending off the dove to see if the bird would bring back evidence of land. Adrian and our times with him were a source of community, a source of life. Such was a powerful lesson in what community is and what community is about: it’s being there for each other, to express and evidence life, it’s helping others keep living and to keep going.

After each haircut, as I reflected upon our time with Adrian, and even now, two years after the fact, my family and I experienced the presence of Christ in our backyard, every month.

When Jesus, and the community with whom he interacted and which were inspired by his life and mission, said/wrote: “I am the way, the truth, and the life,” Jesus embodies it. Standing for the way to true life. Showing the way to live life and the way to truth. In whatever combination we understand and receive what he claims about himself, Jesus is very much interested in and in the business of engaging with us human beings truthfully and truly. It’s because he cares deeply that we live life truly in the presence of God and with one another. Jesus desires that to happen in community, where his spirit is moving in and through conversations, story-telling, prayer, laughter, tears, and all the things that make human relationships interesting and meaningful.

For our family and for Adrian – from the barber’s chair in a theologian’s backyard – as we all struggled with life and faith, we also discovered a bit more about being a holy community; not because there was a posted time announcing that there was a worship service or Bible study, not because there was a stained glass or a cross present. None of the familiar symbols and signs were present that indicated “church” was happening or “theology” was being articulated. All it was were the simple ingredients of honest conversations anchored in love for one another, for faith, for life itself and the bit that God had given us, not knowing whether we would live to see tomorrow but being grateful to God that we had that moment together.

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.