Lawmakers in the U.K. have passed a controversial bill that would legalize assisted dying for terminally ill people in the last months of their life.

Members of Parliament, who are roughly equivalent to U.S. Representatives, voted 330 to 275 in favor of the legislation on Friday after four hours of heated debate.

Lawmakers were given a “free vote” on the issue, which was considered a matter of conscience. This means they did not have to vote along party lines.

None of the major parties gave an official view on the bill, which was proposed by Labour MP Kim Leadbeater. But some prominent MPs — including cabinet ministers — spoke freely about their intentions ahead of the vote.

Leadbeater said she was “overwhelmed” by the result. During the debate, she said some terminally ill people faced “heartbreaking” suffering because of today’s laws, with some taking their own lives to end their pain.

She maintained her bill contained “the most robust and strongest set of safeguards and protections in the world,” to ensure it was not abused.

What Would The Assisted Dying Bill Do?

At the moment, it is illegal in the U.K. to help someone end their life, including helping them access assisted suicide services abroad.

The Terminally Ill Adults (End of Life) Bill would allow terminally ill adults with mental capacity to ask a doctor for help to end their life. This will only be allowed for people thought to be in the last six months of their life.

Two doctors must assess a person’s request for help with their death at least seven days apart. They must independently conclude that a person has a “clear, settled and informed wish to end their own life,” and has not been coerced or pressured into their decision.

The person must then apply to a high-level court to request help with ending their life. If the court approves their request, the applicant must wait two weeks (or two days if they are expeced to die imminently) to reflect on their decision.

They can then apply again to a doctor, who must be satisfied the person is still eligible for assitance in dying. The doctor can then prescribe an “approved substance,” which the applicant would administer themselves.

The assisted dying bill will undergo months of scrutiny and revisions in the U.K.’s upper and lower Houses of Parliament before it becomes law, so the process outlined above may change.

Many questions remain as to how the legislation would be enacted, for example, what “substances” will be allowed and how they will be procured.

Lawmakers will have to consider practical issues including whether assisted dying should be provided by the state via public health or social care services.

The U.K. offers free public healthcare to all via its National Health Service. This includes palliative care like care in a hospice.

Adult social care is usually funded privately, but some people will be eligible for public funds to help them pay.

Is assisted dying legal in the U.S.?

In the U.S., assisted suicide laws are decided at state level. Medical aid in dying is legal in California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, Washington and Washington, D.C.

It is under consideration in more than a dozen other states, including Arizona and New York.

Pro-assisted dying campaigners argue the option provides compassion, agency and dignity for terminally ill people. Those against assisted dying often argue vulnerable people may feel pressured into dying. Some oppose assisted dying on religious grounds.

The general public is broadly in favor of assisted dying and euthanasia — where a physician ends a patient’s life on their request.

Roughly 66% of Americans support medically assisted dying, according to a Gallup poll published earlier this year. A larger majority of 71% support euthanasia.

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