(Photo: Undertakers remove body of an assisted suicide from Dignitas office in Zurich, 20 Jan 2003/Sebastian Derungs)

Switzerland is looking to change the law on assisted suicide to make sure it is only used as a last resort by the terminally ill.  “We have no interest, as a country, in being attractive for suicide tourism,” Justice Minister Eveline Widmer-Schlumpf told a news conference in the capital Berne.

A rise in the number of foreigners seeking to end their lives in Switzerland, and a study last year showing that more and more people seeking assisted suicides in the country do not suffer from a terminal illness, have provoked heated debate.

The cabinet — which is divided on the emotive issue — sent two proposals into the legislative process for consultation, which will last until March 1: one for tighter regulation and the other for an outright ban.

Switzerland’s two main right-to-die groups, Exit and Dignitas, both said they opposed the government proposals and would seek a referendum on the topic if needed.

Read the full story here.

What do you think? Should assisted suicide be liberalised, restricted or banned altogether?

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Muslims who commit adultery in Indonesia’s Aceh province may be stoned to death under a controversial new sharia law passed by the local parliament on Monday.  Aceh is the only province in predominantly Muslim Indonesia to use sharia for its legal code, introduced as part of an autonomy deal in 2002.

The “qanun jinayat”, or sharia law for crimes, covers adultery, consumption of alcohol, rape and homosexuality, according to the draft seen by Reuters. Adultery is punishable by stoning to death, while other punishments include caning, gold fines and imprisonment.

The new law could come into force as soon as next month. See the full story here.

(Photo: Baiturrahman Mosque in Banda Aceh, 15 April 2005/Tarmizy Harva)

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Far from the spotlight of peace talks and military conflicts, Israel is facing a different kind of land crisis: it is running out of space to bury its dead. Most Jewish cemeteries in major cities like Tel Aviv, Jerusalem and Haifa, are filled beyond maximum capacity. Gravestones are packed together leaving little room for mourners to gather.

You can read about a new system of multi-tiered burial chambers being used in the Jewish state to solve the issue of land. It's actually an ancient system, used thousands of years ago by Jewish sages, that was modernised by two Israeli architects and given approval by the country's chief rabbis.

Ancient Sanhedrin tombs and their modern-day revival

Adding to the problem of dwindling burial space for Israelis, each year about 1,500 Jews from around the world choose the Holy Land for their final resting place. For some, the choice could come from the allure of being buried in the Jewish state. For others, it stems from the Bible. And you can always find some group that offers to help make it happen.

Israel's Chief Rabbi Yona Metzger said in an interview with Reuters that it is written in the Talmud -- a collection of ancient Rabbinic texts -- that "the earth of the Holy Land cancels all the sins of the person who passed away so he can go directly to heaven and paradise without sin".

One of the most sought after -- and expensive -- cemeteries is Jerusalem's Mount of Olives, just outside the Old City walls. Many Jews pay thousands of dollars to be buried at the Mount of Olives because the Bibilical Prophet Zecharia said that the Messiah, upon arriving in Jerusalem, will first ressurect those buried there.

One of the many rumours that swirled around Michael Jackson in the final years of his life was that he had secretly converted to Islam and taken the name Mikaeel. The “King of Pop” does not seem to have spoken about this publicly himself, and that scene in Bahrain when he went shopping badly disguised in an Arab woman’s abaya could be put down to his well-known penchant for dressing up. So unless there is some statement in his will or documentary evidence in his estate, his funeral expected this week may be the last time to test whether this rumour has any basis in fact.

(Photo: Veiled Jackson greets security guard as he enters shopping mall in Manama, Bahrain with veiled child, 25 Jan 2006/Hamad Mohammed)

The Jacksons are Jehovah’s Witnesses and could be expected to bury Michael in the tradition of that faith. When he announced the death, his brother Jermaine — a Muslim — ended with the words: “May Allah be with you, Michael, always.” Jermaine said in 2007 he was trying to convince Michael to convert.

