The Bill passed in the House of Commons by 314 votes to 291 in a free vote by MPs this afternoon.
The Bill will now proceed to the House of Lords and is expected to receive Royal Assent by October. A four-year implementation period will follow to allow the NHS, the Department of Health and Social Care, and the Ministry of Justice to develop procedures and guidance. It remains unclear whether the procedure will be available on the NHS or free at the point of use.
I understand why the Bill was introduced and debated. Pain, suffering, the fear of suffering, and the desire for an end-of-life option that avoids travel to Switzerland are powerful and important concerns. I have read and heard the stories of many people affected—many of whom have since died while campaigning for change at the end of their lives.
As your MP, my job is to weigh the impact of proposed new laws and make the best, most informed decision on behalf of my constituents—and I take this responsibility seriously. Some laws are judged by their overall benefit to the majority, but this law is built on offering the strongest possible safeguards for the most vulnerable. I approached this with an open mind but needed to be persuaded that the Bill would not lead to vulnerable people being pressured or coerced into making such a final decision.
Weighing the potential benefits and need for the Bill against the possible consequences if it were misused, inadequately safeguarded, or became a catalyst for cultural change, I decided to vote against it.
I have made every effort to listen carefully to people, including several constituents with terminal illnesses who are facing these decisions themselves, as well as experts working in palliative and end-of-life care.
There were meaningful changes made at committee stage, and I welcomed the fact that the committee was willing to make improvements. Last week, Parliament voted on just three of the many proposed amendments. I voted against an amendment that would have prevented doctors from raising the option of assisted dying with patients. Doctors should be able to present this information alongside all other care options. However, I also voted against allowing doctors to raise this with patients under 18.
Other changes made during committee stage include new regulations on approved substances and devices for self-administration, and a ban on advertising assisted dying services. These aim to balance patient access to information with protections against potential misuse.
A significant amendment was the replacement of the requirement for High Court approval with a new expert panel to review all applications. This panel will consist of:
- A senior lawyer or retired judge, who will chair the panel and provide legal oversight
- A consultant psychiatrist, to assess mental capacity and potential coercion
- A social worker, to understand the patient’s social circumstances and support system
The patient’s family and friends do not need to be informed that a request has been made.
This multidisciplinary approach aims to offer a more practical and compassionate assessment while maintaining vital safeguards. The panel’s decision must be unanimous to authorise an assisted death.
Additionally, a Voluntary Assisted Dying Commissioner will be appointed to oversee the process, produce annual reports, and appoint expert panels to review applications. This role is intended to enhance oversight and accountability.
I believe that a panel of three experts offers stronger protection than a single High Court judge.
A key component of the process is the medical assessment by two doctors, confirming that the patient has less than six months to live. I remain concerned about cases where prognoses prove inaccurate—especially when individuals live longer than expected. While many diagnoses are clear and accurate, some are not.
Equally important is the patient’s mental state. This is why both the psychiatrist and social worker on the panel are tasked with assessing mental capacity and the risk of coercion.
The Royal College of Psychiatrists’ opposition to the Bill—based on significant concerns about safeguarding people with mental health issues—was an important factor in my decision to vote against it.
Dr Lade Smith CBE, President of the Royal College of Psychiatrists, said:
“After extensive engagement with our members, and with the expertise of our assisted dying/assisted suicide working group, the RCPsych has reached the conclusion that we are not confident in the Terminally Ill Adults Bill in its current form, and we therefore cannot support the Bill as it stands.
It’s integral to a psychiatrist’s role to consider how people’s unmet needs affect their desire to live. The Bill, as proposed, does not honour this role, or require other clinicians involved in the process to consider whether someone’s decision to die might change with better support.
We are urging MPs to look again at our concerns for this once-in-a-generation Bill and prevent inadequate assisted dying/assisted suicide proposals from becoming law.”
On balance, I remain deeply concerned about the risks and implications for vulnerable people.
I have attended all debates, held group and one-to-one meetings with constituents, read hundreds of emails, met with experts, and reviewed the impact of similar laws abroad. I also heard from many disabled constituents who fear a cultural shift in how society views those with disabilities.
The limited number of amendments voted on and the small amount of time allocated for debate made me more concerned about the Bill rather than reassured.
This Bill proposes too significant a change in the role of doctors, lawyers, and the state—especially given serious doubts about its ability to safeguard lives and whether it could be implemented effectively in light of workforce shortages in palliative care, mental health, and social care.
I have approached this decision with the seriousness it warrants, carefully considering both the immediate and long-term consequences. I voted against the Bill but will also continue to engage constructively in future votes on amendments proposed by the Lords to ensure that, if passed, the legislation is as safe and effective as possible.