Assisted dying: why Britain should back a change

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Hello and welcome to the Intelligence from the Economist. I'm your host, Rosie Blore. Every weekday we provide a fresh perspective on the event shaping your world. Donald Trump has already influenced the Supreme Court and American society with the justices he appointed during his first term as president. What might happen the second time around? And Frank Auerbach arrived in Britain as a child refugee from Nazi Germany. He spent the rest of his life trying to fix what he saw around him in paint, often returning again and again to the same images. Our obituary's editor remembers him. But first, Should people have the right to choose how they die? The Economist has long argued that a liberal society should let someone who is suffering make a dignified decision about how to end their life. Parts of the world do allow that some people who are terminally ill can legally receive such help, but not in Britain. A week from today, MPs will have a chance to change that. They will vote on a bill that would be a first step to legalising assisted dying in England and Wales. Previously, most MPs had said they would support such a law. Now many are wavering, including Britain's health Secretary, Wes Streeting, who says he won't back it. I've made it clear that I'll be.

Voting against the assisted dying bill this time. That's mainly because I don't think some.

Oppose it on grounds of principle. Many think it will be expensive. But there are also those who worry about what has happened in other countries.

Often when opponents of assisted dying talk about this issue, they point to Canada as an example of the slippery slope.

Georgia Banjo is a Britain correspondent.

The idea is that this law has widened over time and that lots and lots more people are now choosing to end their lives this way. But I don't think that's a great comparison because Canada's law was always relatively more expansive than the bill that's being proposed in England and Wales. And we know if you look at states in America, Australia and also New Zealand, they have all passed assisted dying laws which are restricted to the terminal and we have not yet seen any of them broaden.

So how similar is the bill proposed in England and Wales to the one that has raised anxieties, the one in Canada?

The proposed law is a lot more restrictive. So essentially you've got to be terminally ill, you've got to have less than six months to live. You need two doctors independently of one another to agree that you're of sound mind, that you don't have any mental health conditions which might influence your choice. This approval also needs to then be approved by a High Court judge. He is specifically tasked with looking for any signs that you've been coerced into the choice. So the MP who's responsible for drafting this bill is Kim Lebbeta, who's a Labour mp and I went to meet with her recently to talk about it.

So, for me, the best models were Australia and America.

So various different states in Australia and America.

Her bill is extremely similar to a law passed in Victoria that's a state in Australia. In 2017, that law is already the most restrictive in the world. There is a difference in terms of who gives the final approval. In Victoria, it's a senior civil servant. He signs off. In Kim Leadbeater's bill, it's a High Court judge. And I think a concern about that is we know that in the uk, capacity in courts is really stretched. So I wanted to hear what Leadbeater had to say about that.

I didn't want it to be a tick box exercise.

I didn't want it to be, there's the paperwork. Yes, everything's been signed, tick, tick, tick.

You know, off you go.

But I also really wanted that third.

Layer of safeguarding to be in place. I think that just gives this bill.

An extra level of protection and I do firmly believe it's the right thing to do.

In spite of these small differences, what I think Victoria's law shows is that a law like this can be implemented safely and effectively. We know that even though it's been going for five and a half years now, assisted deaths in Victoria are only about 1% of total deaths. We know that three quarters of those deaths are cancer related and we also know that the median age of a patient is 73.

So the question about whether an assisted dying bill might end up being a slippery slope is just one anxiety. Another of them is that an ill person might be coerced by family members or other people.

Sure. And I think that's a really scary idea. Right. That a vulnerable dying person could be coerced into such a decision. So I was really keen to put that to people I met in Australia and I spoke to quite a few doctors who take part in the process, and none of them said they'd ever seen a hint of coercion in the people they're talking to in the cases they've been involved with. Indeed, one doctor, Dr. Ana Nagus in Western Australia, said it's the opposite. It's normally families trying to talk people out of it.

Another of the issues that comes up is that we need an assisted dying bill because somehow we are not doing enough to make the end of life comfortable in other ways.

