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Medics would not be allowed to raise assisted dying as an option with under-18s, and advertising it would be banned under changes backed by MPs before a final vote expected next week.
The Commons voted on Friday on amendments to the assisted dying bill, which would legalise the option for terminally ill adults in England and Wales who have been told they have fewer than six months to live.
The final Commons vote is scheduled for 20 June, with support and opposition finely balanced amid growing scrutiny of timelines, loopholes and who would ultimately deliver the system.
A majority of MPs approved a clause tabled by the Labour MP Meg Hillier, an opponent of the bill, to ensure health professionals cannot raise the topic of assisted dying with under-18s.
A separate amendment from Hillier to bar health workers from raising the option with adult patients before they have brought it up themselves was voted down.
There were impassioned interventions from both sides of the debate. Rupa Huq, the Labour MP for Ealing Central, said the cost of living crisis would make assisted dying “quite attractive” to people who were struggling.
“We know that BAME communities have lower disposable household income than standard households, and you can just imagine relatives in a housing crisis wanting to speed up grandad’s probate to get a foot on the ladder; or granny or nanny, ma or daddy even convincing themselves that, ‘look, they’d be better off out of the way given the cost of care’,” Huq said.
Caroline Voaden, the Liberal Democrat MP for South Devon, recalled the death of her husband, who she said had been “in extreme pain” with terminal oesophageal cancer, and urged her colleagues to “mind our language” after words like “murder” were used.
“This is about helping people die in a civilised way and helping their families not go through a horrendous experience of watching a loved one die in agony,” Voaden said.
MPs voted in favour of a proposal by Kim Leadbeater, who is sponsoring the bill, to ban advertisements about assisted dying. But they rejected a separate proposal from the Labour MP Paul Waugh for tighter regulations which would have limited any exceptions to this ban. Waugh said he hoped “enough MPs now realise that it is not fit for purpose”.
The bill passed its first stage by a majority of 55 in November. Since then more than a dozen MPs are thought to have switched sides to oppose the bill, though at least three have moved to support it.
A number of other amendments were passed on Friday, including a provision for assisted deaths to not automatically be referred to a coroner and an attempt to regulate substances for use in assisted dying. Demonstrators for and against the bill gathered outside parliament to make their views heard.
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Opening the debate, Leadbeater said it was not about a choice between assisted dying or palliative care. “Palliative and end-of-life care and assisted dying can and do work side by side to give terminally ill patients the care and choice they deserve in their final days,” she said.
As it stands, the proposed legislation for England and Wales would allow terminally ill adults with fewer than six months to live to apply for an assisted death, subject to approval by two doctors and a panel featuring a social worker, a senior legal figure and a psychiatrist.
MPs have a free vote on the bill and any amendments, meaning they vote according to their conscience rather than along party lines. The government is neutral on the legislation.
Stephen Kinnock, a health minister, said parliament had spent more than 90 hours debating the proposals so far, and more than 500 amendments had been considered at the committee stage.
