The significance of legacy and what it can really stir

Concluding an American journey in the footsteps of his hero, Ian Hamlin ponders how legacy arises.

Ian Hamlin

Ian Hamlin has been the minister of a Baptist church since 1994. He previously worked in financial services.

Martin Luther King reaches from the pulpit of a church while he preaches.

MLK preaching at Riverside Church, New York.

The Gotham Center for New York History.

Travelling around recently, considering the impact of the US Civil Rights Movement as part of my sabbatical trip across four States, I’ve been struck by the immediacy of it. It really doesn’t seem very far away, or long ago. Part of that, of course, is its ongoing resonance, but there are also some personal factors. Martin Luther King was just four days younger than my mother, who’s still alive, and I was born in the week leading up to ‘Bloody Sunday’, and the Selma – Montgomery march. Although not strictly true, this feels like a history of my own time.

That sense has, I think, been amplified by some other recent significant dates. Earlier this summer was the sixtieth anniversary of the ‘I Have a Dream’ speech in Washington, the subway in Atlanta is still awash with anniversary posters. Beyond that, of course, just days later, we remembered a similar six decades since the Klu Klux Klan’s bombing of the 16th Street Baptist Church in Birmingham, Alabama, which killed; Addie Mae Collins, Denise McNair, Carole Robertson and Cynthia Wesley, three 14-year-olds, and one 11-year-old girl. A commemorative service was held in the church, just weeks ago.

History had changed, its arc had indeed bent towards justice. Yet such gestures, profound though they may be, rarely tell the whole story.

Less dramatically, yet still poignantly, 2nd November saw the 40th anniversary of Ronald Reagan signing the bill into law, which created Martin Luther King Day as a national holiday in America, on the 3rd Monday of January each year.

Now very much part of the fabric of national life, the holiday represents, as much as anything, the formal adoption of Dr King as a fully-fledged American hero, part of the great story of the Republic, and the ultimate acceptance of this black man by his country.

Symbols like that matter, such a legacy is significant indeed. It was on Martin Luther King Day 2013, that Barak Obama was inaugurated as President of the United States, for the second time, a black man, who spoke, that day, of a dream fulfilled, as he made his oath of office on King’s bible. History had changed, its arc had indeed bent towards justice. Yet such gestures, profound though they may be, rarely tell the whole story.

Should we be satisfied with the unity that comes from an altogether flatter story, even if it tends towards ‘Disneyfication’, or ought we insist upon messy truth... ?

The holiday wasn’t celebrated until January 1986, Reagan himself wasn’t particularly keen on it, it passed only after something of a battle in Congress where, famously, Senator Jesse Helms led a 16-day filibuster, where he claimed King was a subversive radical, dangerous traitor and communist agitator, And, it wasn’t until 2000 that it was acknowledged in all 50 states.

Such details, if known and remembered, serve to confuse the notion of legacy, to muddy the waters and call into question its real heart. Because the easiest histories are the most straightforward, travelling in a straight line from A to B, from problem to solution, tragedy to victory, despair to hope. They mould into the very fabric of the Nation that the key idea, that the good guys won in the end, like they always do, and the Republic sails inexorably on towards even brighter lights to come.

The question of legacy, when it comes to Dr King, as with many others, is vital for sure, but far more complex than that, and contested too. Should we be satisfied with the unity that comes from an altogether flatter story, even if it tends towards ‘Disneyfication’, or ought we insist upon messy truth, with its inherent conflict and challenge, recalled back then, and still present now?

Martin Luther King was far from a hero at the time of his death, quite the contrary, he was well on his way to becoming a pariah. No longer welcome in the Whitehouse, he had fallen foul of Lyndon Johnson over Vietnam, and his consistent enemies in the FBI now seemed to hold sway there. His relative ‘successes’ with the civil rights act of 1964 and the voting rights act of 1965, genuine and monumental as they were, had only served to demonstrate that a lot of the true causes of segregation, north and south, were less amenable to easy legislative removal, and were actually rooted in economics. As he turned his eye increasingly towards housing in particular and poverty in general, as well as what he called ‘the war question’, he largely lost his platform.

On 4th April 1967, at Riverside Church, New York, he gave what many consider to be his greatest and most eloquent speech ever, but few recall it. Distilling his Christian calling, his civil rights history and sense of present-day necessity, ‘the fierce urgency of now’ as he described it, he began by noting, “surely this is the first time in our nation's history that a significant number of its religious leaders have chosen to move beyond the prophesying of smooth patriotism to the high grounds of a firm dissent …” He went on, after giving a detailed dissection of American history and policy in Asia, to declare that “The war in Vietnam is but a symptom of a far deeper malady within the American spirit.” Before continuing to list out what he called ‘a true revolution of values.’ None of this was designed to win him an appreciative audience in an increasingly materialistic America, and it didn’t. King’s approval ratings, according to polls, were firmly in the negative, and falling. The idea then, that someday soon, the whole nation would come together annually to honour him, was laughable.

Just occasionally though, even in the killing, something is stirred that brings out a legacy more powerful than could ever have been imagined, even more so than national commemorative days.

Of course, death changes things, particularly, premature, violent death. It shocks and inevitably provokes both sympathy, and reassessment. It has us wonder, whether we should’ve listened more carefully, when we had the chance. On this site a few days ago, speaking of the current situation in the Middle East, Graham Tomlin longed for leaders of old who were prepared to break the cycle of violence in the name of peace. My mind turned, inevitably, to Martin Luther King, saying that ‘We will meet your physical force with soul force’. Adding, ‘Do what you will, threaten our children, and we will still love you …we will wear you down by our capacity to suffer, in winning the victory we will not only win our freedom, we will so appeal to your heart and your conscience, that we will win you in the process.”

Such talk rarely, gets you national holidays, named in your honour. It more often gets you killed. Just occasionally though, even in the killing, something is stirred that brings out a legacy more powerful than could ever have been imagined, even more so than national commemorative days.

Legacy speaks of the power of passing on, in the words of Jay Z, turned into a popular pin badge, ‘Rosa sat, so Martin could walk, so Barak could run, so we might fly …’ These cascading consequences of commitment, truthfully sketched out here, and which could’ve gone back further, at least to Maisie Till’s courage in sharing the death of her son, which was said to have inspired Rosa Parks. And, certainly they could also be projected forward. To a multitude of actions, large and small, destined to add to that ongoing legacy of justice. These are, in many instances', the continually ‘rolling waters’ of prophetic imagination that King loved to picture.

In his mind, there is no doubt they find their ultimate source and inspiration in a day set aside to remember, not his though, but Easter Day, when resurrection hope forever shook the world. If, on the 3rd Monday of January each year, some thought might be given to that truth, he could be forgiven a quiet, knowing smile.

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.