This is Prospect’s rolling coverage of the assisted dying debate. This page will be updated with the latest from our correspondent, Mark Mardell. Read the rest of our coverage here
5pm
There was a collective sharp intake of breath from the Commons as the deputy speaker announced the result of the final vote of the assisted dying bill’s report stage. Ayes to the right: 259, Noes to the left: 216.
The bill’s supporters claim it is no reflection of what will happen when the whole bill comes back to the commons next Friday and they are probably right.
I said in my first post of the day that I'd be staring at the entrails of the debate to make sense of the future of the bill. How right I was. Like the augurs of old, I found myself staring into a bloody mess, trying to divine meaning from it.
There were three votes, following what had slowly became a rather passionate debate.
The first was on an amendment that would have made the restrictions against advertising even stricter. That was rejected—by a majority of just 26 votes.
Then came an amendment from veteran Labour opponent of assisted dying, Meg Hillier. She wanted to stop doctors from initiating a conversation about assisted dying with patients. That was rejected too, but by an even slimmer majority—just 21 votes.
So, neither of those are comfortable majorities. But a win is a win.
Then came another amendment from Meg Hillier again, this time seeking to stop doctors from having a conversation about assisted dying with those under 18. And that passed—by the much bigger majority of 43.
So what does it all mean?
It’s probably true that in the real world of assisted dying it doesn’t matter—it isn’t available to under-18s anyway, so there would be little point in a doctor raising the subject with them. And there is a political imperative to be seen protect children. Supporters say they’ve been though the voting lists and there are plenty of firm backers of the bill who just happened to differ on this one issue. Again, probably correct. But it is bound to make Leadbeater nervous and it all underlines the volatility of the hearts and minds in this debate.
4pm
After a series of passionate speeches against assisted dying, MPs voted in favour of tightening the proposed law against the wishes of the bill’s author, Kim Leadbeater. A defeat, certainly. A major upset? More like a minor one. After two votes on amendments which went in her favour, one went against by 259 to 216. Supporters say they aren’t worried and they expect to win next week. More very soon.
There was another passionate speech from Scottish Labour MP Melanie Ward. “Let me start by saying that ending suffering is a shared goal of all across this House,” she said. “No one has a monopoly on wanting to end suffering. The question is about how we best do this.
“As a former aid worker, I’m someone who has risked my own life in order to alleviate the suffering of total strangers in war zones. I promise you that I am motivated to end suffering at least as much as the next Member.
“It is worth the House knowing, too, that my darling dad died of terminal cancer in a hospice run and funded by a charity—because the NHS doesn't have that provision.
“Now, new clause 4 matters because we do not live in an equal society—although many of us, particularly on these benches, seek to bring one about. This is a deeply flawed bill, and the truth is that in seeking to give choice to some, it risks causing new harm to a much larger vulnerable group. And the safeguards, which were watered down in Committee stage, will not prevent this.
“Indeed, a letter from over a thousand doctors this week said the Bill will widen inequality and—quote—‘is simply not safe’.
“We heard earlier from the Honourable Member for Rochdale, powerfully, about the impact of advertising on the most vulnerable.
“New clause 4 increases data about the impact on the most vulnerable and brings in proper oversight from the chief medical officer, including in relation to those with protected characteristics.
“Last time we debated this bill, we heard from my Honourable Friend the Member for Bexleyheath and Crayford. We were in the shared situation of having close and dearly loved family members who have complex disabilities.
“My Honourable Friend and our families both know what it is to have to struggle—to fight every week—for access to basic state services that our loved one is entitled to, but cannot access. Services and precious state resources that would increase their equality and ability to live well—but were stretched beyond breaking point by successive Tory governments.
“It is that experience, Madam Deputy Speaker, that brought me into politics and into the Labour Party. And still to this day—away from my work as a Member of this House—I have to fight on behalf of my loved one, who has significant physical impairments as well as learning difficulties, to access the healthcare and support that they desperately need.
Vulnerable people do not always make decisions in their own best interests. And I know too, from my family experience, that vulnerable people can be highly susceptible to pressure from others who do not have their best interests at heart.
2pm
Labour’s Dame Siobhain McDonagh has spoken with real passion about the power this bill would give to ministers to change the founding principles of the NHS.
“This section has remained virtually unchanged since 1946 because it expresses a promise—a comprehensive health service designed to secure improvement in the physical and mental health of the people of England. Those words, spoken by Nye Bevan and enshrined in law, set the purpose of the NHS: a national health service, free at the point of delivery.
