The legacy of Grenfell

Marking the sixth anniversary of the disaster, Graham Tomlin looks to what its legacy needs to be.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Grenfell Tower, wrapped in a protective layer bearing the legend: Grenfell forever in our hearts

The Grenfell Tower protectively wrapped.

The blowup on Unsplash.

It is now six years since an electrical fault in a fridge in the kitchen of a fourth floor flat led to the fire in Grenfell Tower which killed 72 people – the worst loss of life in one single incident in London since the second world war. The rest of the country has understandably moved on, preoccupied by the COVID years, a cost of living crisis and the sheer pace of life, so that Grenfell has retreated to the back of our consciousness and conscience, yet for the bereaved and survivors, who live with the memory every day, these have been six very long years.

We are told the Public Inquiry will report early in 2024, so there is still more time to wait. Meanwhile, the remains of the creaking tower still stand by the Westway in north Kensington.

Whenever I speak to people about Grenfell, the most common question is ‘what is going to happen to the Tower?’

Yet there is the nagging fear from bereaved families and campaigners that once it is demolished, they, and their loved ones will be forgotten: ‘out of sight, out of mind.’

The Tower left to its own devices would probably have fallen long ago. A damaged building like this gradually degrades over time, with the effects of gravity, weather, water seeping into the cracks which ice up in winter, leading to widening of those cracks, concrete falls and so on. As a result, there are over 4,500 props inserted into the building, keeping the creaking infrastructure standing. A large team monitors the building constantly, and it is relatively secure for the next decade if need be, despite the ongoing cost of the operation. The Tower continues to be covered with two linings of white wrapping plastic – an inner one which remains and an outer one that is replaced every year. Some local people would want to see the building come down as it remains a constant painful memory. Yet there is the nagging fear from bereaved families and campaigners that once it is demolished, they, and their loved ones will be forgotten: ‘out of sight, out of mind.’ The ongoing presence of the building, standing alone by the Westway as a constant reminder to the thousands who travel into London each day, is one of the only ways they have to keep the memory alive.

So, looking into the future, what will the legacy of Grenfell be? Convictions of those found to be culpable may well follow and rightly so, if individuals or companies can be clearly identified as having deliberately acted in underhand ways that led to the installation of the highly flammable cladding, or carelessly caused this disaster.

Some people call Grenfell a crime. Some a tragedy. Perhaps both are right. So what do you do when a crime, or a tragedy occurs? What do we do as a society?

Grenfell was not an accident. As I said in my sermon at the fifth anniversary commemoration in Westminster Abbey a year ago, Grenfell “was not an unfortunate accident – it was the result of careless decisions taken, regulations ignored, an industry that seemed at times more interested in making profits and selling products than in the precious value of human life and keeping people safe in their own homes.” In Christian language, Grenfell was the result of sin.

When you recognise you have sinned, the way to begin to put things right is to repent. ‘Repent’ is a strong word, yet it talks about turning and going in a different direction. You recognise that you have done something wrong and you need to put it right. The last six years have revealed a pattern of cutting corners, deception and lack of care in the regulation of building safety. It has also revealed flaws in our housing stock. The government’s Levelling Up Bill gives some protection to those living in insecure blocks of flats, but does not yet protect innocent leaseholders from all the costs of remedying safety faults for which they were not responsible. Some leaseholders are in the fortunate position of having their developers agreeing to foot the bill to make things safe, but others aren’t, and are still facing high insurance premiums, remediation costs and are still waiting to see who will pay, how much will be covered and when.

The Earl of Lytton’s amendment to the bill offers protection to leaseholders by ensuring those responsible for safety defects at the time of construction pay up, or if the company no longer exists. The costs are covered by an industry levy, of money raised from those who have profited from cutting corners in the past, those on whom the Public Inquiry has shone an uncomfortable light. Passing an amendment such as this, that protects vulnerable leaseholders and places the costs on those responsible for them would be a fitting way to enact repentance, to ensure Grenfell is not repeated.

With a tragedy, however, you remember. The Grenfell Memorial Commission continues to meet and work on this very task. Conversations with the community continue and the desire is for a memorial that is peaceful, reflective, positive and respectful. A design team is to be chosen in the coming 12 months, with a view to a final plan being chosen by the end of 2024. The planning process and the building of whatever form of memorial is chosen will then start in 2025, to be finished some time later.

All this will take time and a further thing required beyond repentance and remembering - patience. A visit to the 9/11 memorial in New York recently reminded me how a memorial can help process and manage the pain of remembered tragedy and trauma. The site is comprehensive, respectful, dignified and unforgettable. The 9/11 memorial opened 10 years after the attacks, and the Museum, offering a detailed moment by moment account of the day and what led up to it, opened in 2014, 13 years after the event.

Remembering and repentance takes time and need to be done well. Repentance needs to be thoroughly thought through and enacted wisely. Remembering needs to emerge from deep reflection on what has happened and finding creative ways to being something positive and even beautiful out of tragedy. Neither need to be hurried, otherwise they will be done in a shoddy and off-hand way, which disrespects the memory of those who died.

For many, Grenfell may have dropped out of public consciousness. Yet societies, like people, are defined by the way they learn from mistakes and tragedies. Comprehensive building safety legislation and a dignified memorial that keeps the memory of Grenfell and those who died there alive for years to come will be the best legacy for Grenfell, even though it will take time. We are not there yet, but that future is worth waiting for.

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.