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MPs will vote on whether to approve assisted dying on Friday, in what could be one of the most significant changes to the British legal system in a century.
The free vote on the bill that would allow terminally ill people to end their life has sown division across parliament and split the cabinet and major parties, while creating unlikely alliances across party lines.
The vote is believed to be too close to call: a tracker of MPs who have publicly stated their position on Thursday night showed 265 in favour and 217 against, leaving more than 140 yet to declare their intentions.
Sir Keir Starmer, who previously voiced support for assisted dying, has not said how he will vote, but a number of political heavyweights and former prime ministers have taken positions in the run-up to the ballot, which has become increasingly emotive as the vote approaches.
Gordon Brown, Theresa May, Liz Truss and Boris Johnson — who do not have a vote as they are no longer MPs — have said they oppose the measure, while Lord David Cameron this week said he had changed his mind and supported it.
The bill proposes allowing people who have been given six months left to live to end their life, providing the decision is signed off by two doctors and a High Court judge. The safeguards, intended to allay concerns that people could be coerced into taking their lives, have been criticised by some former judges as inadequate.
On Friday, MPs will debate the measure during the morning, with a result of the vote expected in the early afternoon.
The bill has caused a political rift within the cabinet. Health secretary Wes Streeting was among the first cabinet ministers to break ranks and say he did not support the bill because he was concerned the poor state of palliative care in Britain might push people towards ending their lives. Justice secretary Shabana Mahmood has also said she will vote against it.
Other cabinet ministers, including Bridget Phillipson and Jonathan Reynolds, have said they oppose the bill.
Seven cabinet ministers have so far said they support the bill: Liz Kendall, Lisa Nandy, Hilary Benn, Ed Miliband, Peter Kyle, Louise Haigh and Jo Stevens.
Starmer refused to disclose his voting intentions at a press conference on Thursday, saying he did not want to “put pressure” on MPs even though he had a “huge amount of interest” in the outcome of the ballot.
Several opponents have raised concerns about the process underpinning the bill, arguing that a private members bill brought by Labour MP Kim Leadbeater has meant that an impact assessment was not provided ahead of second reading, and that there has not been sufficient time to debate the bill.
But proponents have argued that it will ultimately be properly scrutinised at the committee stage and in the House of Lords if passed by MPs in Friday’s vote.
They also point out that laws allowing abortion and decriminalising homosexuality were passed by private members’ bills.
Lib Dem MP Sarah Olney said she had found the process over the past few weeks “incredibly stressful”, because of the large amounts of lobbying on both sides, the harrowing stories being shared by constituents, and the lack of authoritative information to help form a position.
“It’s a massive dilemma because the legislation has to be right otherwise it will put people at risk — and how am I supposed to know that?” she said.
If passed, the bill will immediately become a major new challenge for Starmer’s government, which will have to implement the new assisted dying regime.
Downing Street has already suggested the government will carry out an impact assessment on the bill, a study which will include looking at its impact on the already-stretched NHS and judiciary.
Even carrying out an impact assessment throws up challenges for ministers. “Will assisted dying be an NHS-only issue, will it be a mix of NHS and private or will it be just private?” said one Labour official.
Because of the bill’s potential to have a profound impact on public policy, some in Whitehall believe the government may put down its own amendments during its committee stage in the House of Commons to help refine the legislation.
Although the measure will remain a private member’s bill, Labour officials say that ministers and the government machine will immediately have to engage with the legislation and make preparations for it becoming enacted.
Labour officials believe the Ministry of Justice will be the lead department, while Stephen Kinnock, the health minister responsible for palliative care and a supporter of assisted dying, is expected to lead in his department.
Additional reporting by Laura Hughes
