I am writing at the end of what has been an extremely harrowing and emotionally intense few weeks in Parliament, and especially today in the debate. 

After a great deal of consideration, I voted against the Terminally Ill Adults (End of Life) Bill today. While I understand and respect the compassion driving support for this legislation, I believe it poses significant risks that cannot be ignored. 

The bill passed this stage with 330 votes in favour to 275 votes against and this means that now there will be a committee stage of several weeks or months with 17 MPs considering changes to the Bill. It will also be debated in The House of Lords before returning to the House of Commons for the final and binding vote in about six months’ time. This will also be a free vote for all MPs. If then passed there will be a further two years to prepare before it will come into force. 

I will be taking an active interest in this process and re-consider how I vote when it comes back to the House of Commons. 

Over the past weeks I have listened to all sides of the debate on legalising assisted dying to ensure I am fully informed ahead of what will be one of the most consequential votes any of us take as elected representatives. 

I have held two roundtables in Parliament with constituents, one for those in support of assisted dying and one with those against because it is important to me to listen to your views. I also met with NHS doctors, care home workers, hospice staff and legal professionals along with campaigners from either side of the debate. 

I am very grateful to everyone who has engaged with me on this issue, sharing their insights as professionals, energised campaigners, engaged constituents and from those with personal testimonies. These interactions have been very informative and aided me in this difficult decision. 

I absolutely understand that the situation as it is now is not good. People are unable to seek advice from their doctor or discuss their situation with friends or family because it may be illegal. As a result, individuals are choosing to end their suffering through suicide at home or by travelling to Dignitas, while others endure prolonged and painful death. I do understand that palliative care cannot take away all pain and the argument that an assisted death could be a part of palliative care and not instead of it. 

This weighs very heavily on me, and I fully understand the need to have this debate. 

So I have weighed this current reality against both the benefits and harms of this bill.  

Passage of this Bill would mark a significant change in both doctors’ and the state’s role in death. A moral and legal line never crossed before. 

I have looked in depth into the experience in the jurisdictions where legislation on assisted dying has been passed. From this I have serious concerns which I hope will now be considered in the next stages of the debate about the Bill. 

The Association of Palliative Medicine, with 1,400 members who are at the frontline of end-of-life care oppose this Bill for several reasons and I have looked carefully at these, alongside the views of other medical, legal professional bodies and individuals. 

Predicting life expectancy is highly uncertain. Most doctors agree it is difficult to accurately forecast when someone with terminal illness will die, with predictions often overly optimistic or pessimistic. There are many cases of people living far longer than expected and I worry the six-month prognosis requirement in this Bill could lead to irreversible decisions based on unreliable estimates. 

Just today I received a letter from a constituent who would have considered assisted dying when diagnosed if it was an option but is so glad that it wasn’t in the light of her life since. Many people live longer than expected. The problem that this bill is trying to solve is for people in the very last days in extreme pain, and to make their own choice. But the scope of the Bill is wider than just those people. 

I have also reviewed how similar legislation has been implemented in other countries and remain deeply concerned about the risks of coercion. If this law is passed, a prognosis of six months to live could become tied to the option of assisted dying. While this may provide comfort to some, it could also create undue pressure on others—particularly those who are vulnerable due to financial hardship, dependency on family because of ill-health, or other circumstances. These individuals are unlikely to be campaigning on this issue but stand to be most profoundly affected in irreversible ways. Furthermore, the legislation allows the entire process to proceed with the involvement of two doctors and a judge, without any obligation to consult family members, carers, or friends. I find this to be a deeply concerning omission. 

The safeguard is for two medical practitioners to agree and then a High Court judge to check that the process has been followed. I have serious concerns that they would not know the person or the context and would find it hard to judge coercion. Even with safeguards, there have been reports of vulnerable people feeling pressure to end their lives prematurely to avoid being a burden on their families. This is not something I want any vulnerable member of our society to feel. 

Also, the question of assessing the mental state of those wanting an assisted death is troubling. Determining whether someone is of sound mind to make such a profound decision is complex and subjective, with no guarantee of consistency or fairness. 

I fervently hope that there will now be debate and action to increase support for palliative care. There is a clearly a very urgent need, and I will continue to campaign for support for our wonderful Trinity Hospice which is very under-funded. The need for action on palliative care was said again and again in the debate and today marked a significant change in the national and political debate about what we all want – dignity and peace in dying.