The result came in seconds before the 2.30pm deadline. In a sweltering Commons chamber, packed with far more people than you would expect on most days let alone on a Friday when MPs tend to be in their constituencies, the result was announced: by 314 votes to 291, the Terminally Ill Adults (End of Life) Bill had passed its third reading. While the majority for the Ayes was more than halved since the second reading in November, following bitter committee and report stages, assisted dying will now go the Lords, from whence it is highly likely to become law.
It has been quite a week for social revolution, proving landmark change does not run on a linear timescale. The last big legislative shift of this nature was David Cameron’s determination – in opposition to much of his own party – to legalise marriage for same-sex couples in 2013. Twelve years and four elections later, MPs’ vote in favour of the assisted dying bill was the second time in a week parliamentarians chose to make fundamental changes on how the state relates to its citizens. On Tuesday, an amendment to the government’s Crime and Policing Bill that would remove criminal penalties for women who terminate pregnancy beyond the legal limit of 24 weeks passed in the Commons by a majority of 242 votes.
It is notable that neither of these changes are official policy of Keir Starmer’s government. The assisted dying legislation has been brought through the House as a private members bill by Kim Leadbeater – much to the contention of opponents dismayed (indeed, outraged) at the lack of time and to debate it. The abortion amendment was put forward by Labour backbencher Tonia Antoniazzi (who is also, as it happens, a co-sponsor to Leadbeater’s bill). Both were free votes, as matters of conscience are according to parliamentary convention. As Dr Kieran Mullan put it in his closing remarks for the opposition, on this issue of life and death MPs did not even have the line from the whips to advise their decision. They had to make up their own minds, with only their consciences – and a wealth of contradictory expert advice, personal stories and harrowing experiences – to guide them.
Almost six decades ago, parliament was gripped by an even fiercer frenzy of social change. It is well-known that the decriminalisation of homosexuality and the legalisation of abortion occurred as part of the “permissive society” reforms of Harold Wilson’s 1966-70 government, which also included the relaxation of divorce law and the effective abolishing of the death penalty. In fact, they occurred not only in the same year, but the same month: July 1967. On a single day – Thursday 13 July – visitors to the public galleries of parliament would have been able to watch either MPs heatedly debating the Medical Termination of Pregnancy Bill for its report stage and third reading, or the Sexual Offences Bill passing its second reading in the House of Lords.
Both of these reforms were spearheaded not by Wilson’s government directly, but by individuals in the Commons and the Lords. The abortion legislation was a private members’ bill by Liberal MP David Steel who has discussed the comparisons – and differences – with the current assisted dying bill. Decriminalising homosexuality was championed by Lord Arran, whose late brother was gay, then given parliamentary time by the government. (Lord Arran’s other passion project was the protection of badgers. When asked why his efforts on badgers had failed to garner as much support as his crusade for the rights of homosexuals, he replied: “Not many badgers in the House of Lords.”)
Both were also highly contentious, with public opinion deeply divided. “I cannot stand homosexuals… Prison is much too good a place for them” was the view of the Earl of Dudley during a 1966 Lords debate on the subject. A 1965 Daily Mail poll found that, while 63 per cent of people did not think private homosexual acts between consenting adults should be a criminal offence, 93 per cent believed those involved required medical or psychiatric treatment. Attitudes to abortion depended on the justification, with support on health grounds or in the case of rape, but far more mixed views regarding financial reasons or the issue of personal choice. Outside of a very fringe minority, the idea of either of these progressive reforms being reversed today is unthinkable.
Fast-forwarding four and a half decades, parliament again found itself progressing ahead of public opinion. In 2011 when David Cameron first intervened to ensure gay marriage was introduced within his first term as Prime Minister, just 43 per cent of the public supported it. By the time of the vote itself – a process critics regarded as “undemocratic” as it had not been in the Conservative manifesto and relied on votes from the Labour and Liberal Democrat benches – that had risen to 54 per cent. Now, only a tiny minority oppose it. There currently are 75 LGBT MPs in parliament, across five parties, many of whom are married to their partners thanks for Cameron’s reforms.
