Adults with terminal illnesses are on the verge of being granted the legal choice to conclude their own lives following the approval of significant assisted dying legislation by MPs in a critical final vote.

The decision paves the way for the biggest shake-up in end-of-life care in decades after weeks of furious lobbying on both sides.

The Bill now moves to the House of Lords for further scrutiny before it can become law.

Overall, there were 314 votes for the bill compared to 291 against, giving a majority of 23 in favour of the legislation.

Votes in favour included Prime Minister Sir Keir Starmer while Tory leader Kemi Badenoch voted against.

The proposed law allows adults in England and Wales, who have a life expectancy of less than six months, to request a medically assisted death, ensuring strict protective measures are in place.

This development follows a wave of support from the community, including endorsements from TV personality Dame Esther Rantzen, 84, who is contending with stage four lung cancer, and Sophie Blake, 52, who is terminally ill.

Dame Esther said the terminally ill are “truly voiceless” and face an “agonising death” – adding: “This is a crucial debate for the truly voiceless.”

She went on to say: “They are the terminally ill adults for whom life has become unbearable and who need assistance, not to shorten their lives but to shorten an agonising death – and their loved ones who under the current law will be accused of committing a crime if they try to assist or even stay alongside to say goodbye.”

Sophie said: “This is not about wanting to die, but to be able to live the rest of my life with the peace and comfort of having choice.

“I have come to terms with the fact that my life has been shortened, and I do not fear death, but I do fear how I’ll die.”

However, critics of the bill have argued that it could encourage patients to end their own life prematurely, rather than continue to receive care.

They added that disabled and older people could be at risk of being coerced, directly or indirectly, into ending their lives to save money or relieve the burden on family members.

Some have also called for improvements in palliative care and greater investments in hospices to ease suffering as a better and more moral alternative.

Speaking in the Commons today, veteran Labour MP Diane Abbott asked: “What could be more unjust than to lose your life because of poorly drafted legislation?”

Opening the debate in the House earlier, Labour’s Kim Leadbeater – who brought forward the bill – highlighted how she had heard hundreds of stories from people who had seen their loved ones die in traumatic circumstances.

She said: “Not supporting the bill today is not a neutral act. It is a vote for the status quo.

“And it fills me with despair to think MPs could be here in another 10 years time hearing the same stories.”

‘Correct the profound injustices’

Ms Leadbeater called the bill a “compassionate and safe choice” and said it would “correct the profound injustices of the status quo”.

The new law means adults in England and Wales with fewer than six months to live will be allowed to apply for a medically assisted death, under strict safeguards.

Applications will need the approval of two doctors and a new expert panel made up of a legal figure, psychiatrist and social worker — a key change from the original plan which required sign-off from a High Court judge.

The final vote passed after fierce debate and a string of last-minute amendments.

Conservative MP Sir James Cleverly, opposing the move, pushed back on claims it was now or never, telling MPs: “There will be plenty of opportunities.”

Other opponents to the law included former prime ministers Boris Johnson, Theresa May, Liz Truss, and Gordon Brown.

Labour big beast Lord Maurice Glasman also slammed the bill, saying he “loathed” the attempt to “give incentives to old people to die so that their children can get their hands on the house and some money.”

In comments to The Sun, Lord Glasman said: “No parent wants to be a ‘burden’ on their children, and times are hard.  

“This Bill is not only – and pardon my expression – an abortion in its messy confusion, it is also the opposite of what this Government should be supporting.  

“We should love and cherish our old people, support families taking care of their parents and grandparents by supporting and subsidising the building of granny flats.”

MPs accepted an amendment ruling out eligibility for anyone seeking to die solely due to stopping eating or drinking — with Ms Leadbeater stressing it would exclude those with eating disorders.

Another amendment requiring ministers to assess the impact on palliative care within a year also passed, with charity Marie Curie warning this alone would not “make the improvements needed” in end-of-life care.

Campaigners on both sides gathered outside Parliament, with signs reading “Let us choose” and “Don’t make doctors killers”.

Polling published ahead of the vote showed 73 per cent of Brits still support legalising assisted dying –  the same figure as in November’s second reading.