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view of many people, a clear majority according to opinion polls, who feel that the current law on assisted dying is out of date.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 far right rises as the Nordic welfare model is tested to breaking point by immigration

Writing from Stockholm, the New Statesman’s editor observes how mass immigration has tested the old Scandinavian model of welfare capitalism.

In the summer of 1999 I was commissioned by a Scandinavian magazine to write about the completion of the longest road-and-rail link in Europe, connecting Denmark and Sweden across the Øresund strait at the gateway to the Baltic Sea. I was a guest at the ceremony, along with assorted Swedish and Danish royalty, at which the final girder of the concrete and steel-cable-stayed bridge was fitted into place.

It was a cold day but the mood was joyful. The Øresund Fixed Link symbolised the new Europe of open borders and free movement of people. There was much excitement about the creation of an economic zone centred on Copenhagen but incorporating Malmö and the university town of Lund in Sweden. The Øresund Bridge has since become an icon of Scandinavian culture, in part because of the success of the noirish television crime series The Bridge, starring the blank-eyed Sofia Helin as the Swedish police detective Saga Norén, which fetishises the structure in its brilliantly stylised opening credits.

Emergency measures

Last autumn, after Angela Merkel declared that Germany’s borders were open to Syrian refugees, it was across the Øresund that tens of thousands of desperate people began arriving in Sweden, straining the country’s habitual openness to incomers. They were arriving not just from Syria but from Afghanistan, Iraq, Pakistan, Eritrea and elsewhere in Africa – sometimes as many as 10,000 a week. In 2015, 163,000 people registered for asylum in Sweden, including 36,000 unaccompanied children. Many others are presumed to have entered the country illegally. (The comparative figure registering for asylum in Germany was 1.2 million and in Denmark 25,000. David Cameron has pledged to resettle 20,000 Syrian refugees in Britain by 2020.)

There was a sense last November that Stefan Löfven’s minority Social Democratic government was losing control of the situation. As a result, Sweden was forced to introduce emergency border controls, as well as security checks for those arriving across the bridge from Denmark. The rules of the Schengen passport-free area allow for such measures to be enacted in a crisis. Denmark responded by tightening border controls with Germany as fences and barriers were erected across Europe in an attempt to stem the flow of refugees heading north along the so-called western Balkan route.

Sweden’s Blair

To the outsider, Sweden no longer seems to be a country at ease with itself. Mass immigration has tested the old Scandinavian model of welfare capitalism to near breaking point and resentment is festering. “Immigration is now the number one issue facing our country,” Johan Forssell told me when we met at the Riksdag in Stockholm. He is a former chief of staff for Fredrik Reinfeldt, prime minister from 2006-14. As a former leader of the Moderate Party, Reinfeldt is a conservative, but, in his commitment to free markets and open borders, the politician he most resembles is Tony Blair. I was a guest at a lunch for Reinfeldt in London last autumn, and, as he defended his immigration policies, I was struck above all by his liberalism.

In August 2014, in a celebrated speech, he called on his fellow Swedes to “open their hearts” and “show tolerance” to immigrants and asylum-seekers. The speech was received with derision. It surely contributed to the defeat of the Moderate-led centre-right coalition in the general election in which the far-right Sweden Democrats, led by Jimmie Åkesson, recorded their best ever performance, winning 49 out of 349 parliamentary seats. “It was a brave speech, but Freddie didn’t prepare the people for it,” one senior Swedish politician said to me.

Editorial positions

One afternoon I visited Peter Wolodarski, the 38-year-old editor-in-chief of Sweden’s leading quality daily newspaper, Dagens Nyheter (“Today’s News”), at his office in Stockholm. The son of a Polish-Jewish architect who came to Sweden in the 1960s, Wolodarski is highly influential: editor, columnist and television commentator, and an unapologetic liberal internationalist. He likened his politics to David Miliband’s. In the past, Dagens Nyheter, which is privately owned by the Bonnier family, supported the then-hegemonic Social Democrats but, reflecting the fluidity and shifting alliances of Swedish politics, it now pursues what it describes as an “independently liberal” editorial position.

Wolodarski, who used to edit the comment pages, is slim and energetic and speaks perfect English. We discussed the EU referendum in Britain, which alarmed and mystified him, and Islamist terror as well as the rise of the anti-immigrant Sweden Democrats. Security at the Dagens Nyheter offices has been tightened considerably since the Charlie Hebdo massacre – Wolodarski’s paper as well as others in the group republished Charlie cartoons – and it has been reported that as many as 300 Swedish nationals are fighting for Isis in Syria. One Swede, Osama Krayem, is suspected of being part of the group that carried out the Brussels attacks in March. The Sweden Democrats have seized on this as further evidence of the failures of Nordic multiculturalism.

A refugee’s story

One morning I visited a refugee registration centre in Märsta in the northern suburbs. The people there were fleeing war or persecution. Each was waiting to discover where next they would be moved while their asylum application was processed.

One young, secular Muslim woman from Gambia told me she was escaping an arranged marriage (to her mother’s polygamous brother, who was in his sixties) and the horror of female genital mutilation. Articulate and frustrated, she wept as we talked. The next day, I received an email from her. She was now in a small town in the far north. “It is remote here and cold,” she wrote. And then she wished me a “safe return journey” to London.

Jason Cowley is editor of the New Statesman. He has been the editor of Granta, a senior editor at the Observer and a staff writer at the Times.

This article first appeared in the 06 April 2016 issue of the New Statesman, The longest hatred