Dr Anne Merriman obituary: doctor known as ‘mother of palliative care in Africa'

Dr Anne Merriman revolutionised palliative and end-of-life care in Africa after developing a cheap form of oral morphine with a Singapore hospital pharmacist. Originally mixed in a kitchen sink, it included a pound of morphine, a preservative and colouring: lighter doses were green; stronger ones, pink and blue. A bottle cost about $2, a fraction of the cost of western formulations.
Universally known as 'Dr Anne', she said: 'It's easier than baking a cake.' She developed the pain-controlling recipe after seeing terminally ill patients discharged from hospital because 'nothing more could be done for them'. Many died at home in severe and prolonged pain.
'A wild, undisciplined schoolgirl' who became a nun and a doctor, Merriman founded the pioneering Hospice Africa Uganda (HAU) in 1993 at the age of 57. Palliative care was largely unknown in Africa when she started her work in Uganda. HAU has treated more than 35,000 patients and trained more than 10,000 healthcare professionals from 37 African countries in the so-called Merriman model.
Tough, stubborn and charismatic, she conceded that her 'brash and insensitive ways' had offended people, adding: 'I find it amazing that God has used this blemish as one of my greatest strengths.'
It enabled her, she said, to be 'a forceful and obsessive' advocate for hospice care and to stand up to older male doctors who claimed that morphine prescribing would promote drug abuse.
In her book Audacity to Love, published in 2010, she wrote: 'In Africa, in particular, some men are more dominant than in the rest of the world and don't take well to a female doctor bringing in a new speciality.
'Even today in Uganda, considered to have the best palliative care in Africa, there are consultants who refuse to allow patients' pain to be treated with oral morphine, even though sometimes these patients are their own colleagues.'
Calling herself a 'true Scouser', she was born in Liverpool in 1935, the third of four children of Thomas ('Toddy'), a primary school headmaster, and Josephine Merriman (née Dunne). A bright, questioning child, she wanted to become a Catholic priest like her older brother Joseph and later wrote: 'I could not understand such discrimination and I still feel the same way.'
The catalyst for her passion for palliative care emerged in childhood when her 11-year-old brother Bernard died from a brain tumour. She later spoke passionately about the absence of palliative care for him.
There were other signposts signalling a spectacular future in caring. At the age of four, after seeing pictures of sick African children in a magazine, she declared: 'I'm going to Africa to look after the poorly children.'
Nine years later she saw a film showing the Irish head of the Medical Missionaries of Mary (MMM) riding around the Nigerian village of Anua on a bicycle. She told her mother and a nun at school that she wanted to join the order and did so at the age of 18 after leaving Broughton Hall Catholic High School in West Derby, Liverpool.
Recognising a rich potential in the wayward, recalcitrant novice with disappointing exam results, MMM enrolled her in a three-year internship at the International Missionary Training Hospital in Drogheda, Ireland. She spent a further year in a medical laboratory before going to medical school at University College Dublin.
As a young doctor Merriman worked in MMM hospitals in Nigeria and in Drogheda, Edinburgh and Dublin. After 20 years as a religious sister and missionary, she returned to secular life in Liverpool to look after her sick mother and to specialise for eight years in geriatric medicine. Increasingly concerned by patients dying 'without pain and symptom control', she followed the teaching of Dame Cicely Saunders (obituary, July 15, 2005), the founder of the modern hospice movement.
Saunders created a new kind of hospice, St Christopher's in Sydenham, southeast London, combining compassionate care with medical care. But Merriman's vision of a hospice was not restricted to a physical building. Hospice care, she said, could be given in the most appropriate place, including the patient's home. It included emotional, social and spiritual support as well as pain control.
This made pragmatic sense in Uganda where 90 per cent of the population are reported to live in rural areas where doctors are scarce. Uganda became the first African country to permit nurses and trained clinical officers (physician assistants) to prescribe morphine; and the first African country to make palliative care part of its health service.
