U.K. backs assisted dying law, as more countries consider legalization

LONDON — British lawmakers on Friday voted in favor of a bill to legalize assisted dying in England and Wales - a move that could usher in one of the most dramatic social changes this country has seen in years, arguably since the decriminalization of abortion in 1967.

Lawmakers voted 330-275 after a five-hour debate that was emotional, but also respectful and nonpartisan. The bill still faces months of further scrutiny and procedural hurdles. But there’s a good chance of it becoming law.

Opening the debate in Parliament, Kim Leadbeater, the Labour lawmaker championing the bill, said the legislation would give dying people “choice, autonomy and dignity,” though she conceded that it wasn’t an easy decision. “But if any of us wanted an easy life, I’m afraid we are in the wrong place,” she added.

More than 160 lawmakers asked to speak, and campaigners from both sides gathered outside Parliament with signs.

In impassioned remarks, Labour lawmaker Diane Abbott said she was opposed to the bill and worried that those who felt they could be a burden might be pressured to pursue assisted dying. “I can imagine myself saying that, in particular circumstances,” she said.

David Davies, a Conservative lawmaker, explained how he changed his mind and was voting in favor of the bill because “I’m a believer in the sanctity of life … but I’m also an antagonist to torture and misery at the end of life.”

The British government is among several in Europe that have considered relaxing their prohibitions on assisted dying.

Nancy Preston, a palliative care expert at Lancaster University who has given evidence to parliamentary committees in Britain and Ireland, said interest “really picked up during the pandemic.” Some of that, she said, came from people witnessing a bad death “and then feeling, well, I want the option of that not happening with me.”

Austria, Spain and Portugal passed laws legalizing assisted dying in 2021. And while Portugal’s efforts have been blocked by the country’s Constitutional Court, courts in Italy and Germany have effectively allowed it in the absence of national laws.

Last month, politicians in Ireland, one of Europe’s most Catholic countries, voted to endorse a parliamentary report that recommended assisted-suicide legislation. The French National Assembly has also considered a bill allowing approved patients to take lethal medication.

Getting help from doctors or other trusted people to end one’s life is still illegal in most countries around the world. The majority of places that allow it are in Europe, and European public opinion is broadly supportive of allowing assisted dying in some circumstances.

In many of these countries, high-profile cases have helped draw public attention. In Spain, it was Ramón Sampedro - played in a movie by Javier Bardem - who was paralyzed after a diving accident and filmed himself taking poison after a 28-year effort to secure the right to die.

In Italy, it was a disc jockey named Fabiano Antoniani, or DJ Fabo, who was left blind and tetraplegic after a car crash and ultimately went to a Swiss clinic to die.

In England, Esther Rantzen, a well-known television personality who has Stage 4 lung cancer, has helped to galvanize attention. But even if the law is changed, she thinks it will be too late for her.

She is planning to go to Switzerland - one of the few countries where foreigners can request end-of-life services - if her life becomes “unbearable,” she told The Washington Post.

Rantzen said she wouldn’t let her family go with her. Assisting a death is illegal in England and Wales, punishable by up to 14 years in prison. Prosecutions are rare, but they do happen.

“I cannot let that happen to them,” she said in an email, written from her cottage in the New Forest, England. “A painful death or a criminal investigation by the police must not be their last memory of our time together. That would be grim, I want them to remember all the joyful times we have spent together. After all my years working on TV, I’m a performer - I want to leave them wanting more!”

Switzerland has been a main destination for people in Europe who can’t secure an assisted death in their own countries.

Switzerland was the first nation in the world to permit assisted suicide, decriminalizing it in 1942 on the condition that is not driven by “selfish intent,” such as financial gain by the survivors. The person ending their life must also self-administer the lethal substance.

More than 3,900 people ended their lives with Dignitas, an assisted dying organization in Zurich, between 1998 and 2023. Those included 1,454 Germans, 571 Brits, 549 French and 207 Americans.

The cost is about $13,000.

The Swiss approach remains highly regulated. Police arrested several people in September after an American woman died last month in an illegal “suicide pod,” a spaceship-looking capsule that fills with nitrogen gas, cutting off oxygen. Philip Nitschke, the inventor of the device, told the Daily Telegraph that he would introduce the pods to Britain if the assisted dying bill becomes law, but it’s unclear if British ministers would approve nitrogen gas to assist dying.

The English bill is largely modeled after a law in Oregon, the first U.S. state to legalize assisted dying for terminally ill patients. Under the bill, a person could make a request if they are expected to die within six months, can demonstrate a clear wish and can administer the fatal cocktail of drugs themselves. They would have to get approval from two doctors and a high court judge. If approved, they could seek a prescription through the National Health Service.

(Each nation and crown dependency of the United Kingdom is responsible for its own health care. Scotland, Jersey and the Isle of Man are also considering changes to assisted-dying rules.)

Preston wondered about the logistical challenges. “Where do you find the doctors who will do it? Are there enough high court judges? What about health care workers who might agree with it in principle, but don’t want to be involved? … People aren’t thinking through the practicalities, only the moral issues,” she said.

Some opponents in Britain worry about a “slippery slope.” They point to Canada, where eligibility has been extended from those who are terminally ill to people experiencing “unbearable suffering” from an irreversible illness or disability. The Netherlands, which has some of the most permissive dying laws in the world, has expanded its eligibility criteria to include minors, and the country has been debating whether to include people over 75 who feel like they have a “completed life.”

Leadbeater, the main sponsor of the British legislation, called the Terminally Ill Adults (End of Life) Bill, rejected the argument that eligibility would change. On Friday, she said that she purposely titled the bill to specify whom it would cover and that it explicitly excludes mental illness and disabilities.

The proposal has been highly divisive, even within the senior ranks of the governing Labour Party. Prime Minister Keir Starmer previously made clear his support. But Health Secretary Wes Streeting said he was concerned that people might feel a “duty to die.”

The vote on Friday is a free one, meaning lawmakers don’t have to vote along party lines.

Some say that the bill doesn’t go far enough - including Dave Sowry, a Londoner who in 2022 accompanied his wife, Christy, to Dignitas. She had multiple sclerosis, a disorder that impacts nerves in the brain and spinal cord. Sowry said she might not have been eligible under the new proposals if her condition wasn’t deemed “terminal.”

Christy’s death was shrouded in secrecy - she didn’t tell her doctor or many friends, for fear of putting them at risk of prosecution. But she did leave a letter behind. Sowry’s voice cracked when he read it. She had written about becoming a “full-time invalid” and someone who didn’t “want to be.”

After Christy’s death, when Sowry returned to London, he rang the police and told them what he had done. Two uniformed officers grilled him for four stressful hours, and combed through his wife’s iPad to ensure she was the one who made all the travel arrangements. He was then told the police weren’t going to take any further action.

Now he hopes that a change in the law might allow for a better death for others with unbearable suffering. “It was all a very stressful experience, when it should have been a chance to make peace with giving up her life,” he said.