two over the last few hours. broadly two big schools of thought. one group saying if this bill is passed today there is time as it goes through the parliamentary process to scrutinise it and add in more detail, another group saying that now is not the right time and this is too huge a subject to deal with now. subjects such as palliative care, provision of palliative care, should be addressed first. before we return to the commons, let me give you one other piece of breaking political news, heidi alexander has been appointed the new transport secretary after the resignation of louise hay this morning. she was previously surging as court minister and entered politics in 2010. let's return now to the debate. let and entered politics in 2010. let's return now to the debate.- and entered politics in 2010. let's return now to the debate. let us not think badly of _ return now to the debate. let us not think badly of each _ return now to the debate. let us not think badly of each other's _ return now to the debate. let us not think badly of each other's motives, | think badly of each other's motives, let us be curious. my opposition to this bill is grounded in compassion.

to legalise assisted dying is to create the space for coercion, that will undoubtedly see people die who would not otherwise have chosen to do so. there are no safeguards in this bill that will prevent this, indeed, none would be possible, even if we were not going through this hasty process. first there is the risk of self coercion. many of us will have had older relatives who have said they are a burden, so we know reasonably that people will present and make it a sovereign choice but it will be a choice born out of coercion. unless there is a clause in this bill i have missed to employ mind readers, no amount of doctors, safeguards or mechanisms will prevent those who self coerce from opting to die simply because they assume no matter what their loved ones say, everyone would be better off if they were dead. to add

to the statistics we had a moment ago, in canada we know more than one in three people opting for assisted dying dave the reason for choosing to die that they felt they were a burden on others. honestly, i do not see there being any other discussion than that clear evidence. secondly there is coercive control, also being touched upon. in this parliament at the last parliament, we passed ground—breaking and long overdue legislation on domestic violence. society's understanding of this hidden evil has developed and our eyes have been open to one horrific factor in particular, that of insidious manipulative coercive control. thousands of people have been and are today victims of those who seek to neglect their will, take over their lives and coerce them into believing that the perpetrator�*s will this actually bears. we know all of us are

victims. one common theme is that victims. one common theme is that victims often did not realise where being controlled until long afterwards. it can take years for the penny to drop. i do not need to speu the penny to drop. i do not need to spell it out that those coerced into choosing assisted dying for them, that penny will never drop. they will no longer be with us. and people will choose assisted dying because of their pain when they would not do if their pain was properly managed. here is where the evidence from other countries becomes truly disturbing. in fact, terrifying. the countries in europe without assisted dying increased palliative care investment in the last decade by more than three times and those who had legalised it. in the united states, those states without assisted dying swan increase in the size of their palliative care teams, and there was also three times greater than the increase of

us eight that had legalised it. this is no accident, no coincidence. the group that has contacted me most vociferously against this bill had been palliative care doctors. i think him for giving way and we are having this discussion today and i must pay tribute to the lady for the way she has conducted this. we are having this discussion in a sense that implies palliative care across the uk is of the same excellent standard everywhere. i have to inform the house that it is not. it is of deep regret that that is the case. i also want to say that i feel i cannot stand by this today because there are many vulnerable marginalised people that will be impacted by this and i want to support and affirm life and want to do that with dignity. i support and affirm life and want to do that with dignity.— do that with dignity. i thank my friend for her— do that with dignity. i thank my friend for her intervention. - do that with dignity. i thank my friend for her intervention. the | friend for her intervention. the palliative care doctors in touch with me know that to optimise

assisted dying is to inevitably opt to divert resources away from palliative care. that is the evidence. i spoke to one of those doctors this week who works in a hospice and said that the only patients she cares for those who are dying. all of us know what is coming. assisted dying means a shift of focus away from helping people to live in dignity and towards simply helping people to die, and then it becomes a self—fulfilling prophecy. let's not kid ourselves, palliative care is a postcode lottery in this country. especially for the poor, the old. if the motivation of those who choose assisted dying is to end their pain, you can be certain, absolutely certain, those nhs trusts with the weakest palliative care offer will be those with the highest incidences of people choosing to die. in other words, incidences of people choosing to die. in otherwords, it incidences of people choosing to die. in other words, it is not really their choice at all. an observation made to me by a senior oncologist was that there are fewer more stressful situations in a

person's life and to giving a terminal diagnosis. to be told you are going to die. the oncologist in question then explained amongst terminally ill people, there is a vast amount of severe undiagnosed depression and psychological illness, similar but distinct from the danger of self coercion, there is nothing in this bill to safeguard against people who suffer like this from choosing to die before their time, yet in so many cases it will be people's mental health leading them to choose to die and not their physical condition. we simply cannot be all right with this, because here we are on the precipice of agreeing to sanction and support of people in despair. as society, we have chosen a darker path if we choose to end the life of a terminally ill person rather than valuing them and loving them against the desolation they

