British lawmakers vote to legalize assisted dying in landmark decision

LONDON – After an emotive and at times impassioned debate, Britain’s lawmakers on Friday voted to allow assisted dying for terminally ill patients in England and Wales under strict conditions, opening the way to one of the most profound social changes in the country in decades.

By 330 votes to 275, members of Parliament gave their support to a bill that would permit doctors to help some terminally ill patients to end their lives.

Friday’s vote was not the final say on the matter for Parliament, as it will now be scrutinized in parliamentary committees and amendments to the bill may be put forward. But it is a landmark political moment, setting the stage for a significant shift that some have likened to Britain’s legalization of abortion in 1967 and the abolition of the death penalty in 1969.

The new legislation would apply to a narrow group: Applicants would have to be over 18, diagnosed with a terminal illness and have been given no more than six months to live. Two doctors and a judge would be required to give their approval, and the fatal drugs would have to be self-administered.

Assisted dying is already legal in a handful of European countries, as well as in Canada, New Zealand, 10 U.S. states and the District of Columbia.

The bill debated Friday was proposed by a Labour Party member of Parliament, Kim Leadbeater, but lawmakers were given the freedom to vote with their consciences, instead of being expected to vote along a party-line, meaning the outcome was impossible to predict.

During almost five hours of debate Friday in a crowded parliamentary chamber, raw divisions were revealed over an issue that transcended political affiliations.

Meg Hillier, a Labour lawmaker, said the legislation would “cross a Rubicon,” by involving the state in the death of some of those it governs. “This is a fundamental change in the relationship between the state and the citizen, and the patient and their doctor,” she said.

But Kit Malthouse, a Conservative lawmaker, argued in support of the bill, saying, “The deathbed for far too many is a place of misery, torture and degradation, a reign of blood and vomit and tears.” He added, “I see no compassion and beauty in that – only profound human suffering.”

Proponents of assisted dying say it is a merciful way to curtail unbearable suffering in the final months of life.

Under current British law, those who help relatives or friends to end their lives face police questioning and potentially prosecution. So even terminally ill patients who decide to end their life in a country with more permissive rules, like Switzerland, must do so alone to protect their families. That condemns some to a terrible death, some proponents of the bill argued.

Leadbeater told Parliament that her legislation addressed “one of the most significant issues of our time,” and asked colleagues to help families who face “the brutal and cruel reality of the status quo.”

Peter Prinsley, a Labour lawmaker and surgeon, rejected claims by opponents of the bill that its scope would later be extended to include a wider category of people. “This is not some slippery slope,” he said. “We are shortening death, not life, for our patients. This is not life or death; this is death or death.”

Critics view assisted dying as a threat to the old, disabled and those with complex medical conditions, any of whom might feel pressured into agreeing to a premature death.

Some lawmakers said they feared that some of those patients might end their lives prematurely to remove the physical or financial burden on their families.

“People often recognize coercion only after years have passed, yet within a month someone could be dead,” said Rachel Maskell, a Labour lawmaker who worked as a senior physiotherapist in acute medical care. “Malign coercion cases may be few, but as a clinician working at the fringes of life, I heard my patients frequently say, ‘I don’t want to be a burden,’ or ‘I’d rather the money went to the grandchildren than on my care.’”

Under the British system, the scope of the proposed law extends only to England and Wales. A push for similar legislation is underway in the Scottish Parliament.

Polls suggest a clear majority of Britons support the principle of assisted dying as long as conditions are attached, with 65% in favor and 13% opposed, according to one recent survey.

Many faith leaders, however, expressed their opposition to the move and, ahead of the vote, two senior Cabinet ministers, the justice secretary, Shabana Mahmood, and the health secretary, Wes Streeting, also spoke out against the measure.

Streeting argued that training staff to deal with assisted dying would add costs to the country’s National Health Service. He also pointed to the uneven availability of palliative care in Britain, warning that some patients might feel that they effectively had no alternative but to opt for assisted dying.

After Friday’s vote, the foreign secretary, David Lammy, said that he had opposed the measure because of his mother’s end-of-life experience. “Like millions of working class people, her final diagnosis filled her not with fear of death but a fear of being a burden to her family,” he wrote in a letter to his constituents.

In 2015, when lawmakers in Britain last considered the issue of assisted dying, they voted against it by 330 votes to 118. Ahead of Friday’s debate, four former prime ministers, Gordon Brown, Boris Johnson, Theresa May and Liz Truss – none of whom are still elected lawmakers – indicated that they would have opposed the measure if they had a vote.

But David Cameron, who was against the measure when it was debated in 2015 and while he was prime minister, said he had changed his mind.

When it came, the result of the vote marked a clear break with the past, perhaps reflecting shifting social attitudes.

Prime Minister Keir Starmer had refused to say in advance which way he would vote, even though he supported assisted dying in 2015. On Thursday he hinted to reporters that his views had not changed, telling them that he had a strong interest in the issue because he had been responsible for reviewing police investigations into assisted deaths as a chief prosecutor before entering Parliament.

On Friday, alongside a majority of the Cabinet, Starmer voted in favor of a bill that could prove one of the most consequential pieces of legislation to emerge during his time in Downing Street.

This article originally appeared in The New York Times.