The Guardian view on assisted dying debate: a first hurdle cleared – many more lie ahead | Editorial

On Friday, MPs voted to advance legislation on assisted dying in England and Wales, reflecting polling that shows widespread public support. However, a slim majority, of less than one-tenth of the House, should temper the confidence of its proponents. This is a profound, historic decision that demands careful consideration. Parliament was at its best in putting through the proposals to the next stage of deliberation. The debate was marked by sobriety and the welcome absence of partisan bickering. MPs approached the issue with humility, showing respect for every contribution, regardless of stance.

The central tension between individual autonomy and societal responsibility was clearly highlighted by the discussion. MPs were right to allow for further detailed scrutiny, debate and potential amendments to ensure the terminally ill adults (end of life) bill addresses both ethical concerns and practical safeguards effectively. The desire to alleviate suffering is deeply compelling. The legislation proposes allowing mentally competent adults with a terminal diagnosis and less than six months to live to seek medical assistance to end their lives. Safeguards include independent assessments by two doctors, high court approval and a 14-day reflection period. Once the criteria have been met, a doctor may prescribe a self-administered life-ending medication.

Despite these measures, opponents highlight unresolved concerns. It is important, if these proposals do become law, to ensure that vulnerable people are protected, public trust in healthcare is maintained and societal values are upheld. This will only be helped by allowing MPs in parliament’s committee stage to take oral and written evidence, as in the case of government legislation. Many sceptical of the change rested their arguments on variable and inequitable NHS-funded care for those nearing death. Every year, more than half a million people die in the UK, making the quality of end-of-life care crucial for many and, eventually, for all of us. Those against the proposed change argue, with good reason, about the wisdom of having a conversation around dying that focuses on a small group – about 600 annually – who might opt for assisted dying if it were legal.

Critics raise a good question: why does the debate focus disproportionately on the relatively few who might choose assisted dying, while neglecting the far greater number who suffer unnecessarily due to inadequate end-of-life care? It can only be answered substantially by ensuring that assisted dying proceeds in lockstep with universal coverage of palliative and end-of-life services, including hospice care at home.

Opposition to the bill also focused on the risk of coercion, particularly by relatives – pressure that can be difficult to detect. Currently, the Crown Prosecution Service weighs whether decisions in “mercy killings” are made independently and free from duress. Critics worry that legalising assisted dying might inadvertently enable such abuses.

Supporters of the proposed legislation are correct that it would be a necessary step forward. But the bill’s detractors are also right that its provisions are insufficient. This is not a procedural point about an act being passed via a private member’s bill brought forward by the Labour MP Kim Leadbeater. Many of the UK’s most important social reforms in recent years – abortion, the death penalty and divorce – took a similar route.

Impassioned speeches in the House revealed strong feelings on the issue. Some cited religious objections tied to the sanctity of life, while others warned of health inequalities, particularly for disabled people, that could have lethal consequences without stronger safeguards. The first assisted deaths are years away. Many other nations have wrestled with the moral dilemmas raised. The debate underscored the need for unity and effort to ensure any legislation is ethical, fair and protects society’s most vulnerable.

The Guardian

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