Public Devotions
Ruairidh MacLennan asks in the age of public gestures, why our own forms seem to recede and part two on our Assisted Dying piece from Francis Edwards. We also look forward to St Mirin and St Ninian.
One of the curiosities of contemporary living is the prevalence of gestures. Signs expressing empathy for one cause or another, or signals denotative of an allegiance to a given set of ideas, are all around us.
Some may immediately call to mind images of athletes or media personalities ‘taking the knee’. Others may think of flags flown from masts or windows around certain times or events of the year. Yet gestures are not limited to large-scale public events. Gestures are found scattered throughout our ordinary routines and often (quite literally) attached to those we encounter.
Lanyards, badges attached to bags and pronouns in e-mail signatures or Twitter bios are all things we might encounter frequently today. All of these displays serve a denotative and descriptive purpose. They denote a fealty to a vocabulary that may well differ from that of the beholder, while attempting to describe the world as it is viewed by the wearer.
There is a hint of the performative to these things, but fundamentally gestures come to embody a narrative. Gestures can tell us which story the actor is playing a part in, though they can often seem to say more about the actor than the story. They tell us much about a person’s perceptions, their persona and that which they wish to impart. We might even attach a religious dimension to gestures…gestures whose presences are increasingly visible and frequent in many parts of society.
What, then, of religion itself? Are religion and faith marooned in a sea of ideologies with each wave coloured differently depending on where it came from? Not necessarily. Rather than being alien to faith, gestures and demonstrative expressions are well-established parts of a religious life. A world of prostrations, hand-gestures and accessories viewed as superfluous by others isn’t at all new to Christianity. It is something best expressed by Christianity itself.
At a time in which novel expressions rapidly become more public and common, gestures denotative of faith in Jesus Christ are paradoxically becoming more private and rarer. As myriad movements are becoming bolder, confident and assertive in the public expressions of their creeds, Christianity’s adherents seem to be becoming more timid in theirs.
Processions, medals, rosaries…these are all features of faith formerly familiar to many. As society devotes more time and effort to a plurality of its own processions and related devotions, might we be well served in recalling our own faith’s public expressions?
At the heart of faith in Jesus Christ is the cross – a scandalous event that puts all things into their proper context. For Christians, the cross is not something to flee from, but something to be embraced. It is something to be carried, to be worn and to be held up before the world. There is perhaps no better nod to this than that most simple of Christian gestures when we make the sign of the cross.
During an Angelus address delivered at Castel Gandolfo in 2005, Pope Benedict XVI described this action thus:
“To make the sign of the cross is to pronounce a visible and public yes to him who died for us and who is risen, to the God who in the humility and weakness of his love is omnipotent, stronger than all the power and intelligence of the world.”
The sign of the cross then, is not a statement we make in order merely to say something about ourselves, or even to express a merely temporal allegiance with a group or message. The sign of the cross speaks not of ourselves, but of God and his sacrifice for us. It denotes gratitude to Him who gave His life so that we may live.
Unlike gestures we often see displayed in our contemporary lives, the sign of the cross is not ultimately about the preferences of the person making it. The sign of the cross is not so much about its performer, but about the great story that gives all people their proper meaning. Ultimately, the gestures and signals of the secular realm are hollow when shown against the light of the cross.
While the sign of the cross is something that denotes Him who is all-seeing, it is itself something that is often rarely seen in the public realm. Nevertheless, the cross is neither something exclusive to one setting or another, nor is it a strictly private motion to be confined to the interiors of church buildings. As society comes to be more expressive in its gestures in support of a multitude of competing causes, is it not time for Christians to take the sign of the cross to all spaces of day-to-day life also?
As a multitude of gesture-based rituals come to normalise themselves in our daily routines, might there be an opportunity for the sign of the cross to be just as if not even more present? Be it before we have meals, or when we pass Our Lord in his churches, the day presents many an opportunity to hold the cross before ourselves and to the world. Perhaps in a world of ultimately empty gestures, it is the sign of the cross that is needed most of all?
Ruairidh MacLennan is a journalist based in Glasgow.
Assisted Dying: A Grave Threat to Scotland
Part Two by Francis Edwards
In the first part of this article I highlighted two key issues that I feel need addressing:
1. The lack of joined up palliative and social care for all that need it, regardless of age, diagnosis or location
2. ‘Soul Pain’ – As one aspect of what we call ‘Total Pain’. Total pain equals total care. Soul pain has nothing to do with somebodies faith or their religions background.
In 2008 the Scottish government launched “Living and Dying Well”, (LDW) which was their strategy and commitment to the implementation of a cohesive, person-centred and sustainable approach to the provision of high quality palliative and end of life care across Scotland; regardless of age, diagnosis or location of care. This distinction was made by the then Health Minister Nicola Sturgeon She made it very clear at the launch of this strategy that it was for everyone in Scotland. It is my understanding that this has not yet been delivered.
In 2015 we argued that this strategy had not had time to be implemented across Scotland, but when it was there should be no need for the MacDonald Bill. It is my understanding that this strategy has still not been fully implemented and this may well be why some people are back seeking a change in the law? It is estimated that one in four people in the UK today are not able to access the palliative and end-of-life services and support they need. MSPs need to do more to improve end-of-life care across Scotland instead of backing the bill. (https://www.politics.co.uk/comment/2021/06/21/inequality-and-discrimination-even-in-death/)
Soul Pain – what is this you ask? As I have said it is part of what we call “Total Pain”.
