Why are ambulances attacked by rock-throwing youths in Sweden? And how should Germany deal with a recent surge in clan-based crime?
Mark S. Weiner is a professor of legal history, a scholar of multiculturalism and the author of The Rule of the Clan: What an Ancient Form of Social Organization Reveals About the Future of Individual Freedom. Quillette’s European editor Paulina Neuding spoke to him in Stockholm, Sweden. Weiner is currently on a Fulbright scholarship at Uppsala University, where he is teaching about American constitutional law, collaborating with Swedish scholars of prehospital medicine—and riding along with paramedics in immigrant and other neighborhoods. What follows is an edited reproduction of that interview.
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Paulina Neuding: Sweden has experienced a rise in violence against first responders in recent decades, including rock throwing against paramedics in the country’s “vulnerable areas.” How do you explain this phenomenon?
Mark S. Weiner: The easy answer is that Sweden has a growing population of alienated young men, and ambulances are representatives of social and government authority. If I were a second-generation Swedish boy with an immigrant background living in an outlying suburb and experiencing the growing contradictions of Swedish society, I might be tempted to throw a stone at anything with lights and sirens. I’m a bit surprised that it doesn’t happen more. Certainly the problems for the police are far greater than for the ambulance service. A colleague at Karolinska and I are beginning to gather data that we hope will put some objective numbers on what ambulance personnel have experienced—there are still a lot of unknowns.
My concern is that over the course of a generation you could see a much bigger problem, with Sweden developing the Nordic equivalent of Parisian banlieues, especially given the spatial organization of Swedish housing developments, the declining quality of public education, and the resistance to community policing models. Under such conditions, Swedish state legitimacy would begin to erode.
PN: You are an American professor of legal history who has been riding along with ambulances while on a Fulbright scholarship in Sweden. Can you explain that?
MW: A few years ago I obtained an Emergency Medical Technician license and began to volunteer for an ambulance service near my home in Connecticut. I’m still a beginner, but I’m compelled by the EMS way of life and attitude toward the world. Just as I was about to give a talk about Trumpism and the philosophy of history at an academic conference, a colleague had some medical trouble and I was able to assist him while an ambulance raced to the scene. That got me thinking about whether I could shed light on emergency medical services from the perspective of critical theory.
The traditional terms for evaluating EMS practices are efficiency of service provision, quality of care, and cost. But what if we also thought about the ambulance service in relation to the values of democratic society? What would we see differently? For instance, volunteer EMS programs and citizen medical preparedness can be understood not simply as components of societal “resilience” but also as vital to community self-governance.
When an ambulance arrives at an emergency, it’s a communicative act by the state to its citizens. As I was preparing to come to Sweden, I grew curious about how that communication might be transformed in a country undergoing rapid demographic change. I also wondered how the shifting ethnic character of the patient population here might affect the experience of ambulance nurses on the ground. I first came into dialogue with Swedish intellectuals five years ago around issues of multiculturalism, so exploring cross-cultural emergency medicine seemed like a natural way to bridge my past and present interests and to engage with the country—which is one of the many good things that the Fulbright program encourages.
PN: What kind of culture clashes have you observed while accompanying paramedics in Sweden? And what do paramedics tell you about their experiences?
MW: Paramedics and ambulance nurses in Sweden work on a very high level, and like EMS personnel everywhere they are very practical people. They don’t overthink things or turn their experience into ideology, thank goodness.
That said, one thing that I have heard repeatedly is how unusual it is for them to enter households with large, extended families—it’s so different from the small nuclear family tradition in Sweden. In their telling, the difference can be distracting. Most of them also report some uncertainty about how to interpret the way that people from non-European countries express pain. They’re sometimes viewed as overly dramatic. Whether that’s true or not, the perception is concerning because it raises the possibility of group-based under-diagnosis.
And then I have a suspicion that some immigrants may perceive the ambulance service in Sweden through the lens of what EMS meant for them back home. In many countries, ambulance services are much less skilled than in Sweden, and they may have different institutional relationships with the police, for instance whether or not they are required to report crime. I also wonder if the way that immigrants view the ambulance service here may have been influenced by their experience with public authority in general in their countries of origin.
PN: You’re trying to develop a typology for these problems. What can you tell us about that?
MW: My hope has been to divide an emergency response into its component parts (dispatch, arrival on scene, first contact with the patient, and so on) and then to learn when different cross-cultural problems occur and at what intensity, and then to offer a theoretical framework for understanding what’s going on. The challenges come in many forms, arise from different sources, and require different solutions.
Language barriers eventually may be mitigated through the use of hand-held translators, though we’re not there yet. Disorientation created by large family groups may require special simulation training for students. Concerns about cross-sex touching of patients by care providers may benefit from community intervention by religious authorities, or on-board knowledge about religious law of the kind provided by faith-based EMS providers like Hatzalah. Ethnic-based suspicion may suggest the need for minority recruitment into EMS careers. Misperceptions about the ambulance service may require educational modules for immigrants as a condition for residency.
