The state should “never offer death as a service”, the Justice Secretary has said, in a strongly worded intervention over the assisted dying Bill ahead of a historic Commons vote next week.

In a letter to constituents, Shabana Mahmood said she was “profoundly concerned” by the legislation, not just for religious reasons but because it could create a “slippery slope towards death on demand”.

Ms Mahmood has previously made clear she would vote against the Bill alongside Health Secretary Wes Streeting, who faced a backlash after suggesting the changes would cost the NHS more.

Government launches review of physician associates
Health Secretary Wes Streeting faced a backlash after suggesting the draft law could cost the NHS more (Peter Byrne/PA)

But her letter to voters, first reported by the Observer, goes further, stating: “Sadly, recent scandals – such as Hillsborough, infected blood and the Post Office Horizon – have reminded us that the state and those acting on its behalf are not always benign.

“I have always held the view that, for this reason, the state should serve a clear role. It should protect and preserve life, not take it away. The state should never offer death as a service.”

She said “the greatest risk of all is the pressure the elderly, vulnerable, sick or disabled may place upon themselves”.

Backbench Labour MP for Spen Valley Kim Leadbeater, who has introduced the Bill, said Ms Mahmood was a “good friend” but “good friends don’t always agree”.

The Justice Secretary’s intervention comes despite a letter from Cabinet Secretary Simon Case last month outlining that ministers should remain neutral on the issue and avoid taking part in public debate.

Prime Minister Sir Keir Starmer has declined to say whether he will back the Bill, arguing that he does not want to pressure MPs. Members will be given a free vote to act according to their personal beliefs, rather than in line with party policy.

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Sir Keir Starmer has declined to say how he will vote (PA)

But prominent figures including former prime minister Gordon Brown have voiced opposition to the legislation, insisting better end-of-life care is needed instead of assisted dying.

Ms Mahmood, Mr Streeting and Education Secretary Bridget Phillipson have said they will vote against the Bill while care minister Stephen Kinnock said he supports it.

Proponents argue existing legislation fails to respect patient autonomy and discriminates financially between those who can afford to travel abroad to end their lives within the law and those who cannot.

Leading barristers including former director of public prosecutions Sir Max Hill KC have spoken in favour of the Bill, saying it would offer better safeguards than the current system through a process involving two doctors and a judge.

Ms Leadbeater has described her Bill as the most “robust” in the world, with “three layers of scrutiny” in the form of a sign-off by two doctors and a High Court judge.

It would also make coercion an offence with a possible punishment of 14 years in jail.

The Bill, which covers England and Wales, states only terminally ill adults with under six months left to live and a settled wish to die would be eligible.

In response to Ms Mahmood’s comments, Ms Leadbeater said: “Shabana is a good friend and I have the utmost respect for her but good friends don’t always agree.

“I recognise her sincerity and her compassion and fully respect her belief in the sanctity of life but the other points she raises have been made on a number of occasions and I have answered them in the thorough drafting and presentation of the Bill.

“The strict eligibility criteria make it very clear that we are only talking about people who are already dying.”

She added: “The Bill would give dying people the autonomy, dignity and choice to shorten their death if they wish. “