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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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
Jamie Squire/Getty Images
Show Hide image

Clinton and Trump: do presidential debates really matter?

The ability of the candiates to perform in front of the cameras is unlikely to impact the final result.

The upcoming televised presidential debates between Hillary Clinton and Donald Trump are undoubtedly the most eagerly anticipated for many years. No doubt there are various surprises in store – this has been, after all, the most surprising of campaigns.

People will be particularly fascinated to see if Trump dials down his bombastic rhetoric and perhaps even adds some substance to the vague policy pronouncements he has made so far. To a lesser extent, many will also be interested in whether Clinton can add the necessary zest to what some consider her lacklustre style, and whether she can prove she’s made a sterling recovery from her recent bout with pneumonia.

It’s possible that some voters may in fact change their minds based on what they see in the two’s only on-camera encounters. And yet, barring a true disaster or devastating triumph, it’s unlikely that anything the candidates say or do will make much difference to the overall result.

This might not seem all that surprising for these two candidates in particular. Leaving aside how long they’ve both been in public life, social media and the 24-hour news cycle have put Clinton and Trump under incredible scrutiny ever since they announced their respective candidacies – and their every sentence and gesture has already been analysed in the greatest detail.

Trump in particular has received more free publicity from the networks and Twitter than even he could afford, and it’s highly unlikely that he will say anything that the US public hasn’t heard before. Similarly, voters’ impressions of Clinton are apparently so deeply entrenched that she probably won’t change many people’s minds.

Yet there are also broader reasons why presidential TV debates are less important than we might imagine.

Looking the part

Even before the media environment became as saturated as it is today, debates were rarely, if ever, decisive in presidential elections. The exception was possibly the very first TV debate in 1960, which pitted the then vice-president, Richard Nixon, against John F. Kennedy.

At the time, the election was so close that the young, relatively inexperienced but highly telegenic Kennedy was able to reap the benefits of putting his case directly to viewers. He was the underdog; a relative unknown in comparison to Nixon and so had more to gain from such national exposure. Nixon, as the establishment figure, had a lot to lose.

In the end, Kennedy’s narrow victory may well have been because of his debate performances. But his success also demonstrated another important feature of television debates: that viewers take more notice of what they see than what they hear.

Notoriously, television viewers responded very favourably to Kennedy’s film-star good looks, but were turned off by Nixon, who refused to wear make-up and looked sweaty and uncomfortable under the studio lights. In contrast, those who listened on the radio believed that Nixon had come out on top. It seems that viewers saw Kennedy as more “presidential” than Nixon, especially given his calmness under pressure. Kennedy did work hard to exploit some of Nixon’s weaknesses on policy, but in the end, that turned out not to be the point.

Kennedy’s success was one of the reasons that neither of his two successors, Lyndon B. Johnson and then a resurgent Nixon, participated in any such events when they were running for the presidency. Although some debates were held in the primaries, there were no face-to-face contests between presidential candidates in 1964, 1968 or 1972.

The next debates were held in 1976, another tight campaign. These yielded a notorious moment in the second encounter between Gerald R Ford and Jimmy Carter, when the incumbent Ford appeared to throw the election away with a poorly judged remark declaring that there was no Soviet domination of Eastern Europe. As myth has it, this gaffe stalled Ford’s polling surge; he ultimately lost the election.

Yet even this was not decisive. Although the comment did the president no favours, it’s highly debatable whether it in fact had an impact on the overall result; Ford actually closed the polling gap with Carter between the debates and the general election. People’s reactions to the debate had less to do with the substance of his remark and much more with the media’s constant replay and analysis of that moment, which continues to mar Ford’s reputation to this day.

Selective memory

This pattern has continued in the election cycles that have followed, as slips and awkward moments rather than substance provide the media with dominant themes. Many people recall vice-presidential candidate Dan Quayle’s cack-handed attempt to compare himself to Kennedy in 1988, or George Bush senior’s ill-judged glance at his watch when listening to a question in 1992; few probably remember much about what policies they discussed, or whether, if they won, they carried them out.

If anything, the shortcomings of the TV debate format have become more pronounced in the current cycle. Although neither of the main candidates in this year’s election wants for national exposure, the primary debates have tended to favour the underdog and those who claim to be outsiders.

On the Republican side, Trump’s various moderate competitors were one by one hobbled and engulfed; Clinton, for her part, spent months slugging it out with her remarkably successful left-wing rival Bernie Sanders, never quite landing a televised knockout punch and ultimately only defeating him properly after six months of primaries.

While credible policy proposals seem to matter less than ever, things that would have once been considered catastrophic gaffes have become par for the course. Indeed, one could argue that Trump’s success so far is because he has built his campaign on half-truths and outright lies without care for the consequences.

So despite all the anticipation, this year’s debates probably won’t tell us very much about what will happen after the president takes office next January; the analysis will almost certainly focus less on what the candidates have to say and more on how they say it. Voters will no doubt tune in in great, possibly record-breaking numbers, but they’ll come away with precious little sense of what’s in store for their country.

Equally, the spectacles we’re about to witness might be pyrotechnic enough, but they’re unlikely to decide the result in November. And in the unlikely event that they do, it won’t be for the right reasons.

Andrew Priest is a lecturer in Modern US History at the University of Essex

This article was originally published on The Conversation. Read the original article.