MPs narrowly pass assisted dying bill in landmark Commons vote

The Terminally Ill Adults Bill passed the House of Commons by 314 votes to 291 – a majority of 23 – representing a narrower margin than when the Bill was first debated in November, when it passed by 55 votes.

The Bill now moves to the House of Lords for further consideration, where it may be amended but is not expected to be rejected outright. If approved, the government would have up to four years to implement it, meaning assisted dying may not become available until 2029.

The bill was led through the Commons by Labour MP Kim Leadbeater (pictured), who said the result left her "over the moon," noting its personal significance coming nine years after the murder of her sister, MP Jo Cox.

“We have a system where it is legal to starve yourself to death, which can take days or weeks, but it is not legal to seek assistance from a doctor, to take an approved substance yourself, to end your pain or suffering and take back control in your dying days,” Leadbeteater said. “It simply does not make sense.”

The Bill will now go to the House of Lords where revisions can be made before finally returning to the Commons where discussions for Royal Assent can begin.

The Commons had earlier approved amendments, including one to close the “anorexia loophole” that would have allowed eligibility based on life-threatening malnutrition, and another requiring a government review of palliative care services within a year of the bill’s passage. An amendment to block access to assisted dying for people with mental health issues or those feeling burdensome was defeated.

Decisions about assisted dying in the current plans are said to be made by an expert, multi-disciplinary panel, including social workers, following sign off from two independent doctors.

A number of social work organisations have raised concerns and had input into the Bill and the role of social workers in the plans.

In May, the Association of Palliative Care Social Workers (APCSW) – representing some 200 specialist palliative care social workers working across the UK in hospices, hospitals, and community settings – called for ‘earlier and more robust involvement’ of specialist social workers in the process while maintaining a ‘neutral’ position on the debate.

“Social workers’ comprehensive experience and expertise in the areas of mental capacity and safeguarding mean we are optimally positioned to support a holistic and person-centred assessment. Social workers have a well-established role in balancing protection and empowerment, particularly where people may be vulnerable or disadvantaged,” the statement said.

“However, we would like to draw attention to some of the points that are made in the Equality Impact Assessment. This highlights the increased vulnerability of people who are disabled or disadvantaged by factors such as poverty, membership of certain ethnic minority groups, or as older people who are dependent on others for their care.

“Reflecting these concerns, we argue that the legislation - if passed - should include an explicit requirement for the involvement of a suitably qualified and experienced social worker at an early stage of the decision-making process. This would allow time for social workers to undertake a holistic assessment and to ensure that all reasonable measures had been taken to ensure a reliable assessment of mental capacity; and rule out any form of coercion. It would also allow time to identify and explore all available sources of material support or specialist care that could materially affect the person’s comfort and decision making.”

Meanwhile, the British Association of Social Workers (BASW) has warned that any additional duties for social workers in the process will need to be met with additional resources.

“While we welcome [the inclusion of social workers on the proposed independent panels], we have also been clear with MPs that any new panel established along the lines that Ms Leadbeater is proposing will require more resources and investment to ensure that there are enough professionals to meet demand,” BASW said in a statement in February.

“Furthermore, with these new responsibilities, there will be a need for relevant professional registration, training, supervision and accreditation for ensuring that the professionals involved are appropriately qualified and supported to carry out this function. Legal protections, which at the moment only cover healthcare professionals in the Bill, must also be suitably extended to other professionals, including social workers.”