The post-mortem period hasn’t looked very Muslim so far. Traditions vary, but in Islamic funeral practices in general, autopsies and cremation are out and the body should be buried quickly, usually in a day or two. Jackson is reported to have asked for cremation in his will and his family has asked for a second autopsy after the first one failed to pinpoint the cause of death without long toxicology tests.

Jehovah’s Witnesses prefer short and simple funerals, usually with a Scripture reading, and warn adherents against funerals with emotional outbursts ranging “from frantic wailing and shouting in the presence of the corpse to joyous festivities after the burial. Unrestrained feasting, drunkenness, and dancing to loud music often characterize such funeral celebrations.”

The focal point of an Islamic funeral is the funeral prayer called the salat al-janazah. An imam facing Mecca leads the faithful in saying the prayer, punctuated by declarations of Allahu Akbar. The corpse of the deceased is placed perpendicular to the qibla, the direction of Mecca in which all worshippers are standing, rather than in the same direction as the faithful as usual in a Christian funeral.

The funeral service could be in the Jehovah’s Witness style, it could be Islamic or it could be a mix of the two (maybe even with borrowings from other traditions as well). If Michael Jackson’s artistic career is anything to go by, the third option wouldn’t be a surprise at all.

It’s not every day that the Vatican newspaper suggests that a man accused of paedophilia and said to have converted to Islam might be immortal. But that’s what L’Osservatore Romano did today. In a tribute to Michael Jackson — itself another sign of the “new look” that editor-in-chief Giovanni Maria Vian has given it — the paper included him in a pop music heaven at an unusually earthly location:

“But will he really be dead? It wouldn’t be surprising if, in a few years, he was spotted in a gas station in Memphis, perhaps with his former father-in-law Elvis Presley, another of those myths - like Janis Joplin, Jim Morrison, Jimi Hendrix or John Lennon - that never die in the imagination of their fans. And Michael Jackson, who died yesterday at the age of fifty, is definitely a pop music legend.”

The tribute reviews Jackson’s career, from the time “when he was still black” through his “humanly difficult … crossover” to “new genres not entirely attributable to any specific area, where one cannot distinguish between black and white.” It praises his mega-album Thriller “which is known also to those who do not frequent these musical worlds” and calls him a “great dancer” (grande ballerino).

The article ends on the delicate issue of accusations of paedophilia, a cloud that hung over Jackson’s later years and has dogged the Catholic Church as well. The singer hit his artistic peak with Thriller, it said, but always stayed enormously popular. “Not always, unfortunately, for artistic reasons,” it wrote. “His judicial ups and downs following allegations of paedophilia are well known. But no charge, even as bad and shameful, was sufficient to diminish his legend among the millions of fans around the world. The proof of the emotional reactions aroused by the news of his death. News many don’t believe. Maybe someone in Memphis has already seen him.”

(Photo: Michael Jackson in Munich, 9 June 1999/Michael Kappeler)

Flu fears are already changing the face of some religious services, from Mexico where church gatherings are discouraged to the United States where wine shared from a common cup has been suspended in some parishes. We’ve already blogged about this but offer more detail from other places here.

U.S. Catholic bishops have issued general guidelines saying clergy and lay ministers who distribute communion wafers “should be encouraged to wash their hands before Mass begins,  or even to use an alcohol based anti-bacterial solution before and after distributing Holy Communion.”

“They should instruct people who feel ill not to receive from the cup,” containing wine which Catholics believe becomes the blood of Jesus Christ during Mass.

And while the bishops’ Committee on divine Worship said it does not see the need for widespread changes in liturgy, some churches have already made then.

In Texas where border communities have been hit by flu cases Bishop Raymundo Pena of the Diocese of Brownsville has asked priests to offer only bread to communicants, give communion in the hand and not on the tongue and ask parishioners not to hold hands during recitation of the Lord’s Prayer or to shake hands at the sign of peace during Mass.

