LONDON — U.K. lawmakers on Friday voted down legislation to allow terminally ill adults in England and Wales to choose to end their lives.

Following an impassioned four-hour debate in the elected House of Commons, the Terminally Ill Adults (End of Life) Bill was rejected 286 to 270. The outcome was somewhat surprising given that an almost identical bill had passed last year with a margin of 23 votes.

The vote brings an end to a two-year debate in Parliament about assisted dying, during which the House of Commons had backed assisted dying on two previous occasions. Their backing wasn’t enough for it to become law because it was effectively filibustered by unelected lawmakers in the House of Lords.

Back in the House of Commons on Friday, the bill had proposed allowing adults in England and Wales who have fewer than six months to live to apply for an assisted death subject to the approval of two doctors and an expert panel.

Many individual lawmakers relayed their own stories both in favor of and against the proposal. The government took a neutral stance, meaning lawmakers voted according to their consciences rather than along party lines.

The new U.K. leader, Prime Minister Andy Burnham, didn’t vote because he said he didn’t want to “unduly influence the debate.”

Opponents branded the bill unsafe and unworkable, citing concerns around potential coercion of vulnerable people and a lack of safeguards for those with disabilities.

Lawmaker and cancer surgeon Dr. Zubir Ahmed also noted uncertainty around a doctor’s prognosis.

“I have to be honest with you,” he said. “When I am asked to prognosticate as to whether someone has six months to live or not, I am as often wrong as I am right.”

The leader of Catholics in England and Wales, Archbishop Richard Moth, called the bill “wrong in principle” and “deeply flawed. The Church of England’s Archbishop of Canterbury, Sarah Mullally, also objected to the bill.

Medical colleges, including the Royal College of Psychiatrists, had raised “serious concerns” about the bill, saying there were “too many unanswered questions about the safeguarding of people with mental illness.”

Proponents of assisted suicide  had hoped it would mark the biggest change to social policy in the U.K. since abortion was partially legalized in 1967.

 

Countries where assisted suicide is legal include Switzerland, Australia, Belgium and Spain, with regulations on qualifying criteria varying by jurisdiction.