Yeah. So this is the classic argument really now, about palliative care, which has been raised by people like Wes treating the Health Secretary. Again, this was something I really looked for in Victoria, because I think the idea that someone's doing that because they can't get good care would be awful. But there's no evidence that's the case. So there's no evidence that uptake is higher in areas where palliative care is patchier. And the other thing about Victoria is that now, after a lot of controversy when the bill was being passed, the idea of assisted dying isn't that controversial anymore.

Most MPs in Britain support assisted dying in principle, according to all the surveys that we've done. What's going to happen with this bill?

Yeah, it's a really strange thing because we know most MPs support the principle, but it seems like some of them are wavering about whether they should vote for this bill. I think part of that has to do with the leadership of Keir Starmer, the Prime Minister. So he also supports his sister dying, but he's not handled this whole process very well. He hasn't allowed enough time for a debate. He hasn't helped Kim Led Beater draft a legislation when I think that could have been possible. I think for issues as controversial as this, it's important that they're always free votes. But I think what's happened in this instance is that the Prime Minister's been absent, the Health Secretary, Wes Streeting's been actively opposed. And so that means that a lot of MPs, many of them new after the election in July, are now having doubts. And again, if you compare this with Victoria's experience, the government was a lot more involved. The debate lasted, I think, over a hundred hours. And here we've got a debate on a Friday afternoon and it'll be maybe five hours. So you can see why opponents of the bill, some of them I've spoken to, like Rachel Maskell, who's another mp, think this whole thing's been quite rushed.

And do they have a point?

Yeah, to be honest, I think they do. I think you can imagine a situation where this whole thing had been better planned, where, again, if you look at the evidence, it's pretty clear that such a restrictive bill can be passed safely. There'll be plenty of time to work out the details later on. This vote's meant to be about the principles, and as Leadbeater told me, 29th November is just the start of the parliamentary process. There'll be for scrutiny afterwards.

So if this assisted dying bill doesn't pass, is assisted dying in Britain over?

It's a really tough one. The last time this was debated was 2015. It's been almost a decade since. I think Leadbeater thinks that, you know, this is the strictest bill so far that we've ever had. It's got the most safeguards built into it. And actually, my fear is that if this bill does pass, it will be too restrictive. If it passes, it would be the strictest bill in the world. I think some of us would actually prefer to see a law with fewer safeguards and maybe there would be a chance to pass a law like that down the line when MPs have really had a chance to look at the evidence. The risk is it's actually the opposite of a slippery slope, that actually what could happen if this bill passes is that we all end up in a straitjacket where it's actually really hard for people to use this law. But I think regardless of the issues we have with this bill, clearly this is something we want to see pass.

Georgia, thank you so much for joining me.

Thank you so much, Rosie.

During his first term as president, Donald Trump reshaped America's Supreme Court, appointing three justices to the nine member lineup. She is a woman of unparalleled achievement, towering intellect, sterling credentials, and unyielding loyalty to the Constitution.

Judge Amy Coney Barrett.

Tonight, it is my honor and privilege.

To announce that I will nominate Judge Brett Kavanaugh.

Judge Gorse has outstanding legal skills, a brilliant mind, tremendous discipline, and has earned bipartisan. With two thirds of its judges conservative, the court has already made decisions that have changed American society. And in Trump's second term, that shift could become even more pronounced.

By 2028, more than half of the nine justices on the Supreme Court could be appointed by Donald Trump.

Stephen Mazzy writes about the Supreme Court.

That would mean one president would have appointed a majority of the court. And that is something that hasn't happened in a very long time. And we should recall that America is unique in that justices serve for life. So there are many imprints that Donald Trump could leave on America. But his most profound and longest lasting legacy could well be reshaping the Supreme Court.

So just before we move on to the future, can you remind me what happened last time Trump was in power? So after 2016, well, eight years ago.

We had a balanced court. We had an eight member, four to four court. Justice Scalia had died that February, and Senate Republicans had refused to let Barack Obama fill his seat. So we knew an appointment was coming. And the person Donald Trump chose when he came into office early in 2017 was Neil Gorsuch. Between 2017 and 2020, Trump managed to appoint Neil Gorsuch and then Brett Kavanaugh in 2018. And as voting in the 2020 election was already underway, Amy Coney Barrett. So, as of October 27, 2020, when Justice Barrett donned her robes, Trump had transformed a balanced court to a lopsided 3 conservative majority court.