After her mother's death in 1981, Merriman worked in Calcutta with Mother Teresa whose order included a hospice; in Penang in Malaysia as an associate professor; and in Singapore as a senior teaching fellow.
In 1990 she accepted an invitation to become the first medical director of the Nairobi Hospice, only to leave quickly because of 'bureaucratic interference'.
A case history she published in Contact, a World Council of Churches journal, secured her future in Africa. Describing a terminally ill patient who had a pain-free, peaceful death, it attracted invitations from several African countries who wanted to develop palliative care services. She chose Uganda as it was emerging from 25 years of war and reeling under the HIV crisis.
Archbishop Emeritus Desmond Tutu (obituary, December 27, 2021) said in 2018: 'Anne has created a uniquely African template of love, dignity, care and compassion for people.'
Nominated for the Nobel peace prize in 2014 and appointed MBE, Merriman protested that 'caring for the dying is the lowest priority in healthcare because doctors are trying to cure, not to care'.
She lived in a large house overlooking Lake Victoria with her 'family', including three housekeepers and 15 dogs, once led by Adam and Eve. When Eve died she declared that Adam was grieving and found him a new partner.
A warm, welcoming hostess, she was renowned locally for her Tuesday night dinners where 12 or more guests would include local dignitaries, visiting specialists and overnighting donors and volunteers.
But she could also, as she put it, create a frosty atmosphere in a tropical climate. In one notable case, she highlighted the tragedy of Robert, a terminally ill 12-year-old boy with a huge cancer, a Burkitt's lymphoma, on his face. Robert slept under a counter in his aunt's shop and Merriman regularly took him to the hospice for a change of scene.
He grimaced in pain as they drove across the many potholes along the way. Merriman said: 'After his [Robert's] death, the President of the USA, Bill Clinton, visited Uganda … They levelled the road so he wouldn't get a bump on the bum. The Roberts of this world do not count. But Presidents do. How sick is that?'
Anne Merriman, doctor, was born on May 13, 1935. She died from respiratory failure on May 18, 2025, aged 90

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Patrick Maguire, chief political commentator at The Times, tells Times Radio that Sir Keir Starmer's lack of input into the important debate on assisted dying is the 'perfect encapsulation' of the PM's administration so far. Please enable cookies and other technologies to view this content. You can update your cookies preferences any time using privacy manager. In 2022, Dave Sowry accompanied his wife Christy to the Dignitas clinic in Switzerland, where she chose an assisted death to end the suffering caused by her multiple sclerosis. Although her condition was not classified as terminal, Sowry and his wife believed it had become intolerable and left her with no quality of life. Following her death, Sowry was questioned by UK police but ultimately faced no legal action. He said: 'We got married in 2006. We'd been together for 20 years. 'The first conversation at Dignitas was very strange. I suddenly got this gut feeling where I just couldn't believe this was happening. 'The whole process, the legal system, encourages an unbelievable amount of anxiety and stress at what is the most difficult time in somebody's life, and that is really cruel. 'I think at the moment people only really have three options: They can continue to suffer intolerably until they die. They can go to Dignitas if they can afford to, but even then that's not an easy process. Or they can take life into their own hands. 'It's cruel. So not doing anything, not passing the law, is not a safe thing to do.' A Tory MP indicated he had changed his voting position on the assisted dying bill since it was first introduced. Mike Wood, the MP for Kingswinford & South Staffordshire, told the Commons: 'I didn't vote at second reading in November. 'The member for Spen Valley [Kim Leadbeater] in her opening speech this morning said that we could choose to vote with our head or with our heart. 'I am afraid it is that tension, that conflict, that I have been grappling with over the last few months.' He said his 'sympathy of the principle of assisted dying was as strong as it ever was', but later added he would be 'voting against this afternoon' because he did not believe the Bill offered enough safeguards. Downing Street declined to say whether Sir Keir Starmer will attend the Commons debate on the assisted dying Bill. A Number 10 spokesman said: 'I'm not going to get ahead of proceedings in the House or speculate on the prime minister's movements … the prime minister is working in Number 10, but as I say I'm not going to speculate on the PM's movements today.' Dame Prue Leith, who supports the bill, has said outside parliament: 'I'm both nervous and confident. I'm nervous to say 'we have won', because I'm superstitious. 