Article
Comment
Gaza
Israel
War & peace
7 min read

Gaza-Israel: bankrupt ideas still capture too many of us

One year on, we’ve turned no pages, learned no lessons, made no progress.

Todd  is the Executive Director and Co-Founder of Telos Group. It forms communities of American peacemakers across lines of difference and conflict, including Israel/Palestine. 

A graffitied concrete border wall stands below a blue sky and dusty ground
Border wall between Gaza and Israel.

It’s the first anniversary of October 7, and we’re left with the grim task of finding a way to appropriately honor the dead, stand in solidarity with the bereaved, and mourn with all who mourn.  And we do this as we acknowledge our ongoing collective failure and the unimaginable and avoidable loss of so many innocent lives, each one with its own promise and possibility forever denied.  In the end, it’s hard to find a way to commemorate the horror of that day because it’s still going on.  We’ve turned no pages, learned no lessons, made no progress.  

Someday there will no doubt be a grand and somber memorial that tells the story of the brutal October 7 attack. The victims of that day will be remembered, the captives and their fates memorialized. And some day there will be a museum that tells the story of what many already believe will be characterized in the historical record as a genocide in Gaza. To what we already know of the massive destruction of a place and a people will be added details that will be excavated from the rubble, testimonies from the traumatized survivors, heartbreaking tales of orphans and of the destruction of entire families. Maybe these places of collective memory will offer greater context for the world in which the tragedies that created them took place, some kind of “never again” lessons to learn, and no doubt some sharp analysis of the failures that led to these days of great darkness.  If these attempts at memorialization are honest, they will hold many of us up to withering critique. We’ll be in the museums too, enduring rebuke for the indifference that led us here or for our zero-sum thinking that could only imagine a world born of and sustained by violence in all its forms.  

These are lone and lonely voices in a land besieged by brutality, dehumanization, and ideologies of ethnic and religious supremacy.  But they are not unicorns. 

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If we don't want the story to be about our blind complicity, but about our courage, we still have time to own our agency. Because this isn't over yet. We can mark this day by remembering that it will continue to be like all the others until we all do our part to achieve a ceasefire, a release of captives, and an end to support for systems of inequality and control.  In whatever ways great or small that we can, we have to reject the logic of violence and the ideologies of hatred and exclusion.  And to be active participants in cultivating in ourselves and in our communities an imagination for the way each human life is sacred and our flourishing is tied to that of our neighbors.   

We do this even as we pause and honor the innocent dead in Israel, in Gaza, in the West Bank, and now in Lebanon. We mourn with all those who mourn. But we do that with people still dying in Gaza, with millions of Palestinians still displaced, with disease and hunger rampant, with Israeli hostages still being held, with massive street protests calling for a ceasefire being ignored, with hundreds of thousands of Israelis still displaced from their homes in the north and the south, with Hezbollah rockets still falling and now with the war more fully advancing into Lebanon, with a wider regional war ever a distinct and terrifying possibility, with settlers rampaging in the West Bank with impunity, with ideological zealots setting the terms of debate, with economic catastrophe as hundreds of thousands of West Bank Palestinians have endured a year with no income, and with palpable fear among Palestinian citizens of Israel.   

The bankruptcy of the ideas that have prevailed this past year remain firmly in control and continue to capture the imagination of too many.  And yet there are those who know that violence begets violence begets violence, and that this is how we got here, not how we get out.   

I spent a day in New York City last month with four members of the Parents Circle/Families Forum, an organization made up of 700 Palestinian and Israeli families, each who have each lost a loved one in the conflict. In addition to the pain of loss they share, they also share a commitment to a rejection of the very notion of revenge and an embrace of the work of reconciliation.  Four members of this group traveled to the United States for a two-week tour to help us understand our part in their shattered and unjust reality and to let us know that there is another way if we can find the courage to pursue it.  That way is mutuality.  It is an embrace of security, dignity and freedom for all the people of their traumatized shared homeland, Israelis and Palestinians alike, in equal measure.   

Each member of this unlikely tribe has a unique story of personal loss, and as they speak, they tell of the worst day of their lives, over and over again.  But there is exponential power in the fact that these stories are told in one voice.  Two members visiting the U.S. are mothers, one Israeli and one Palestinian, who have lost children in the conflict and have been transformed by the deep realization that they share the same pain. One was a young man whose ten-year-old sister was killed by an Israeli border policeman and after some years of anger-fueled stone throwing as a teenager, he began to channel his trauma into the work of resisting occupation and violence via the collaborative work of justice, freedom and security through reconciliation.  And one of the newest members of this work is a man whose mother, an internationally recognized Israeli peace activist, was killed in a kibbutz on October 7.  He has chosen to pick up his mother’s work and devote himself to a just peace for himself and for all his neighbors, Palestinians included.  

These are lone and lonely voices in a land besieged by brutality, dehumanization, and ideologies of ethnic and religious supremacy.  But they are not unicorns. There are others there whose stories need to be told and whose work needs our support.  

My church is preaching a sermon series reflecting on the leadership and choices of the kings of biblical Israel and Judah.  Their stories are old but their inclinations to violence, their neglect of care for the poor and the widow, and their lack of concern for justice are timeless. In a recent sermon I was struck by my pastor’s observation that even those of us who have regularly engaged with the Bible all our lives don’t always know much about the kings, but we do know something of the prophets.  They are, in his words, “the ones who hold the story for God.” And in times like these,  as we descend ever deeper into darkness and inhumanity, they are the ones who share in the pathos of God, to borrow from rabbi Abraham Joshua Heschel. But they also show us the way out. Warmongers in the Middle East and here in the West are creating massive destruction. We too easily and readily live within the world created by their corrupted imagination.  We can’t ignore them. But we don’t have to listen to them. Listen to the prophets, those who hold The Story of God’s shalom, of his kingdom of justice and peace.  They are still among us.  One of our responses is to make sure we’re listening to these voices, amplifying them, and following their lead.  

As a Christian, over this past year, I have found myself being drawn more deeply into the life and the person and the divinity of Jesus of Nazareth. The deep love of the maligned and suffering, enemy-loving  Jesus, he who was accused by the religious establishment, executed by one of the great empires of history, mocked and spit upon, all for the threat he posed to those addicted to power, control, exclusion and the violence needed to enforce it all.  This is the Jesus who boldly declared liberation of the captives, vision for the blind, food for the hungry--a new kingdom of justice and mercy, of wholeness and shalom.   

None of these things I believe absolve me from acting.  Jesus is not my cop out, he’s my way out.  What if we who seek to follow him were to repent of our propensity to violence, our fascination with the zero-sum binaries we use to create hierarchies of exclusion, and our failure to demonstrate our love for God by showing love of our neighbor?  We might not solve all the problems that are destroying us but we’d at least stop contributing to them. And imagine what a more generative and healing presence in the world we would be if we joined our voices with others of different faiths and none who also believe in a world more just and whole.  I would argue that the world in all its diversity and complexity needs Christians to mark this day and this moment is by taking Jesus so seriously that we start to live out his calling to be active participants in the work of justice, healing and repair and living reminders that all are made in the image of God, violence begets violence, and the simple truth of Mother Theresa who said, “If we have no peace it’s because we’ve forgotten we belong to each other.” 

Article
Assisted dying
Comment
Politics
7 min read

Assisted dying hasn’t resolved Swiss end of life debates

Despite attempts to normalise it, new challenges still arise.

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.