At the end of November, MPs will have a chance to debate and vote on legalising assisted dying for the first time in a decade.
They will vote on a bill proposed by Kim Leadbeater, Labour MP for Spen Valley. She insists it has “the strictest protections and safeguards of any legislation anywhere in the world.”
If MPs vote through the legislation, the UK could follow in the footsteps of other countries, including Switzerland, Canada, Spain and the Netherlands, where it is already legal for someone to seek medical assistance to end their life.
MPs, however, remain incredibly divided over the issue. A recent poll by i conducted before the bill text was published found that 54 per cent of MPs currently expressed a degree of support for the legislation, while 35 per cent were opposed and 11 per cent were undecided.
With less than three weeks to go until the issue returns to the Commons, here are the key reasons why some MPs fear the legislation won’t work:
Limited bill scrutiny
Many MPs faced with voting on assisted dying legislation have criticised the decision to present it as a private member’s bill (PMB) rather than it being put forward by the Government.
There is historical precedence for using a PMB on laws related to matters of conscience. The legalisation of abortion, decriminalisation of homosexuality and the abolition of the death penalty were all brought in through such bills.
However, such bills have a much stricter time limit, with MPs given only five hours to debate this bill at the second reading on 29 November. It is also being debated on a Friday – a day when MPs usually return to their constituencies.
Darren Jones, Chief Secretary to the Treasury, has stated that he would vote against or abstain on the bill because it is being delivered via a PMB.
He said: “My view is that a private member’s bill is not the right way to try to introduce a change in law on such a complex issue.
“This is because private member’s bills, which are introduced by backbench MPs, don’t get anywhere near the same level of scrutiny and debate as the Bills put forward by the Government – and legalising assisted dying is far from a straightforward issue.
Labour MP Rachael Maskell has also expressed concerns about the time allotted to scrutinise the legislation. She told i she was “very concerned about the whole process” and felt the bill had been “rushed”.
She also questioned whether Leadbeater was the right person to propose the bill, adding: “I’ve spoken to Kim Leadbeater, and she said she’s ‘learning a lot. ‘ Well, now’s not the time to learn. If she’s proposing this as a bill, she should have done her learning ahead of this.
Former shadow home secretary Diane Abbott also questioned why the full text of the bill was published less than three weeks before the debate. “I do not share the reported enthusiasm for the Assisted Dying Bill. And it is painfully late to be bringing forward a draft bill, with so little time [to] consider its contents,” she wrote on X.
‘Slippery slope’
Many opponents of the legislation also cite concerns about it leading to a “slippery slope,” suggesting that the bill could be expanded later with undesirable consequences.
Those touting this criticism often point to Canada, where assisted dying has been legal for those with a terminal illness since 2016.
However, in 2021, a new law was brought forward to relax some of the restrictions. The changes allowed people to seek assisted dying if their death was “reasonably foreseeable” and required the approval of only one doctor. It also has plans to allow individuals with severe mental illness to end their life – but this has been delayed repeatedly.
These changes have been heavily criticised, however, by both disability campaigners and United Nations human rights experts, and plans to expand assisted dying to those with mental illness have now been delayed until 2027.
Speaking before the bill text was published, Reform UK MP James McMurdock told i: “I have serious concerns about the potential for this legislation to be misused, misinterpreted, or expanded over time.
“My foremost responsibility is to protect, and my guiding principle is to do no harm. I must also act in the broader interests of society, with consideration to the potential for unintended consequences.”
The DUP MP Sammy Wilson, who is opposed to the bill, also warned about the “danger of legislative drift”, claiming that there could be “a widening of the scope of the legislation over a period of time, such as has happened with the abortion legislation.”
However, in a pamphlet sent to all MPs seen by i, Leadbeater tried to address these concerns directly. The document insisted that a slippery slope “cannot happen here” as in other countries.
It claimed that the shift seen in Canada was due to the country’s Supreme Court deciding how the law could be interpreted, something Leadbeater claimed couldn’t occur under the UK’s constitution.
“The bill you are being asked to support is very clear and very different… the bedrock of the UK’s system is the sovereignty of our Parliament,” the pamphlet states.
NHS and judicial capacity
Under Leadbeater’s proposals, two doctors and a judge must approve any request for assisted dying. Some critics of this approach, however, have suggested the NHS and court system may not have the capacity to deliver these changes.
Speaking to The Times, Conservative MP Dr Ben Spencer said: “We are not talking about the pressures on the NHS. Are you going to prioritise people who want to end their lives over people who want their chemotherapy? So far, I haven’t seen a bill that I think would work.”