'It's so moving to see all these people with placards of people they've lost or people who are dying of cancer. 'It's hard not to cry because I think they have done such a good job, let's hope we've won.' Leith is the mother of Daniel Kruger MP, a leading voice opposing the bill. Andrew Copson, Humanists UK chief executive, said he believes this is the moment for change. 'Parliament has been debating assisted dying for 90 years,' he said. 'Since then, the situation has only got more acute. People are living longer and more people are suffering from different conditions at the end of life. 'My grandmother had bowel cancer. She was a determined woman, knew her own mind. She knew what she wanted to do. She wasn't rich enough to go abroad. 'That made me realise there is still a taboo around talking about death, and I think we need to take death much more seriously and acknowledge the reality of it. 'And in order to have that conversation for ourselves and with the ones we love, we have to know we've got options. 'For me, it's all about freedom of choice. Every single person has the right to self determination over the most intimate of things they have, which is their own body.' 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But as this is Leadbeater's bill and wasn't one of Labour's election pledges, peers might feel emboldened to block the bill as a whole. Supporters will hope that the bill could be granted royal assent — the final stage before completion — before the end of 2025. But even if the bill is finalised this year, the legislation comes with an implementation period of up to four years to allow the courts and the health service to catch up. This means there could be no legal assisted deaths in the UK this decade. The NHS is not ready to handle assisted dying, Sir James Cleverly has said. In a speech in the Commons, the former home secretary said the NHS would have to divert resources to deal with setting up assisted dying within the four-year period defined in the bill. He said the deadline would result in the writing of a 'blank cheque' for the service to get it up and running. 'Commencement dates matter, they are not just some arbitrary date on a piece of paper and I understand the desire of people to make sure this can't be lost down the back of the sofa when it comes to government work', he said. 'But when people upon whom we rely to deliver this say they are not ready and they don't feel they will be ready, they don't have enough people, they don't have enough capacity, they will have to take resource from current provisions to move across to this provision which will be driven by a statutory requirement and a locked in commencement date, we should listen. 'We should listen and if the people who are going to make this work and work as well as we hope it will if it becomes legislation say that they are not confident that they can make it happen, we should be very, very careful about demanding that they prioritise this and that is what this legislation says.' The chief executive of Care Not Killing called for MPs to reject the bill. Speaking outside Parliament, Dr Gordon Macdonald said: 'As this is a private members' bill, the MP in charge of the bill was able to choose who she wanted in the committee, choose who she wanted to give evidence and decide which amendments would be accepted and which wouldn't, so I believe the whole process is completely flawed and I believe the government needs to hold responsibility for this. 'Keir Starmer should have taken responsibility for this.' He added: 'We're seeing more MPs who are voting against it which doesn't surprise me as the more people think about this issue the more likely they are to support it.' Outside Parliment, more campaign groups have gathered with banners and placards with slogans ranging from 'no to assisted suicide', 'legalise assisted dying and let us choose' and 'don't make doctors killers.' At the rally is Louise Shackleton, 58, from North Yorkshire. She said her husband Anthony was diagnosed with motor neurone disease in 2018. He died by assisted suicide at Dignitas in December 2024 to avoid the suffering and loss of autonomy it would bring. Shackleton accompanied him to Switzerland and, upon returning, surrendered herself to police. Despite the ongoing investigation, she has no regrets and believes that if assisted dying was legal in the UK, their family could have been together during Anthony's final moments. 'Knowing the exact date when your loved one's going to die is difficult. But I had to weigh that up with if he didn't go there, what his death would be like for him. This journey wasn't about me. It was all about him. His choice, his decision,' she said. 