“They may bow to their neighbor or place their hands on each other’s shoulders,” he suggested in a memo.

The archbishop of San Antonio, Jose Gomez, made a similar request of his flock.

The Archdiocee of New York says it has asked pastors to tell those worried about shaking hands during Mass that “there are other ways to offer the sign of peace, including a wave, a nod of the head or some other gesture. Handshakes are not mandated.”

The Archdiocese of Chicago  has told pastors who minister to its the 2.3 million Catholics that they may caution church-goers about drinking wine from the cup or shaking hands during mass if they think it is appropriate.

My colleague Ed Stoddard in Dallas reports that the Southern Baptist of Texas Convention, part of the largest U.S. Protestant church, had checked with several congregations in Fort Worth and Houston and none was cancelling Sunday services though they will if local authorities ask them to do so.

But it is a differnt scene in Mexico where the new strain of flu first appeared, as correspondent Michael Scott O’Boyle reports:

“Sunday Masses in Mexico City and the densely populated surrounding valley have been suspended, with a rare simulcast of Mass from the Basicilica de Guadalupe by the two national TV channels. Sparsely attended daily Masses have still been allowed  in the capital, and churches remain open to the public.

“On a national level bishops are asking that priests distribute communion by hand and congregations pass on the peace offering, but Masses are not being unifromly suspended — only in certain communities where there have been signs of the outbreak, said Fr. Jesus Aguilar from the Mexico City archdiocese.

“A huge national youth conference this weekend, aimed at fanning anti-abortion movements as certain areas of the country move to legalize abortions … had to be cancelled. Even Mexico’s cult of Saint Death is heeding the government calls, cancelling its celebrations that take place on the first of every month before street altars reared to the skeletal saint, the most famous of which is off the Tepito district, the capital’s biggest black market den.”

(Photo:A man wears a surgical mask as he prays at the Metropolitan Cathedral in Mexico City. REUTERS/Jorge Dan, April 28, 2009, MEXICO)

If you go by what’s reported in the media (including by us), you’d think cemetery desecrations in France like the big one last weekend happen occasionally and target mostly Jewish and Muslim graves. Those are the cases the police report and we write about. A report by two parliamentary deputies, however, has taken an overall look at the problem nationwide and come up with some unexpected conclusions.

First, there are far more cemetery desecrations than we knew about. They happen on an average of every two to three days!  There were 144 last year and 110 up until Sept. 1 this year. And most of them target Christian — which in France would mean overwhelmingly Catholic — graves. Most desecrations are vandalism by teenagers, with only a small minority prompted by the racism, anti-Semitism or satanic cult practices normally highlighted in the media, the report said. The news story on this by our parliamentary correspondent Emile Picy is here.

(Photo: Police inspect desecrated graves in France, 8 Dec 2008/Pascal Rossignol)

The report is not aimed at playing down the gravity of attacks on Muslim and Jewish graves, but rather to get an overall idea of the problem in order to suggest possible remedies. It lists some obvious ideas like better surveillance of cemeteries and better use of existing punishment. What I found the most interesting was their discussion of the waning respect for the dead. The title of the report highlights this — “Du respect des morts à la mort du respect?” (”From respect for the dead to the death of respect?”)

“The place that death occupies in our society is ambiguous and has evolved a lot in less than a generation,” it said. “Death is omnipresent in films, video games, film clips and music. It is often staged in a violent way, with many effects that seems realistic, all the while being more and more ‘virtual’ for many young people. At the same time, the end of life — 516,000 people died in France in 2007 — is often a reality that is hidden and kept at a distance … the increase in cremation also helps to keep death at more of a distance … the relationship that young people have with death and graves has necessarily changed. Distancing death from life can cause indifference and eventually a loss of sense and respect. What is not known or put aside can progressively lose its sacred dimension.”