In an effort to try and make sense of what can make very little sense and how I may start to work with somebody who may find it hard to make sense of what is going on in their bodies, in their lives and on their journey; and more importantly may manifest this pain in a physical way and therefore are given medication as our only response. I have come to see that this ‘pain’ or ‘suffering’ or what I now call ‘soul pain’ needs a different approach. I have come to see that suffering is not a question that demands an answer; it is not a problem that demands a solution; it is a mystery that demands a presence. To be able to be present we need to learn to be able to just sit, to watch, to wait and to wonder what might happen next if we don’t interfere… If we learn to listen
Soul pain is a way into and trying to understand that inner pain and it’s on my ‘check-list’, when I am assessing a patient or their family who are in ‘pain’. It is born out of many years of clinical experience of working with both adults and children in the clinical setting. I have learnt that:
Soul pain is something you come to ‘Feel’, ‘See’, and ‘Sense’ in another and you see it first in their eyes.
We could go into an exploration of words and concepts around soul, pain and suffering, but I don’t have the space here. For now let’s just say that:
“Soul is not a thing, but a quality or a dimension of experiencing life and ourselves. It has to do with depth, value, relatedness, heart, and personal substance. I do not use the word here as an object of religious belief or as something to do with immortality” (Moore 1992, p5 (American psychotherapist).
The key words here are the ones I have highlighted. In short the soul is:
‘The essential part of each of us’
‘The world within’
‘The world we ignore at our peril’
22 years ago Michael Kearney defined soul pain for us in his powerful book ‘Mortally Wounded’. He said:
“Soul pain is the experience of an individual who has become disconnected and alienated from the deepest and most fundamental aspects of him or herself” (Kearney 1996, page 60).
Again the key words here are, “disconnected”, “alienated” and “fundamental aspects”. It is in these words that some of the symptomatology of soul pain may be found.
“Soul pain is a deep homesickness having little to do with physical location and everything to do with our longing for the embrace of those who share life with us and our yearning to feel at home in the world.”
(ATTIG, T. 1996, page 21)
Soul pain is a pain no nurse or doctor can treat or cure with medication from the Control Drug cupboard. Unfortunately this is usually the only thing that is offered. This only sedates and does not allow for the story to be told or the work somebody may have to do before they die. Good palliative care allows this to happen if the patient wants to fully engage with it. Sadly not everyone does and we read their stories by those who support AD on Twitter
On a personal note my main concern in this debate is around asking health care professionals to be involved in the process and the "moral injury” that it can cause them and them close to them e.g. their family. It is not only about the person requesting AD. You will need two doctors to make the assessment and in some case you may also need a psychiatrist if mental capacity is an issue. You need a doctor to prescribe a lethal does of medication, a pharmacist to dispense it and a nurse or doctor to administer the medication.
All these professionals are trained to ‘do no harm’. In the 2015 Bill it stated that a facilitator, or “friend at the end”, should have no prior relationship with the patient and is given the task of collecting the prescription and agreeing the process of assisted dying. Where are these ‘facilitators going to be found and how are they going to be regulated and supported?
This Bill will put an obligation on NHS staff and those working in Hospice to provide access to AD.
In conclusion we do assist and accompany people while they are dying and we call it palliative and end-of-life-care (EOLC) and not assisted dying. We don't train or ask our professionals to kill patients who are suffering. We owe them a duty of care as well and not cause them any moral injury that may well stay with them for the rest of their lives. “Do no harm”. This Bill is crossing the Rubicon for a profession entrusted to always act in the best interests of the patient and “to first do no harm”.
Michael Veitch, parliamentary officer at Care for Scotland in 2015 said:
"This law will not just affect the small number of individuals who might choose to access assisted suicide... It will affect every person living with a terminal illness, fundamentally alter the doctor-patient relationship and devalue disabled people's lives..."
This Bill risks sending a clear message that certain lives are no longer worth living regardless of some of the safeguards the Bill may include. We have already seen incremental extensions to the criteria for inclusion in Canada, Oregon, Belgium and the Netherlands. They have all expanded their criteria for assisted dying. Can we be sure that this will not happen in Scotland or even the UK? It is what is referred to as the “slippery slope argument” If legalised; AD should be separated from mainstream health care.
In short, there are more ethical ways to help patients at the end of their life than prescribing them a lethal does of medication, prescribed on the NHS and administered by a member of its staff? To be very clear we should all advocate and support fully funded palliative and EOLC for everyone regardless of age, location and diagnosis. If LDW had been fully implement by MSPs we would not be having this debate again in Scotland about AD.
Two key concepts:
Palliative Care is a philosophy of care and not a location of care e.g. care can be deliver wherever the patient is located.
Hospice comes from the monastic tradition of offering hospitality to sick pilgrims on a journey. They were places of rest and refreshment for sick pilgrims on a journey, usually on their way to the Holy Land. The modern day hospice movement have adopted this concept. So hospices are places of rest and refreshment for sick pilgrims on a journey.
Francis Edwards is a retired Lead Pallative Care Nurse and advocate for excellent end of life care.
To Read Part 1 of this piece again click here.
Over the next two weeks we have some important Scottish Saints to remember; Saint Mirin and Saint Ninian. Below are two videos, one by St Mirin TV starring Bishop John Keenan and the other by our friend John Woodside.
St Mirin, Feast Day 15th September, 6th Century.
St Ninian, Feast Day 16th September, 5th Century
John Woodside talks about the Father of Scottish missions.
God Bless from Eric and the Team