'For me, ideally the bill goes through and that people are allowed to have autonomy in how they end their lives.' Teachers Catie and Becky Fenner joined a group of Dignity in Dying campaigners in Parliament Square ahead of this afternoon's vote. Their mother, who had motor neurone disease, flew to Dignitas in Switzerland to end her life. The sisters said that worrying about the legal implications of this meant they did not get to properly say goodbye and grieve. Catie, 37, from Oxfordshire, said: 'We were left quite traumatised by the whole experience — not only seeing a parent go through a really horrible disease but then the secrecy of the planning. 'We have had grief counselling. We don't want any other family to go through what we went through. 'We want families to be able to say goodbye in this country without the fear of prosecution.' Anorexia patients could still access assisted dying through a 'loophole', Labour MP Naz Shah has warned. Referring to her amendment 14, to prevent a patient meeting the requirements for an assisted death 'solely as a result of voluntarily stopping eating or drinking' — which MPs backed earlier today — and a further amendment 38 which was not added to the bill, Shah told the Commons: 'This is not the anorexia loophole that has been closed — that was another amendment. 'When people stop voluntarily eating and drinking, that is not what happens to people with anorexia. People with anorexia stop eating and drinking because they have a psychiatric illness. These are two categorically different issues. 'So I must make it clear, absolutely clear, even though amendment 14 has passed today, this amendment does not address concerns about anorexia or close that loophole.' Please enable cookies and other technologies to view this content. You can update your cookies preferences any time using privacy manager. Sir Roger Gale, who is standing in for the Speaker, has told MPs they have limited time to debate the third reading of the assisted dying bill. A vote must be called before 2.30pm, as per parliamentary procedure. Sir Roger said: 'It's understandable that a lot of members would wish to take part on both sides of the House and in both sides of the argument. 'Looking around, it's quite clear we cannot accommodate everybody. 'That means that inevitably, it is likely that will be quite a considerable number of interventions. 'All I would say — gently — is that interventions will be taken into account when considering the order of priority in which members are called.' Tracy Acheampong, 22, a nursing student at University of Birmingham, said it was important to be here today with the BLW Campus Ministry Church group in order to show her concerns around safeguarding with the law. She said: ' I believe that despite there being sickness and death, there is hope. As somebody who has worked in the healthcare field since the day I turned 18, I've seen countless deaths. And I don't think the failure of our healthcare system should warrant people deciding to take their own lives or because they feel like a burden or that they think there is no hope in their situation. 'But I don't think passing on this law will assist them. I've seen so many people deteriorate to their lowest point. I've worked in hospices and care homes where people stop seeing their relatives until the point of death.' Mother of the House Diane Abbott said she was not opposed to the principle of assisted dying, but urged MPs to reject the bill for fear that 'people will lose their lives who do not need to'. The Labour MP said: 'I came to this House to be a voice for the voiceless. Who could be more voiceless than somebody who is in their sickbed and believes they are dying? 'I ask members in this debate to speak up for the voiceless one more time, because there is no doubt that if this bill is passed in its current form, people will lose their lives who do not need to, and they will be amongst the most vulnerable and marginalised in our society.' Kim Leadbeater has warned the Commons the assisted dying bill 'is not a choice between living and dying — it is a choice for terminally ill people about how they die'. The Labour MP added: 'I fully appreciate that there are some colleagues who would never vote for any version of this bill due to their own fundamental beliefs — be they religious or otherwise. 'I am respectful of their views, despite disagreeing, but to those colleagues who are supportive of a change in the law but are hesitant about if now is the time — if we don't vote to change the law today — what does that mean? 'It means we will have many more years of heartbreaking stories from terminally ill people and their families, of pain and trauma, suicide attempts, PTSD, lonely trips to Switzerland, police investigations and everything else we have all heard over recent months.' Sir James Cleverly has said he was 'concerned about the practicalities' of the bill. The Conservative former minister also told the Commons: 'I have no doubt the vast majority … in this House is sympathetic with the underlying motivation of this bill.' Describing himself as an atheist, he added: 'I've had this said to me on a number of occasions, 'if you had seen someone suffering, you would agree with this bill'. 