In a significant and emotionally charged decision, Members of Parliament have approved a groundbreaking bill that could transform end-of-life choices in England and Wales. The Terminally Ill Adults Bill, which would allow terminally ill adults the legal right to end their lives, was passed in the House of Commons by a vote of 314 to 291. With a narrow majority of 23 votes, the bill now moves to the House of Lords for additional scrutiny, where its future still hangs in the balance.
This latest vote saw a decline in support compared to its initial debate in November, when the margin stood at 55. Despite this drop, the bill’s passage marks a pivotal step toward legalizing assisted dying, a move that has long been the subject of ethical, medical, and political debate. The deeply personal nature of the issue was reflected in the Commons, where several MPs shared stories of witnessing the suffering of terminally ill friends and relatives.
Should the House of Lords pass the legislation later this year, the government would have up to four years to put the measures into practice. This means that assisted dying could realistically become available by 2029. MPs were allowed a free vote on the matter, meaning they were not obligated to follow party lines. While Prime Minister Sir Keir Starmer supported the bill, prominent figures such as Conservative leader Kemi Badenoch and Health Secretary Wes Streeting voted against it.
Labour MP Kim Leadbeater, who played a key role in advancing the bill through the Commons, expressed her deep emotional investment in the legislation following the vote. Speaking to the BBC, she said, “I know what this means for terminally ill people and their loved ones.” Leadbeater also noted the personal significance of the week, which marked nine years since the murder of her sister, Labour MP Jo Cox. She recalled, “Jo used to say if good people don’t step forward and come into politics then what do we end up with? And even though some of us feel quite out of place in this place at times we are here to make a difference and we’re here to make positive change that society has asked us to do.”
The bill has faced criticism from those who fear it could lead to vulnerable individuals being coerced into ending their lives. In response to these concerns, Leadbeater stated she was “100% confident” that the proposed safeguards were sufficient to prevent abuse.
Among the bill’s vocal critics is Conservative MP Danny Kruger, who pointed out the reduced majority and claimed, “It is clear support for this bill is ebbing away fast.” Kruger expressed hope that the House of Lords would either reject the bill or significantly strengthen its provisions. He added that it would not be unconstitutional for the Lords to block the bill, especially since assisted dying had not been featured in Labour’s election manifesto.
Despite this opposition, supporters of the bill remain optimistic. They believe that although the House of Lords may propose amendments, it is unlikely the bill will be rejected altogether. Should the Lords suggest changes, the amended bill would still need final approval from the Commons before it could be enacted into law.
Dame Esther Rantzen, a well-known broadcaster and advocate for the bill, praised the Commons’ decision. “This will make a huge positive difference, protecting millions of terminally ill patients and their families from the agony and loss of dignity created by a bad death. Thank you, Parliament,” she said.
On the other side of the debate, Paralympian and member of the House of Lords Tanni Grey-Thompson voiced her concerns. She said she had received messages from “disabled people [who] are absolutely terrified” by the implications of the bill. Grey-Thompson intends to introduce amendments aimed at tightening the legislation to ensure no one is pressured into ending their life.
Jan Noble, head of St Christopher’s hospice charity, emphasized the need for improved end-of-life care, regardless of the bill’s fate. “It is now vital the government ensures high-quality end-of-life care was available for everyone,” she stated, adding, “For that we need a better funding model for hospices.”
As MPs debated the bill inside Parliament, hundreds of campaigners gathered outside under sweltering conditions to voice their support or opposition. Supporters aligned with the Dignity in Dying campaign wore bright pink shirts and shared emotional moments after the bill was passed. Pamela Fisher, a lay preacher in the Church of England and supporter of assisted dying, hailed the vote as “a major step forward to the creation of a more compassionate society.”
Among the crowd were the family members of Keith Fenton, a former Squadron Major in the Royal Engineers, who stood in Parliament Square holding a placard with his photo. His widow, Sara, recounted how Keith, who suffered from Huntington’s disease, had once considered going to a Dignitas clinic in Switzerland. Initially resistant to the idea, she admitted, “I was being selfish,” especially after he attempted to take his own life.
Despite the strong support, there was no shortage of opposition outside Westminster. Many campaigners voiced concerns over the bill’s potential risks to vulnerable people. Sister Doreen Cunningham, representing the Sisters of Nazareth mission, hoped the Lords would strengthen the proposed safeguards. “The MPs did talk about safeguards but they’re far from what we would call safeguards,” she said, as hymns were sung quietly by disappointed protesters.
George Fielding of the Not Dead Yet campaign described the vote as “incredibly disappointing.” Fielding, who has cerebral palsy, believes the bill is fundamentally “ableist” and argued that many disabled individuals seeking to end their lives are often coping with unresolved trauma and emotional pain. Sitting beside a symbolic graveside in his wheelchair, Fielding urged peers in the Lords to examine the bill thoroughly. “We must ask the Lords to scrutinise this bill line by line to promote other alternatives – palliative care, social care, a better benefits system — to ensure everyone has the right to live a joyful life.”
Ahead of the final vote, MPs spent over three hours discussing the bill’s broader principles. Conservative MP James Cleverly remarked that many medical bodies, though neutral on the concept of assisted dying, opposed the specific details of the bill. “When the people upon whom we rely to deliver this say we are not ready… we should listen,” he cautioned.
In support of the bill, Labour MP Peter Prinsley offered a poignant argument. “There is an absolute sanctity of human life, but we are not dealing with life or death – we are dealing with death or death. For there is also a sanctity of human dignity and fundamental to that is surely choice – who are we to deny that to the dying?”
Earlier in the day, MPs voted on several amendments discussed the previous week. These included closing the so-called “anorexia loophole” to prevent individuals suffering from life-threatening malnutrition from qualifying for assisted dying. Parliament also approved an amendment requiring a government review of palliative care services within a year of the bill’s enactment. However, a proposed measure to restrict assisted dying for individuals with mental health issues or feelings of being a burden was defeated by a majority of 53 votes.
As the bill heads to the House of Lords, the national conversation around assisted dying is set to intensify. While it has passed a critical hurdle, many uncertainties and debates remain on the road to possibly reshaping how the UK handles end-of-life decisions.