would feel if we were given a diagnosis of that sort. no wonder the government suicide prevention advisory opposes this bill. while i totally respect many colleagues and they will take a different view, i am opposed to this bill because i am am opposed to this bill because i am a liberal. libertarians believe personal liberty is so important they can be no fetters upon it, but i am a liberal, not a libertarian. i believe freedom is essential to the right of individuals and that underpins a decent society but my rights must be held in check if they nullify your rights. since we know that legalised assisted dying is to permit people to die who will self coerce, it is a consequence of manipulative coercive control, to permit people to die outrageously, not because of a real sovereign choice because of a heartbreaking hobson's choice due to inefficient palliative care, then i have no choice but to oppose that. i urge

all of us to stand in defence of those most vulnerable people to defiantly defend their liberty and make a renewed commitment to world—class palliative care and to human dignity and to reject this bill. human dignity and to re'ect this bill. , , ., , thank bill. five minutes, please. thank ou. bill. five minutes, please. thank yom today's _ bill. five minutes, please. thank you. today's decision _ bill. five minutes, please. thank you. today's decision has - bill. five minutes, please. thank you. today's decision has been i bill. five minutes, please. thank. you. today's decision has been one of the hardest i have had to make. in my career in disability law and policy i chose not to focus on debates on whether disabled people should be borne or we should die. i focus on enabling disabled people to live better more fulfilling lives. today i find myself voting in a way i thought i never would, i will be voting in favour of moving the bill to the next stage of the legislative process. that has been a difficult journey for me. i have emerged hereby reflecting on the evidence, my only experience and listening to the many constituents who have written to me in support of the

bill, sharing their compelling and tragic stories of death. death which did not come dignity or respect. in reflecting on my own life, one moment from my childhood stood out. when i was six years old, i had major surgery on my hips, i was in body plasterfrom my major surgery on my hips, i was in body plaster from my chest to my ankles, in so much pain and requiring so much morphine that my skin began to itch. i remember vividly laying in a hospital bed in sheffield children's hospital and saying to my parents, i want to die, please let me die. i needed to escape from that body that i was inhabiting. that moment has come back to me all these years later. that moment made it clear to me that if this bill was about intolerable suffering, i would if this bill was about intolerable suffering, iwould not if this bill was about intolerable suffering, i would not be voting for it. i have subsequently had a good life, a fulfilling life, a life where i have worked towards ensuring disabled people are valued by our

society. but that moment also gave me a glimpse of how i would want to live my death. just as i have lived my life stop powered by choices available to me, living at death with a dignity and respect and having the comfort of knowing that i might have control over that very difficult time. for so often control is taken away from disabled people in all sort of circumstances, in order to ensure there is compassionate choice at the end of life, it is right that this bill is tightly drawn around the final stage of terminal illness for adults and includes the strongest safeguards. the choice of assisted dying as one option for adults when facing six months terminal illness must be set alongside the choice of receiving the best possible palliative and end—of—life care or it is no choice

at all. having analysed the bill closely, therefore, there are choices eight changes i want to see a committee stage to strengthen his options and ensure the way that chaseis options and ensure the way that chase is presented by medical practitioners is always in the round. people deserve teen death and for those who do not choose to end their lives in this way, they and their lives in this way, they and their loved ones should feel reassured and safe in the knowledge they will receive the very best of care. i would also want to ensure the final stages of this bill properly defined dishonesty, coercion and pressure. i think it is necessary to embed mandatory language in the bill around the need for a code of practice on palliative care, as well as improving the regulations on training for medical practitioners. i trust my friend, the memberfor spend practitioners. i trust my friend, the member for spend valley, to look at these amendments and continue to listen to members as she has done

throughout this process. however people vote in this house today, a decision of conscience, it is incumbent on all of us to commit to improve palliative end—of—life and aduu improve palliative end—of—life and adult social care. it must be the start of the work that we do in this place to ensure the very highest standards in these areas, that will be a very great legacy indeed. giving people the dignity they need in that moment of death. for many others across the chamber considering these issues has been extremely hard and upsetting. we have had to go to the depths of ourselves to understand what traits we would make today. while we may enter different voting lobbies, we leave this chamber shoulder to shoulder and i know we will all work in our own ways to make systemic change to improve the lives of our constituents and people up and down this country. constituents and people up and down this country-—