'Well, Mr Speaker, I have seen someone suffering — my closest friend earlier this year died painfully of oesophageal cancer and I was with him in the final weeks of his life. 'So I come at this not from a position of faith nor from a position of ignorance.' Sister Doreen Cunningham, who cares for elderly people, attended a gathering outside parliament to oppose the 'lazy' bill. The nun said: 'I feel the need to speak for the vulnerable people. This bill suppresses the people who do not receive proper care. 'It is the lazy way out instead of giving patients the proper care they deserve. 'A lot of work could be done in the NHS to reform it.' Sister Doreen said she worried people would be scared if the assisted dying bill was offered to them. Choosing not to support the assisted dying bill is 'not a neutral act', Kim Leadbeater has told the Commons. The Labour MP for Spen Valley said: 'It is an either/or decision for us today — either we vote for the safe effective workable reform contained in this bill or we say the status quo is acceptable. 'Over recent months I have heard hundreds of stories from people who have lost loved ones in deeply difficult and traumatic circumstances … along with many terminally ill people themselves.' She added: 'Not supporting the bill today is not a neutral act, it is a vote for the status quo … and it fills me with despair to think MPs could be here in another 10 years' time hearing the same stories.' Labour MP Kim Leadbeater has told parliament that the assisted dying bill had sparked 'different views'. She was responding to Conservative former minister Simon Hoare who intervened in her speech, and asked whether she was 'concerned' about 'the growing canon of professionals and their independent professional bodies' who 'have urged great caution' and were 'opposed to the details of this bill and believe it should be defeated?' Leadbeater, who tabled the Terminally Ill Adults (End of Life) Bill, replied: 'I think what he's saying is people have got different views … we have different views in this House and different people in different professions have different views. 'Every royal college has a neutral position on assisted dying.' Jonathan Dimbleby has joined campaigners for assisted dying outside parliament, where the veteran presenter was photographed posing for selfies with activists from Dignity in Dying. His brother, the sculptor Nicholas Dimbleby, died with motor neurone disease. He said: 'Last year my younger brother Nicholas, who was a very fine sculptor, much loved by everyone, a very funny man who was a centre of everyone's attention, he was stricken by motor neurone disease. 'I watched him wither away physically. I watched him become a shell until he died with his mind intact, his body broken. 'And I talked to him about this, and I asked him, do you want to me campaign on this because he wanted to have that right, and he said 'yes, please do'.' • Jonathan Dimbleby's hardest interview: with his dying brother A black van passed by the crowds in Parliament Square with an electronic screen which read messages against the bill. It was set up by organisation and flashed: 'Kill the Bill, not the ill', 'No safeguards. No oversight. No compassion' and 'Stop the NHS from becoming the National Homicide Service.' Dame Prue Leith has joined campaigners outside Parliament showing their support for the assisted dying bill. The 85-year-old writer, restaurateur and Great British Bake Off presenter said she was 'quietly confident' about the vote's outcome after a lengthy, 'hard and uphill battle'. Leith added: 'I find it so moving to see all the photographs of people you've lost or who are dying of cancer as we speak. 'It is utterly disgraceful that in a civilised world, we should be allowing this. 'Today, I hope we are going to win. I try to be quietly confident. But whether we win or lose, you have done a fantastic job, and I hope we're not going to have to ask you to do it again.' Kim Leadbeater said the assisted dying bill she is sponsoring will 'offer a compassionate and safe choice to terminally ill people who want to make it'. Speaking at today's third reading, the Labour MP for Spen Valley told the Commons: 'I have been pleased to work with members on all sides of the debate to ensure that this legislation is something that parliament can be proud of. 