“We’re about to reach the 80th anniversary of the 1945—the moment that set in train the NHS—and the 77th anniversary of the founding of the NHS itself. Fundamental to that is the point you make: that the NHS must be free at the point of need, built on care, compassion, and life.”
She continued: “And that is why I have tabled my amendment—to prevent anyone from tampering with the NHS as founded by our forefathers.
“Because let’s be clear about what Clause 38 of this bill would allow: it would allow a minister, through delegated legislation, to rewrite the very purpose of our NHS. And it would let them do so without the full scrutiny that primary legislation demands. It would mean parliament could be denied any real chance to amend or reject that change.
“These are not abstract constitutional concerns. This is about whether the founding promise of the NHS can be quietly removed—not through open debate, not by an act of parliament, but by a handful of MPs behind closed doors in a committee room.
“And once the pass is sold, there is no telling what future governments might do or undo.
“This is why this matters so deeply. Because the NHS is not just a set of services. It’s a promise—a promise made right here in this House nearly 80 years ago during the second reading of the 1946 NHS bill.”
11.30
Labour MP Dr Jeevun Sandher has been speaking about the widespread perception if this bill passes it will undermine ethnic minorities’ already low trust in the NHS and the proposal to have a representative to look after their interests.
“Ethnic minorities are less likely to access assisted dying when a jurisdiction is in place.
“In Oregon, 10 per cent of those using or accessing assisted dying are ethnic minorities, compared to 40 per cent of the population. In California, 15 per cent of ethnic minorities access this option, compared to making up 30 per cent of the population.
“That is not the point. The point of this bill is to give people the choice to end their life, regardless of the colour of their skin. There is no special quality about the colour of my skin that affects my access—or the need for a special representative—in this case, a case that is covered by the EHRC, that is covered in the Secretary of State’s remit.”
11am
13th June
MPs are now debating Kim Leadbeater’s bill in the Commons for the second time this year. No one expects this to end with the main vote today. That doesn’t mean it is impossible that the critical decision will be taken before the end of the day, but most expect that will happen in a week’s time.
So what is today’s session about? It is the second day of the report stage when (some) amendments are debated and (some) are voted on.
According to the excellent briefing from the Hansard Society the debate will be about: “approved substances and devices; advertising; inquests; investigations and death certification; guidance and codes of practice; Welsh language; monitoring, consultation and reviews; the Assisted Dying Commissioner; implementation; regulations; extent; and commencement."
In other words, a lot of pretty technical stuff. Important, of course but a lot of us will be attempting to read the entrails of the debate to discern the bill’s future fate. ITV news suggests that “94 MPs are so far planning to vote for it, 97 plan to vote against it, 14 remain undecided and 17 are due to abstain”—which sounds tight until you realise they don’t know, or at least, don’t say what 428 of them are planning on doing.
12th June
It is a big day tomorrow for the assisted dying bill—and the following Friday may be even bigger. I say may because, truthfully, no one quite knows what’s going to happen. I’ll be sitting there with my trusty guide from the Hansard Society at my side, trying to work it all out.
But procedural details aside, I think it’s vital that MPs remember why they’re voting—and who they’re there for. This is about people who are suffering terribly and want to end their lives with dignity. This isn’t about protecting professional pride or indulging a few miffed organisations who feel they’re not being sufficiently consulted. Nor is it about protecting people who wouldn’t even qualify under this bill: those who are not terminally ill.
I’d like people to read a very moving letter from Linda Clarke—a tireless campaigner and, like me, someone living with Parkinson’s. I know her through our Parkinson’s campaign but she got in touch recently to ask whether I could help publicise her letter. I’m very glad to do so.
Please politicians, allow me a choice—the choice my younger sister had
I implore MPs who are attending parliament on the next two Fridays not to cast your votes based coldly on whether assisted death should be permitted, but to ask instead how they can safely allow terminally ill people who suffer excruciating pain and have six months or less to live to have a choice of an assisted death.
While I greatly respect all different religious beliefs regarding how a person dies, please don’t take the choice of an assisted death away from any terminally ill person who desperately wishes to make that choice.
Any death of a loved one is not easy, or without sadness and emotion.
I feel this profoundly because a little over a year ago, on 22nd May 2024, on a beach of her choice, at a time of her choice, my sister took her choice of an assisted death.
My husband, daughter and I spent the last seven weeks of my sister’s life with her and her partner Paul Qualtrough in New Zealand, where she chose not only how to live on her terms, but how to die on her terms.