This is a subject in which Sweden could be an intellectual leader. The country has a high-level ambulance service, a major tradition of academic medicine, and rapidly-shifting demography. But at the moment it will be hindered from doing so by the impermissibility of collecting statistics on the basis of race and ethnicity, and by the discomfort many Swedes have in talking about cultural differences.
PN: Let’s go back to your main field of study: What is clan culture and in what parts of the world can it be observed?
MW: What I call the “rule of the clan” is a form of socio-legal order that links radical constitutional decentralization to extended kin groups, or associations of fictive kinship, with a culture of group honor and shame. It tends to exist under conditions in which modern central government is weak, because in the absence of effective government, family groups and other collective actors tend to fill the remaining vacuum of power. You can broadly contrast the rule of the clan with societies governed by the liberal rule of law, which have modern government arrangements—for instance, professional, bureaucratic, neutral administration—and which take the individual as their constitutive unit, seeking to maximize individual autonomy along a variety of measures.
The rule of the clan exists along a spectrum. It’s at the core of very traditional communities that we commonly call tribal. It exists in the midst of more advanced but still incomplete or weak states, for instance in parts of the Philippines or Albania. It thrives alongside and often captures developing states, for instance under the Palestinian Authority or in former Soviet central Asia, where it sometimes goes under the name of “clannism,” to use a term from the 2004 U.N. Arab Human Development Report. And it’s present even within modern liberal democracies. Inner-city gangs act a great deal like traditional clans, especially in their feuding patterns—though of course not in their dedication to unlawful activity. Major corporations today likewise threaten to take on certain characteristics of post-modern clannism.
PN: Europe has taken in large numbers of asylum seekers in recent decades from clan-based societies. What do we need to know about the differences between Western individualist culture, and the norms of clan societies?
MW: People who have grown up under the rule of the clan have a very different experience with government authority than those who grew up in Sweden. This is a nation with a long and deep tradition of powerful state administration, stretching back to Lord High Chancellor Axel Oxenstierna in the 17th century through the development of the social democratic “people’s home” in the 1930s. The modes of justifying state authority here are rational, neutral and bureaucratic. Swedes are used to elite managerialism and social engineering. It’s part of the air they breathe.
Many immigrants don’t have that same experience. Often in their countries of origin public power is justified with reference to kinship, or there may be profound distrust of government per se. One of the great tasks of Sweden and Europe in the coming generation will be to create a bridge between those differing views of the state.
PN: You have also pointed out that from the perspective of someone who is steeped in a clan culture, Western individualism may not at all seem attractive. Why is that?
MW: All you have to do is read Émile Durkheim on suicide. Western liberal modernity presents a host of distinctive problems of social isolation and moral dislocation. I wonder how many people would choose to live this way if they chose from behind the veil of ignorance. Probably fewer people than we’d hope. In the end we’re all naked and afraid.
By contrast, there are lots of benefits to organizing society along clan lines. The rule of the clan possesses values of solidarity and social justice that most modern liberal societies have real difficulty achieving. That’s why we tend to romanticize them in popular culture. They’re at the core of our utopian imaginary. Western liberals shouldn’t ignore its attractions, but instead should incorporate them into their political vision.
PN: In Germany, a debate has flared up about clan-based crime, mainly in Berlin and the state of North-Rhine Westphalia. What do Western European countries need to understand about family-based crime and how it differs from other kinds of organized crime?
MW: The German journalist Maybrit Illner hosted an excellent program about this recently. Networks of family-based crime are tight and difficult to penetrate. That’s because their codes of honor and loyalty are linked to a mode of socio-legal order that exists independently of the state. We should be developing long-term thinking about the provision of public order with this threat in mind.
PN: Honor violence is a fairly recent phenomenon in Europe that has received a lot of attention in the past few decades. You say that we cannot understand honor violence without fully understanding clan culture?
MW: Such violence doesn’t grow out of individualism. It arises from a group-based culture in which people’s ability to work their will in the world is dependent upon the relative social worth or honor of their extended kin, and it’s linked in turn to a group-based socio-legal structure. Within that structure, honor violence makes sense—it has its own rationality, just like the reciprocal tit-for-tat of the blood feud. That doesn’t make it any less abhorrent from my perspective, but if you’re going to prevent the practice, it’s essential to appreciate what it represents.
PN: Attacks against ambulance drivers, firefighters and police—is this an equally common phenomenon in the U.S. as it is in Sweden?
MW: The United States is a big and diverse place, over 30 times the size of Sweden, so it’s hard to compare. And I’ll leave aside issues of police violence and violence against police—that I think is a separate issue, because police represent coercive as opposed to purely ameliorative authority. Obviously there we have a major problem.
But when we’re just talking about EMS and firefighters, there seems to be a difference. I have the impression that violence against firefighters in the United States—for instance, someone deliberately sets a fire in a home and creates a booby trap inside—arises more from idiosyncratic psychological factors of the perpetrators than from group alienation or ethnic resentment, say of the kind Sweden saw in Gothenburg around 2009. The same seems to be true with regards to the ambulance service. When the 911 system was created, there was a problem with long response times in minority communities. That’s how we got “911 Is a Joke,” the hit song and music video by Public Enemy, which cruelly slanders the ambulance service, though it may have done some ultimate good. Still, I think even that was a different kind of phenomenon.