'A cogent, workable bill that has one simple thread running through it — the need to correct the profound injustices of the status quo and to offer a compassionate and safe choice to terminally ill people who want to make it.' MPs have started the final debate on the Terminally Ill Adults (End of Life) Bill. The outcome will lead to it either clearing the House of Commons and moving to the Lords, or falling completely — the latter of which could mean the issue might not return to Westminster for a decade. The relatively narrow majority of 55 from the historic yes vote last November means every vote will count today. The bill would fall if 28 MPs switched directly from voting yes to no, but only if all other MPs voted the same way as in November, including those who abstained. Outside the houses of Parliament, peaceful crowds have already gathered ahead of the vote, clutching banners and chanting 'our freedom, our choice, listen to our voice.' Among those is Catriona MacFarlan, 45, holding a blue sign with the words 'freedom of choice', who had travelled down from Edinbugh in the early hours of the morning to be here for the vote. She said: 'My dad is terminally ill. He is not able to to have a dignified ending. It's going to be horrible as he carries on. But there are no protections for people like him. So I just want to give people the choice to end their lives with dignity, surrounded by their family and loved ones, and not have to suffer a really horrible ending.' Dame Esther Rantzen's daughter has admitted she struggled to sleep last night in anticipation of today's vote on assisted dying. Rebecca Wilcox, who was outside Parliament to champion the Dignity in Dying campaign, said she hoped the bill would be passed. She said: 'This is such an important time for this bill, the third and final vote, and then hopefully it will go on to the House of Lords. 'It couldn't be more entrenched with safeguards; it couldn't be a kinder, more compassionate bill that respects choice at the end of life, that respects kindness and empathy and gives us all an option when every other option has been taken away. 'It would be the perfect tool for a palliative care doctor to have in their med bag.' A ban on advertising assisted dying would be extended to all of the UK, should the bill pass, MPs have agreed. They also voted for the UK-wide extension of regulations about approved substances intended to be used to help terminally ill patients to die. Politicians have this morning approved an opt-out for medical professionals being extended to Scotland. MPs voted 275 in favour, 209 against, majority 66. MPs have agreed to an amendment that requires the government to publish an assessment of palliative and end-of-life care within one year of the Act's passage. They have nodded through amendment 21 — one of multiple proposed tweaks to the bill. MPs called 'aye' to approve Liberal Democrat MP Munira Wilson's amendment. It means that ministers would have to consider the state of health services for patients near the end of their lives, covering pain and symptom management, psychological support and access to information. Religious leaders are making last-minute bids to sway undecided MPs, hoping to convince them to oppose assisted dying. The Bishop of London, the Right Rev Sarah Mullally, who is also England's former chief nursing officer, said it was an 'unsafe and unworkable' bill and said: 'If enacted, this bill would arrive amidst hugely inequitable access to palliative care and an NHS on life support. The potential for abuse and uninformed or coerced decisions is enormous. 'This is not about so-called progressivism versus conservatism, or atheism versus religion. This is about the kind of society we want to live in.' She said the parliamentary process had 'presented more unanswered questions, left more doubts, and seen so-called protections crumble away before even coming into law'. Cardinal Vincent Nichols, the Catholic Archbishop of Westminster, said: 'A right to assisted suicide given to individuals is highly likely to become a duty on care homes and hospices to facilitate it. We fear that this bill will thereby seriously affect the provision of social care and palliative care across the country.' A vote must be called before 2.30pm, as per parliamentary procedure. MPs in the House of Commons have this morning been voting on changes within the bill since it was last put to them in November. The proposed legislation would allow terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death. This request would be subject to approval by two doctors and a panel featuring a social worker, a senior legal figure and a psychiatrist. MPs have agreed that ministers should get powers to update the National Health Service Act 2006 as part of the bill, to include voluntary assisted dying services as part of the NHS's purposes. Amid fears the bill could become 'the Trojan horse that breaks the NHS', Dame Siobhain McDonagh, a Labour MP, pushed her amendment 12 to a vote, which would have blocked ministers from broadening the NHS's purposes without a fresh bill. But MPs rejected her proposal 269 votes to 223, majority 46. While there is no obligation on MPs to take part in the free