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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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 toxic new right-wing media will outlast Trump even if he’s impeached

Fox News and a network of smaller outlets have created an alternative version of reality. That ecosystem might prove more durable than the US president. 

An early end to Donald Trump’s presidency looks more feasible than at any time in the 117 days since his inauguration.

The New York Times revealed on Tuesday that FBI director James Comey – who was fired by Trump a week ago – wrote a memo recording the President’s request he “let go” an investigation into links between Michael Flynn, Trump’s pick for national security advisor, and Russia.

Already there is talk of impeachment, not least because the crime Trump is accused of - obstructing justice - is the same one that ended Richard Nixon's presidency.

But with a Republican-controlled Congress the impeachment process would be long and fraught, and is only likely to succeed if public opinion, and particularly the opinion of the Republican voters, swings decisively against Trump.

In another era, the rolling coverage of the president's chaotic, incompetent and potentially corrupt administration might have pushed the needle far enough. But many of those Republican voters will make their decision about whether or not to stick with Trump based not on investigative reporting in the NYT or Washington Post, but based on reading a right-wing media ecosystem filled with distortions, distractions and fabrications.

That ecosystem – which spans new and (relatively) old media - will be going into overdrive to protect a president it helped elect, and who in turn has nourished it with praise and access.

On Monday, BuzzFeed’s Charlie Warzel took a forensic look at how a new breed of hyper-partisan right wing sites – what he calls the "Upside Down media" – tried to undermine and discredit claims that Trump disclosed sensitive security information to Russian officials.

The same tactics can already be seen just 24 hours later. Notorious conspiracist site Infowars talks of “saboteurs” and “turncoats” undermining the administration with leaks, mirroring an email from Trump’s campaign team sent late on Tuesday. Newsmax, another right-leaning sight with links to Trump, attacks the source of the story, asking in its web splash “Why did Comey wait so long?”. GatewayPundit, which published several false stories about Hillary Clinton during the election campaign, appears to have ignored the story altogether. 

As Warzel points out, these new sites work in concert with older media, in particular Rupert Murdoch’s ratings-topping cable news channel Fox News.

Fox initially underplayed the Comey memo’s significance, switching later to projecting the story as a media-led attack on Trump. At the time of publication, the Fox homepage led with a splash headlined: “THE SHOW MUST GO ON Lawmakers vow to focus on Trump agenda despite WH controversies.”

Fox acts as a source of validation for the newly established right-wing sites. Once Fox has covered a story, smaller sites can push further and faster, knowing that they aren't going too far from at least one outlet considered respectable and mainstream. If anything should make the UK value the impartiality rules, however imperfect, which govern its broadcast news, it’s Fox’s central role in enabling this toxic mix of misinformation.

These new media sites have another weapon, however. They understand and exploit the way internet platforms - in particular Facebook - are designed to maximise attention. They have found that playing on very human desires for stories that confirm our biases and trigger emotional responses is the best way to build audiences and win fans, and they have little compulsion abusing that knowledge.

This isn’t just a Trump or Fox-related phenomenon. It’s not even just a right-wing one. In both the US and the UK left-wing hyper-partisan sites with a tenuous relationship with the truth have sprung up. They have followed the same playbook, and in most cases the same advertising-based funding model, which has worked so well for the right. Emotive headlines, spun stories, outright fabrications and an insistence that “the corrupt mainstream media won’t report this” work just as well in generating clicks and shares for both ends of the political spectrum.

The main difference between the two political poles is that the right has benefited from an ideologically and temperamentally suited president, and a facilitator in Fox News. 

Of course the combined efforts of this new media and the Fox-led old may still fail. Trump’s recent transgressions appear so severe that they could break through to even his diehard supporters.

But if Trump does fall, the new right wing media ecosystem is unlikely to fall with him. 

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