this country. very five minutes. -- considerate _ this country. very five minutes. -- considerate five _ this country. very five minutes. -- considerate five minutes. - this country. very five minutes. -- considerate five minutes. it - this country. very five minutes. -- considerate five minutes. it must i this country. very five minutes. -- i considerate five minutes. it must be one of the most _ considerate five minutes. it must be one of the most painful _ considerate five minutes. it must be one of the most painful decisions i one of the most painful decisions for most members in this house, the one we are taking today, certainly it is for me. i am somebody who has changed their position. i'm a believer in the sanctity of life but i'm also an antagonist to torture and misery at the end—of—life. accordingly, i intend to vote for a second reading and i say to those who made procedural comments on this, second reading is a point of principle but not a point of conclusion. i have done that because since the scandal of doctor shipman and the murders he carried out, the behaviour of the health service has changed and i have witnessed with constituents in particular, any number of people who have died slowly and in agony beyond the reach of palliative care exemplified that

brilliantly. but beyond the reach of palliative care. no matter how much we do this, we cannot fix this problem. secondly, iwill disagree with my honourable friend for hampshire north west, it is not insulting to the other people who tried this already to critique what they have done. we have the example of a very wide—ranging outcomes to people, other countries that have tried this. if i thought at first reading that the alp and we are heading toward his belgian, i will vote against. if it is canada, i will vote against, australia, i will vote in favour. that is what the next stage of this process is about. this bill has a number of areas they know that they have to put right,

about a dozen in truth. i will pick one because it is technical and awkward. section 11.2 of the bill appears to give doctors the right to initiate this process. after the dnr scandal during the covid crisis, i do not point out that any price. i don't want the state initiating this process. that is a critical thing for me. the decision on second reason reading is in principle, not outcome. the only belief has said she is going to work very hard to make committee work and i'm sure she will. i want to say this to the government. i understand perfectly well that they are trying to maintain a relative strict neutrality but there is a distinction here between neutrality and responsibility. ithink distinction here between neutrality and responsibility. i think they need to focus on the issue of

responsibility. this bill is more important than most of the bills in your manifesto, and i'm not trying to be read. more people in the dog and duck, more people care about this than they care about most other things we are doing. it deserves four days in report stage in government time, we don't need a royal commission, this house can do this but it needs to be given the option to do it, so i say to the government the path of responsibility is give us the time to get this right and if we get it right it will be one of the things we can be proud. in the coming years until we eventually leave this place. i reiterate i want this bill to succeed. it is more important than most bills we handle. it can't

be dealt in a few hours of committee so i will vote for it today but i want the government to help me to be able to vote for a good bill at the end of this. i able to vote for a good bill at the end of this-— able to vote for a good bill at the end of this. . ., ., ., ., end of this. i am honoured to have been called _ end of this. i am honoured to have been called in _ end of this. i am honoured to have been called in this _ end of this. i am honoured to have been called in this debate. - end of this. i am honoured to have been called in this debate. it - end of this. i am honoured to have been called in this debate. it has l been called in this debate. it has been called in this debate. it has been particularly moving to hear contributions from across the house. the feelings for me have a particularly raw i have i witnessed my close friend sharon dying of cancer —— dying of cancer over the last few months. she had good access to palliative and hospice care and died at home with her sister and niece. even with this support her final days were difficult and her sister wrote to me, she was highly distressed, every day she said she had never wanted to die, it was very undignified for her and it was heartbreaking to observe but be powerless to help. each story that we hear of loss and grief is unique. as legislators we must consider

everyone who will be affected both directly and indirectly. the public and the courts are looking to parliament to answer the question of whether position assisted suicide should be a legal option. it is incumbent on us as parliamentarians to do thejob incumbent on us as parliamentarians to do the job properly. incumbent on us as parliamentarians to do thejob properly. i have spent the past weeks listening to constituents, professionals and experts in this place and i have read numerous reports and articles. as well as the moral and ethical dilemmas there are many complex and practical considerations on examination. i take a different view from the right honourable member who has just from the right honourable member who hasjust spoken. i from the right honourable member who has just spoken. i welcome the reassurances from the honourable member from reassurances from the honourable memberfrom spring reassurances from the honourable member from spring valley and the commitment that that they should take evidence, but i'm not confident a private members bill process will be able to adequately address this. i will support the cross—party