vote, those present today in the House of Commons also have the option to formally abstain. Health Secretary Wes Streeting described bill sponsor Kim Leadbeater's work on the proposed legislation as 'extremely helpful', but confirmed in April that he still intended to vote against it. Vicky Foxcroft received hugs and other gestures of support from her Labour backbench colleagues as she appeared in the Commons a day after resigning as a government whip over welfare reform proposals she could not support. The Labour MP for Lewisham North was seen walking through the chamber as MPs took part in votes on the assisted dying bill this morning. Several colleagues approached her, offering warm words, hugs, an arm on the shoulder or a pat on the back, following her decision to resign from the government. Will Keir Starmer vote today? The prime minister is working from Number 10 and is yet to make a decision, despite the historic nature of the vote. There is a suggestion that Starmer, who is in favour of assisted dying, could enter into an informal 'pairing' arrangement with David Lammy, the foreign secretary who is opposed but currently in Geneva for negotiations with Iran. Officials insist that no decision has been made, and say he is still weighing up whether to attend. But in politics perceptions matter, and failing to take part in the vote could be viewed by some as a sign that he is cooling on the idea. A proposal to disapply the presumption that a person has capacity unless the opposite is established in cases of assisted dying requests has been rejected by MPs. The Commons voted 213 to 266, majority 53 to reject amendment 24, which was tabled by Daniel Francis, the Labour MP for Bexleyheath & Crayford. In November last year, MPs voted in favour of the assisted dying bill but some MPs have already indicated they will changes sides on Friday. This is how they voted in the last reading of the bill. MPs have this morning voted to reject an amendment which would have prevented a person who is substantially motivated by feeling they are a burden from qualifying for assisted dying. Conservative MP Rebecca Paul's new clause 16 stated that a wish to end one's own life should not be substantially motivated by factors such as a mental disorder, disability or suicidal ideation. The Commons voted 208 to 261, majority 53 against. Naz Shah, Labour MP for Bradford West, has told Times Radio that Kim Leadbeater's private member's bill to legalise assisted dying is 'dangerous' and a public safety issue'. Calling for its rejection, she said: 'The bill is ultimately flawed. Today we're not voting on the principle of this bill, we're voting on the legislation. 'That's my job and the amendments that I have tabled to close the anorexia loophole hasn't been closed, it's not been accepted, it won't be voted on and that leaves huge loopholes and it's not safe. For me it's a public safety issue, this bill.' Please enable cookies and other technologies to view this content. You can update your cookies preferences any time using privacy manager. Conservative leader Kemi Badenoch has urged her MPs to vote against the legislation, describing it as 'a bad bill' despite being 'previously supportive of assisted suicide'. She claimed it has 'not been done properly'. On Thursday, Badenoch said that although she had previously supported the idea, 'this is not how we should do legislation like this'. She also said she does not believe the 'NHS and other services are ready'. Badenoch added, 'I will be voting no and I hope as many Conservative MPs as possible will be supporting me in that'. MPs are entitled to have a free vote on the bill, meaning they decide according to their conscience rather than along party lines. If it is passed today, it will then be scrutinised by the House of Lords. Sky News said that it is hard to predict at this stage how the upper chamber will react to it, given the unusual combination of a free vote on a private member's bill. However, it warned there was a 'small chance' of upper chamber delays 'to stop it by keeping it in limbo until the king's speech to parliament later this year'. Decca Aitkenhead was nine when a GP risked jail to help her mother to die. Years later she watched her best friend succumb to the slow torture of Huntington's disease, and for a few days she found herself confronting her own death. She tells Jane Mulkerrins how those experiences have shaped her views on assisted dying. Public support for the bill remains high, according to the latest YouGov poll. The proportion of people who feel assisted dying should be legal in principle has risen slightly, to 75 per cent from 73 per cent in November. Its survey of 2,003 adults in Great Britain took place last month and the findings were published yesterday. Kim Leadbeater, the Labour MP behind the Terminally Ill Adults (End of Life) Bill, has warned that defeat for the bill would end hopes of changing