Friday briefing: The historic and controversial assisted dying bill nears its final hurdle

Morning. The UK once again faces a historic decision. MPs will today have their final chance to debate and vote on the contentious assisted dying bill. If it passes, it will move to the House of Lords and if approved could become law as early as October.
As it stands, the proposed legislation for England and Wales would allow terminally ill adults with less than six months to live to apply for an assisted death.
The bill passed its second reading with a majority of 55 last November. But since then, the issue has become increasingly emotionally and politically charged, with both sides accusing campaigners and MPs of making divisive remarks or acting unjustly.
Demonstrators for and against the bill have gathered outside parliament at every stage to make their voices heard.
Supporters of the bill, led by Labour MP Kim Leadbeater, say it is returning to the Commons with strengthened safeguards. The vote was delayed after a months-long committee stage, which considered more than 150 amendments earlier this year.
But opponents argue the bill still lacks sufficient protections for vulnerable people, and has been rushed.
The numbers are expected to be far tighter this time, though supporters are still confident the bill will pass. While some MPs are thought to have moved to support the bill, more are believed to have switched sides to oppose it.
How has the bill changed since last year's vote? What impact has that had on both its supporters and critics? And if it passes, what happens next? To answer those thorny questions, I spoke to Jessica Elgot, the Guardian's deputy political editor. That's after the headlines.
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The bill has gone through significant changes since it was voted on last November. The most controversial is a change from what had been first proposed, that a high court judge would have final say on every case. Now, it will be a panel, which would include a psychiatrist, a social worker, and a senior lawyer.
'This is very much what I would describe as vibes-based legislation, in that it's obviously impractical for a high court judge to decide on every case,' Jessica said. 'But for lots of people who were voting in favour of it, it sounded really safe. But once it got to the committee stages, when they start to look at the practical application, it became obvious that it wouldn't work. There are 19 high court judges in the family court division in England and Wales.'
Some suggest the proposal of a panel brings more relevant expertise, especially on issues like coercion. 'But it's harder for Leadbeater (pictured above, centre) to make the case that it's 'the safest and most robust bill in the world' without that judicial oversight,' Jessica added.
A number of amendments have been accepted to the bill. Medics will not be allowed to raise assisted dying as an option with under-18s, and advertising will be banned. Other amendments include a provision for assisted deaths not to automatically be referred to a coroner and an attempt to regulate substances for use in assisted dying.
'They've accepted a few opposition amendments, which is their way of showing that they're listening,' Jessica explained. They include an amendment by Naz Shah, who was a very vocal opponent of the bill, about anorexia. There was a fear from some eating disorder campaigners that anorexia can get so serious towards the end that it could basically be considered terminal.
'So there will be a specific clause, proposed by Shah, to make sure that doesn't happen and they've accepted that. There's also one from another opponent, Munira Wilson, the Lib Dem MP. She wants the secretary of state to have a duty to report on the condition of palliative care services. Again, another big fear for opponents of the bill is that people will want to access assisted dying simply because the state of services is so poor that people choose to end their own life when with the right pain management and care, their life could be prolonged.'
The last amendment is a key moral and political point for Labour, Jessica added. It's hard to square saying 'we need to fix the NHS' while also offering assisted dying. 'Politically, Wes Streeting thinks that's a very dangerous thing for the government to be seen to be doing. The government will ultimately have to take responsibility for this bill, even if it keeps saying the government's neutral and it's a private member's bill. From public perception, it will be this Labour government that made it happen. And No 10 know that.'
The debate has deteriorated on both sides
The anger and distrust between the opposing sides has ramped up considerably since the bill first passed.
'People often talk about parliament at its best, where MPs make extraordinarily powerful speeches on both sides that are very passionate, where it doesn't become party political. It's just about taking on your opponent's arguments, rather than aspersions made about what people's motivations may or may not be. I think that we have seen that start to disintegrate over the past six months, on both sides,' Jessica told me.
Those who support the bill accuse the other side of being driven by well-funded rightwing Christian groups, with people not disclosing religious motivations and instead claiming safeguarding concerns that are often theoretical or implausible, Jessica added. They've also been accused of using procedural tactics to delay the bill.
On the other side, critics of the bill say that Leadbeater's treatment of colleagues who oppose her has been poor. They argue there are so many loopholes, and that this is all being pushed through as a cost-saving measure for the NHS.
'Things have become very personal and that has been fuelled by the fact that it's become a big deal on social media,' Jessica said.
Who has changed their mind?
In terms of how people are voting, there's been some movement, Jessica tells me.
'Minister Chris Bryant has now moved to yes; he abstained at the last vote. And Ellie Reeves, the Labour chair, who also abstained last time, is now expected to vote yes.
