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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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 first godless US election

America’s evangelical right has chosen Donald Trump, who hardly even pays lip service to having faith.

There has never been an openly non-Christian president of the United States. There has never been an openly atheist senator. God, seemingly, is a rock-solid prerequisite for American political life.

Or it was, until this year.

Early in the 2016 primaries, preacher and former Arkansas governor Mike Huckabee and former senator Rick Santorum – both darlings of the evangelical far right – fell by the wayside. So did Wisconsin governor Scott Walker, the son of a preacher.

Ted Cruz, once the Republican race had thinned, tried to present himself as the last godly man, but was roundly beaten – even among evangelicals – by Donald Trump, a man whose lip service to religion was so cursory as to verge on satire.

Trump may have claimed in a televised debate that “nobody reads the Bible more than me”, but he demurred when pressed to name even a verse he liked. His pronouncements show a lack of any knowledge or interest in faith and its tenets; he once called a communion wafer his “little cracker”.

The boorish Trump is a man at whose megalomaniacal pronouncements any half-hearted glance reveals a belief in, if any god at all, only the one he sees in a mirror. The national exercise in cognitive dissonance required for America’s religious rightwingers to convince themselves that he’s a candidate with whom they have anything in common is truly staggering.

But evangelicals don’t seem troubled. In the March primary in Florida, Trump carried 49 per cent of the evangelical vote. He won Mississippi, a state where fully three-quarters of Republican primary voters are white evangelicals.

In the Democratic primary, Bernie Sanders became the first Jewish candidate ever to win a presidential primary – though he has barely once spoken about his faith – and Hillary Clinton has spoken about god on the campaign trail only occasionally, without receiving much media play. In fact, when the question of faith came up at one Democratic debate there was a backlash against CNN for even asking.

The truth is that Christian faith as a requisite for political power has drooped into a kind of virtue-signalling: the “Jesus Is My Homeboy” bumper-sticker; the crucifix tattoo; the meme on social media about footprints in the sand. It is about identity politics, tribal politics, me-and-mine versus you-and-yours politics, but it hasn’t really been about faith for a while.

What the hell happened?

Partly, there was a demographic shift. “Unaffiliated” is by far the fastest-growing religious category in the US, according to a study by the Pew Research Center, which also showed that the total proportion of Americans who define as Christian dropped almost 9 percentage points between 2007 and 2014.

There is no doubt that America is still a fairly devout nation compared with the UK, but the political mythos that developed around its Christianity is a relatively late invention. The words “under god” were only implanted into the pledge of allegiance – between the words “one nation” and “indivisible” – in 1954, by President Eisenhower.

The ascendance of the political power of the Christian right in America happened in 1979, when a televangelist called Jerry Falwell founded a pressure group called Moral Majority.

Moral Majority’s support for Ronald Reagan was widely credited for his victory in the 1980 election, which in turn secured for them a position at the top table of Republican politics. For three decades, the Christian right was the single most important voting bloc in America.

But its power has been waning for a decade, and there are greater priorities in the American national psyche now.

Trump’s greatest asset throughout the primary was what makes his religiosity or lack thereof immaterial: his authenticity. His lack of a filter, his ability to wriggle free from gaffes which would have felled any other candidate with a simple shrug. This is what not just religious voters, but all of the Republican voting base were waiting for: someone who isn’t pandering, who hasn’t focus-grouped what they want to hear.

They don’t care that he may or may not truly share their belief in god. Almost all voters in this election cycle – including evangelicals, polling suggests – prioritise the economy over values anyway.

On top of that, the Christian right is facing the beginnings of an insurgency from within its own ranks; a paradigm shift in conservatism. A new culture war is beginning, fought by the alt-right, a movement whelped on anarchic message boards like 4chan, whose philosophical instincts lean towards the libertarian and anarcho-capitalist, and to whom the antique bloviation of Christian morality politics means nothing.

Trump doesn’t pander, an approach only made possible by social media, which amplifies his voice six millionfold while simultaneously circumventing the old establishment constructs – like the media – which had previously acted as gatekeepers to power.

The Christian right – now personified in Jerry Falwell Jr and Liberty University, which Falwell senior founded in the Seventies – found itself another of those constructs. They were forced to choose: jump on board the Trump Train or be left behind.

They chose Trump.

Nicky Woolf is a writer for the Guardian based in the US. He tweets @NickyWoolf.