Anna Soubry is right: we must stop fudging issue of assisted dying

Compassion should win the argument

The new health Minister Anna Soubry has articulated the view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date. 

As is well documented, over the last decade Britons have been travelling abroad to die. But, this is just one part of the problem. Dying Britons have also been ending their lives at home, sometimes with the assistance of loved ones, and evidence suggests that some doctors are illegally helping their patients to die. None of this occurs within a legal framework, agreed by Parliament, which allows healthcare professionals to openly discuss and support, if upfront safeguards are met, a dying patient’s request to die. 

Instead, we muddle along with a fudge. The Director of Public Prosecutions (DPP), understandably reluctant to prosecute those who have helped a loved one to die, has set out factors for and against prosecution that effectively decriminalises compassionate amateur assistance. However, the assistance of a doctor or a nurse in a professional capacity is a specific factor in favour of prosecution. In fairness to the DPP his hands are largely tied by statute. Only Parliament can create a safeguarded process of assisted dying. Their failure to do so to date means that we have effectively outsourced assisted dying to family members and the Swiss. No wonder Anna Soubry described the law as “ridiculous and appalling”.  

Of course, there are valid concerns about changing the law. Some fear that it would put people under pressure, real or imagined, to die. But, the evidence from those countries that have legalised and regulated some form of assistance to die shows this fear to be misguided. In the US state of Oregon, where assisted dying was legalised in 1997, assisted dying works safely and effectively. Eligibility has never been extended beyond terminal illness, and numbers are low – assisted deaths have never amounted to more than 0.25 per cent of all deaths per year – and there is no evidence that potentially vulnerable groups (such as people with disabilities, or people who are over 85) are negatively affected.

In reality it is the current fudge that does not sufficiently protect people. Surely people would be better protected if the law thoroughly examined a person’s request to die when they are still alive. Our society is built on the premise of trusting competent adults to make decisions for themselves – such as the right to refuse treatment. To safeguard against undue influence we advocate informed decision making via access to relevant information. When it comes to assisted dying this is not achieved by turning a blind eye, but rather by allowing dying patients who wish to control the time and manner of their death the option of discussing their wish and their alternative choices with healthcare professionals. A process that would also allow healthcare professionals to assess diagnosis, prognosis, competence and whether there has been any undue influence.

Dignity in Dying in partnership with the All-Party Parliamentary Party on Choice at the End of Life is currently consulting on a draft assisted dying bill. The consultation closes on 20 November, and its aim is to create the most robust assisted dying bill possible that both enables choice at the end of life and offers better protection. We would ask anyone interested in this important issue to make their views known, whether supportive or opposed. A final report will be published next year at which point the former Justice Secretary Lord Falconer has committed to bringing a private members bill in the House of Lords.

Three countries in Europe and two States in the US already allow some form of assistance to die, and they look set to be followed shortly by France and Canada. It’s time Britain followed suit. Not only is it the compassionate thing to do, but it also provides the best means of protection for patients at the end of life when they are at their most vulnerable.

James Harris is the director of campaigns and communications at Dignity in Dying

The late Tony Nicklinson who fought for the right to die with doctors' assistance. Photograph: Getty Images
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"We are not going to change": Barcelona defies terror with a return to normality

After a attack which killed 14 and injured scores more, shock gives way to defiance and unity.

A perfect summer afternoon in Barcelona suddenly turned into a nightmare on Thursday evening, a nightmare that has become far too common in Europe in recent years. 

“I was having a coffee here [in Plaça Catalunya] and was about to go and walk down there like everyday, because I live just off the Ramblas”, says 26-year-old Eneko de Marcos, pointing down the promenade. “I stayed because I was waiting for a friend, and when she came we heard a big noise and then everyone was running."

Thousands of people, most of them tourists, had been ambling casually along the Ramblas, the most iconic of Barcelona boulevards, which descends from Plaça Catalunya to the old port and the sea, when a white van had mounted the pedestrianised centre of the walk and began driving into people. 

Even after the van came to a stop, leaving a trail of dead and injured in its wake, De Marcos and hundreds of others were trapped for hours inside bars, shops and hotels while the police cordoned off the area and investigated the scene.