I wholeheartedly supported my sister’s chosen exit from her prolonged, painful, terminal illness. I have complete faith in Kim Leadbeater’s determination to make this assisted dying bill appropriate for the UK.
It was an extremely difficult time, from the return of my 57-year-old sister’s breast cancer, the realisation that it was terminal, and her suffering and painful deterioration. My sister, Tracy Hickman, had worked her way up to the top of her profession, was the director of an accounting firm and became a mentor. She travelled extensively, and her favourite pastime was running marathons, which she did on every continent. Her partner, family and friends were of great importance to Tracy; when she made friends with you, it was for life. Tracy loved her family deeply, especially her nieces and nephews. We spent the last 18 months of her life saying goodbye in person to all her lovely friends and loving family.
When her cancer spread to her spine, lungs and brain, and her body was failing to function properly, and her pain continuously persisted in spite of her drug regimen, we prayed for her release.
Tracy led a big life. She reached her full and best potential. She will always be loved and missed.
If you want to hear her opinions on assisted death, you will find it here on a podcast that was made shortly before her death.
I wholeheartedly supported my sister’s chosen exit from her prolonged, painful, terminal illness. However, I would not vote in favour of assisted dying if I were a resident of Canada or some American states, as I believe their policies are open to coercion and misuse. The UK has the advantage of being able to observe which countries have strong safety regulations attached to their assisted dying laws, and which have failed to protect their citizens from coercion and misuse. I have complete faith in Kim Leadbeater’s determination to make this assisted dying bill appropriate for the UK.
Even though I was and am fully behind my sister’s dying choice, I felt a great apprehension of the actual assisted death day. If I felt even the tiniest hint of doubt from my darling sister, how could I witness her choice of a life end and support her?
I worried needlessly. It was such a surreal experience—all the previous two years of decline, pain and suffering seemed to come to an almighty crescendo. Tracy was actually happy and exuded an inner peace and tranquillity. She was the strongest person present in the weakest body imaginable. She did not falter once on the morning of her death. In fact, sitting in the car, on the way to her chosen beach, she made us all laugh—which sounds crazy, but as in life she was in full control of her death.
When we were gathered around her propped up on her walker chair, she produced chocolate that we all shared. After spending some time together, she announced that she was ready. So we texted the government official and doctor, who then put a line in Tracy’s arm. The doctor retreated until Tracy chose the time to proceed—by New Zealand law, she could change her mind at any moment. But my strong and loving sister stuck rigidly to her choice. The doctor administered the medication and again retreated, telling us to take all the time we needed. My sister was completely relaxed and serene throughout her time on the beach. She passed while holding hands with her loved ones. During these last minutes, an unplanned dialogue took place about our happy times with her, each person expressing a memory. I reminded her of when she was younger and I cut her fringe too short, and told her that I will always love her.
It was an emotional, profound experience, one that added to the pain of losing a very loved younger sibling. But that is a cost I am wholeheartedly willing to pay.
A year has passed since my sister stopped breathing. When I reflect back over the whole traumatic return of her breast cancer diagnosis and consequent decline, and her chosen death, it all still hurts—but for her, I would do it all again.
I am not only imploring ministers on behalf of my sister to have a choice, but also I am pleading on my own behalf. In 2015 I also had breast cancer which reached my lymph nodes, so I could also be a candidate for it to return, and I wish to have the same life end choice as my sister.
Assisted dying should be a choice for the terminally ill citizens who meet a carefully considered, and compassionate criteria. Even if it’s not your own choice, or it does not align with your religious or personal beliefs, please allow others this humane and essential choice.
Tracy’s sister,
Linda Clarke
9th June
This time last week, I was sitting in the grand surroundings of the Royal College of Nursing (RCN)’s London headquarters for a fascinating joint event with Marie Curie on end-of-life care. I was pleased to be wearing both my hats at the same time. Usually, I have to juggle them day by day throughout the week—and that’s often difficult.
The two hats? Writing this column for Prospect and being one of the Movers and Shakers—not only the podcast about Parkinson’s but also a campaign for better care which seems to have taken over large parts of my life.
I was there as a guest speaker, both because I write here about assisted dying and because I have Parkinson’s. So the whole business of palliative care and assisted dying is rather more personal to me than it is to many others.
One of the first things I did was make sure everybody had seen the QR code or could click on and sign parkypetition.com so we can have a full debate in parliament on Parkinson’s. This is in part a shameless piece of self-promotion, but it is also relevant to the debate about assisted dying.