PN: Why do you think that is?
MW: The United States has a much longer tradition of dealing with ethnic pluralism than Sweden, and ambulance and fire services have put in a lot of hard work to get things right. I also suspect that our programs of race-based affirmative action in employment play a role, though they generally violate European human rights norms and would be forbidden here.
PN: You have visited some of Sweden’s so-called vulnerable areas while riding along with ambulances. What was your initial reaction?
MW: Americans embrace the concept of ethnic neighborhoods as a positive feature of cultural pluralism, so the fact that I was sometimes the only white person around didn’t register as significant until I remembered that I was in Sweden. Rinkeby looked a lot like many neighborhoods in Los Angeles, where I grew up, and I’m looking forward to spending more time there. They certainly don’t look like “bad” neighborhoods as you’d expect them in the United States—though the only times I’ve visited with either the ambulance service or on my own have been during the day. In a Somali neighborhood in Gothenburg I walked into a bazar with a burly Swedish police officer whom everyone treated like a long-lost brother.
But statistics tell a different story about crime, and about political radicalization, as do newspaper reports about grenades and the new high-level trauma gear that I saw in the back of a Stockholm ambulance. And some things about these neighborhoods were really concerning. For one, their architecture. They seem designed to be alienating and depressing, but then that’s the case for a lot of Swedish housing. Also, although socially vulnerable neighborhoods are troubled by definition, I never saw a single police officer walking the beat. That probably hurts the vast majority of law-abiding community members who deserve public support. Finally, unlike in the United States these neighborhoods are very easy to ignore. In an American city, you can’t avoid encountering social alienation—it’s in your face every single day. That’s because our poverty is in the center, and the suburbs are places people go to escape it. In Sweden, it’s the opposite. I think that a person could live his or her entire life here without really encountering the ethnic problems of the suburbs. That creates an unhelpful political dynamic.
PN: Let’s talk about the “the Nordic gold”—i.e. high levels of trust between individuals, and between the public and the state. Is this something that you’ve experienced first-hand during your time in Scandinavia?
MW: Absolutely—it’s incredible, at both an interpersonal and social level. There’s just a lot less mutual wariness, conflict and friction than in the United States. If you’re at a dinner table in Sweden with people you don’t know, but to whom you’ve been introduced by a friend, the sense of being part of an in-group is deeply palpable, and very nice. I can’t tell you how many times people here have invited me and my wife to their summer homes on first acquaintance, or even to use them while they’re away. And the comparative lack of crime and the comfort people have in public places is wonderful. I suspect that at least aspects of this social trust were historically dependent on Sweden’s ethnic homogeneity, just as the greater social disorder in America stems partly from its pluralism. The trick for Sweden will be to maintain its high levels of social trust under its new demographic circumstances, which is one reason why I’ve advocated that Swedes embrace a thicker sense of national identity—one that’s as robust as it is inclusive.
PN: You have mentioned “The man behind the uniform” is a successful initiative. Can you explain that?
MW: The Man Behind the Uniform—Människan bakom uniformen in Swedish—is a community outreach program that developed in Gothenburg about 10 years ago in the wake of some violent incidents between immigrant youths and first responders. The program introduces young people to firefighters, ambulance workers, police, private security guards, and even tram operators, and it helps them learn about each other’s lives.
It’s very thoughtful and systematic, and though it’s just a small piece of a puzzle, I think it’s amazing. In fact I think it could contain the philosophical seeds for a new Swedish national identity and self-understanding. By introducing young people with immigrant backgrounds to public authorities, it serves as a bridge between two models of kinship, between the rule of the clan and the people’s home, and it could help reconceive the people’s home for today. It could help foster a more complex and self-conscious sense of civic place.
PN: But what does it say about a society like Sweden that “The man behind the uniform” is suddenly needed?
MW: It’s a society under stress. But many people are also eager to solve its problems. And there are some creative thinkers out there, though mostly I think they’re working on the ground—there’s a lot of room in Sweden for the development of public awareness of ground truths.
PN: Finally, you define yourself as a liberal, and you also volunteered for the Hillary Clinton campaign during the presidential election. Is there a right-left divide when it comes to the willingness to speak about problems of multiculturalism, such as clashes between individualist and clan-based norms?
MW: My experience has been that I have much freer, more open and genuinely inquisitive conversations with intellectuals on the center-right than on the left in Sweden—and I’m eager to talk with absolutely anyone and everyone I can.
My concern is that the left here is closing itself off, and that its resistance to thinking about cultural differences is a progressive parallel to right-wing climate change denial and that it could eventually eat it intellectually from inside. I have the sad impression that public thinking on the left here is ossifying, which would be terrible for everyone, on the right as much as the left. Then again, I’m an American, and that sometimes creates an initial distrust that one has to work to overcome.
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