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In contrast, assisted dying has wider public support than it does in parliament: as was cited Friday’s debate, 75 per cent of people support the principle of the terminally ill being able to choose to end their suffering, while 73 per cent support the actual bill. Parliament is in catch-up mode, which is no doubt one reason MPs have backed the move, despite serious concerns remaining about its impact.
Of course, it is not the job of MPs to simply parrot public opinion. They are sent to parliament to represent their constituents by considering factors – legal, medical, societal – that those who elect them are freed from thinking about. This responsibility was the focus of Friday’s debate, as MP after MP – from all corners of the Chamber – stood up to warn about potential unintended consequences. “As parliamentarians, today we have to cast quite possibly one of the most consequential votes of our time in this place,” Liberal Democrat Munira Wilson cautioned the House. Conservative Tom Tugendhat called it “a transformation in the way in which power lies”, while Labour’s Chi Onwurah echoed the words of many of her colleagues when she told the chamber: “This is not your average bill. It fundamentally changes the relationship between state and citizen.”
There were many more speeches opposing specific aspects of the bill: the insufficiency of safeguards; the potential for coercion; the risks to disabled people, those suffering with mental health conditions such as anorexia, and victims of domestic abuse; medical complications regarding the process itself; the concerns of professional bodies of doctors and psychiatrists; and issue of substandard palliative care – not to mention criticism of the committee and report stages and the lack of time to debate amendments.
The link to the abortion vote of Tuesday was made both implicitly and directly. Lib Dem Sarah Olney talked of the “settled consensus” on abortion provision since David Steel’s bill, unchanged for 58 years until Tuesday, because of the work that had gone into it before the parliamentary stages to ensure a stable foundation. Labour’s Jen Craft talked of being immediately offered a termination when medical professional discovered her unborn daughter would have Down Syndrome, warning “We cannot legislate against discrimination”. This is not the first time parliament has considered shifting perspectives on how to value human life. It is not even the first time this week.
On the other side came equally passionate arguments: on a status quo that is “cruel” and “unacceptable”, beset with “profound injustices”; on compassion, humanity, choice, and pain relief; on alleviating suffering and attempting to shorten death as opposed to shortening life, as the Roman philosopher Seneca would have put it. But anyone watching could not fail to notice that the pro speeches were significantly outnumbered – surprising, given the end result. Perhaps, with the numbers anticipated to come down on the side of passing the legislation, those against felt an even fiercer moral duty to get their objections on record at this final moment.
One voice notably absent from the debate was that of the Prime Minister himself. A long-standing personal supporter of assisted dying, Keir Starmer has chosen to keep this process at arms-length throughout its passage. There were doubts as to whether he would even turn up on Friday. (He was in Canada for the G7 on Tuesday for the abortion vote – an absence that has fuelled criticism of a Prime Minister too detached to lead.) In the end, he made the journey from Downing Street to the Palace of Westminster, pausing his contemplation of the UK’s response if the US decides to attack Iran in Downing Street to watch the closing speeches and walk through the Aye lobby.
Moments beforehand, health minister Stephen Kinnock had closed the debate by assuring the House that “should it be the will of Parliament for this legislation to pass, the government will ensure the safe, effective implementation of this service” – a promise that threw into stark relief the government’s determination not to involve itself with this legislation. Kinnock was following Kieran Mullan summing up for the opposition benches, who had criticised the government for not providing more time on the floor of the House for such an important issue.
When the history books cover Starmer’s time in office, it is highly likely that assisted dying and the change it represents will be the cornerstone of his legacy. The consequences of this legislation are more far-reaching than Cameron’s push for marriage equality – more significant, even, than the 1967 reforms to abortion and gay rights. We have examples from around the world of how assisting dying provision can expand; while Britain is behind some other countries on the trajectory, we have little way of anticipating the full consequences of this shift. In 2013, critics of same-sex marriage argued it was an assault on the family that would irreparably damage the foundations of society. For most people in the UK today, the objections from scarcely over a decade ago look patently ridiculous.
But opinion polls can only tell us so much, and trends can go in more than one direction. Stark warnings were raised in the Commons on Friday – warnings that could well transpire to be Cassandra-like prophecies without the right legal, medical and societal frameworks. Failure in this regard will be considered – rightly – a failure of the Starmer government. Whether he intended it or not, this could end up being the defining week of Starmer’s tenure as Prime Minister.
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