Seeing the Ramblas and the surrounding areas completely empty of people following the attack is, for anyone used to the area, unreal and the first reaction for most has been shock. Barcelona had felt safe both to locals and tourists, which had been coming to the city in increasing numbers since last year, many perhaps trying to avoid other destinations in Europe seen as more at risk of attack. 

Shock gave way to confusion and fear during the evening. The van driver was still at large and a series of ugly images, videos and unconfirmed rumours about other attacks spread across social media and the news. The number of victims increased steadily to 13 dead and more than 80 injured of many different nationalities.

At 11pm the city centre and its surroundings were eerily quiet and dark. Few people were venturing on to the streets, and the bar terraces which would normally be packed with people enjoying the late dinners Spaniards are famous for were half empty.

The next morning Barcelona woke up to the news that after 1am that night the Police had stopped a second attack in the touristic beach town of Cambrils, an hour and a half away to the south. What was going on? The streets of Barcelona were still quiet, far too quiet in a city usually noisy and crowded, and again the terraces, so symptomatic of the Barcelona’s mood, were unusually empty.

“I always said something like this would never happen in Barcelona”, says Joaquín Alegre, 76, walking through Plaça de Catalunya the morning after with his friend, Juan Pastor, 74, who nods and agrees: “I always felt safe.”

But slowly fear had given way to defiance. “Afraid? No, no, no”, insists Joaquín. “We’re going to carry on like normal, respecting the victims and condemning the attack, but we are not going to change”, says Juan.

Little by little the Ramblas and the whole area started to fill up during the day. People came from all directions, all kinds of people, speaking all kinds of language. The day was beautiful, the sky was blue, there are no clouds in sight and it got hotter by the minute. It began to look like Barcelona again.

“It’s important not to show fear, that’s what (the terrorists) want”, says Emily, an 18-year-old from Dresden, in Germany, who landed yesterday at Barcelona airport with her mother a few minutes after the attack. She says people were checking their phones while still on the plane and then one girl said aloud there’d been a terrorist attack in Barcelona. “It’s important to come here (to Plaça Catalunya) at this time”, says her mother, Anna, 42, both of them sitting on a low wall at the square.

Next to them, where the Ramblas begins, people once again filled the boulevard full of shops and hotels, which many locals also see as a symbol of how tourism has gone wrong in Barcelona. But Catalans, Spaniards from elsewhere and foreigners mingled happily, feeling united against a common enemy. Many left flowers and lit candles at the feet of a big ornamental lamppost on top of the Ramblas, many others did the same next to the famous Canaletes fountain a little down the promenade. 

“We the people have to respond to this by getting out and taking the streets”, says Albert Roca, a 54 year old publicist, who’s decided to come against the wishes of his girlfriend, who told him he was crazy. “I took a picture of the Ramblas and sent it to her and wrote, ‘Look how many crazy people there are’.”

Just before noon the Mayor of Barcelona Ada Colau visited the Plaça Catalunya with her retinue. She is a very popular figure who comes from civil society in a country where many citizens don’t feel properly represented by traditional politicians. Many people followed her carrying roses, a symbol of Barcelona, while they made their way into the square.

Shortly after, around 100,000 people packed Plaça Catalunya and its adjacent streets for a minute of silence begins for the victims. Only the flapping of pigeon’s wings overhead can be heard. And then an applause and a loud chant break the silence: “I am not afraid! I am not afraid!”, sang the people in Catalan.

Along with Colau in the centre of the square there was Carles Puigdemont, the head of the Catalan regional government and leader of the independence movement that has called for a referendum on 1 October, and along side them, King Felipe as the head of State, and Mariano Rajoy, the Prime Minister of Spain and a bitter political rival of Puigdemont. Seeing them standing together presents an image that until yesterday afternoon would’ve seemed impossible.

Very slowly people start emptying the square, where many still remain singing defiantly. “The attacks yesterday were a disgrace”, says a doorman just outside the city centre as Barcelona began returning to normality, “but we are going to carry on, what else can we do?”