What is assisted dying and how could the law change?
- Published
Labour MP Kim Leadbeater says her bill includes "the strictest safeguards anywhere in the world"
MPs have voted in favour of a bill to legalise assisted dying in England and Wales.
The bill will face months of further scrutiny and votes in the Commons and Lords before the proposed changes could become law.
At present, laws throughout the UK prevent people from asking for medical help to die.
What is the proposed law on assisted dying in England and Wales?
The Terminally Ill Adults (End of Life) Bill, external was introduced by backbench Labour MP Kim Leadbeater.
It proposes giving terminally ill people the right to choose to end their life.
It says that anyone who wants to end their life must:
be over 18 and live in England and Wales, and have been registered with a GP for at least 12 months
have the mental capacity to make the choice and be deemed to have expressed a clear, settled and informed wish, free from coercion or pressure
be expected to die within six months
make two separate declarations, witnessed and signed, about their wish to die
satisfy two independent doctors that they are eligible - with at least seven days between each assessment
Under the proposals, a High Court judge would have to rule each time a person makes a request to end their life. A patient would then have to wait 14 days after the ruling, allowing them to have a period of reflection.
A doctor would prepare the substance being used to end the patient's life, but the person would take it themselves. The bill does not say which drug would be used.
It would be illegal to use dishonesty, pressure or coerce someone into declaring they want to end their life, with a possible 14-year prison sentence.
How did MPs vote on assisted dying?
The historic vote saw 330 MPs vote in favour of allowing assisted dying and 275 against it.
It followed five hours of passionate debate, during which MPs shared personal stories and those against the bill called for better end-of-life care.
MPs were given a free vote on the issue, which meant they could make their own decision rather than follow party instructions. The government is impartial on the issue.
Prime Minister Sir Keir Starmer was among those to vote in favour of the bill, as was Chancellor Rachel Reeves.
However, Deputy Prime Minister Angela Rayner, Foreign Secretary David Lammy, Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood all voted against.
Among the Conservatives, Rishi Sunak and Oliver Dowden, the former prime minister and deputy prime minister, were in a minority to support assisted dying. Kemi Badenoch, the new Conservative leader, voted against.
When MPs last voted on the issue in 2015, they rejected different proposals by 330 votes to 118, external.
When could assisted dying become law?
There are still many months of parliamentary activity ahead, but the bill now moves forward with the backing of the House of Commons.
It means such a law has moved a step closer but it must still pass through five parliamentary stages handled by MPs and five more by peers, and further rounds of voting.
MPs heard there would a period of up to two years before any new law was implemented because "it is more important to get this right than to do it quickly".
It is also possible the bill could fall and not become law at all.
How might the law change in Scotland?
A separate bill is under discussion in Scotland.
Liberal Democrat MSP Liam McArthur drafted the Assisted Dying for Terminally Ill Adults (Scotland) Bill.
If passed by MSPs, eligible applicants would have to:
be resident in Scotland for at least 12 months
be registered with a GP in Scotland
be terminally ill
have the mental capacity to make the request
The bill is being considered by the health committee ahead of an initial vote by MSPs, which is not expected until 2025.
In October 2024, Scottish Health Secretary Neil Gray said the proposed legislation went beyond the limits of Holyrood's powers, and was a matter for Westminster.
However, McArthur said he was confident the UK and Scottish governments could find a solution if MSPs backed his bill.
Who opposes assisted dying?
Opponents warn that people could be put under pressure to end their lives and want improvements to palliative care instead.
Paralympian and House of Lords crossbencher Baroness Grey-Thompson is a vocal critic.
She told the BBC she is worried about "the impact on vulnerable people, on disabled people, [the risk of] coercive control, and the ability of doctors to make a six-month diagnosis".
Lady Grey-Thompson is a long-standing critic of legalising assisted dying
Actor and disability-rights activist Liz Carr, who made BBC One documentary Better Off Dead?, also opposes changing the law.
"Some of us have very real fears based on our lived experience and based on what has happened in other countries where it's legal," she wrote on X.
Dr Gordon Macdonald, from campaign group Care Not Killing, said: "The safest law is the one we currently have.
"This bill is being rushed with indecent haste and ignores the deep-seated problems in the UK's broken and patchy palliative care system."
Who wants the law on assisted dying to change?
Kim Leadbeater, the MP who introduced the bill, said the law needs changing because some people "have a horrible, harrowing death", however good their end-of-life or palliative care is.
She said her bill includes "the strictest safeguards anywhere in the world".
Cancer patient Nathaniel Dye worked with Ms Leadbeater on her bill. He said it would allow people a death which was "as kind and compassionate as possible".
The Dignity in Dying campaign group said the bill provides the "most detailed, robust proposals" on the issue that "Westminster has ever considered".
According to chief executive Sarah Wootton, the fact that every year "up to 650 terminally ill people end their own lives, often in lonely and traumatic ways," shows that the status quo is not working.
Dame Esther Rantzen, who has stage four lung cancer, has joined Dignitas in Switzerland
One of the highest-profile advocates for change is broadcaster Dame Esther Rantzen, who has stage-four lung cancer.
"All I'm asking for is that we be given the dignity of choice," Dame Esther told BBC News. "If I decide that my own life is not worth living, please may I ask for help to die?"
Both the British Medical Association, external, which represents doctors, and the Royal College of Nursing, external are neutral on the issue.
What are assisted dying, assisted suicide and euthanasia?
There is some debate over exactly what the various terms mean, external.
However, assisted dying generally refers to a person who is terminally ill receiving lethal drugs from a medical practitioner, which they administer themselves.
Assisted suicide is intentionally helping another person to end their life, including someone who is not terminally ill. That could involve providing lethal medication or helping them travel to another jurisdiction to die.
Euthanasia is the act of deliberately ending a person's life to relieve suffering in which a lethal drug is administered by a physician. Patients may not be terminally ill.
There are two types: voluntary euthanasia, where a patient consents; and non-voluntary, where they cannot because, for example, they are in a coma.
Where is euthanasia or assisted dying legal around the world?
The Dignity in Dying campaign group says more than 200 million people around the world have legal access to assisted dying, external.
Switzerland has allowed assisted suicide since 1942. Its Dignitas facility - which accepts foreign patients as well as Swiss nationals. Between 1998 and 2023 it helped 571 Britons to die, external.
Assisted suicide is also legal in Austria.
In the US, 11 states - Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC - allow "physician-assisted dying".
It permits doctors to prescribe lethal drugs for self-administration.
Voluntary euthanasia is legal in Canada where it is called medical assistance in dying. It can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration.
It is also legal in Spain and Colombia, both of which also permit assisted suicide.
Assisted dying is legal in some parts of Australia but the law differs across states.
New Zealand's End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.
Three countries have laws that allow people who are not terminally ill to receive assistance to die: The Netherlands, Belgium and Luxembourg.