British lawmakers on Friday approved plans to introduce medically assisted dying for terminally ill patients in England and Wales, advancing what would be one of the biggest social changes seen in Britain in decades.
After a debate that was at times emotive and fraught but remained respectful in tone, legislators supported the proposal by a vote of 314 to 291.
The vote on Friday was the second time lawmakers have approved the idea of medically assisted dying, after an initial vote in November of last year that was followed by months of scrutiny and debate in parliamentary committees. The issue has provoked deep division in and beyond the British Parliament.
The bill now goes to the unelected second chamber of the Parliament, the House of Lords. While the Lords can amend legislation, the fact that the bill has the support of elected lawmakers means that it is very likely to become law.
That would mean Britain would join a number of jurisdictions where assisted dying is permitted, including a small number of European countries, Canada and New Zealand, as well as 10 U.S. states and the District of Columbia.
It also makes Friday’s vote a consequential decision on changes that some have likened to Britain’s legalization of abortion in 1967 and the abolition of the death penalty in 1969. The vote comes days after lawmakers supported moves to decriminalize abortion for women in England and Wales, although medical professionals could still be prosecuted for carrying out terminations after 24 weeks.
The assisted dying legislation is deliberately narrow in scope. To qualify, patients would have to be over the age of 18, diagnosed with a terminal illness and have been given no more than six months to live. The lethal substance, provided by a doctor, would be administered by the person themselves.
The decision to go ahead would need approval by two doctors and a panel featuring a social worker, a senior legal figure such as a former judge, and a psychiatrist. A previous version of the plan would have put a judge in charge of the decision, but that idea was dropped because of the burden it would impose on the country’s already stretched court system.
The bill was introduced not by the British government, led by Prime Minister Keir Starmer, but by a backbench lawmaker from his Labour Party, Kim Leadbeater. Because it was regarded as an issue of conscience, lawmakers were permitted to vote as they saw fit rather than being instructed along party lines.
Months of scrutiny of the bill exposed sharp divisions over its impact.
Supporters of medically assisted dying argue it will curtail suffering in the final months of life. Under current law, Britons who help relatives or friends to end their lives face police questioning and potential prosecution. That means that terminally ill patients who decide to end their life in a country with more permissive rules, such as Switzerland, often do so alone to protect their families.
“This is not a choice between living or dying; it is a choice for terminally ill people about how they die,” Ms. Leadbeater said. “Giving dying people choice about how they die is about compassion, control, dignity and bodily autonomy.”
Opponents regard the measure as a threat to vulnerable people with complex medical conditions, who might feel pressure to agree to a premature death, perhaps to end physical or financial burdens on their families. Others have argued that, once the principle was established, the criteria for an assisted death could expand.
Some critics oppose the legislation on religious grounds as a matter of principle, but in Friday’s debate most of those who argued against it cited practical problems with the bill, claiming it contained insufficient safeguards.
“There is no doubt that if this is passed in its current form, people will lose their lives who do not need to, and they will be amongst the most vulnerable and marginalized in our society,” said Diane Abbott, a Labour Party veteran and the longest serving elected female lawmaker.
Under British parliamentary rules the bill will only return to the House of Commons if members of the House of Lords amend it. If that happens, further scrutiny in the Commons will be limited to the specific changes made by the second chamber.
Stephen Castle is a London correspondent of The Times, writing widely about Britain, its politics and the country’s relationship with Europe.
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