Article
Comment
Sport
5 min read

What’s Simone Biles doing today?

How to live with winning and losing.

Juila is a writer and social justice advocate. 

A gold medallist bites her medal.
Simone's gold medal moment.
@simonebiles

I wonder about what Simone Biles is doing today. She is one of the many athletes whose Paris 2024 was about more than gold; it was about redemption. Now the Games are over, what happens to their restoration story?  

The narrative about redemption seemed to dominate the headlines and linger in post-event interviews. Some Olympians came to the Games seeking it. Gymnast Rhys McClenaghan was tipped for gold in Tokyo 2020 but stumbled on the pommel horse, finishing in seventh place. In France, he climbed to the top of the podium.  

Others completed a fall and rise within the two weeks themselves. Sprinter Jeremiah Azu had a faltering beginning to the Games, disqualified for a false start in the individual 100m heat. Just six days later he was clutching a bronze medal for the relay.  

Then there are those like taekwondo athlete, Jade Jones, who also laboured for years and gave their all – but didn’t get the payoff that they sought. What does the story mean when it is unfulfilled? And when the Games are over, how do people live with winning and losing?  

Into our messy, maybe frightening, sometimes ordinary, lives, we love a redemption story to brighten and neaten things up. 

After years of professional procrastination, a few months ago I finally took the plunge and joined LinkedIn. An impressive feat, I know. It was driven by practicality; I was finishing a job as a climate policy advocate and making the leap into consultancy. But I’ve been fascinated to discover how people in my community, and millions of others, are sharing tender and vulnerable ideas and thoughts in this social workspace. They are coming with questions – what does success look like? How are you navigating your purpose in the day to day? What world do you want your children to inherit? – and gentle ideas about their answers.  

People are asking about and reflecting on how to navigate winning, and losing, and living in the murky space in between.  

This feels striking because one of the other prevalent stories many of us believe, maybe unconsciously, is that life will generally be good and any setbacks are the exception. Growing up in the Nineties the message seemed to be: the world is your oyster if you work for it. Put in the effort, and the losses will be few and the trajectory will be up.  

But the last few years in particular – economic volatility, growing exposure of deep inequalities, the worsening climate crisis – hammer home that this is not reliably the case. No matter how much effort you put in, we rarely live through one type of season at a time. Joy and suffering co-exist. And amongst the highs and the lows, there is a whole lot of everyday living. Show up at the desk, the school gate, the supermarket.   

Into our messy, maybe frightening, sometimes ordinary, lives, we love a redemption story to brighten and neaten things up.  

The sting of winning or losing is softened when we stop ascribing all meaning to them, and instead cast them in the context of a wider story. 

But part of the problem with many of the redemption tales we share is that they rely on the person themselves to deliver their own restoration. They’ve had (and are perhaps blamed for) a fall from grace, and now it’s up to them to find it within themselves – their physical, mental and emotional capacity – to achieve restoration. That’s a heavy weight to put on anyone’s shoulders (however broad they may be).  

And any redemption gained is fleeting. Medal winners talk about ‘gold medal syndrome’: the post-competition feeling of depression, loneliness and emptiness. For those athletes who’ve now headed home after fulfilling a salvation arc, is the emotional dip going to be even steeper, harder?  

Most of us won’t be Olympians, despite how expertly we discuss the diving scores every four years, but that sense of deflation after achieving a long-sought goal can be resonant. We’ve strived and risked ourselves for something, only to find the aftertaste is a bit flat. That new job is good but flawed. Winning that award doesn’t stop a rejection landing in the inbox the next day. The house renovations are already showing cracks. Winning and losing are both transient. A redemption made ourselves rarely satisfies or lasts. 

The sting of winning or losing is softened when we stop ascribing all meaning to them, and instead cast them in the context of a wider story. One that goes further than a single person or moment – a birth, a podium, a bonus. Such a story can speak beyond our own lives to the core challenges we face in the world: fairness into a broken economic system; peace instead of violence in our communities; flourishing, not escalating environmental crises.   

During my years of climate advocacy, I have sometimes envied colleagues working on more tightly defined topics with the possibility (only fulfilled through huge amounts of wisdom and graft, of course) of winning. Change a law, solve a problem. As the climate gets warmer and more unpredictable, it’s easy to have a sense that, at best, you are just making things a little less bad. The wins are in the context of a lot of disappointments, and a whole lot more grey space in between. 

But by being able to root my day to day in a bigger story, I can move forward with hope. Understanding our lives as part of an even greater narrative – the story of this world that God loves and sustains and restores – saves us from the pressure and heartache of trying to redeem our own lives. Instead, we can live them – the wins, the losses, and all the mundane moments in between – in light of that bigger story.  

Looking at the world through the lens of God’s redemption story helps us to stay clear-sighted: celebrating the successes and not make them our whole world; naming the problems and still acting with hope and grit. 

A redemption arc is a beautiful one. I want to hold onto that longing, but find it in a story that’s deeper, longer and richer than I can see. A story that lasts.  

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.