For the link to the petition comes complete with a map I’ve become rather obsessed with. It shows exactly which areas—in terms of parliamentary constituencies—have the most signatures. It updates automatically.
What it revealed, almost at first glance, is that the prosperous south coast has the most signatures. Inner city areas in London, Birmingham, Bradford and Leeds have the fewest in England.
That made me think. Bradford, Birmingham and inner London aren’t just poorer areas—they are also areas with large ethnic minority populations. That worried me. Not just because they weren’t signing—but because people in those communities presumably don’t get the benefit of the kind of expertise that Parkinson’s care can bring.
I can’t say why. Maybe people in those constituencies aren’t getting the information the various charities push out more generally.
What on earth has this got to do with assisted dying, you ask? Or end-of-life care?
Well, everything, really. It struck me a long time ago that we ought to be doing more work on the attitudes of ethnic minorities to these questions. It’s a subject that’s too often paid lip service or ignored altogether.
The RCN conference definitely put an emphasis on changing this. So I spoke to three of the main speakers that afternoon. The first was Rekha Vijayshankar, deputy head of Quality and Clinical Governance at Marie Curie as well as a Queen’s nurse and a Churchill fellow. She told me that the concept of what makes a good death varies between cultures.
“I think our understanding of death and dying—and of what constitutes a good death—is quite an Anglophone understanding,” she said. “It places great importance on individual autonomy: control, decision-making, personal preferences and values.
“But for the vast majority of global majority populations—communities with more collectivist traditions—decision-making takes a different form. In these contexts, individual choice takes a back seat to communal, familial or collective decision-making. So autonomy, in the sense we often mean it, simply isn’t as central. That’s likely because these communities have a much longer historical presence on the planet than we do. They come from ancient civilisations with deeply rooted systems for handling death, dying and loss. These are expressed through spiritual, religious and cultural frameworks that help integrate loss into daily life.
“A good example is the way grief is experienced. In Anglophone cultures, grief is something we work through—an emotional state to be processed. But in many global majority communities, there’s often no word for ‘grief’ as such. Instead, there are words like sorrow, pain and loss—but these aren’t problems to solve. They are ever-present, sitting at the table with you. And they’re integrated into life through ritual, religious practices, sanctification and continuing bonds.”
This is undoubtably true, although it rather disturbed me in the way it seemed to lump people with greatly different histories, religions and geography together (more on that in a moment). Butt it did make me want to seek out people with individual experience of the communities involved. One such was Rohit Sagoo, who’s the founder and director of British Sikh Nurses. He’s been a nurse for 26 years, and tells me that one of the key tenets of Sikhism is seva, or selfless service. He saw an opportunity to give back to his community in setting up a table at the gurdwara (Sikh temple) with a blood pressure machine, where he took readings.
“That small act spiralled. We were contacted by the Department of Health and Social Care and started working with NHS Blood and Transplant, helping raise awareness around organ donation. During Covid-19, we worked to dispel vaccine myths and promote hand-washing and public health guidance.
“So far, we’ve screened over 6,000 people in the Sikh community. We found that about 60 per cent are walking around with undiagnosed hypertension. That’s a major health inequality. We’ve raised that issue at government level.
“We’ve also supported nine families looking for living kidney or stem cell donors. And we support around 120 internationally educated nurses—many Sikh, but also from other faiths—with pastoral care, professional development, interview preparation and OSCE training.
“Another strand of our work is with Resuscitation Council UK, teaching bystander CPR to Sikh communities. We’ve trained around 500 to 600 participants over the past few years. So yes, it’s been a wonderful labour of love, and it continues.”
I asked Sagoo: what is the Sikh attitude towards death?
“In Sikhism, we view death as a transition,” he said. “The body is just a vessel—the soul continues its journey. We believe death is governed by Waheguru—God—and that we shouldn't interfere with divine will.
“It’s very much rooted in scripture. If our death is already written, then that’s how it’s going to unfold. So when we talk about things like assisted dying it becomes a very difficult conversation, because it seems to go against what’s already written.
“We also talk about kismet, or destiny. Life’s journey includes hardship, and death is one of those hardships we all face. The idea is to walk through that journey rather than cut it short.”
I asked if this meant any Sikh would be opposed to assisted dying.
“From a Sikh perspective—my own included—I would say yes, it can be seen as disrupting the soul’s journey,” he said. “If we intervene in the process of dying, there may be spiritual consequences.
“But speaking as a nurse, I also see the reality of pain and suffering, and I understand the importance of compassion. So there’s a tension between theological doctrine and the humane response to suffering. That’s where the debate lies: do we let Waheguru’s will unfold, or do we say, ‘I cannot suffer anymore’?
