Parliament debated assisted dying (the Terminally Ill Adults (End of Life) Bill) on 20th June 2025. This was the third reading of Kim Leadbeater’s private member’s bill and it passed. The number of MPs in support was fell from 330 at the 2nd reading to 314. 52% voted in favour, 48% against. It feels close. A bill that passes its 3rd reading will not return to the House of Commons, but will be debated in the House of Lords, a chamber that does not traditionally reject a law that has passed through the nation’s elected representatives. Therefore, assisted dying should become legal, and available in around 4 years.
The debate explored the classic arguments for and against. For – choice, autonomy; against – concern for the vulnerable who may be coerced, overtly or otherwise, into making a choice that they would not otherwise have arrived at. Reading the speeches in Hansard is a great way to understand both the principles and the way our MPs think.
Here I present what I feel are the ‘highlights’, both for and against. I have chosen excerpts that make points powerfully and succinctly. There were some very powerful stories where the experience of people who had suffered as they approached death were shared. Although these are anecdotes, they are of great value, but I have not included all of them here. I have omitted MPs’ names.
One important point that does come through is that MPs were not debating the principle of assisted dying, but the detailed provisions of the bill. Many opponents described themselves as supporters in principle, but the concerns they had about safeguards meant that they could not vote in favour. The bill has gone through several modifications, including;
- Assisted dying review panels to replace high court review
- Voluntary assisted dying commissioner to oversee
- Opt-out provision for health professionals
- Advertising ban
- Prohibition from discussing assisted dying with individuals under the age of 18
- Exclusion of people who have chosen voluntary stopping eating and drinking (VSED)
- Review of palliative care services within a year of legalisation
Several brought up the fact that if the bill passed, there would be a statutory duty to provide assisted dying but no palliative care, which nearly everyone agrees is underfunded. It is a good point.
The debate was generally nuanced. One MP said voting either way would leave a proportion of people unhappy, or anxious, or unsatisfied. If the bill passed, the vulnerable might be at risk of coercion; if the bill failed, the dying would be at risk of unnecessary suffering.
My overall impression is that although it was the bill they voted on, MPs were largely motivated by their core attitude to the principle.
IN SUPPORT OF THE BILL
We have a system in which it legal for someone to starve themselves to death, which can take days or weeks, but where it is not legal for someone to seek assistance from a doctor to take an approved substance themselves to end their pain or suffering and take back control in their dying days.
“Has your doctor persuaded you to do this?” Do we honestly think that a social worker, psychiatrist or lawyer is totally incapable of finding coercion? That is exactly what the panel is there to do, and that is exactly what those safeguards will provide.
This Bill addresses a situation where the status quo is utterly unacceptable.
…with the advance of medical techniques that prolong life but not necessarily the quality of life, the case for the compassionate ending to one’s life will continue to grow.
We have a chance to neatly bookend the week by establishing the existential right of the individual, when given a terminal diagnosis, to choose how one might exit this earthly realm
… in the heart-wrenching words of Decca Aitkenhead, who wrote in The Times last week, and which I found particularly moving:“critics of the bill have begun to frame the debate as if leaving the law as it stands does not hurt anyone. It does.” She said that opponents “worry about speculative, hypothetical victims—but the status quo creates indisputable, real life victims”.
In my view, the Bill now has more controls than when we looked at it on Second Reading, not fewer. I also reject the suggestion that the Bill has not received sufficient scrutiny. The debate on assisted dying has been ongoing for many years.
The Bill is not about shortening life; it is about shortening death.
His body became skeletal and his speech gradually disappeared. In one of the last times when he still was able to speak, he called out to me from his bed and told me that if there was a pill that he could take to end his life, he would very much like to take it.
Finally, the momentum for law change is spreading across the British Isles and beyond. Last month, MSPs voted by a clear majority to pass Liam McArthur’s assisted dying Bill. The Isle of Man’s Bill is awaiting Royal Assent, and will potentially be available for terminally ill residents from 2027. The direction of travel is to give dying people true choice at the end of life. We cannot leave dying people in England and Wales behind.
No one is more voiceless in this debate than those terminally ill adults who suffered painful, traumatic and undignified deaths under the current system, as well as their families.
There are folks who talk about the concept of self-coercion, but others would frame such a decision as a choice. Self-coercion is a choice.
