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Jersey politicians have approved the principle of legalising assisted dying in the island.
A further debate on the issue will be held next year, after details of the processes and safeguards have been worked up.
If those proposals are backed then a draft law could be discussed and voted on in 2023.
Assisted dying involves allowing some terminally ill adults to end their lives with medical supervision.
The vote by Jersey politicians was 36 in favour, 10 against and three absent.
Analysis - Freddie Miller, BBC Jersey Political Reporter
This is undoubtedly a hugely significant decision which could have implications beyond Jersey's shores.
But this historic vote represents the beginning, rather than the end, of a process which might - or might not - eventually see assisted dying legalised in the island.
Detailed work will now begin to determine how assisted dying could be permitted while ensuring vulnerable people remain safe.
At least two more separate votes will be required before the law can be changed.
Those opposed to assisted dying are certain to continue campaigning, while for those who have long called for the law to be changed, this will be seen as a major step forward.
Safeguards agreed include a pre-approval process, a mandatory period of reflection, pre-approved locations and while registered medical professionals should be able to assist, they are not under a legal duty to do so.
Physician assisted suicide - the prescription of lethal drugs - and voluntary euthanasia, where a person has their life ended by a registered medical practitioner, would become legal under the agreed proposals.
During the debate Deputy Louise Doublet said: "We must recognise the elderly and vulnerable have an inherent value as human beings and ensure they have a place in our society.
"We can do that and look after the rights of those who are suffering unbearably. We can do both."
Minister for Health and Social Services, Deputy Richard Renouf, who spoke against the proposals, said: "Safeguards can be built up and to the best of our ability, but none of them can be truly effective.
"None of them would truly protect patients who are going to become vulnerable if assisted dying were to be introduced."
Deputy David Johnson said: "I think it's important we proceed to the next step where all the various arguments, the processes and safeguards can be fleshed out in greater detail."
Deputy Carina Alves said despite her beliefs she agreed with the proposition.
"This proposition is about choice and I would never want anyone to restrict my choices on something that impacts me and my body," she said.
"Regardless of my faith I have no right to do that."
The principles agreed by politicians include that the scheme is only open to Jersey residents, aged 18 or over, who have the capacity to make the decision.
The debate was called after 78% of the citizens' jury, made up of islanders who were asked to apply, ruled it was in favour of changing the law.
Jersey assisted dying principles
- Island resident
- Aged 18 or above
- Individual has a voluntary, clear, settled and informed wish to end their own life
- They have capacity to make the decision to end their own life
- They have been diagnosed with a terminal illness, which is expected to result in unbearable suffering that cannot be alleviated and is reasonably expected to die within six months; or, has an incurable physical condition, resulting in unbearable suffering that cannot be alleviated
Kathy Riddick, from Humanists UK which includes Channel Islands Humanists, said: "This considered and respectful debate has shown that there is a will in Jersey to afford freedom of choice to those with terminal illness or who are incurably suffering.
"Making sure the correct safeguards are in place will be undertaken with the same level of consideration, showing that Jersey is ready to spearhead this significant change and hopefully set the standard for the rest of the UK and Crown Dependencies to follow suit."
The coordinators of Care for Life Jersey said they were very disappointed at the decision, describing the proposals as "flawed and dangerous".
They plan to continue to be involved in the public debate abound the issue, call for the rejection of assisted dying "in favour of genuine reforms to laws relating to suicide and end-of-life care".
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