Article

Character

Comment

Politics

9 July 2024

6 min read

Why the Prime Minister should swear this new oath

A proposed new constitutional instrument is a hopeful recognition of the human condition.

Yaroslav Walker

Yaroslav is Vicar of Christ Church, Hampstead.

Keir Starmer stands in the House of Commons and recites an oath from a card held up in front of him.

Starmer swears allegiance to King Charles III, September 2022.

Thank the Almighty, the General Election is over! We have a Prime Minister. We have another cadre of MPs, some old hands and many Young Turks, all ready for the excitement of Parliamentary procedural intrigue and (hopefully) hungry to exercise their power for the betterment of their constituents. As a nation, we can all breathe a sigh of relief. We have emerged, blinking, into the sunlight of what I can only hope is five years of a milder political climate.

What happens next?

Well, today, every MP, new or old, will swear the Oath of Allegiance to King Charles III. This is not optional. Anyone refusing to do so cannot exercise their rights as an MP and will not receive their salary. Ultimately, the refuseniks can have the reality of their election voided. The wording of the oath excels in comprehensive brevity:

I swear by Almighty God that I will be faithful and bear true allegiance to His Majesty King Charles, his heirs and successors, according to law. So help me God.

The Monarch is anointed as the protector of the realm, always seeking what is best for Great Britain, and so to swear an oath to be faithful to the Monarch is to swear to seek the best for their realm. It is all perfectly simple and logical.

But is it enough?

It would seem that swearing fealty to the Crown is no longer enough. Now the PM must specifically swear not to lie to the Sovereign and the nation.

Some would argue not. Our political life has been marked by controversy for as long as I have been old enough to be politically aware. MPs expenses, the coalition Government, the Brexit referendum, parliamentary gridlock, Downing Street lockdown parties…Liz Truss! It’s all been like a circus, except all the animals are dead, the clowns just sit around screaming and crying, and the tent burns down. Trust in our political establishment could hardly be lower. Perhaps in light of this, a couple of constitutional scholars have mooted the idea of an extra oath - one for the Prime Minister.

Professor Andrew Blick, of King’s College, London, and Baron Hennessy of Nympsfield have written an open letter, on behalf of The Constitution Society, inviting the new Prime Minister to swear an additional oath specifically for their office.

The oath is intended to act as a confidence booster - an extra promise that the most powerful MP in the land will abide by the conventions of our constitution: Cabinet Government, The Ministerial Code, Civil Service Impartiality, etc. In an effort to restrain the darker impulses of the PM, the oath would also mean swearing to uphold the seven Nolan Principles: Selflessness, Integrity, Objectivity, Accountability, Openness, Honesty, Leadership. It would seem that swearing fealty to the Crown is no longer enough. Now the PM must specifically swear not to lie to the Sovereign and the nation.

In a moment of unattractive despair, I can’t help but let out a depressed sigh.

Yet, I also have hope. This new constitutional instrument would, on the surface, be a morose admission of defeat. We can no longer assume honesty in those who wield the most power and influence. Look deeper and you see a fascinating, and hopeful, recognition of the political (and human!) condition.

The very act of swearing an oath is itself a virtue. It is an act that puts one face to face with absolute truth, goodness, and beauty.

I find this new oath fascinating, and rather cheering, in spite of all my previous electoral gloom, because it clearly speaks to the human need for the transcendent and the eternal. So often our politics seems to be mired in the drudgery of the immediate: will the economy grow in the next quarter, will NHS waiting lists diminish by the end of the calendar year, will the crime stats be favourable any time soon. We rarely hear of any ‘vision’ for our country the looks to the horizon - not even the decade, let alone the voyage into the forever. Yet this oath does just that!

It does so in two ways.

Firstly, by seeking to enshrine the Nolan principles, it recognises the distinction between ‘values’ and ‘virtues’. Values have the veneer of the absolute but are far too easily jettisoned when necessity dictates. Commitment to a value is good, but is in constant competition with other values: openness battles the need for state-secrecy, honesty’s sword is often broken in the face of obfuscation’s onslaught, etc. The holding of values is a static thing, which can wilt and die in the burning heat of reality. A virtue, on the other hand, is something which must be constantly practiced and nurtured. A virtue always looks to its ideal form - a universal perfection of honesty or selflessness. Swearing an oath to uphold the Nolan Principles means committing to operating by them every day, and so allowing them to grow in the individual, becoming easier and easier to live by until the practitioner of virtue struggles NOT to operate in their eternal light.

Secondly, the very act of swearing an oath is itself a virtue. It is an act that puts one face to face with absolute truth, goodness, and beauty. The act of making an oath recognises that our lives and deeds are not simply contingent moments in the pitiless march of time, but that they resound in the halls of eternity.

I think this is why Jesus warns people against swearing oaths in the fifth chapter of the Gospel according to Matthew. When reading this warning in the light of the serious, radical, and even hyperbolic speech that comes before, it is clear that Jesus doesn’t want us to avoid making promises, but that he realises just how bad we are at keeping them. Swearing an oath (invoking eternity, the absolute, the divine!) means that when we break our oaths we diminish ourselves in the face of God.

“Let your word be ‘Yes, Yes’ or ‘No, No’; anything more than this comes from the evil one.”

This is not a command to avoid promises and promise keeping, but a radical call to live one’s life always in the light of eternity, so that even the simple ‘yes’ is the truest oath one can make.

We need leaders - political and otherwise - who can offer the human soul something more than simply an uninspiring roadmap for five years of moderate economic improvement. We need leaders who can inspire the nation with a vision of eternity. We need leaders who point us to that horizon of the absolute where we do not see individual good acts warring against the forces of apathy and indifference, but see the Good itself illuminating our every moment with hope and joy.

Perhaps an oath - an admission that there is meaning beyond our momentary finitude - is the best way to inject a bit more universality and meaning into a political system that has left this author feeling quite so cold so far.

I shall pray for our new Prime Minister, and for all our new MPs. I shall hold them before the face of God who is beyond all immediate concerns and pray that they may have the vision of our eternal destiny ever in their minds and in their hearts. I shall earnestly intercede that they recognise that their oaths are not simply a formula of words, but a positive spur to lead us into a future that never ceases to grown brighter and brighter with the light of our eternal destiny.

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.