Article
Comment
War & peace
7 min read

How to disagree agreeably

How do we converse passionately about controversial topics without falling out or falling into war? Jörg Friedrichs shares his insights after a difficult conversation with a colleague.
Two 1950's men un suits sit at a table dominated by a large hanging microphone. One points a raise hand and finger into the air. The other listens.
A 1951 BBC debate between Iorwerth Thomas MP and Gwynfor Evans Teitl.
Llyfrgell Genedlaethol Cymru / The National Library of Wales, vis Unsplash.

Last year in spring, I bumped into an academic colleague whom I had not seen for a long time. I mean, we had talked over screens but not seen each other in person. He is a valued colleague, yet we ended up having a difficult conversation about the Ukraine war where we could have easily fallen out. It was close but, fortunately, did not happen, so let me share how we had a productive discussion instead. Of course, we did not end up agreeing on everything, but we did let one another finish. Avoiding an escalation was not easy then and is never easy in situations of this kind, but it is worth trying because relationships are more important than asserting personal viewpoints. 

Differences of opinion escalate easily in so many situations, especially in war-like ones. We see this with the war in Ukraine, but also in the context of the so-called culture wars. How do we disagree agreeably when people hold strong and principled views about controversial issues? Gender and lifestyle? Religion and race? How do we express a nuanced view that might question strongly held opinions, without either being labelled as something nefarious - “racist”, “woke”. Or thus labelling somebody else? What I am going to share is applicable to many situations, from the culture wars to marital disputes, from conversations over football to a post-mortem between parents when their kids have had a meltdown in the playground.  

Difficult conversations

There is no question that conflict generates false moral certainties, and it is often good to question them. Just because Russia attacked Ukraine, is anything to punish Russia justified? Conversely, just because Ukraine has suffered an attack, is it a victim nation deserving unlimited and unconditional support regardless of its own actions? Is the West, because it supports Ukraine, unquestionably in the right? Is any support of Russia, or even an attitude of neutrality, totally objectionable?  

In a war situation, people tend to look at things in a black-and-white fashion, and even-handed views are unpopular. Expressing them requires courage because partisan observers will attack us when we fail to roundly condemn one side while exonerating the other.  

How are we going to react when they do so? We will certainly feel put on the spot, but this does not disqualify their arguments. We therefore must consider their accusations with humility.  

In my conversation with the colleague, he accused me of spreading “Kremlin propaganda” when I suggested that the West should be more sensitive to the concerns expressed by Russia as a humiliated great power. Spreading Kremlin propaganda is not a minor accusation these days, and I did not feel I deserved it. I therefore found that, in a situation like this, keeping one’s patience is challenging. I was tempted to counterattack, perhaps accusing the colleague of being prejudiced. Instead, I had to take a deep breath and explain to him, as calmly as I could, that my aim was not to side with Russia but to suggest something that might have enabled, and might still enable, diplomatic negotiations and peaceful change rather than replicating a conflict that is so hugely damaging.  

From my point of view, the colleague had accused me unjustly, and so I found it difficult to render justice to what he was saying. Yet, while spreading Kremlin propaganda was not my aim, I had to recognise that part of what I had said overlapped with what a Kremlin propagandist might say. It was uncomfortable to accept that, perhaps, my colleague had put his finger on a vulnerable spot and I should take greater care to distance myself. To make things worse for myself, my colleague also pointed me to a factual inaccuracy regarding a historical detail.  In all honesty, I found it challenging to accept any form of criticism from someone who had just accused me of spreading Kremlin propaganda. Yet, the intellectual virtue of docility demanded me to concede the inaccuracy of this particular historical claim and stand corrected. I had to remember that, ultimately, what unites us is a search for truth, and that the truth can only reveal itself in a discursive spirit of give-and-take. 