The report suggests that schools teach more about the death rituals of different cultures to inculcate more respect for the dead in young people. Police — but apparently not pupils — might also learn more about “religion in its cultural dimension” to understand the phenomenon better. This being an official report in France, it could not find fault with the official policy of laïcité, which is more aggressively secularist than just a policy of separation of church and state. But it’s hard not to sense a touch of nostalgia in it for an earlier French society that had more respect for its dead and (but don’t say this in public!) for religion.

(Photo: Desecrated Jewish graves in France, 31 Oct 2004/Vincent Kessler)

The full report is only in French and not yet posted on a website. We’ll link to it once it appears.

Vatican officials seldom single out political leaders who differ with the Church on issues like abortion rights or embryonic stem cell research. But now that the Vatican’s highest court is led by an American, the former St. Louis Archbishop Raymond Burke, we can expect things to get more explicit in Vatican City — at least when when it comes to U.S. politics.

Burke, who was named prefect of the Vatican’s Supreme Court of the Apostolic Signature in June, told the Italian Catholic newspaper Avvenire that the U.S. Democratic Party risked “transforming itself definitively into a party of death for its decisions on bioethical issues.” He then attacked two of the party’s most high profile Catholics — vice presidential candidate Joe Biden and House Speaker Nancy Pelosi — for misrepresenting Church teaching on abortion.

He said Biden and Pelosi, “while presenting themselves as good Catholics, have presented Church doctrine on abortion in a false and tendentious way.”

Pelosi drew U.S. bishops’ scorn for saying in a television interview last month that the Church itself had long debated when human life begins. Biden is a practicing Catholic who also supports abortion rights and analysts have said he could help woo wavering Catholics into Obama’s fold. Both argue that they cannot impose their religious views on others.

Burke said pro-life Democrats were “rare” and that it saddened him that the party that helped “our immigrant parents and grandparents” prosper in America had changed so much over the years.

Burke made headlines as archbishop of St. Louis for his public attacks on public figures who strayed from Catholic teaching. He suggested during the 2004 presidential campaign that Democratic presidential nominee John Kerry, a Catholic, should be denied communion because of his views on abortion. Several bishops said at the time they would not give him communion and the media staked out churches where he attended Mass to see if he received it.

“Lately, I’ve noticed that other bishops are coming to this position,” Burke told Avvenire, which is owned by the Italian bishops’ conference.

Cardinal Joseph Ratzinger, now Pope Benedict XVI, wrote a letter in 2004 to American bishops restating the Church position that a priest must refuse to distribute communion to a Catholic politician who supported abortion rights. But Burke lamented that the letter was never distributed.

Burke’s criticism isn’t limited to Democrats. Last year, he accused singer Sheryl Crow of being “a high profile proponent of the destruction of innocent lives” for defending a woman’s right to have an abortion and for being a proponent of stem cell research. He resigned as head of a children’s medical charity that featured the singer for a benefit concert.

Pope Benedict has been encouraging Catholic bishops to speak out more openly on public policy issues to make the Church’s voice heard. Any bets on when we’ll hear from Burke next?

The Vatican has caused a stir by appearing to want to redefine death and then denying any such thing. If where there’s smoke, there’s fire, we haven’t heard the end of this yet.

It all started with a front-page article in the Vatican daily L’Osservatore Romano challenging the widely-accepted concept that brain death — the irreversible end of all brain activity — is the right standard for determining that someone has died. The article argued that doctors developed that standard 40 years ago to enable them to harvest organs for transplantation. The article by Lucetta Scaraffia, an Italian history professor and bioethicist, argued:

“The scientific justification of (the brain death standard) rests on a peculiar definition of the nervous system that is now being questioned by new research, which casts doubt on the fact that brain death leads to the disintegration of the body … The idea that the human person ceases to exist when the brain no longer functions, while the body is kept alive thanks to artificial respiration, implies an identification of the person with brain activity alone. This contradicts the concept of the person according to Catholic doctrine and thus contradicts the directives of the Church in the case of patients in a persistent coma.”

