Review

Books

Culture

Music

18 July 2023

5 min read

The Creative Act by Rick Rubin – no prisoners taken

A biography lacking in personal anecdotes, makes up for it with a profound understanding of the creative process. Imogen Stokes recommends an essential read on art’s transformative power.

Imogen Stokes

Imogen Stokes is a musician and member of Voka Gentle. She is also part of P.S. a missional community of multidisciplinary artists supporting and encouraging each other to cultivate a biblical culture of worship and fellowship in the heart of industry.

Rick Rubin | The Creative Act: A Way of Being

From Johnny Cash to Kanye West, Rick Rubin has worked with some of the biggest names in music. Notably titled ‘the most important producer of the last 20 years’ by MTV, the famously bearded founder of Def Jam records has nine Grammy awards under his belt and is one of the most sought-after producers working today.

Written over the course of four years, a period that saw Rubin work with bands such as The Strokes and The Red Hot Chilli Peppers, The Creative Act: A Way of Being might promise a memoir yet assumes the form of something more like a self-help guide. Rubin distils what he has learned throughout his illustrious 40-year career into a series of short chapters that read somewhat like meditations, contemplating the meaning of art in general; how to make it well and why it matters to keep trying. While its dearth of personal anecdotes may be disappointing to fans hoping to gain insight into some of the producer’s many exploits, this book requires little to no contextual knowledge of Rubin’s life and work to enjoy.

“There was a version of the book three years ago,” Rubin told The Bookseller magazine last October. “The content was similar but the feeling of it... it did not feel like a call to action. It was beautiful, but it wasn’t inspirational.” If inspiring artists to create meaningful art is Rubin’s primary aim, suffice to say The Creative Act: A Way of Being largely succeeds.

Happily, this book is not just for musicians; for any working artist in search of practical guidance, Rubin offers encouragements and hands-on suggestions for how to cultivate discipline, maintain creative perspective and successfully finish work. His tips are, in many cases, refreshingly rudimentary. Set up a daily schedule of practice and stick to it. Level up your taste in the medium you are working in. Allow yourself to be distracted sometimes. Such instructions immediately reminded me of Oblique Strategies, Brian Eno and Peter Schmidt’s tarot-like deck of pithy creative prompts, conceived in 1975 as a work of art and designed to stimulate creativity. And the advice is sage. As an artist myself, I had barely gotten halfway through when my highlighter began to run out of ink.

Rubin’s thesis on art-making is full of self-aware contradiction. It is a serious matter, he says, but it’s also reliant on play. One should employ a rigorous schedule yet embrace rest and spontaneity. Practise your craft but be aware of the value in naivety;

‘often the most innovative ideas come from those who master the rules to such a degree that they can see past them or from those who never learned them at all’,

and remember that both years of artistic toil and a five-minute flash of inspiration can both produce a valuable result.

[It] does an excellent job of meeting the creative in their tiredness while celebrating their bravery.

It is this ability to understand and speak to the tensions faced by an overwhelming majority of artists that is a real strength of this book and a testament to Rubin’s experience as a producer. The creative process is rarely straightforward; success can be difficult to define and inspiration elusive. However, he admits, in the pursuit of great art ‘there are no shortcuts.’ The Creative Act: A Way of Being does an excellent job of meeting the creative in their tiredness while celebrating their bravery. It exists, at the end of the day, to remind them why it’s important to make art at all. I can corroborate this with my own experience: as a reader I brought all the baggage of any working artist. I felt understood and reassured, both by Rubin’s reverence for art-making and by his admission that art is rarely straightforward, and that artists can be hard to understand. This, for Rubin, is by no means an indictment. It’s part of the journey, and an important one at that.

Rubin’s reverence for the power of art and the significance of the artist is without question. This can sometimes, though, verge on the eulogising of unhealthy behaviour— an issue, I can’t help but feel, is endemic to the music industry at large.

'The great artists in history… are protective of their art in a way that is not always co-operative. Their needs as a creator come first. Often at the expense of their personal lives and relationships',

writes Rubin, excusing selfishness as a ‘childlike spirit’ to be aspired to. Surely, while singular focus is key, this doesn’t need to override a generosity of spirit, does it? Van Gogh certainly didn’t think so, famously writing:

‘there is nothing more truly artistic than to love people.’

There’s an evident undercurrent of divine inspiration woven throughout the book, too. Rubin acknowledges and explores the cosmic thread that runs through all things, the energy of which the artist both observes and channels through their work. The artist without this spiritual viewpoint, he posits, is at a crucial disadvantage. For Rubin, the spiritual world provides a crucial sense of wonder and a degree of open-mindedness rarely found within the confines of science. A dedication towards a deeper connection with and understanding of the ‘Source’ (the creative force of the universe) will inevitably merit a greater artistic encounter. Rubin therefore encourages artists to be disciplined in their spiritual practice in order to ‘build up the musculature of the psyche to more acutely tune in and receive from the divine’.

Rick Rubin with Neil Diamond, 2006. Photo by MusicLoverDiamond.

As a believer, of course I perceived Rubin’s ‘Source’ to be a metonym for the God of the Bible, and while occasionally Rubin’s universalism strays into abstraction— perhaps even cliché— there is genuine substance here; many of his spiritual encouragements overlap significantly with Christian teachings, for instance his appeal to artists to be ‘in’ currents of culture, not ‘of’ them, and the assertion that ‘it is better to follow the universe than those around you’. He admires the biblical attitudes of patience, discipline and child-likeness, and even quotes directly from the Bible’s book of Ecclesiastes, ‘for everything there is a season... ’, when illustrating the rhythms of nature.

Although it might be viewed as a simple guide to creative rules and rhythms, at the heart of this book the challenge is set.

You are either living as an artist, or you’re not. You are either adopting this way of being, or you aren’t.

Rubin takes no prisoners. The Creative Act: A Way of Being is an essential read for anyone looking to explore the importance of art or to remind themselves why they shouldn’t give up. For Rubin, a facilitator and a collaborator, the transformational powers of art are undeniable and artists themselves are almost magical creatures who need understanding and care. This book is both about, and for them.

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 tired-looking doctor sits at a desk dealing with paperwork.

Francisco Venâncio on Unsplash.

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.