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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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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The age of China's female self-made billionaires – and why it could soon be over

Rags to riches stories like Zhou Qunfei's are becoming less common.

Elizabeth Holmes, 33, was the darling of Silicon Valley, and the world’s youngest self-made female billionaire. Then, after a series of lawsuits, the value of her healthcare firm plummeted.

Holmes might have abdicated the billionaire crown, but another tech queen was ready to take it. Only this time, the self-made female billionaire was not a blonde American, but Zhou Qunfei, a 47-year-old from China. She dropped out of high school and began working at a watch lens factory as a teenager. In 1993, when she was in her early twenties, she founded her own company. Her big break came ten years later, when Motorola asked her to develop a glass screen for smartphones. She said yes.

Zhou is in fact more typical of the SMFB set than Holmes. Of those listed by Forbes, 37.5 per cent come from China, compared to 30 per cent from the United States. Add in the five SMFB from Hong Kong, and the Middle Kingdom dominates the list. Nipping at Zhou’s heels for top spot are Chan Laiwa, a property developer who also curates a museum, and Wa Yajun, also a property developer. Alibaba founder Jack Ma declared his “secret sauce” was hiring as many women as possible.

So should the advice to young feminists be “Go East, young woman”? Not quite, according to the academic Séagh Kehoe, who runs the Twitter account Women in China and whose research areas include gender and identity in the country.

“I haven’t seen any of these self-made female billionaires talking about feminism,” says Kehoe. Instead, a popular narrative in China is “the idea of pulling yourself up by your boot straps”. So far as female entrepreneurs embrace feminism, it’s of the corporate variety – Sheryl Sandberg’s book Lean In has been translated into Mandarin.

In fact, Kehoe believes the rise of the self-made woman is down to three historic factors – the legacy of Maoist equality, and both the disruption and the opportunity associated with the post-Mao economic reforms.

Mao brought in the 1950 Marriage Law, a radical break with China’s patriarchal traditions, which banned marriage without a woman’s consent, and gave women the right to divorce for the first time.

In Communist China, women were also encouraged to work. “That is something that was actively promoted - that women should be an important part of the labour force,” says Kehoe. “At the same time, they also had the burden of cooking and cleaning. They had to shoulder this double burden.”

After Mao’s death, his successor Deng Xiaoping began dismantling the communist economy in favour of a more market-based system. This included reducing the number of workers at state-owned enterprises. “A lot of women lost their jobs,” says Kehoe. “They were often the first to be laid off.”

For some women – such as the SMFBs – this was counterbalanced by the huge opportunities the new, liberal economy presented. “All this came together to be a driving force for women to be independent,” Kehoe says.

The one child policy, although deeply troubling to feminists in terms of the power it dictates over women’s bodies, not to mention the tendency for mothers to abort female foetuses, may have also played a role. “There is an argument out there that, for all of the harm the one child policy has done, for daughters who were the only child in the family, resources were pushed towards that child,” says Kehoe. “That could be why female entrepreneurs in China have been successful.”

Indeed, for all the dominance of the Chinese SMFBs, it could be short-lived. Mao-era equality is already under threat. Women’s political participation peaked in the 1970s, and today’s leaders are preoccupied with the looming fact of an aging population.

“There has been quite a lot of pushback towards women returning to the home,” says Kehoe. Chinese state media increasingly stresses the role of “good mothers” and social stability. The one child policy has been replaced by a two child policy, but without a comparable strengthening of maternity workplace rights.

Meanwhile, as inequality widens, and a new set of economic elites entrench their positions, rags to riches stories like Zhou Qunfei's are becoming less common. So could the Chinese SMFBs be a unique phenomenon, a generation that rode the crest of a single wave?

“Maybe,” says Kehoe. “The 1980s was the time for self-made billionaires. The odds aren’t so good now.”

Julia Rampen is the digital news editor of the New Statesman (previously editor of The Staggers, The New Statesman's online rolling politics blog). She has also been deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.