'But there's been much more traffic the other way. A few Conservatives, including former minister George Freeman, and one Reform MP and a former one, Lee Anderson and Rupert Lowe, as well as some Labour MPs, some of whom either previously abstained or voted for the bill. Others include former health minister Andrew Gwynne, he abstained, and he's now voting against, and the chair of the work and pensions select committee, Debbie Abrahams, who also previously abstained and is now voting against. These are relatively high-profile people,' Jessica explained.
LabourList provides a useful overview of Labour MPs who have switched sides.
There are also people who won't be there, because the date of the bill changed a few times. 'So a lot of it's up in the air. David Lammy, for example, who is against the bill, will be in Geneva for a meeting of foreign ministers because of the international crisis. There are lots of different things going on in the margins, in terms of who can or can't be there, which makes turnout really important,' Jessica said.
What happens next?
If the bill passes its third reading in the House of Commons, it then has to pass the Lords, where there will be more debate and scrutiny. But, Jessica said, once a bill like this, about a major issue of conscience, passes the elected house, she has no expectations that the Lords will block it.
'The pro side hope that it would get royal assent, which would mean it becomes law by around October. After that, there's a four-year implementation period,' Jessica said.
Assisted dying is becoming more normalised across the western world. Countries that have legalised it include the Netherlands, Belgium, Spain and Canada, as well as US states like Oregon.
'In Canada, the law is much wider,' Jessica said. 'There have been a lot more controversial cases and it's almost seen as a kind of cautionary tale.'
Jessica explains that many of the cases we remember from media reports, including those who travelled to Dignitas in Switzerland, involved individuals with neurological conditions like motor neurone disease or Parkinson's.
'These are people who feared losing their cognitive function or dignity, and that's what motivated them to seek an assisted death. But under this bill, they wouldn't be eligible. It only applies to people with a terminal illness.'
The disconnect between public perception and the bill's actual scope could spark its own wave of controversy. But for now, campaigners on both sides are bracing themselves for the outcome of this fateful vote.
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Our critics' roundup of the best things to watch, read, play and listen to right now
TVShifty | ★★★★☆
Ian Curtis's latest is a rare purely UK-focused dissection of recent history, built around the idea that the growing atomisation of society has ushered in an age in which the concept of a shared reality on which we can all depend has dissolved – and with it any hope of a functioning democracy. We stop before Brexit and Donald Trump, but it is clear how Curtis believes the seeds have been sown for all our current sorrows. Is the viewer persuaded? It depends where you start from, of course – and it will depend perhaps even more on how you feel about this most Marmite of film-makers. Lucy Mangan
Film
Elio | ★★★☆☆
There are some sweet retro-Spielbergian thrills in Pixar's amiable new family animation. It has charm, likability and that potent ingredient: childhood loneliness and vulnerability. Its opening act is set aboard a military base where an ambitious young officer has postponed or even abandoned her dream of being an astronaut to look after her orphaned nephew. But once the film leaves planet Earth and its recognisably real, lump-in-the-throat emotional world and inhabits the goofy multi-voiced arena of space aliens, it loses, for me, a little (though not all) of its charge. Peter Bradshaw
Theatre4.48 Psychosis by Sarah Kane, Royal Court theatre, London
Variously abstruse and lucid in its arguments on life, death and suicide, and still original in form – but this production feels like the reconstruction of a seminal performance rather than a seminal performance for today. Maybe this is because Kane's position has changed in the intervening decades: she sits firmly in the canon. So this replica-like revival has the strange effect of a museum piece in this 'new writing' space, posthumous and reverential. Dramatically it is sedate – you wish for something messier, louder, angrier. But there is still value in its staging and poignancy, too. It is beautifully performed with moments of bared anguish and delicate detail. Arifa Akbar
Music
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A bit of good news to remind you that the world's not all bad
From Paris to Amsterdam to Oslo, this week Guardian correspondents reported on the rising number of urban swimmers taking a dip in their city rivers.
Why are more Europeans are taking the plunge? Whether it's self-started social swim club in Copenhagen or a 300-strong 'Dip-Dip-Hurrah' protest asking for better access to urban waters in Berlin, it's all about community and seeing and experiencing their cities in a new way.
As for all the yucky stuff you might worry about? 'I'm not worried,' says one Berliner with classic German pragmatism. 'I'm a farmer's son and grew up swimming in ponds with thousands of catfish and leeches.'
Sign up here for a weekly roundup of The Upside, sent to you every Sunday
And finally, the Guardian's puzzles are here to keep you entertained throughout the day. Until tomorrow.
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