Article
Comment
Freedom of Belief
6 min read

The month of May(hem) in Manipur

On the 27th May, Archbishop Justin Welby tweeted about the violence unfolding in Manipur. Belle Tindall re-winds the clock to May 3rd and tracks the events that led to his tweet.

Belle is the staff writer at Seen & Unseen and co-host of its Re-enchanting podcast.

A church interior glowing red as parts of its furniture burn. A man walks down the aisel
A video still of a church interior on fire, during violent clashes in Manipur, India.
Open Doors.

 

A note to our readers: this article includes reports that some readers may find particularly distressing. 

On 27th May, the Archbishop of Canterbury, Justin Welby, tweeted about his concern at what has been, and still is, unfolding in Manipur in India. He wrote, 

‘I’ve been distressed to hear about the attacks on the indigenous tribal Christians of Manipur, India, and of the churches that have been destroyed in recent weeks. 

Kailean Khongsai is training for ordination to the priesthood in the Church of England, and is from Manipur. I join him in praying regional authorities would protect all minority groups, including Christians and their places of worship, and that justice and peace would prevail.’ 

In doing so, Archbishop Justin pointed the world in the direction of those who are facing extreme pressure, discrimination, and violence in their home of Manipur. Therefore, allow me to paint a fuller picture of what has been happening (largely unnoticed) for weeks now – let’s rewind to May 3rd.  

May 3rd  

On the streets of Manipur, a state in the northeast of India, indigenous communities protested the (apparent) impending accreditation of Scheduled Tribe status to the Meiti community. Let me provide some context as to why this would be a development to protest about.  

Manipur is a self-governed state. A state that is home to the Meiti community, who make up around 53 per cent of the population, and other indigenous communities – the largest of which are the Kuki community, to the south, and the Naga community to the north. There is, and has long been, friction between these neighbouring people groups. The Kuki and Naga communities, being minority groups, have Scheduled Tribal status, thus ensuring that they have a right to protection (particularly regarding the reservations they call home) and representation. The Meiti people, being the state’s majority demographic, do not have such a status… yet.  

Despite their legal protection, the Kuki people, in particular, have already faced ongoing evictions from their homes in the hill regions that they have inhabited for hundreds of years. Their expectation is that this is only the beginning. The fear is that, if the Meiti people were to be granted a similar Tribe status, it would result in the Kuki people further losing the right to keep and protect their spaces in both the hills and the forests. It would also pave the way for the Meiti people to assert more societal dominance, as they would be entitled to increased governmental representation; the imbalance would no longer be countered. 

 And so, on May 3rd, people from both the Kuki and Naga communities took to the streets and marched for ‘tribal solidarity’.  

Within a matter of hours, a peaceful protest was transformed into riotous violence as the people marching were met with a wall of resistance. Since that Wednesday afternoon, whole villages have been burnt down, around 15,000 people have been made homeless, hundreds have been injured, the price of essentials has risen to unprecedented levels, schools and public facilities have been closed, internet has been suspended, and although numbers are proving a challenge to confirm, it is thought that anywhere between thirty to seventy people have been killed. Some media outlets are perceiving this violence as the rumblings of an impending civil war; while the Kuki and Naga communities are placing the entirety of the blame upon the Meiti people, The Meiti community are directing all blame toward the tribal communities. And the violence continues to rage on.     

May 4th 

Recent footage has emerged of a particularly heinous incident taking place on 4th May, one that has re-caught the world's attention and thus prompted Prime Minister Narendra Modi to break his silence, declaring that the attack has 'shamed India'. 

Two women, both of whom belonging to the Kuki community, were taken from a police van, stripped, publicly paraded and sexually assaulted in broad daylight. Two men, the younger woman's brother and father, were killed while trying to protect them. It is now being reported that this attack was carried out by armed Meiti men, none of which were arrested until astonishingly recently, more than two months after the attack took place. 

Manipur is imploding, and the violent ramifications are devastating.

But there is just one more piece of context that undergirds the Archbishop’s tweet, one more thing to note about the societal dynamics at play in Manipur: while the Meiti community are a majority Hindu people group, the various indigenous groups are almost entirely Christian. As such, Open Doors have reported that the women who were subjected to to the afore-mentioned attack were Christian women.   

A complex ethno-religious conflict  

The goings-on in Manipur are anything but simple; and so, it is not my intention to reduce the geographic, political, and historic complexities of this conflict, nor to wholly define it as a war between religions. Following Archbishop Justin’s lead, it is with particular caution that I speak of violence being inflicted particularly on Christians in Manipur, acknowledging that it is not the only identity marker that is proving to be targetable.  

Nevertheless, it is being widely reported that Christians are being singled out; their Christianity used as a target to aim at, their identity wielded as a weapon against them. Whether it be as the means or the end, as the goal or merely the tactic: it is happening.  

 According to further Open Doors’ reports, derived from their partners in Manipur, around three hundred churches have been burnt down thus far, one of which still had people in it when it was set alight. A further one hundred public Christian buildings have been destroyed, while one thousand homes which were owned/inhabited by Christian people were ruined, while neighbouring properties remained untouched.  

And it isn’t only the Kuki Christians who are facing such discrimination, the (very few) Meiti Christians are also facing particular difficulties as a result of their unusual ethno-religious identity. Noticing this, one Indian news publication is reporting that from the perspective of the Meiti Hindus, Meiti Christians are somewhat of an oxymoron, personified. It is believed that to be Christian is to have converted to a tribal way of living (assimilating the Kuki and Naga people), and therefore comes with assumptions of deep betrayal. And yet, the publication also observes that ‘if their [Christian] faith is making them feel insecure in the valley, it has not come to their rescue in the hills either. The Kukis have made no distinction between them and other Meiteis’. They are, subsequently, a community that are ‘sandwiched’ in conflict.  

While the conflict is undoubtedly spilling over ethnic and religious lines, Manipur has just become one of the most dangerous places on earth to be a Christian. In yet another part of the world, it is now a hazardous faith.  

And so, back to Archbishop Justin’s tweet.  

The need to be seen  

One only needs to spend thirty or so seconds tracking the comments generated by this particular tweet to get a sense of how powerful it is to be seen. To be noticed when in distress, to be acknowledged when in chaos, to be advocated for when in danger.  

In many ways, social media is a genie that we wish we were able to squeeze back into the bottle. And as justified as such feelings often are, in this case, as in many others in our recent history, it has proved to be a way in which our eyes are opened to what is happening in the most remote corners of our world. Archbishop Justin has publically called for protection, justice, and peace, and in doing so, has made it difficult for the conflict to continue to rumble on unnoticed.  

It is now on all of us to refuse to look away. The people of Manipur, Christian and otherwise, need us to continue to look in their direction. 

 

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.