And of course, that's had a huge impact on policy, hasn't it? Most obviously with the overturning of Roe vs. Wade.

Yes. In 2022, Trump's three justices joined in the Dobbs opinion, which overturned Roe vs. Wade, which had protected a right to abortion for five decades. But the court has done a lot of other things since 2020. The court has greatly expanded gun rights. It has gutted the power of administrative agen. It has brought church and state closer together constitutionally than they have ever been. And this past July, the court surprised a lot of people in the bracingly titled case of Trump versus US to give presidents immunity from criminal prosecution for nearly everything they do. And that decision pulled the plug on a quite tenable lawsuit against Donald Trump for his role trying to overthrow the last election.

You've mentioned that we might get some new justices who would need to leave.

The two justices who are furthest to the right on the court are also the justices who are the two oldest. They are Clarence Thomas at 76 and Samuel Alito at 74. And there is some expectation that one or both of these men will step down in the next year or two to let Donald Trump name their successors, while Trump has a fairly comfortable majority in the Senate. And it's also worth noting that John Roberts, the chief justice, turns 70 years old one week after Trump enters the White House. And Justice Sonia Sotomayor, one of the three remaining liberal justices, is already 70. So it's not unthinkable that Trump could have three or four appointments in his second term. But if he gets two, although the six to three balance would not change, that balance would be extended potentially for decades, and it would very much be Donald Trump's court.

And do you have any sense of who Trump might pick for the court and what they stand for?

There are two relatively young judges, both on the Fifth Circuit Court of Appeals, which is America's most conservative court, who a lot of people are mentioning as possible replacements for Thomas and Alito. One of them is James Ho. He's 51. He has described gun rights as the ultimate guarantor of all other liberties enjoyed by Americans. He regularly injects himself into culture war battles, for example, boycotting students from certain law schools when he's hiring clerks. In a recent interview, he announced his position that birthright citizenship, which is a foundational right in the 14th Amendment that says if you are born in the United States States, you are a citizen thereof, does not apply to children of migrants who cross the border illegally. He called them, in this interview, invaders. And some of his outrageous rulings, like purporting to take abortion pills off the shelf or saying that violent domestic abusers have a right to own guns, have been roundly rejected by the justices when they've reached the Supreme Court. There are other contenders. Another one is also at the Fifth Circuit Court of Appeals. His name is Andrew Oldham. He's younger than ho at age 46, and he clerked for Justice Alito in 2008. Likewise, Judge Ho had clerked for Justice Thomas. So there might be some sort of poetic transfer of judicial power between Thomas and Alito and those two 5th Circuit judges.

Do you have any sense, given all of this, what we can expect from the court under Trump? What kind of issues might be in the in tray?

There's the very important question of whether and to what extent the court will provide guardrails against likely excesses of a second Trump term. It's important to recall that the court did check Trump's power in some ways during his first term. When he wanted to add a citizenship question to the census, they blocked that. When Trump wanted to protect his financial records and taxes from prying eyes, they didn't let him do that. They cut back on the first two iterations of his travel ban against people coming from Muslim countries. And also there was a decision involving DACA, the Deferred Action for Childhood Arrivals, which was the 2012 liberalization under Obama, the court blocked Trump's attempt to rescind that. I still expect the court, despite everything I've said, to be a bulwark against truly outrageous moves, such as if Trump does try to rescind the citizenship of people born on American soil. And Justice Barrett in particular, seems less likely to enable Trump in a second term than her brethren. But because the court is now six to three, she'll need to be joined by at least one more conservative to form a majority with the three liberal justices. And the most likely person to join her in those cases would be the Chief Justice, John Roberts or Brett Kavanaugh. And those justices, I think, cannot be counted on.

Stephen, thank you so much for talking to me.

Oh, Rosie, thank you.