Some will say that there are no limits to the comfort that expert palliative care can deliver, but that has not been my observation, particularly as I think about some of my patients with advanced, disfiguring head and neck cancers, and about the terrible loss of dignity and autonomy that I have seen. That is what people fear, and that is why I believe that we are right to give people a choice—a final autonomous choice.
I do not think we will see coercion to undergo assisted dying; families are more likely to talk patients out of it.
Profound sadness as our lives are ending is quite normal, and clinical depression should be treated, but my observation is that the patients we are talking about are clear-headed and very rational
YouGov polling published yesterday again showed that the public—the citizens we serve—back it too, with 75% supporting assisted dying in principle and 73% supporting the Bill as it stands.
It is worth reiterating that this Bill is about not choosing death but how to face death when it is already at the door. It is about that final chapter of life—that short chapter. As many of our constituents have told us time and again, it is a chapter that they write in pain, fear and desperation.
We have heard, again and again, stories of people forced to travel abroad to die in lonely circumstances. We see loving spouses prosecuted for holding the hand of someone they have loved for 50 years. We see lonely suicides in quiet suburban bedrooms: lives ended not because of terminal illness, but because of a lack of legal options.
The Bill brings order where there is confusion; it brings safeguards where there is silence; and it replaces secrecy with structure and fear with honesty.
We do not honour life by prolonging suffering. We honour life by giving it meaning and power. The one thing that dying people ask for in their agonising final moments is control over the disease that is destroying them. The status quo, my friends, is completely unacceptable.
individuals should have the autonomy to make decisions about such a personal and profound part of their life—the end of their life. That is fundamental to dignity at the end of life.
Currently, if a person would like to choose assisted dying, that choice is only open to them if they have sufficient financial resources. This is an equity issue: if a person is financially poor, terminally ill and nearing the end of their life, they do not have the freedom to choose assisted dying.
IN OPPOSITION TO THE BILL
“What is this medical professional expecting of me? What are they thinking? Where is their head?” Whereas, with the situation we have at the moment, the patient knows that the medical professional is dutybound to do no harm, and to preserve life and dignity wherever possible.
…we know that there could be circumstances where assisted dying would be on a statutory basis and the provision of palliative care would not.
I am struck by the number of professional bodies that are neutral on the topic of assisted dying in general but opposed to the provisions within this Bill in particular. We cannot just say, “They are neutral on assisted dying, and therefore this particular vehicle has to progress.”
Those bodies say that they do not have the people to populate those panels, yet that is what the commencement date demands.
We hear about panels. The people talking about panels presumably have not had much to do with them. I would not put my life, or the life of anyone dear to me, in the hands of a panel of officials.
Does the right hon. Lady find it rather peculiar that the previous Parliament spent 746 hours discussing the death of a fox and about 98 hours discussing the death of fellow humans?
There has been a lot of talk about there being no evidence of coercion, but within the family, the most powerful coercion is silence: it is the failure to answer when a question is put. If police cannot spot coercion in domestic violence, how can they be expected to spot coercion in assisted dying?
But what choice does the Bill hold for someone who, all their life, has lacked agency, particularly in a family context, which may be particularly the case in certain cultures and communities?
I came to this House to be a voice for the voiceless—that has not always been favoured by my own leadership, but that is why I came to the House. Who could be more voiceless than somebody who is in their sick bed and believes that they are dying?
This is the question for all Members: what is the margin of error that we are willing to risk today when it comes to something as serious as death?
However, the Bill allows someone to say to a doctor on a panel, “I want to go because I do not want to be a burden,” even if they are not suffering at that point in time. It also allows them to say, “I want to go now, so that my family have a larger inheritance.
I do not claim that every disabled person opposes assisted dying, but I do claim that the vast majority of disabled people and their organisations oppose it. They need the health and social care system fixing first. They want us as parliamentarians to assist them to live, not to die.
…we talk a lot about choice in dying, but how is that choice informed if palliative care in the UK is simply not good enough?
It is very difficult to argue that we can ask somebody to assist in a person’s death when they are within six months of dying of cancer—although there is no universal testimony or acceptance about how we work out those six months—but not if they are suffering from some appalling degenerative disease or are a quadriplegic or have no quality of life. So I think there is actually an argument that, if we pass this Bill today, we will move in the direction of Canada and we will have death on demand.
