UK Lawmakers Approve Assisted-Dying Law

British lawmakers voted Friday to legalize assisted dying — a final step in the House of Commons that means the practice will almost certainly be permitted in England and Wales in the coming years, marking a pivotal societal change.

Lawmakers voted 314 to 291 for legalization following an impassioned, four-hour debate. Modeled on a law in Oregon, the Terminally Ill Adults (End of Life) Bill will allow terminally ill people to choose to die. Those with less than six months to live will be permitted to seek lethal medication from the National Health Service, subject to approval of two doctors and a panel of experts.

The bill now moves to the House of Lords, the upper chamber of the British Parliament, for further scrutiny, but it is highly likely to become law.

“I do not underestimate the significance of this day,” Kim Leadbeater, a Labour Party lawmaker and main champion of the bill, said Friday as she opened the debate. “This is not a choice for living and dying. It is a choice for terminally ill people about how they die.”

While assisted dying is illegal in most countries, a growing number of nations and jurisdictions have adopted legislation or are considering it. In England and Wales, assisting a death remains illegal and punishable by up to 14 years in prison.

A poll published this week found that 73 percent of Britons backed the assisted-dying bill.

While lawmakers voted in favor of the bill in November, at an earlier stage in the legislative process, uncertainty lingered ahead of Friday’s vote. Hundreds of demonstrators on both sides gathered outside Parliament. Some carried placards that read, “Let Us Choose.” Others held signs saying, “Don’t make doctors killers.”

Many of those who spoke during the debate shared personal stories.

Mark Garnier, a Conservative Party politician, spoke about witnessing the dying days of his mother, who had pancreatic cancer and endured a “huge amount of pain.” Garnier compared her ordeal to that of a constituent who also had pancreatic cancer but went through a state-provided assisted-dying program in Spain that made her “suffering much less.”

Josh Babarinde, a Liberal Democrat, read out a letter from a constituent traumatized by the death of her partner, who struggled to breathe, was incontinent and repeatedly asked for her help to end his life. He then “stuffed yards of his top sheet into his mouth” in an attempt to die,” Babarinde said, adding: “This could have been avoided with an assisted-dying” law.

Several lawmakers, including Liberal Democrat Steve Darling, said they had changed their minds in recent weeks.

In an interview with The Washington Post, Darling said he was concerned about palliative care funding, which in Britain is highly dependent on charitable donations.

“People might think, ‘I could bite the bullet and get out of this situation because I’m not receiving a service that gives me a decent quality of life toward the end,’” said Darling, who opposed the measure. “If the government were to say, ‘There’s clear evidence of palliative care about to arrive just over the horizon’ … I would almost certainly back the bill. But that isn’t the case.”

Others who said they agreed with the principle of letting people choose to die but could not back the bill included Labour member Vicky Foxcroft, who cited her work with disabled people. “They want us as parliamentarians to assist them to live, not to die,” Foxcroft told Parliament.

The issue remains divisive among parties. Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood, whose departments will each be impacted if the change becomes law, both opposed the bill. Prime Minister Keir Starmer made it clear that he supports the measure, citing his experience as the country’s former chief prosecutor.

Over the past two decades, more than 3,900 Britons have ended their lives with the Switzerland-based organization Dignitas. A few people who helped them were investigated or arrested.

The vote Friday was a free vote, meaning that lawmakers could decide based on their own conscience rather than along party lines. It was the second time this week that Parliament held a free vote, which is often allowed on issues of ethics or conscience. Earlier this week, lawmakers voted in favor of decriminalizing abortion in England and Wales.

One major revision to the bill in recent months was to eliminate the need for approval from a high court judge. No other country or jurisdiction with legalized assisted dying has that kind of stringent judicial oversight, and it was initially sold to some wavering lawmakers as a reason to back the bill.

That requirement was dropped in favor of a three-person expert panel — a lawyer, social worker and psychiatrist — that will oversee applications. Leadbeater said this would make the bill stronger, as members of the panel would have more relevant expertise and would be better able to spot red flags. Spain uses a similar kind of expert panel.

Some professional bodies, such as the Royal College of Psychiatrists, remain neutral on the principle of assisted dying but opposed the legislation as written. Their concerns included the shortage of qualified staff for the expert panels.

The government’s own “impact assessment” found that the law could lead to 7,500 requests a year within a decade.

Some campaigners had hoped for greater eligibility, to include patients experiencing unbearable suffering with no prospect of improvement, or allowing a doctor to administer a lethal cocktail of drugs.

This bill allows assisted dying only for terminally ill patients who can administer the medication themselves.

Speaking in Parliament, Peter Prinsley, a Labour lawmaker, said that “as a young doctor, I found the measures that we’re debating today completely unconscionable.” However, he added, “now that I’m an old doctor, I feel sure this is an essential change.”

“We are not dealing with life or death, rather death or death,” Prinsley said. “And fundamental to that is surely choice. Who are we to deny that to the dying?”