amendment to call for an independent review, a systematic public consultation on these legal changes and an independent assessment of palliative care. with a background in health and social care board and specifically ageing, i am particularly mindful of the context of this bill. inequalities in access to palliative and end—of—life care. some hundred thousand people die each year who could benefit from end—of—life care who don't receive it. those from lower socio— cake —— a socio— economic patterns are likely to get care. i believe investment in palliative care must come before a change in the law is implemented. the second point is the failure to reform social care. some people have to spend their life savings including the value of their

homes and care right now we are going to break up to speak to fergus walsh, the bbc�*s medical editor. fergus, i wonder what your reflections are on the debate so far? it reflections are on the debate so far? ., , , reflections are on the debate so far? . , , ., ., ., ., far? it has been an emotional, intelligent _ far? it has been an emotional, intelligent and _ far? it has been an emotional, intelligent and impassioned i far? it has been an emotional, - intelligent and impassioned debate, and a courteous one, which you often don't seem parliament because this is a matter of conscience for mps and they are going to be voting on something which is literally a matter of life and death, which would herald potentially the biggest social change we have seen since the abortion act nearly 60 years ago and we have heard passionate arguments on both sides. it has been impressive to hear the voices we have heard, many talking about their own personal life experiences or those of their constituents. we have

'ust heard those of their constituents. we have just heard from _ those of their constituents. we have just heard from david _ those of their constituents. we have just heard from david davis, - those of their constituents. we have just heard from david davis, one - those of their constituents. we have just heard from david davis, one ofl just heard from david davis, one of the longest serving mps in the common saying he is going to vote for the bill now, but he said he is reserving the right to change his mind later in the process. one thing he talked about was this issue of doctors initiating the process of taking that decision to move towards assisted dying. he said he didn't want that at any price. he was talking about if we move towards a particular model in a particular country wouldn't vote for it later on. he would vote for it. what evidence is there from the other countries that already have assisted dying of this so—called slippery slope where if you allow this to happen then it broadened to include more and more people? let happen then it broadened to include more and more people?— happen then it broadened to include more and more people? let me give ou a more and more people? let me give you a counle — more and more people? let me give you a couole of— more and more people? let me give you a couple of examples. _ more and more people? let me give you a couple of examples. one - more and more people? let me give you a couple of examples. one that| you a couple of examples. one that the pru lobby would quote, is oregon in the united states, which is sad assisted dying for the terminally ill expected to die within two

months, it has to be signed off by two doctors. it is pretty similar to what is being planned here. that hasn't changed, that criteria hasn't changed since 1997. the only expansion there has been is no you don't have to be resident in the state of oregon to qualify for it. those who are opposed will say, look at canada. it only introduced assisted dying initially for the terminally ill in 2016 and within five years i have expanded to others, to those who had intolerable suffering. kim leadbettersaid others, to those who had intolerable suffering. kim leadbetter said that while it will be different here because in canada that change was due to a court challenge, whereas the court he made it very clear this is a decision for parliament. so both sides can point to international examples to say there either will be or would be a slippery slope. either will be or would be a slippery slope-—

either will be or would be a sliue sloe. ., ., slippery slope. one of the other issues we _ slippery slope. one of the other issues we keep _ slippery slope. one of the other issues we keep hearing - slippery slope. one of the other issues we keep hearing about i slippery slope. one of the other issues we keep hearing about in slippery slope. one of the other- issues we keep hearing about in this debate is that of palliative care. lots of mps who have spoken today saying that they want this to be focused on first. one person calling for a royal commission on palliative care. tim farron sang it in eu countries without assisted dying, investment in palliative care has gone up by more than three times as previously, but that is not the case in countries in the eu with assisted dying. talk to us about the uk's states of palliative care. some of the speakers centre needs to be much more investment in that before the uk considers assisted dying. both sides agree that palliative care needs to improve. there needs to be substantial investment. it can be exceptional, palliative care here. those who are opposed to say, but

look, it is too patchy, if you introduce assisted dying it will be offered essentially as an option instead of good palliative care. those in favour say it is not either or. there was a commons select committee investigation, a very big investigation earlier this year, which looked at assisted dying around the world. it found in those countries which had introduced a right to die, palliative care had not got worse and in many cases it had got better. so the pru lobby say let's improve palliative care as well. it is not an either or. let's go over to the house of commons and speak to a political correspondent, helen katz. helen, a very different mood, very different feel in this debate today compared to most debates. , ., , debate today compared to most debates. , . , , , debates. there is. that is because mps are here _

