The following analysis was written by Hannah Slater for her ‘Gentle Roars’ Substack, and is reproduced here with her permission. If you would like to read more of Hannah’s publications and support her work, please consider becoming a free or paid subscriber, at Hannah Slater | Substack or Upgrade to paid
On Friday MPs voted against Lauren Edwards MP’s Terminally Ill Adults (End of Life) Bill at its second reading by a margin of just 16 votes. That was despite Kim Leadbeater’s almost identical Bill being passed by the House of Commons at its third reading in June 2025 by a margin of 23 votes, before it was blocked by the Lords. Friday’s vote has killed Lauren’s Bill — and with it, the latest chance to bring legal assisted dying to England and Wales.
It’s a devastating result for campaigners who have spent years fighting for this change, often as a result of difficult personal experiences with loved ones and many of whom travelled to Parliament Square on Friday for the vote. I wasn’t able to make it to London myself, but I am deeply disappointed in the outcome.
Let’s be clear about exactly what the House of Commons voted for last week, when it voted the Bill down:
More unnecessary suffering
Palliative care is excellent, but even the best palliative care cannot relieve pain 100% of the time. Some people are allergic to opioids. Some of us will lose the ability to communicate pain as our disease progresses. Many of us will become incontinent, and that loss of dignity is its own source of suffering. The anxieties about and fear of what the end might look like takes a toll on the mental health of people like me, living with a terminal illness, in the time we have left.
A two-tier system for the dying
People with money, and the physical strength to travel, can go to Dignitas in Switzerland for a legal assisted death — even though most of them would rather do it in this country, surrounded by family. People without the money, or too ill to travel, are left with suicide as their only route to any control over the timing of their death. That is a worse, lonelier and more traumatic death, for them and for the people left behind.
A four-hour debate, on both sides of a deeply personal issue
More than 90 MPs wanted to speak. On both sides, many brought personal accounts of losing family members. Former Health Minister Ashley Dalton — herself living with a terminal cancer diagnosis — voted against the Bill, arguing that depression and suicidal thoughts are common immediately after a terminal diagnosis, and the Bill did not adequately screen for this.
I have huge respect for Ashley Dalton. But a stage four diagnosis doesn’t automatically mean someone has less than six months to live. Stage four cancer patients are living longer than ever, for years and some for decades. To me, her argument makes the case for properly funding psychological support for people with a new diagnosis — not for blocking assisted dying altogether. And having poor mental health after a diagnosis doesn’t mean someone lacks the mental capacity to make this decision – those are two different questions.
Surgeon and MP Dr Zubir Ahmed, who also voted against, argued that “six months to live” is an increasingly unreliable clinical marker given modern treatments. I agree — I was told I had “a few months” to live in June 2025. I’ve wondered how a six-month eligibility test could work fairly given how frequently people outlive their prognosis. But surely the timeframe test would never be based on statistical averages handed out at the point of diagnosis. It would be based on that individual’s own history of diagnosis and response to treatment, reassessed by multiple professionals throughout the process. And crucially, if an individual is certified as meeting the criteria for an assisted death – there would be zero obligation on that person to go through with it if their health improved unexpectedly or they simply just changed their mind.
Timing, not principle
What’s striking is that many of the MPs who voted against weren’t rejecting assisted dying in principle — they were objecting to the timing, process and detail. A lot of them believe social and palliative care need to be properly funded first, and see that investment as the most important safeguard against coercion. Others felt a change this significant should come through a Government Bill, not a private member’s Bill.
Coercion is a real and serious concern and I don’t dismiss it. But I think the Bill’s safeguards were sufficient. Jess Phillips MP, who has real authority on domestic abuse and coercive control, made a powerful case for the Bill on Friday. She pointed out that suicide already outstrips homicide as the leading cause of death for women experiencing domestic abuse and coercive control. In other words, coercion into death is happening under the status quo — we just don’t check for it until after someone is dead. The Bill would have checked for it at every stage of the process, before anyone was certified for an assisted death.
Palliative care: the one thing everyone agreed on
Whichever side they were on, almost every MP who spoke agreed that palliative care in this country is underfunded and inconsistent. They just disagreed about whether that should delay assisted dying, or run alongside it. I’ve written before about why I think it doesn’t need to wait. Even in defeat, two consecutive Bills — Kim Leadbeater’s and now Lauren Edwards’ — have put overdue political pressure and attention on palliative care funding. Whatever happens next, that’s a real legacy.
Why did the Commons flip?
An almost identical Bill, sponsored by Kim Leadbeater, passed the Commons in 2025, before the House of Lords blocked it earlier this year. So what changed?
Mostly, it wasn’t MPs switching sides. It was MPs who backed the Bill last time abstaining or not showing up on Friday. Why so many? I suspect at least some Labour MPs were mirroring new Prime Minister Andy Burnham’s position — which has been fairly consistent over time: not against assisted dying in principle, but not willing to legislate for it before care funding is fixed.
That’s actually a big part of why I am hopeful that assisted dying will still eventually become law in England and Wales. Burnham has committed to fixing social and palliative care, and has said on record that assisted dying is a conversation for afterwards. Despite years of governments failing to grapple with NHS and social care reform, there’s a genuine sense of drive from him on this. Once palliative care has real investment behind it, Parliament will find it much harder to say no to assisted dying. Given that most of the public already supports a change in the law, there’s a real path here to a manifesto commitment for a government Bill at the next election, if Burnham delivers on care and wants to build on it.
Finally — my thanks to John Slinger MP, who had my words ready to read out in the debate on my behalf as a patient with a terminal diagnosis. He wasn’t called to speak. But he read them out in Parliament’s Central Lobby after the vote anyway, and I’m grateful to him for that.
