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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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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After his latest reshuffle, who’s who on Donald Trump’s campaign team?

Following a number of personnel shake-ups, here is a guide to who’s in and who’s out of the Republican candidate’s campaign team.

Donald Trump’s campaign chairman, Paul Manafort, stepped down last week. A man as controversial as Trump himself, he has departed following the announcement last Wednesday of a new campaign manager and CEO for Team Trump. Manafort had only been in the post for two months, following another campaign team reshuffle by Trump back in June.

In order to keep up with the cast changes within Team Trump, here’s the low-down of who is who in the Republican candidate’s camp, and who-was-who before they, for one reason or another, fell out of favour.

IN

Kellyanne Conway, campaign manager

Kellyane Conway is a Republican campaign manager with a history of clients who do a line in outlandish statements. Former Missouri Congressman Todd Akin, whose campaign Conway managed in 2012, is infamous for his comments on “legitimate rape”.

Despite losing that campaign, Conway’s experiences with outspoken male candidates should stand her in good stead to run Trump’s bid. She is already credited with somewhat tempering his rhetoric, through the use of pre-written speeches, teleprompters and his recent apology, although he has since walked that back.

Conway is described as an expert in delivering messages to female voters and has had her own polling outfit, The Polling Firm/WomanTrend for over 20 years and supported Ted Cruz’s campaign before he was vanquished by Trump in May. Her strategy will include praising Trump on TV and trying to craft an image of him as a dependable candidate without diminishing his outlier appeal.

She recently told MSNBC, “I think you should judge people by their actions, not just their words on a campaign trail”. Given that Trump’s campaign pledges, particularly those on immigration, veer towards the completely unworkable, one wonders what else besides words he actually has to offer.

Perhaps Conway, with her experience of attempting to repackage gaffes will be the one to tell us. Conway also told TIME magazine that there is “no question” that Trump is a better candidate than Hillary Clinton. Given Trump’s frightening comments on abortion, to name just one issue, it’s difficult to see how this would prove true.

Stephen Bannon, campaign CEO

While Conway may bring a more thoughtful, considered touch to Trump’s hitherto frenetic campaigning, Stephen Bannon promises to bring just the opposite.

Bannon is executive chairman of right-wing media outlet Breitbart, also the online home of British alt-right provocateur Milo Yiannopoulos. Once described by Bloomberg as “the most dangerous political operative in America”, the ex-Goldman Sachs banker can only be expected to want to up Trump’s rhetoric as the election approaches to maintain his radical edge.

Trump has explicitly stated that: “I don’t wanna change. I mean, you have to be you. If you start pivoting, you’re not being honest with people”.

As Bannon leads a news site with sometimes as outlandish and insensitive views as Trump himself, one can safely assume that Bannon will have no problem letting Trump “be himself”.

The Trump Brood, advisers

While his employed advisers come and go, the people that have been unwaveringly loyal to Trump, and play key advisory roles, are his four adult children: Donald Jr, 38, Ivanka, 34, Erik 22 and Tiffany, 22. With personalities as colourful as their father’s, the Trump children have been close to the campaign since its inception.

Donald Jr personally delivered the bad news to Lewandowski, the younger Trumps describing him as a “control freak”. Although it’s common for the offspring of politicians to take part in their parent’s campaigns (see Chelsea Clinton), in Trump’s case the influence of his children goes undiluted by swathes of professionals. This, despite his actual employed campaign directors being experienced establishment figures, adds credence to the image of Trump’s brand as family-based and folksy, furthering also his criticism of Hillary Clinton as being “crookedly” in the sway of bankers and elites.

Lewandowski’s ultimate downfall has been attributed to his attempts to spread negative stories in the media about Jared Kushner, Trump’s son-in-law and husband of Ivanka. Ivanka and Kushner were long-time critics of Lewandowski for his indulgence and encouragement of Trump’s most divisive instincts, and apparently they were integral to his firing.

Whether any good came from this is hard to discern, as Trump still managed to insult the Muslim community all over again with his comments last month about the late solider Humayun Khan, also insulting veterans and “gold star” families in the process.

OUT

Paul Manafort, former national campaign chair

Although Trump called his departing campaign manager “a true professional”, Manafort has recently been beset by personal controversy and criticised for failing to deliver results. Manafort has taken the blame for the poor polling results that have followed Trump’s awful last few weeks, with Trump’s recent (lacklustre and unspecific) apology representing a complete change of tack.

Despite his many years of experience in politics, Manafort fell out of favour with Trump partly because of his spending on media, such as a $4 radio appearance in Ohio, Pennsylvania, Florida and North Carolina. Trump was judging these investments worthwhile.

Manafort’s personal cachet was also diminished by his dodgy links to ex-clients including Ukrainian former prime minister, the pro-Russian Victor Yanukovych. As Trump has already racked up a number of Russia-related gaffes, continued association was Manafort would have likely proven electorally unwise.

Corey Lewandowski, former campaign manager

Campaign manager until Trump’s team shake-up in June this year, Lewandowski was not the picture of a calm and collected operative. With a list of antics behind him such as bringing a gun to work and then suing when it was taken away from him and lacking the experience of ever having directed a national race, Lewandowski was a divisive figure from the start of Trump’s bid for the nomination.

Although Lewandowski most often accompanied Trump on the nomination campaign trail, it was Manafort, even then, who was in charge of most of the campaign’s logistics, making use of his 40 plus years of experience to do so.

Trump was clearly taken with Lewandowski’s aggressive campaign techniques, as he stood by him even when Lewandowski was charged with battery against former Breitbart reporter Michelle Fields. Although the charges were later dropped, these kind of stories do not bode well for Conway’s hopes for a more women-friendly Trump.

***

Perhaps this latest round of hiring and firing will do him some good, but with only three weeks to go until absentee voting begins in some states, the new team doesn’t have much time.