As Donald Trump thinks about his future plans, Democrats are considering how to respond to them. Today's episode of Checks and Balance, our weekly US Podcast, will be looking at how the Democrats are regrouping after losing the election. You'll need to be a subscriber to listen.

Almost every day of the week. For more than six decades, Frank Auerbach would stroll along Mornington Crescent, a very typical North London street.

Ann Rowe is the Economist's obituaries editor.

Tall terraced houses of sooty red brick and stucco with a small park or garden railed off to one side. He would often go there at dawn with a sketch pad and do drawings of it, because he loved to just watch the deserted streets before anyone had stirred. And this was his whole world, this plus gritty Camden Town on the edge of it, and Primrose Hill with its green slopes and lovely views of London. That was about as far as he got out of this radius. And he painted this world again and again and again. If you went through the wicket gate and down to his studio, the door opened on a complete explosion of paint. He worked really in a storm, almost throwing his paint around, squeezing the tubes directly onto the canvas and layering up his paint so thickly that it sometimes looked as if it wasn't paint at all, but sand or mud or something like that. He loved layering and layering his paint. And when he went round the bomb sites of London, which were another cause of great fascination to him, very dramatic, he found them. He would produce these pictures that looked as if they were great turmoils of mud, general darkness and gloom after the war. But he did in the end begin to become a little bit lighter in his approach. There was, however, an itch always in the back of his mind that he had to create one Memorable image. He didn't feel yet that he had. He'd got to make a painting that would stick in the public mind, that would seem to stand by itself, even without having anything to do with him. And so his technique, after he'd layered and layered and layered the paint up on the paper, was often just to scrape it all off again because he was still dissatisfied with it. His sitters would hear him muttering, rubbish, complete rubbish. So this meant that his bill for paint was absolutely extraordinary, because at first he had rather dull blacks and browns and greens, and then he moved into much brighter colors. But he used tremendous amounts of it, and he reckoned that 95% of it would just end up in the bin, because he would paint and paint again and layer on the paint and scrape it all off. And that was his technique. He did the same with his sketches and drawings in charcoal or graphite. He would rub them out with a rubber and try and draw over them, rub them out again. And he was rather pleased with the effect of ghostliness that appeared on the paper. His only memory from his early years was putting a brush in the paint box and feeling how the brush went in and then seeing the colors soak into the paper. This was extraordinarily exciting, and it was poignant that it was his only childhood memory, because his childhood was interrupted abruptly when he was 8, when his parents sent him to England by the Kindertransport. They themselves were so anxious about what was happening with the Nazis that they decided they couldn't risk bringing him up in Germany anymore. But they did not escape, and they were murdered in Auschwitz in 1942. Oddly, by then, Frank Auerbach had become so acclimatized to England that he hardly remembered his parents. And he was becoming more and more obsessed with being an artist. At school, he focused on art all the time. When he was 16, he decided an artist was what he was going to be. And when he had finished at art school, he tried to sell his paintings from the pavement. And he could never really do anything new. He felt that had not been tried before. But what he could produce was what his mind saw, because his mind was unique and it was new, and nobody else was going to grasp an object quite in the same way. So his style of painting was really coming from deep inside himself. He didn't think it was expressionist, he just thought it was a portrayal of his mind at that moment. And that meant he could keep on and on painting. There would be no end to it, because his objects and faces were different every time. Of day he looked at them every time his mood changed. There was always something that was making the subject of his painting different and that was why he kept on until he was 93 and would have kept on further if he could possibly have managed it. He was still enchanted by the way the light of the dawn on Mornington Crescent changed every single time he passed.

Ann Row on Frank Auerbach, who has died aged 93. That's all for this episode of the Intelligence. The show's editors are Chris Impey and Jack Gill. Our deputy editor is John Joe Devlin and our sound designer is Will Rowe with help this week from Timo Saila. Our senior producers are Rory Galloway and Sarah Larnyuk. Our senior creative producer is William Warren. Our producers are Maggie Khadifa and Benji Guy. And our assistant producers are Henrietta McFarlane and Kunal Patel with extra production help this week from Jonathan Day. We'll all see you back here for the weekend. Intelligence tomorrow.