debates. there is. that is because mps are here voting _ debates. there is. that is because mps are here voting with - debates. there is. that is because mps are here voting with their- mps are here voting with their conscience, it is a conscience vote. there isn't a party line to stick to. we are not saying that you sometimes see when you tune in to the commons and you can see the jeering and heckling. today there is none of that. mps are listening quietly to thoughtful speeches that draw from their own experience and of those of their constituents. it is clear they have given this a lot of thought. even just visually you can see in the way when they are when they are intervening on each other, often when it is a party political debate you will see them doing that to prop up someone on their own side, be critical somebody on the opposite. today it is completely different. you can see them on one side of the house intervening to support someone on the other side. that is because it is that situation where it is up to each individual mp to make up their own minds. .,

each individual mp to make up their own minds-— own minds. that session started at 9:30am. own minds. that session started at 9:30am the _ own minds. that session started at 9:30am. the speaker _ own minds. that session started at 9:30am. the speaker said - own minds. that session started at 9:30am. the speaker said the - own minds. that session started atj 9:30am. the speaker said the vote would be happening at 2:30pm. how long should it take to get the results? ., ., results? voting works in the same wa as it results? voting works in the same way as it would — results? voting works in the same way as it would in _ results? voting works in the same way as it would in any _ results? voting works in the same way as it would in any other- results? voting works in the same way as it would in any other kind l results? voting works in the same | way as it would in any other kind of bill. the motion will be perch, then the house will divide and they will go through those lobbies, through the yes or no lobby. those votes get tallied. it is the usual process of having to walk through the lobbies physically, then you get the tally of votes at the end and that will get announced in the commons chamber. usually in the sort of divisions they take about 15 minutes orso divisions they take about 15 minutes or so to do, so you would expect that to be the sort of timeframe we are looking at, at about 2:30pm. if this bill passes, what happens next? this is the second reading, so this is the point where mps are approving the principle that this bill should

go forward and that the way this bill addresses it is the way to do that. if it passes, what happens next it will go to committee stage, that means there will be a lot more scrutiny. a committee of mps will look at it line by line. earlier, kid leadbetter when opened this debate in an temp two reassure some of those who are worried about the detail of the bill and worried that some of the specifics don't go far enough, she has suggested that she is going to come unusually for this kind of bill, ask for that committee to be able to take evidence from people outside of parliament that would give it that power. she said that process will take a number of weeks which would be ample time and they would make sure that committee had a different range of views reflected and a different range of political parties reflected on it, too. that is an effort to quell some of the worries from some mps who

have doubts about this process and wants the committee stage has happened it comes back for another debate and vote by mps, which would be the final go—ahead from the commons on this bill, and then after that it would need to go to the house of lords and go through all that process once again to finally become law. that process once again to finally loecome law-— that process once again to finally become law. ., ,, , become law. helen, thank you very much. become law. helen, thank you very much- let's — become law. helen, thank you very much. let's take _ become law. helen, thank you very much. let's take it _ become law. helen, thank you very much. let's take it back _ become law. helen, thank you very much. let's take it back and - become law. helen, thank you very much. let's take it back and said i much. let's take it back and said the house of commons chamber. an mp in favour of the bill is now speaking, saying it is unfair that anyone has to travel to switzerland to enter life. mr; anyone has to travel to switzerland to enter life-— to enter life. my grandfather sadly suffered greatly _ to enter life. my grandfather sadly suffered greatly in _ to enter life. my grandfather sadly suffered greatly in the _ to enter life. my grandfather sadly suffered greatly in the final- to enter life. my grandfather sadly suffered greatly in the final weeks| suffered greatly in the final weeks of his life. rented blind during his final days which was a cruel irony for a man who did so much to advance optics. actually it was the haunted look on my father's face when he

arrived home having spent the final few days with harold in terrible pain and suffering before he finally died that had a lasting impression on me. surely, in a modern society, if we are able to live a good life, we must be able to have a good death. many have written to me and families have spoken to me and have shed their own stories, watching their loved ones die in unnecessary pain and indignity. while many have raised concerns around the need for better funded palliative care services in our country, i reiterate the point made that this bill does not represent an either or proposal. as my honourable friend has said over the last few weeks, this legislation at its core is not about ending life but about shortening death. this is fundamentally an

issue of dignity, compassion and humanity and i would encourage all members across the house to use their power as an elected representative today to alleviate the needless pain of thousands of individuals and their families and ensure we take the first step to providing choice at the end of life by legalising assisted dying. to discuss matters of life and death is to recognise the gravity of one's role as a member of parliament. the bill before us 60 shorten the suffering of the terminally ill, those with just six months to live, no one else. for too many, death is not a singular moment but an excruciating journey of terror and agony as your body turns on you. but arguments we must wait for palliative care to improve on our country archaeological. this does not prevent us improving our palliative care system and in