The scale of victory for opponents of the Bill was almost exactly the same as when it was last debated in 1997. This is remarkable, given the degree of public support for reform – over 80% according to a poll earlier this year. I respect the deeply held convictions of those who oppose assisted dying but I can’t help but reflect on how out of step with public mood Parliament appears to be on this issue of such profound importance.  And before anyone reacts – yes I understand we have a representative democracy and I know that it cuts both ways. I am deeply relieved that Parliament has always rejected hanging!

I used to oppose assisted dying. I shared the concerns of many people about the risk this could pose to vulnerable individuals under pressure from greedy relatives. However, in recent years my views have been challenged.

During my time as a Health Minister and my years as a Member of Parliament I have heard the testimonies of people with terminal conditions, often in great pain, who wanted the right to end their suffering with dignity and in a way of their choosing. Listening to these stories has forced me to confront the principles at stake.

Ultimately, the question surely is: should it be the individual or the state who decides? For me, as a Liberal, there can be no doubt. I know that I would want the right to decide for myself, so I cannot deny it to others.

As Care Minister, I was completely focused on improving end of life care, an area of medicine too often neglected in the past. I had to address really serious concerns about how the Liverpool Care Pathway had been applied in many hospitals as a one size fits all protocol.

What has emerged from the review I initiated is a new approach which focuses completely on the priorities and needs of the individual patient. There is a strong consensus now that, at the end of life, the patient’s wishes come first – on resuscitation, on where to die and so on. How odd then, that when it comes to the most profound question of all, we deny the person the right to decide.

The current legal situation is not just a messy compromise; it is cruel and wrong. We put families into the most invidious position. If they act out of compassion in helping a loved one to die, they still face having their home declared a ‘crime scene’ and then face an investigation which could go on for months, interfering horribly with the process of grieving. The DPP guidelines talk about ‘the suspect’. Surely we can’t put people through this.

Some people, of course, travel to another country to end their life, if they can afford it. But even that is, surely, grotesque – expecting a dying person to travel to an alien clinic in another country, when they could be at home with loved ones. For those who can’t afford to travel, they face the dreadful choice of soldiering on, perhaps in great pain and loss of dignity – or commit suicide. A Labour MP today wrote of how his own father ended his life in this way. Surely, again, this is intolerable.

Another concern people often raise is that giving people the right to die would somehow distract from, or conflict with, steps to ensure excellent palliative care. But good palliative care and assisted dying are in no way incompatible. It is up to Parliament to ensure that we invest enough in palliative care. In Oregon, where assisted dying has been lawful for many years, there is better access to specialist palliative care than in most other states.

John Stuart Mill wrote: “The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

I will keep campaigning for that sovereignty to be respected at the end of life, despite the defeat in Parliament today.