It’s a conversation the Sikh community hasn’t really had. Or if they have, it hasn’t been very open. There’s a lot of stigma around death. It’s often a shut-down subject.”
Next I spoke to Olajumoke Isaiah, who is a member of the Royal College of Nursing Pain and Palliative Care Forum, and also leads the palliative and end-of-life care team from the RCN’s Pain and Palliative Care forum.
“For people from ethnic minority backgrounds, it’s important to recognise they’re often marginalised—sometimes because of language barriers, sometimes because of a lack of understanding of the health system, and sometimes due to stereotyping and assumptions about particular groups,” she told me.
“We have to move away from generalisations and ask: what is important to this individual?”
So I put it to Vijayshankar that her “global south” label rather ignored the rich diversity that makes up modern Britain.
“There’s vast diversity—cultural, religious, economic, political—and different hierarchies of power and intracultural stigma,” she responded. “But they do all share something in common: a legacy of colonialism, which has often resulted in resource poverty and marginalisation. They are now labelled as ‘developing nations’, but that label hides a long, rich past.”
And, I asked, doesn’t the immigrant experience itself mean a constant flux of identity and so shifting attitudes?
It depends on who you ask, she said. “For example, older generations—from Nigeria, Jamaica, Pakistan or Gujarat—may carry deep intercultural stigma around certain illnesses. In some south Asian languages, dementia is translated as ‘madness’. That stigma contributes to late disclosure and delayed access to care, often long after curative treatments are possible. There can also be a belief in miracle cures—whether from spiritual healers or occult practices—which complicates engagement with formal health systems.
“These older generations, including those from the Windrush era or immigrants from east Africa in the 1960s, may carry disenfranchised grief—grief that’s not acknowledged or supported within the dominant culture. This sits uncomfortably alongside a colonised mentality of ‘the west knows best’. As a result, death and dying often aren’t talked about openly, especially not with professionals. These conversations may still happen—but privately, within families. That’s why rates of advance care planning are so low among minoritised populations. It’s not that people haven’t thought about it; they’ve just done it in their own way. And that way is just as valid.”
That does raise the question, once again, of how health professionals can reach into these communities.
Isaiah is clear: “Communication. That’s the first thing—empathetic, sensitive communication about what’s important to them, in a language they understand. Just because someone doesn’t speak English doesn’t mean they don’t have the right to understand or to be part of the conversation. If they need to speak in another language, are we providing the right translation method? That way, we can ask what’s important to them, and tailor their care accordingly.”
I am hearing more and more the view that assisted dying could further undermine trust in the NHS among people who have little trust anyway in the medical profession. It concerns me, but I worry if we accept it as a reason to reject the bill it has huge implications. After all, politicians are very widely distrusted—does that mean MPs shouldn’t pass any new laws until that is fixed, because any new legislation could further undermine that trust?
So I asked my interviewees: where does all this leave the debate on assisted dying?
Vijayshankar tells me: “It’s complex—particularly because individual autonomy, again, isn’t the dominant lens. From what I’ve learned, people from these communities tend to focus more on quality of life than on the right to end life. The logic of ‘my life is no longer worth living, so I should end it’ doesn’t always resonate. And yes, the idea of being a burden may exist—but it’s shaped by different moral frameworks.
“Filial piety—duty to one’s elders—is a core virtue. During my Churchill Fellowship in India, I saw that clearly. In Kerala, palliative care is owned entirely by local neighbourhoods. Communities contribute what they can into a shared fund that pays for nurses and doctors. That happens because people feel accountable for each other.
“I remember meeting young people with spinal injuries being cared for entirely by their families. One father, who had very little formal education, said to me: ‘Why should I depend on anyone else? He’s my son. If I don’t care for him, who will?’ That sense of responsibility was deeply moving—and deeply instructive.”
Isaiah said: “At the Royal College of Nursing we have a neutral position, and I do personally as well. But I think it’s important to say that assisted dying needs to be part of a broader conversation—not just in parliament, but with the people it affects. We need to understand what good end-of-life care looks like, first and foremost… The real question is: are we giving people the basics first, before they’re even thinking about assisted dying?
Sagoo told me his organisation is neither for nor against assisted dying—but for education. “There’s a lot of resistance. But I believe there’s also room for discussion. Not just about assisted dying—but about death in general. Talking about what death means, what our soul’s journey is, and how we prepare for it, is deeply enriching. That’s the real starting point.”
