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British MPs’ approval of the assisted dying bill made history – and revealed a rare kind of parliamentary debate. While the bill must still pass through the House of Lords, it is now widely expected to become law in England and Wales.

What stood out even more than the result was the tone of the debate. Despite passionate disagreement, MPs conducted themselves with respect and thoughtfulness – a striking contrast to today’s often polarised political climate. That, in itself, felt like a moment of democratic maturity.

Unsurprisingly, MPs in favour of the bill made familiar arguments, focusing on choice, dignity and the desire to avoid unbearable suffering at the end of life. What stood out, though, was how little opposition there was to the principle of assisted dying.

Gone were the sweeping religious or philosophical arguments that once dominated such debates. Very few MPs spoke about the sanctity of life or raised moral objections to the idea of assisted dying itself.

Instead, many of those who voiced concerns focused on this particular bill, especially its safeguards. Their worry wasn’t whether we should allow assisted dying, but whether the law goes far enough to protect the vulnerable. It’s a valid concern, and one likely to shape scrutiny as the bill heads to the Lords.

So, how safe is the bill as currently drafted? Does it protect against the risks of coercion, misdiagnosis, or vulnerable people being pushed toward ending their lives? As a researcher of end-of-life issues and an expert witness in Seales v Attorney General, the leading New Zealand case on assisted dying, I believe the choice that the bill will introduce in England and Wales seems a lot less vulnerable to pressure and coercion than the sorts of life-ending choices the law has long allowed.

As Kim Leadbeater pointed out in her speech, no decision involving people near the end of life is ever entirely without risk. Diagnoses can be wrong. External influences, both subtle and overt, are impossible to eliminate completely.

But what’s important is that the safeguards around assisted dying, as proposed, are stricter than those in many other medical decisions that the law already permits.

For instance, adults in the UK currently have the legal right to refuse life-saving treatment. That includes cases where the treatment could restore them to full health.

The classic example is a Jehovah’s Witness refusing a blood transfusion. Courts have consistently upheld the right of mentally competent people to make that choice, even when the outcome is death.

This remains true even if the person’s situation arises from a previous suicide attempt. The central legal question is not why they want to die, but whether they are mentally capable of understanding and weighing their options.

The assisted dying bill sets a far narrower scope. It only applies to people with an “inevitably progressive illness or disease which cannot be reversed by treatment” and which is likely to lead to death within six months. In other words, people who are already extremely ill.

Yes, doctors might occasionally misjudge a prognosis. But the law will still only apply to those facing certain death in the near future, a very different group from those currently allowed to refuse care.

Pressure or coercion

No major life decision happens in a vacuum. We are all influenced by people around us: family, friends, culture, religion. But legally, coercion only becomes a problem when someone’s ability to choose freely is overwhelmed.

In medical law, that’s not always easy to determine. Is a devout patient refusing treatment out of genuine belief or pressure from their religious community? Is someone declining chemotherapy being subtly manipulated by family members with ulterior motives?

These grey areas are familiar – and they already exist. But the safeguards proposed in the assisted dying bill are arguably stronger than those surrounding many current end-of-life choices.

Two doctors will be required to independently assess whether the person is making the request voluntarily and without coercion. A multi-disciplinary panel will also need to confirm this.

On top of that, the bill introduces serious new criminal offences: up to 14 years in prison for anyone who pressures someone into requesting assisted dying, and a life sentence for those who unlawfully administer the drugs.

Self-coercion

Some MPs raised concerns about “self-coercion”: the idea that someone might choose assisted dying not because they genuinely want it, but because they feel like a burden to others.

It’s a deeply human worry. Most of us would be horrified to think an elderly parent or terminally ill partner felt they had to die to make life easier for us.

One proposed amendment tried to address this, suggesting that people should only be allowed access to assisted dying if their motivation was “for their own sake rather than for the benefit of others.”

It’s easy to understand the intent behind that. But ultimately, I would argue it’s probably right that the amendment was rejected.

UK courts have long upheld the principle that patients don’t need to justify their values. The test is whether they are mentally competent: whether they understand the information and can weigh it up to make a decision.

Judges and doctors don’t need to agree with the beliefs behind that decision. They don’t need to endorse a Jehovah’s Witness’s refusal of a transfusion. Nor must they accept that a life without “sparkle” is not worth living, as one woman once described her own situation before legally refusing treatment.

The assisted dying bill won’t remove all risk. No law could. But in many ways, it introduces a choice that is less open to abuse and pressure than decisions we’ve already accepted as legal for decades.

The debate isn’t over, and the House of Lords will no doubt return to these issues. But today’s vote was more than a political milestone. It was a moment of thoughtful, measured debate – and perhaps, a sign that we can tackle the hardest moral questions without descending into division.

Colin Gavaghan is a member of ‘Lawyers for End of Life Choice’ and a board member of ‘Yes for Compassion’. He was an expert witness for the plaintiff in Seales v Attorney General.