LONDON — British lawmakers are set to vote Friday on whether to back a bill to help terminally ill adults end their lives in England and Wales, in what could be one of the most consequential social policy decisions they will ever make.
Members of Parliament supported legalizing assisted dying when they first debated the issue in November by 330 votes to 275.
Since then, the Terminally Ill Adults (End of Life) Bill has undergone months of scrutiny leading to some changes in the proposed legislation, which is being shepherded through Parliament by Labour lawmaker Kim Leadbeater rather than the government.
Leadbeater is confident lawmakers will back the bill.
“We have the most robust piece of legislation in the world in front of us tomorrow, and I know that many colleagues have engaged very closely with the legislation and will make their decision based on those facts and that evidence, and that cannot be disputed,” Leadbeater said Thursday on the eve of the vote alongside bereaved and terminally ill people.
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 elderly could be at risk of being coerced, directly or indirectly, to end their lives to save money or relieve the burden on family members. Others have called for the improvement of palliative care to ease suffering as an alternative.
The vote is potentially the biggest change to social policy since abortion was legalized in 1967.
The Terminally Ill Adults (End of Life) Bill would allow terminally ill adults aged over 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.
The outcome of the vote is unclear, as some lawmakers who backed the bill in the fall only did so on the proviso there would be changes made. Some who backed the bill then have voiced disappointment at the changes, while others have indicated Parliament has not been given enough time to debate the issues.
The vote is a free one, meaning lawmakers vote according to their conscience rather than on party lines. Alliances have formed across the political divide.
If 28 members switched directly from backing the bill to opposing it, while others voted exactly the same way, the legislation would fail.
Friday’s vote is not the end of the matter. The legislation would then go 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 was not 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.
If the bill is passed, backers say implementation will take four years, rather than the initially suggested two. That means it could become law in 2029, around the time the next general election must be held.
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 would not 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.
There is clear no consensus in the cabinet about the measure.
Prime Minister Keir Starmer has indicated he will back the bill on Friday. His health secretary, Wes Streeting, is opposed but said he will respect the outcome.
There are also questions about how it would impact the U.K.’s state-funded National Health Service, hospice care and the legal system.
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.
