The moral sugar high of the protest vote

We shouldn’t give politicians bloody noses over insurmountable single issues.

Yaroslav Walker

Yaroslav is Vicar of Christ Church, Hampstead.

A winning candidate at an election address the audience from a lectern while the loosing candidates look on

The victorious candidate at the Rochdale by-election.

A cat was elected as a Member of Parliament. A cat. George Galloway - former Labour party MP and Rula Lenska’s former cat - has been elected as Member of Parliament for Rochdale. The unique circumstances of the by-election make this a less surprising result than one might think. The Labour Party disowned their candidate, the Tory Party hardly contested the seat, and the sheer number of inappropriate independents meant that a split-vote victory for Galloway was entirely foreseeable. One must also note Galloway’s many skills: as a campaigner, an orator, and a dirty-tactic by-election gadfly.

So…Rula Lenska’s cat did the unimaginable and won a seat in Parliament. How did the cat do this? He convinced people that they could vote for him to protest the current Parliamentary position on the Israel-Gaza War. In his victory speech, Galloway gave an ominous warning: “Keir Starmer…this is for Gaza.” He went on to intimate that his victory was due to the high proportion of Muslim voters in Rochdale; their disgust at the Labour Party’s response to the Israeli invasion of Gaza morphing into a wish to give Keir Starmer (‘one cheek of the same backside’ - Rishi Sunak being the other cheek) a bloody-nose. He warned that Starmer “…will pay a high price for…enabling, encouraging, and covering for the catastrophe presently going on in occupied Palestine, in the Gaza strip.”

My fellow voters are intelligent enough to recognise that the single addition of George Galloway to the green benches will do almost nothing to affect change. They have voted so, the general consensus goes, simply to register their fury at the plight of ‘fellow Muslims’. I simply want to respond with a question. Is this moral?

People vote for all sorts of reasons. If we believe political scientists and pollsters, voters might care about many things, but will end up voting on the basis of one thing. Normally the economy. One’s own economic interest is a perfectly rational reason to vote for one party’s promises than another. There is a potential immediate impact on our lives and those of our family and friends. But Gaza?

Sociologists have spilt a tremendous amount of ink describing how human communities tend towards ‘tribal’ affection. We tend to feel more connected to those who are like us - in terms of geographic location, in terms of obvious racial characteristics, in terms of language and culture, of course religion. The notion that the Gazan War is a war on Muslims would be a natural driver for the Muslim community of Rochdale to vote ‘for’ their fellow Muslims.

On the other hand, in the world of modern ethics there has been a move to recognise that such tribal allegiance is ultimately meaningless - a call to see all human beings as equally worthy of our care and attention, especially irrespective of geography. Peter Singer famously presented the thought experiment of a drowning child - if we are willing to get our shoes wet and muddy to save a drowning child we walk by a shallow pond, why aren’t we willing to give up some of our wealth to alleviate the war-stricken poverty of a Gazan child many miles away?

The people of Rochdale must vote as their conscience requires. I simply worry that their conscience has taken on an impossible burden of care that they will struggle to sustain.

The words of Jesus seem to support such an ethic, which is always global in its vision. We are not only to love our neighbour as ourselves, we are to go out into all the world, evangelising the nations. From its beginning the Christian faith has preached that loving our neighbour means loving everyone. Everyone is a beloved child of God. Everyone is our neighbour. Surely a vote for Galloway, a vote of rage against the occupation of Gaza, is fundamentally moral - either on grounds of tribe, or rejection of tribe. Surely its Christian!

I’m not so sure.

I’m not so sure we fallen humans actually have the capacity to ‘care’ about the horrors that go on many, many miles away. Jesus tells us to love our neighbour as ourselves, but we barely have the emotional energy to love ourselves. We live in a society of such activity and distraction - with a seemingly concomitant rise in the incidence of hopelessness and depression - that I don’t think we can really give our moral and emotional energy to an event as distant and overwhelming as the plight of Gazan civilians. We can barely give it to our families. We can barely give it to ourselves. C S Lewis once wrote that the best way of eradicating suffering was people working away quietly at limited objectives: “I think the art of life consists in tackling each immediate evil as well as we can.”

Jesus was the ultimate localist - God became incarnate as a unique individual, of a particular tribe, of a particular nation, in a particular time and place. Jesus taught an ethic of universal love and dignity and respect, but lived out in specific acts of service. He didn’t wash the feet of all Jerusalem - just his disciples. He didn’t heal all disease everywhere and forever - but he did restore sight to the few blind people he met. St Paul wrote individual letters to individual communities. Yes, he asked them to pray for him and each other, but otherwise told them to focus on their immediate needs and charity and holiness. The popularity of Jordan Peterson is largely based on the achievability of his slightly nebulous self-help worldview: make YOUR bed, keep YOUR back straight, look after YOUR family. Improve yourself first if you want to even begin improving the world. You’ll probably never manage to improve more than your village…maybe only your own household. That might be enough.

I don’t judge those who voted for Galloway as a Gaza-conflict protest. A new campaign, ‘The Muslim Vote’, has emerged to persuade Muslim voters to lend their support to candidates who commit to ‘Peace in Palestine’ – ceasefire, sanction Israel, and a state for the Palestinians. It is becoming clear that what appears to have happened in Rochdale may well happen in constituencies up and down the country. The idea of the ‘Muslim vote’, which Galloway was able to turn into electoral victory, is being given form and force. It is emotive and persuasive, and may well convince people who have no link to Gaza other than their Muslim faith. It is entirely possible that some of the voters have family and friends trapped in the siege. I empathise with their vote and weep for their sorrow.

I don’t judge those who voted for Galloway as a Gaza-conflict protest. I do, however, worry that many have taken upon themselves a fundamentally unwieldy ethic. Galloway is not a one-man parliamentary wrecking ball - whatever he says. The position of the Government will not be changed by his election. The resolve of the Israeli military is unlikely to be dinted by the UK Government, no matter what resolutions the House of Commons passes. The people of Rochdale must vote as their conscience requires. I simply worry that their conscience has taken on an impossible burden of care that they will struggle to sustain. Perhaps they would be more fulfilled and more effective if they cast their vote on the basis of what could be achieved for them in their community, in the immediate future.

We must pray for the people of Gaza, and we must not cease praying; but I would suggest that we must vote in the interests of the people of our own place, our own constituency. Giving the Labour Party a bloody nose over Gaza might be an immediate moral-sugar-high. Electing an MP who will actually work for the needs of the community in their particularity will certainly be less instantaneously thrilling - but maybe it is more moral.

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.