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Lawmakers in Britain voted on Friday to allow assisted dying for terminally ill patients in England and Wales under strict conditions, opening the way to one of the most profound social changes in the country in decades.

After five hours of debate in the House of Commons, they voted by 330 to 275 to support a plan that would allow doctors to help patients with less than six months to live to end their lives

Assisted dying is legal in a handful of European countries, Canada, New Zealand, and in 10 U. S. states California, Colorado, DC, Hawaii, Maine, Montana (authorized by court ruling), New Jersey, New Mexico, Oregon, Vermont & Washington. Federal law in the United States does not provide a constitutional right to physician-assisted suicide. The U. S. Supreme Court ruled in 1997 that states have the authority to decide whether to legalize or criminalize physician-assisted suicide, as it is not protected under the Constitution's Due Process Clause. This decision allows individual states to establish their own laws regarding medical aid in dying, resulting in a patchwork of regulations across the country.

The decision in Westminster followed weeks of fraught, often emotional public debate in Britain on a complex ethical question that has transcended political affiliations and provoked sharp disagreement.

The bill that lawmakers approved on Friday would apply to a narrow group: Applicants would have to be over 18, diagnosed with a terminal illness and have been given six months or less to live. Two doctors and a judge would be required to approve a patient’s choice to end their life, and fatal drugs would have to be self-administered.