Shared concerns unite all sides of the euthanasia debate | Peter Beresford

Brigit Forsyth, the actor best know as Thelma in Whatever Happened to the Likely Lads? is currently playing a terminally ill musician on stage. Her character in Killing Time says she’s a “prime candidate for a one-way trip to Switzerland”. Forsyth has disclosed that her GP grandfather helped dying patients end their lives and that she is in favour of euthanasia. Her comments are the latest in a long line of opinions on legalised assisted dying reported in the press, which has a habit of oversimplifying the complex arguments for and against. And this seems to be damaging our ability to hold meaningful public debate on the subject.

With this in mind, a study funded by the Joseph Rowntree Foundation sought the views of people with strongly opposed opinions on the matter. Participants in both groups included people with palliative care backgrounds, older and disabled people, those from organisations concerned with care and support and individuals from academic, social work and policy backgrounds.

What emerged is a surprising amount of common ground. People with apparently polarised views on legalising the right to die often shared areas of interest and concern. It is these areas that should form the basis for further public discussion, argues the report, Assisted Dying: Developing the Debate, which is published on Wednesday by the Shaping Our Lives network of user-led groups, service users and disabled people.

Shared concerns included clear agreement that palliative care for terminally ill people is inadequate. Whether for or against assisted dying, participants showed a willingness to discuss quality of life for terminally ill people, the value placed on good-quality care, and how to invest in and provide access to this care in the face of economic inequality.

Participants recognised that the debate on legalising assisted dying was taking place in an unequal society: we often place lower social value on older, sick, and disabled people. The research identified a willingness to discuss prevailing societal values, including the concept of “being a burden” on society; the value society placed on social care and support work; and our social attitudes towards death and dying. “How should assisted dying be funded?”, “Where should it be performed?”, and “What methods and means of self-administering a fatal dose should be used?”, were just some of the common questions raised.

Despite disagreement about the extent to which detailed processes and safeguards should be included in assisted dying legislation, participants from across the spectrum of opinion generally agreed that the “how” questions were not being discussed in enough depth.

Areas of shared understanding also emerged when respondents discussed ethical and existential ideas around death and dying, including the psychological aspects of pain and suffering, both for individuals and their loved ones. “All participants had a wish to find the best way forward with compassion for people who are terminally ill, regardless of being for or against legalising assisted dying,” the report concludes.

The study shows that the issues are far more complex than much of the public debate has so far allowed. Death and dying is a core issue for human beings, and public debate must reflect this. It is time to embrace the personal, social, policy and ethical issues that participants have highlighted.

Back in the theatre, Forsyth’s dying musician is visited by a young carer (Zoe Mills) who feels it is her duty to help put older people out of their misery. According to the reviews, she comes to realise that life and death is more nuanced.

Shared concerns unite all sides of the euthanasia debate | Peter Beresford

Strong rhetoric on the two sides of e-cigarettes debate but tiny proof

A woman smoking an electronic cigarette. Photograph: Rex Characteristics

E-cigarettes are either going to save hundreds of thousands of lives by helping folks to quit smoking or they are going to destroy millions of lives by luring youngsters and younger folks into the habit. It is extremely challenging for the onlooker to know what to feel, when the rhetoric is flying in the two directions from very eminent folks who all have a passionate commitment to public overall health.

The most current letter to Margaret Chan, director basic of the Planet Well being Organisation, swings the pendulum firmly back to the place of the opponents of a cost-free industry in e-cigarettes. The language is challenging and uncompromising. It is signed by these who concern, primarily based on decades of proof of negative behaviour, that the tobacco companies are obtaining concerned in the nicotine delivery units in buy to undermine bans on cigarette marketing and smoking in public locations.

The letter is a response to a single from 53 scientists to Chan, sent on 3 June, which stated in no less direct language that treating e-cigarettes like tobacco would deprive smokers of a new and increasingly popular way to quit. E-cigarettes, the scientists say, are a really useful harm reduction instrument, permitting smokers to get their nicotine resolve without having the deadly tar in cigarettes. Amongst these who signed the earlier letter have been Professor Gerry Stimson, of Imperial University, who has been at the forefront of harm reduction advocacy in medication the former government drugs adviser David Nutt and Michel Kazatchkine, ex-head of the Global Fund, whose primary interest is HIV.

The opposing letter has twice the amount of signatories, from all over the planet. They fear a comeback by Massive Tobacco, which is turning into the most significant player in the e-cigarette industry. They do not think claims that the market wants to diversify. E-cigarettes could demonstrate to be a rewarding market place, but globally tobacco is massive, and increasing in the developing world. Why would Huge Tobacco support e-cigarettes if they are probably to shrink that market, the opponents inquire.

The WHO has been moving in their direction. Some smaller European countries, this kind of as Slovenia, have been asking for suggestions, and there are stories of e-cigarette shops opening outside colleges. In October, the WHO will meet to go over no matter whether to carry e-cigarettes into the framework convention on tobacco control, a single of the proudest achievements of the WHO, despite the fact that the guy who played the lead role in its improvement whilst at the WHO, Derek Yach, now of the Vitality Institute in New York, is 1 of the 53 signatories opposing that.

There are imagined to be two million men and women employing e-cigarettes in the Uk, and a lot of of them say they have managed to cease smoking as a result. A lot of argue passionately that they have been rescued from harm and that everyone must have a correct to use them if they want to. Powerful feelings have led to outbursts of anger and even vitriol on Twitter, and some public health medical doctors say they have been threatened. That has increased their personal conviction that malign forces – in the form of the tobacco business – should be pulling the strings.

In the end, only very good scientific proof will persuade the critics of e-cigarettes that they are not a danger. The studies that have been carried out, this kind of as a recent a single by Professor Robert West, from University College London, which showed that e-cigarettes had been far more effective than nicotine substitute treatment in helping people quit smoking, are not ample, opponents say. Their argument is that, till we know, we ought to opt to be secure rather than sorry.

Strong rhetoric on the two sides of e-cigarettes debate but tiny proof