Disagreeing agreeably 

We then had a productive discussion where I was able to point out that, during the crisis preceding the attack, Russia had made it very clear that the casus belli (cause of the war) had been a dispute over whether Ukraine was entitled to join a military alliance perceived as hostile by Russia. The USA and its allies insisted that this was not negotiable. Was that, and is that, worth a conflict that is killing countless people and has dire consequences for global energy and food systems? Has everything been done to avoid the war, and is everything being done to end it? While it is easy to see that Putin’s Russia is wrong, are we sure that “we” are right?  

Since the end of the Cold War, “we” (that is, Washington and its allies) have been involved in a significant number of military interventions, from Kosovo to Afghanistan and from Iraq to Libya. By comparison, Moscow has hardly been involved in any out-of-area interventions. Where Russia has invaded an adjacent country or region, as in Crimea and South Ossetia, the trigger was always the fear of a neighbouring country turning hostile. While attacking a neighbouring country is unacceptable, it seems fair to ask if the USA would stand by idly if a hostile power were extending its reach into its own regional neighbourhood (Cuba, Nicaragua, Granada). While a US attack on a country in its regional neighbourhood seems unlikely under present circumstances, there is a need to understand Russia beyond condemning the invasion of Ukraine. 

Unfortunately, propaganda from both sides has become so intense that it is becoming difficult to gain an even-handed understanding. There has even been open debate about using nuclear weapons. 35 years ago, the Cold War ended with a consensus that a nuclear war cannot be won and must never be fought. Indeed, fear of a nuclear holocaust was one of the reasons why the Cold War remained, largely, “cold.” There was communication with Moscow even under Brezhnev. Today, some would see a dialogue with Putin as treason. How can fundamental lessons of diplomacy and deterrence be unlearned so quickly?

We must value and recognize not only those whom we find it easy to empathize with, such as the Ukrainian and Russian people, but also those whom we dread and whom we fear. 

While my colleague stood his ground and reminded me, repeatedly, that “we” must punish or even humiliate Putin’s Russia for its attack on a sovereign country, we were able to have a calm debate where he listened to my arguments as much as I listened to his.  

This was only possible because I had stuck, as best I could, to a series of intellectual virtues, highlighted above in bold: courage; humility; patience; justice; docility; and search for truth. The list goes back to Nigel Biggar, a moral theologian who has adapted Christian virtues for intellectual needs. Professing such virtues is easy in principle, but hard in the heat of a real encounter. In the exchange with my colleague, I passed the test by the skin of my teeth. At other times, I fall short.  

Now, for those familiar with the lore of Christian virtues, you will know that 'six' is a weird number. Everything should come in 'sevens'. So Nigel Bigger gives us a final, seventh intellectual virtue. Charity. Quite possibly the most important.

If only we could become like brothers and sisters who are able to carry out our disagreements in love, giving each other the benefit of the doubt in having sincere intentions and reasoning to the best of our abilities.  

Of course, virtue sounds like a very grand word. Perhaps there are saintly figures who “possess” virtues as personal qualities. For the rest of us, virtues are aims to which we should strive, however much we struggle to reach them. Centuries ago, even a child would have been able to enumerate the seven virtues of Christian morality. Today, some of us may still remember the three theological virtues (love, faith and hope), but what were again the four natural or cardinal virtues? Well, never mind.  

In a twist that encapsulates the best of the Christian tradition, the virtues are not about being virtuous in a self-righteous way. Contrary to the pagan tradition where virtue is something heroic, Christian virtues are about valuing and recognizing others while humbling and decentring ourselves. We must value and recognize not only those whom we find it easy to empathize with, such as the Ukrainian and Russian people, but also those whom we dread and whom we fear. Christian virtues equip us for the arduous task of entering a dialogue with Putin’s Russia, with the view to seeking peace. Having negotiated with everyone from Stalin to the Vietcong, from Gaddafi to the Taliban, we hear today that the idea of negotiating with Putin’s Russia is naïve at best and misguided at worst. Yes, it is going to be fiendishly difficult. Yet, it is necessary. Equipped with intellectual virtues, nothing should stop us from trying. Neither should we stop trying to have conversations across the trenches, even those of the culture wars.   

Note: this post uses material from an earlier post by the same author.  

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.