The Vatican accepts organ transplantation and the brain death standard, which is widely used in Catholic hospitals. Declaring the brain death criterion un-Catholic would mean those hospitals would have to revert to the cardiac death standard alone. But that leaves a much smaller window for removing viable organs and would make one kind of transplantation — heart transplants — all but impossible. As it is, there is already such a shortage of organs for transplantation that scandalous black markets for them exist and some experts want to see organs sold like commodities on an open market.

The Vatican has not changed its view on brain death despite holding two scientific conferences (in 2005 and 2006) to discuss it, but there are dissenters among Catholic bioethicists like Scaraffia who want to keep the debate going. She used the 40th anniversary of the pioneering Harvard Report that advocated the brain death standard to call for a reassessment.

Rev. Federico Lombardi, the Vatican’s chief spokesman, got plenty of calls asking whether this was a change in the Church’s position. “This is not a Vatican document,” he responded. “It is an article by a historian that takes some considerations into account but it is not part of Church teaching.”

End-of-life issues are some of the most difficult challengesin ethics and some bioethicists say people should choose their definition of death in advance to ensure they don’t leave the moral quandary to others.

The influential New England Journal of Medicine reopened this long-standing debate last month with an article questioning whether some patients declared brain dead were in fact really dead. Patients with massive brain damage can be declared brain dead even though their vital bodily functions continue to work, wrote Robert Truog of Harvard Medical School and Franklin Miller of the National Institutes of Health. “The arguments about why these patients should be considered dead have never been fully convincing,” they wrote.

Another criterion, the end of a heart’s beating, seems questionable when doctors can declare cardiac death and the transplant and restart the heart in another patient, they said. These cases suggested, they argued, that “the medical profession has been gerrymandering the definition of death to carefully conform with conditions that are most favourable to transplantation”.

Another article reported that doctors in Denver had taken hearts from three brain-damaged infants within 75 to 180 seconds after their cardiac deaths and then successfully implanted and restarted them in other babies.

In the same series, bioethicist Robert Veatch of Georgetown University’s Kennedy Institute of Ethics wrote that declaring cardiac death and then transplanting the same heart amounted to “ending a life by organ removal”.

Do you think the ethical issues that Scaraffia brings up justify a challenge to the brain death criterion? Or should the priority be on making sure doctors have as many organs for transplant as possible?

UPDATE:  Sandro Magister has just put out a very thorough analysis of this issue on his blog www.chiesa. For the English-language version, click here.

“The Good Death,” a play about euthanasia, has brought the issue of “mercy killing” to Dutch theatres at a time when such deaths are falling. They dropped to 2,325, or 1.7 percent of all deaths in 2005, from 2.6 percent in 2001. Playing to packed houses throughout the Netherlands, which legalised euthanasia in 2002, the play shows the law has not removed the moral dilemma for many involved.

In fact, part of the reason for the drop in euthanasia deaths could be that agonised doctors are opting to give patients heavy sedation until they die, rather than putting an end to their lives. Even some patients who have asked for euthanasia are given continuous deep sedation instead. This feature by our Netherlands chief correspondent Emma Thomasson looks at the issues involved.

This raises the question of whether deep sedation, while being presented as palliative care that is ethically acceptable for many faiths, is not in fact “euthanasia lite.” Or at least whether it is being used as such. The British Medical Journal has suggested this in a report that prompted an editorial and a lively reader discussion. “Although the exact cause of this trend is unclear, there are indications that continuous deep sedation may in some cases be being used as a substitute for euthanasia,” a report in Science Daily said.

The fall in Dutch euthanasia deaths is sometimes cited by “death in dignity” campaigners in other European countries as a sign that legalisation is not a slippery slope towards the easy disposal of ailing patients. This suggests it might lead in another direction that could undermine the palliative care option often presented as the alternative to legalised euthanasia.

Where do you think the line should be drawn in end-of-life care?