the law for another decade as she rejected claims of rushing through reform. She insisted her bill is 'the most robust piece of legislation in the world' and has argued dying people must be given choice at the end of their lives in a conversation which has seen support from high-profile figures including Dame Esther Rantzen. Leadbeater said it had 'gone through hours and hours and hours of scrutiny', adding: 'This is not being rushed through, this is not a quick thing that's happened overnight.' Four Labour MPs confirmed on the eve of today's vote that they will switch sides to oppose the proposed new law. Paul Foster, Jonathan Hinder, Markus Campbell-Savours and Kanishka Narayan wrote to fellow MPs to voice concerns about the safety of the proposed legislation. They branded it as being 'drastically weakened', citing the scrapping of the High Court Judge safeguard as a key reason. However, Bill sponsor Kim Leadbeater has insisted that replacing the judge's approval with multidisciplinary panels strengthens the legislation, as it will incorporate wider expert knowledge to assess assisted dying applications. Protesters and campaigners have been gathering this morning in Westminster before the vote on the assisted dying bill. Photos from the scene show supporters from campaign group Dignity in Dying holding pink placards with white letters urging 'legalise assisted dying, vote yes today.' Opponents of the bill are wearing white masks with the word 'euthanise' on the forehead, and they are holding white signs saying 'don't make doctors killers' and 'protect our NHS from becoming a national suicide service'. In 1937, Switzerland legalised assisted suicide provided those doing the assisting were not motivated by 'any selfish intent'. Six decades later, the US state of Oregon legalised physician-assisted suicide for people with less than six months to live. In 2001, the Netherlands became the first country in the world to decriminalise assisted dying. As MPs vote on the bill today, this is how other countries in the world compare. Read in full: Where is assisted dying legal? How the rules worldwide compare More than 7,500 terminally ill people a year could seek state support to end their life within a decade of the practice being legalised, the government estimates. Officials believe about 60 per cent of requests for assisted dying would be approved, equating to approximately 4,500 or 0.68 per cent of all deaths from 2039 onwards. The findings came in an impact assessment drawn up by the Department for Health and Social Care. Officials also estimated that legalising the practice in the UK could cost the NHS tens of millions of pounds. Staff time costs ranged from £412,000 to £1.98 million in year one, to between £2.6 million and £11.5 million in year ten. MPs will today take part in the final Commons vote on whether to back a bill to help terminally ill adults end their lives in England and Wales. Politicians supported legalising assisted dying when they first debated the issue in November by 330 votes to 275. However, since then the outcome has become too close to call, after analysis by The Times showed that margin eroding. The Terminally Ill Adults (End of Life) Bill has undergone months of scrutiny leading to some changes in the proposed legislation. One change is to replace the role of a High Court judge in signing off an application for an assisted death with a panel of experts. This panel would contain a senior lawyer, a psychiatrist, and a social worker. Advocates of assisted dying believe their bill will pass its final Commons vote on Friday, despite a shift among MPs against it. Kim Leadbeater, the MP who proposed the law change, denied the bill has been rushed and remained confident MPs would vote in favour of it. Read in full: Assisted dying vote 'too close to call' as MPs turn against bill Sir Keir Starmer has yet to decide whether he will take part in today's landmark vote on assisted dying as he deals with the Middle East crisis. The prime minister, who is in favour of assisted dying, is working from Downing Street today but could end up missing the vote depending on his commitments as he seeks to deescalate the conflict between Iran and Israel. A government source said no decision as been made He backed assisted dying in 2015 and has signalled that his view has not changed. The issue is deeply divisive and has split the Labour Party. Starmer said this week: 'It is a matter for individual parliamentarians, which is why I've not waded in with a view on this publicly, and I'm not going to now it's coming to a conclusion. 'There has been a lot of time discussing it, both in Parliament and beyond Parliament, and quite right too. It's a really serious issue. 'My own position is long-standing and well-known in relation to it, based on my experience when I was chief prosecutor for five years, where I oversaw every case that was investigated.'