…the Bill still does not even define “dishonesty”, “coercion” or “pressure”. Let me say that clearly again—it does not define “coercion”. If we, as legislators, cannot do that, then who will?
An older relative knows that assisted death is now possible and that their family is struggling to get by, in difficult economic circumstances. They have a health condition, with a prognosis of five months to live, even though studies show that most such prognoses are wrong about 50% of the time. What will stop our parents or grandparents from deciding to seek assisted dying purely to “do the right thing” by their loved ones?
Surely, we cannot vote for measures today that would lead to a social determinant of an early death
That is why this debate, frankly, needs a little more honesty. We have heard the blandishments and the warm words of euphemism; we have heard this called assisted dying, but the truth is that it is not assisted dying. Assisted dying is what a hospice already does today—helping people, caring for them and supporting them. This is assisted killing or assisted suicide,
The experience of Roger Foley, a Canadian living with a degenerative condition, warns us:
“As Canada has expanded its assisted dying law, I have faced neglect, verbal abuse, and denial of essential care. I’ve been told my care needs are too much work, and my life has been devalued. Worse still, I have been approached and told by healthcare staff to consider opting for Medical Aid in Dying. Instead of offering compassionate support to alleviate my suffering, it is suggested…that I should end my life.”
The question for us now is this: after all the consideration, can we be satisfied that our duties to protect people’s wellbeing and safeguard them from harm will be fulfilled if we pass the Bill? From everything that I have seen, heard and read, the answer must be no.
My mother, who was disabled, often in great pain and a cancer survivor, was a member of the Voluntary Euthanasia Society and Exit, as Dignity in Dying was previously called. I can honestly say that Newcastle United, feminism, and the right to die were mother’s milk to me. My position is not based on ideological, cultural or religious reasons.
I urge colleagues not to vote for the Bill, because it is without the rigour or scrutiny necessary to make assisted dying work in practice.
This Bill lacks the safeguards, which we must have, to deal with the reality that there are powerful economic and personal incentives for both the state and family members to encourage the vulnerable into taking their own lives.
We should specifically consider the impact on ethnic communities: we know the prism of racist assumptions through which healthcare has too often been administered —the huge inequalities in maternal health and mental health, to name just two examples.
If I am making such a choice—making a decision that will inevitably lead to the shortening of life—I want to be absolutely confident that I am doing so for the right reasons and that the risks and unintended consequences are minimised, and I am afraid that this Bill does not meet that high confidence bar.
I continue to have significant concerns about the potential for assisted dying to be abused and to be extended way beyond the originally intended scope.
Those who express a belief in God and the sanctity of life should be respected, not sneered at. It is perfectly legitimate for religious beliefs to influence one’s views on assisted dying
That brings me to the heart of the conundrum we face today. Many of us in this place want to give people choice and autonomy over how they leave this world, but the reality—I have seen it up close and personal these past six weeks—is that our NHS and care system is nowhere near up to giving people that choice. It is creaking at the seams.
The very people who will be tasked with delivering the service we are legislating for today—and, by the way, we still have no idea what that service will look like, or how it will be funded—say it is not safe. How many lives taken in error is too many? One? One in 10? One in 100?
Imagine the scenario of your mother. You were there when Dad used to belittle her. In public, it was jokes putting her down, but in the house, you would hear him say that she was worthless and ugly and would be better off dead. You got out of there as soon as you could, but she would never leave—she loved him, and could not see a life for herself outside of his control. You could see her health deteriorating, but he often stopped her from going to the doctor or reaching out to friends. One day, you get a call from your dad to say, “She’s dead. She got an assisted death.”
A prominent campaigner in favour of this Bill said: “Even if a few grannies get bullied into it, isn’t that a price worth paying for all the people who could die with dignity?” Please, we must not settle for this.
The consequences of getting this wrong are severe, and the risks of getting it wrong with an NHS still in recovery are too high
I worry about the quiet, imperceptible and unspoken coercion that could emerge if we go ahead with this system. I worry about vulnerable people who would feel a duty to die, and I am not satisfied that the Bill has enough safeguards against that.
The practical reality of what we see today is that, without radical improvements to palliative care, a joined-up digital system, and clear recorded centralised data on when and how we talk to patients about the treatment they are getting, and about what that means—not just for the length of their life, but for the quality of their life—we will continue to have a postcode lottery.
