What’s at stake in the UK assisted suicide vote
The bill’s opponents believe the vote is now ‘on a knife edge.’
British lawmakers will vote Friday on a bill seeking to legalize assisted suicide.
Both advocates and opponents of the bill say that if it becomes law it will mark a radical social change, on a par with the legalization of abortion in 1967.
What are the bill’s provisions? What are people saying about it? And what are its chances of passing?
What does the bill say?
On Oct. 16, Labour Party politician Kim Leadbeater introduced the Terminally Ill Adults (End of Life) Bill in the House of Commons, the lower house of the U.K. parliament.
Most U.K. bills are introduced by the government and driven through parliament with the help of “whips,” who pressure colleagues to toe the ruling party’s line. But Leadbeater’s text is a private members’ bill, meaning she presented it on her own initiative, rather than the government’s behalf, after winning a ballot among members of parliament (MPs).
Private members’ bills rarely succeed because they lack the government’s supporting apparatus. According to the U.K.’s Institute for Government think tank, only 110 out of more than 2,500 such bills became law between 2010 and 2024.
But they can be the vehicle for dramatic social changes. The 1967 act legalizing abortion in the U.K. — which was followed by similar legislation around the world — began as a private members’ bill.
Parliament has previously rejected bills seeking to legalize assisted suicide. But Leadbeater’s bill, which would apply to England and Wales, is believed to have a better chance of passing than most. That’s for two reasons.
First, the composition of the House of Commons has changed significantly since the July general election, which resulted in a Labour landslide. The center-left Labour Party — whose members are generally more favorable toward assisted suicide — now has a commanding 403 seats, compared to the opposition Conservative Party’s 121 seats.
Second, incoming Prime Minister Keir Starmer supports a change in the law. As director of public prosecutions in 2010, he issued new rules clarifying when individuals would be prosecuted for assisting in a suicide. As an MP in 2015, he backed an assisted suicide bill that was defeated in the House of Commons by 330 votes to 118.
Why is there a new bill on the same topic just nine years later? Earlier this year, Starmer promised the television presenter Esther Rantzen, who has stage four lung cancer, he would make time for a fresh attempt to alter the law.
But despite his advocacy, Starmer has insisted MPs will have a “free vote” on the Leadbeater bill, rather than being instructed how to vote by their parties.
The draft legislation’s full title is “a bill to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life; and for connected purposes.”
The bill states that a terminally ill person, whose death “can reasonably be expected within 6 months,” may, “on request, be provided with assistance to end their own life.”
The draft defines terminal illness as “an inevitably progressive illness, disease or medical condition which cannot be reversed by treatment.” It says that if a person meets the criteria, a doctor can give them an “approved substance” with which to end their lives.
Inducing another person to use an “approved substance” through “dishonesty, coercion or pressure” would be an offense, as would the falsification or destruction of documents relating to the assisted suicide process.
Medical practitioners with conscientious objections would be required to refer patients to a colleague who accepts the practice.
The bill’s full text was published Nov. 11, just 18 days before its second reading, the first opportunity to debate the bill’s principles. In contrast, MPs had seven weeks to scrutinize the 2015 assisted suicide bill before its second reading.
Who’s saying what?
In a well-received pastoral letter in October, Cardinal Vincent Nichols, the president of the English and Welsh bishops’ conference, set out three concerns about the bill.
The first was to “be careful what you wish for,” because every country that has legalized assisted suicide has seen the practice expand inexorably. The second was that the “right to die” can become “a duty to die.” The third was that no longer seeing life as a gift from God diminishes human dignity.
“This is not a freedom of choice we can take for ourselves without undermining the foundations of trust and shared dignity on which a stable society rests,” the Archbishop of Westminster wrote.
The Anscombe Bioethics Centre, named after philosopher and Catholic convert Elizabeth Anscombe, has presented evidence that the legalization of assisted suicide leads to a deterioration in palliative care and end-of-life care.