More than 3,400 doctors, nurses, and healthcare professionals have also written to the Prime Minister to warn that assisted dying cannot be introduced safely while the NHS is “broken”.
The letter, organised by doctor campaign group Our Duty Of Care, warned that “disarray” within the healthcare system renders legalisation fundamentally unsafe.
“The thought of assisted suicide being introduced and managed safely at such a time is remarkably out of touch with the gravity of the current mental health crisis and pressures on staff,” the letter, first reported by The Telegraph, said.
Speaking at a press conference on Tuesday, however, former justice secretary Lord Charlie Falconer dismissed concerns that the court system would not have the capacity to take on assisted dying cases.
He insisted that family courts were “very, very good” at dealing with time-sensitive cases like those involving terminally ill patients, adding: “I’ve got absolutely no doubt that the court will manage this.”
“The nature of these applications will be that they will not take a long time. They are not like care proceedings that can take years… [Assisted dying cases] will almost invariably take precedence. So, other cases might have to wait… they are not going to have, in my view, a significant impact on court delays in the family division,” he said.
‘Insufficient’ safeguards
Politicians on both sides of the debate have stressed the need for strong safeguards when it comes to assisted dying.
Labour MP Dr Simon Opher, who is supportive of the legislation, told a fringe conference at the Labour Party conference in October: “I believe that those safeguards must be rigorous to protect those with disabilities and other long-term conditions who have not received a terminal diagnosis, and I completely understand the concerns that are being raised around this incredibly sensitive issue.”
A second Labour MP also told i that they were “minded to support a change in the law in a limited set of circumstances” and wanted reassurance that there would be “proper safeguards in place to prevent coercion and abuse”.
However, DUP MP Sammy Wilson said that “there is sufficient evidence from those countries which have already adopted this legislation such as Canada to raise legitimate concerns about the abuse of such legislation.”
To address these fears, Leadbeater has said that her bill contains the most stringent safeguards of any country, pointing out that no other jurisdiction requires a High Court judge to be involved in the process.
Her bill also creates a new offence, which makes it illegal to encourage somebody into assisted dying against their will.
Anyone found guilty of encouraging someone to either apply for assisted dying or administer the lethal medication through “dishonesty, coercion or pressure” could face up to 14 years in prison. However, questions remain over how this would be policed.
Diverting palliative care resources
MPs supportive of the assisted dying legislation have argued that the process would complement rather than replace palliative care provisions. However, fears remain that the new law could divert focus from the palliative care and hospice sector.
One Labour MP told i: “Instead of giving the state a role in enabling death, we should turn our focus to improving our already fantastic palliative care, improving conversations around death, and provide better mental health care for those with terminal illness. The Government should always be oriented towards life.”
Many MPs supportive of the bill, including Labour MP Lizzi Collinge, have also insisted that palliative care must remain a priority. She said: “Assisted dying is not and should never be an alternative to high-quality palliative and end of life care. Each person nearing the end of their life should feel reassured and safe in the knowledge they will receive the very best care.
But she added: “As a strong supporter of the hospice movement and a good death for all, I do not believe there is a conflict between both excellent palliative care and having the right, under strict circumstances, to an assisted death.”
Speaking at a press conference on the legislation on Monday, Leadbeater said that the UK should talk about challenges in the palliative care sector alongside assisted dying.
“They’re not mutually exclusive things. And actually, what is really good is that we’re having these conversations now as a result of this bill,” she said.
“For some people, palliative care simply cannot meet their needs, so it’s not an either-or. We’ve got to address both of those issues.”
MPs declining to vote on it
The upcoming Commons vote will be a free vote, meaning that MPs can vote according to their conscience rather than along party lines. However, this also means that they aren’t required by their party to vote at all.
The last time MPs voted on this issue in 2015, 329 opposed the legislation, 117 voted in favour, and 200 abstained.
Speaking at the press conference on Tuesday, Labour MP Peter Prinsley, who worked as a doctor before entering politics, criticised colleagues who planned to abstain on 29 November.
“I’d just like to say that I don’t think that abstaining, which people may be tempted to do, is a neutral act,” he said.
“I think that people need to make a decision about this, and that’s what I’m encouraging people to do.
“Those who said to me they won’t be able to decide, so they’re going to not come, they’re going to abstain, I would like them to come and make a decision.”
One source campaigning for assisted dying also told i they feared that abstentions could lead to the bill failing to pass once more.
“If the several hundred undecided MPs vote against or don’t show up, I think this issue will be forgotten for another decade. I think there’s a risk of history repeating itself,” they said.
