LONDON (AP) — U.K. lawmakers on Friday approved a bill to allow terminally ill adults in England and Wales to choose to end their lives in a historic vote in Parliament that takes it a step nearer to becoming law.
Members of Parliament voted 314-291 to back the Terminally Ill Adults (End of Life) Bill following an impassioned and respectful 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 by Labour lawmaker Kim Leadbeater rather than the government
It's not quite law yet as the bill now goes to the unelected House of Lords, which can amend or delay policy, though it can’t overrule the lower chamber.
The vote is potentially the biggest change to social policy since abortion was partially legalized in 1967.
Divisive issue
In opening the debate, Leadbeater relayed how she had heard hundreds of stories from people who saw their loved ones die in traumatic circumstances.
“Not supporting the bill today is not a neutral act. It is a vote for the status quo," she said. "And it fills me with despair to think MPs could be here in another 10 years’ time hearing the same stories.”
Proponents of the bill argue those with a terminal diagnosis must be given a choice at the end of their lives. However, opponents say the 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. Others have called for improvements in palliative care and greater investments in hospices to ease suffering as a better and more moral alternative.
Diane Abbott, a veteran left-wing Labour lawmaker, urged MPs to “speak up for the voiceless one more time, because there is no doubt that if this bill 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.”
Passions were running 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.”
What lawmakers are voting 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 terminally ill person would have to be capable of taking the fatal drugs themselves.
Proponents of the bill say wealthy individuals can travel to Switzerland, which allows foreigners to legally end their lives, while others have to face possible prosecution for helping their loves ones die.
Timeline for the bill
Friday's result isn't the end of the matter. The legislation now goes to the unelected House of Lords, which has the power to delay and amend policy, though it can't overrule the lower chamber.
Since assisted dying wasn't in the governing Labour Party's election manifesto last year, the House of Lords has more room to maneuver. Any amendments would then go back to the House of Commons.
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.
Changes to the bill
Plenty of revisions have been made to the measure, but not enough for some.
Perhaps the most important change was to drop 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 also were 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.
It was already the case that doctors wouldn't be required to take part, but lawmakers have since voted to insert a new clause into the bill extending the provision to anyone.
The wording means “no person,” including social care workers and pharmacists, is obliged to take part in assisted dying and can therefore opt out.
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 it. But Streeting has said that he would respect the outcome.
There are also questions about 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.
Pan Pylas, The Associated Press