It’s not just Catholics — an often marginal minority in the U.K. — who have spoken out against the bill. Leaders of other religious groups signed a joint letter expressing fears the bill would lead to “life-threatening abuse and coercion.”
Signatories included the Anglican Bishop Sarah Mullally, who previously served as the chief nursing officer for England, Chief Rabbi Ephraim Mirvis, and Muslim Council of Britain secretary general Zara Mohammed.
However, not all religious voices oppose the bill. George Carey, the Anglican Archbishop of Canterbury from 1991 to 2002, is a vocal proponent of assisted suicide.
Opposition to the bill is not confined to believers. Clare Fox, an atheist member of the House of Lords, the upper house of the U.K. parliament, has argued that the legislation would fundamentally alter the relationship between the state and citizens.
“This would be the state authorizing the killing of its citizens,” she said.
Disability rights advocates have played a prominent role in the debate, including the Paralympic gold medallist Tanni Grey-Thompson and the actor Liz Carr, presenter of the documentary “Better Off Dead?” They fear that if the practice is permitted, disabled people will face ever-growing pressure to opt for assisted suicide. Disabled people’s organizations have expressed united opposition to the legalization of assisted suicide.
The bill has also brought together politicians from opposing sides of the ideological spectrum.
Labour’s Diane Abbott and the Conservatives’ Edward Leigh, respectively the longest-serving female and male MPs, wrote a joint op-ed in the Guardian newspaper Nov. 20. They pointed out that many newly elected MPs would be voting “on what is, quite literally, a matter of life and death” with just 12 weeks’ experience of parliamentary life. More than half of the 650 MPs elected in July have never held the position before.
“There is more than a suspicion that the pressure groups behind this proposed change have sought to take advantage of an inexperienced new parliament,” Abbott and Leigh said.
While opponents are uniting across the aisle, divisions have emerged within the Labour government.
The U.K.’s health minister Wes Streeting has forcefully expressed his opposition to the bill, suggesting the costs of introducing “a new service to enable assisted dying” would require cuts elsewhere to the U.K.’s already fragile National Health Service.
Justice minister Shabana Mahmood, the U.K.’s most senior Muslim politician, has said she will vote against the bill, arguing that “the right to die, for some, will — inexorably and inevitably — become the duty to die for others.”
Streeting and Mahmood’s interventions have provoked furious reactions from the bill’s supporters — suggesting they may prove influential.
What happens next?
On Nov. 29, MPs are expected to debate the bill for five hours. More than 100 lawmakers have said they wish to speak.
At the end of the debate, they will vote. If the bill wins majority support, it will have cleared a critical hurdle. It would then proceed to the committee stage, where it would be examined line by line and amendments suggested.
The bill would then enter a report stage before facing a third reading and vote in the House of Commons. After that, it would head to the House of Lords for a first and second reading, committee and report stages, and a third reading.
Finally, the bill would become law with the assent of King Charles III.
When the bill was first mooted, commentators suggested it had a good chance of passing, given Labour’s dominance and Keir Starmer’s tacit backing. But in recent days, the tone of coverage has changed perceptibly.
Mark Mason, the BBC’s political editor, wrote Nov. 25 that “sentiment has ebbed and flowed over the last few weeks, with opponents of change perhaps gaining some momentum after the Health Secretary Wes Streeting came out on their side of the argument.”
He noted that the bill’s opponents now believe the vote is “on a knife edge.”
An op-ed published by the Institute for Government argued that the government had undermined assisted suicide advocates by failing to prepare for the bill with a nationwide debate on end-of-life care, as has happened in other European countries such as France.
“At the moment it looks like a case that hasty legislation may end up meaning no legislation,” authors Hannah White and Jill Rutter wrote.
But with so many fresh faces in parliament and the political atmospherics constantly shifting, no one can be certain what the outcome will be this Friday.
> Finally, the bill would become law with the assent of King Charles III.
Can he say no?
Praying for the UK