MPs vote to legalise assisted dying in landmark moment - what happens next?

MPs have voted to legalise assisted dying in a landmark decision which could pave the way for what has been described as the biggest social shift in Britain for decades.
Despite impassioned arguments from the bill's opponents - who say vulnerable people could be coerced into ending their lives early, and that the state should have no role in it - MPs voted by a majority of ** to press ahead with the policy.
However, that does not guarantee that terminally ill people will be able to have an assisted death in England and Wales anytime soon.
In fact, there are still several hurdles for the bill to pass before it can become law. And, even if it achieves that, years could pass before any law is implemented and the practice of assisted dying begins.
So what happens now that MPs have approved the Terminally Ill Adults (End of Life) Bill?
The Lords
After a bill has successfully passed through the House of Commons, it must then go through the same stages of scrutiny in the unelected House of Lords.
That means there's still a first reading, second reading, the committee stage, the report stage and the final third reading of the bill, before it can become law.
If the Lords decide they aren't happy with an aspect of the bill, they send it back to the Commons with amendments, which MPs then debate and consider whether to accept.
This can happen several times, in a process known as parliamentary ping-pong, and it can delay a bill's passage for months.
But this time there's a time limit: the last scheduled date that the Commons can currently consider a Private Members' Bill in this parliamentary session is Friday 11 July.
So in theory, there's less than a month for the Lords to decide, however its likely the government would choose to extend the session so the legislation passes.
Despite these various hurdles, it is expected that the Lords will move quickly to approve the bill.
The King
After the Lords approve a bill, the next stage before it becomes law is Royal Assent.
This is where it lands on the King's desk for a final bit of ceremonial scrutiny.
As the UK's head of state, the King has the final say on all bills. Howver, in reality and according to the constitution, he would always approve any bill which has successfully passed through Parliament.
Once it has the King's royal seal of approval, the policy goes from being a called a bill to an act. It's new name will be the Terminally Ill Adults (End of Life) Act.
And then it's down to the government to implement it.
Implementation
If the process goes as quickly as expected, the bill would finally become law later this year - ten years after the previous unsuccessful attempt to introduce it.
But it could be 2029 by the time the law is implemented.
That's because a clause in the bill gives the government up to four years to work out exactly how the practice of assisted dying will work.
In that time, the health secretary will make important decisions about the process, including the required qualifications for doctors, the forms of identification patients would have to provide, the records that would have to be kept by doctors and the codes of practice that would govern the assisted dying process.
A decision would also have to be made on which lethal substance could be used to bring about death.
So the next general election could be around the corner by the time terminally ill people, with less than six months to live, can have an assisted death in England and Wales.
But the aim, as set out by Ms Leadbeater, is for the government to implement the law a lot sooner.
What will it mean for the NHS?
ITV News Health Correspondent Rebecca Barry said: The bill doesn't spell out how an assisted dying service should be delivered, but there are three potential models:
- It could be integrated into the current healthcare system, with doctors in existing hospitals and care settings providing assisted dying services - like they do in the Netherlands.
- Or it could be more like Switzerland, where assisted dying is a distinct service outside of the health system - run by non-profit organisations.
- Finally, it might be a hybrid model, like abortion services in the UK, where the NHS has overall responsibility - but it is delivered by a separate provider.
The bill states that assisted dying should be provided free of charge, but, if it is publicly funded, it will sit alongside services which are not - like hospices, which get the majority of their funding from charity.
When the NHS is already facing enormous pressures, some will question how it will manage to deliver such complex additional responsibilities.
What about the rest of the UK?
The assisted dying bill only applies to England and Wales, not the rest of the UK, because health is devolved in Scotland and Northern Ireland.
Scotland is currently considering its own assisted dying bill, which Members of the Scottish Parliament have given approval to in principle. It's at a much earlier stage than Westminster's bill but proponents expect it to pass.
But campaigners say Northern Ireland is being left behind, because lawmakers there do not appear to be following the rest of the UK. The country's Department for Health has said there are "no plans to introduce legislation on assisted dying".
Other parts of the British Isles, including Jersey and the Isle of Man have already legalised assisted dying.

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Esther Rantzen urges Lords not to block assisted dying bill

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Peers challenge Esther Rantzen over assisted dying bill comments

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