Members of Parliament voted 314-291 to back the Terminally Ill Adults (End of Life) Bill following an impassioned debate. The majority of 23 was less than the 55 when they last voted on the issue in November, meaning that some lawmakers changed their minds in the intervening months.
Since November, the bill has been scrutinized, leading to some changes in the proposed legislation, which has been shepherded through Parliament by Kim Leadbeater, the Labour lawmaker who proposed the bill.
“I appreciate it's a huge moment for the country,” she told Sky News after the vote. “It was a huge sense of relief because this is the right thing to do.”
The bill now goes to the unelected House of Lords, which can amend or delay policy, though it can’t overrule the lower chamber.
What lawmakers voted on
The bill would allow terminally ill adults over age 18 in England and Wales, who are deemed to have less than six months to live, to apply for an assisted death. The bill doesn’t apply to Northern Ireland or Scotland, which is holding its own vote on the issue.
One of the most important changes to the bill from last November was the dropping of the requirement that a judge sign off on any decision. Many in the legal profession had objected.
Now any request would be subject to approval by two doctors and a panel featuring a social worker, senior legal figure and psychiatrist.
Changes were also made to ensure the establishment of independent advocates to support people with learning disabilities, autism or mental health conditions and the creation of a disability advisory board.
After receiving a go-ahead from doctors and the panel, the terminally ill person would have to be capable of taking the fatal drugs themselves.
Another big change made was that “no person,” including doctors, social care workers and pharmacists, will be obliged to take part.
Divisive issue
The bill has divided lawmakers for months. The vote was a free one, meaning lawmakers vote according to their conscience rather than on party lines. Alliances have formed across the political divide.
Proponents of the bill argued that those with a terminal diagnosis must be given a choice at the end of their lives to relieve their suffering. They also said that the current situation discriminates against the poor as wealthy individuals can already travel to Switzerland, which allows foreigners to legally end their lives, while others have to face possible prosecution for helping their loved ones die.
However, opponents warned that the most vulnerable in society, such as disabled and older people, could be at risk of being coerced, directly or indirectly, into ending their lives to save money or relieve the burden on family members.
Both sides agreed on the need to make improvements in palliative care and greater investments in hospices to ease suffering.
Passions ran high outside of Parliament where hundreds of people gathered to make their voices heard.
Supporters were dressed in clothing emblazoned with the phrase “Campaign for Dignity in Dying,” while opponents held up banners urging lawmakers not to make the state-run National Health Service the “National Suicide Service.”
Supporters wept, jumped and hugged each other as the bill was backed.
“This is for all the people who couldn’t be here today," said Sarah Wootton, chief executive of Dignity in Dying. “This vote sends a clear message. Parliament stands with the public and change is coming.”
Timeline for the bill
The legislation now goes to the unelected House of Lords. Any amendments would then go back to the House of Commons.
There's also the possibility of legal challenge to the policy. Opposition campaigners such as “Right To Life U.K.” and “Care Not Killing” said after the vote that they weren’t giving up the fight.
Backers of the bill say implementation will take four years, rather than the initially suggested two. That means it could become law in 2029, around the time that the next general election must be held.
Government stance
There is clearly no consensus in the Cabinet about the measure.
Prime Minister Keir Starmer backed the bill on Friday, while his health secretary, Wes Streeting, voted against.
The government has said it will respect the outcome.
However, it's not clear what the cost implications are, or how it would impact the NHS, hospice care and the legal system.
Nations where assisted dying is legal
Other countries that have legalized assisted suicide include Australia, Belgium, Canada and parts of the United States, with regulations on who is eligible varying by jurisdiction.
Assisted suicide is different from euthanasia, allowed in the Netherlands and Canada, which involves health care practitioners administering a lethal injection at the patient's request in specific circumstances.
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