The Isle of Man has moved a step closer to legalising assisted dying after its parliament backed a proposal to allow terminally ill, mentally competent adults to choose an assisted death. The House of Keys voted through a bill setting the self-governing UK crown dependency on a path to becoming the first part of Britain and Ireland to legalise assisted dying, subject to safeguards. It is estimated that between two and 40 people would use the law annually. It would also allow a person to request a doctor to administer a lethal injection, known as euthanasia. But the Isle of Man is unlikely to become like Switzerland, the destination for at least 540 Britons to access legal assisted dying. If it becomes law, assisted dying in the Isle of Man will only be for people expected to die within six months who have been resident for at least a year. Some members of the Isle of Man parliament nevertheless raised concerns that people from the mainland would move there to make use of the legislation, placing unsustainable strain on the local health system. The bill has further stages to go through before it is enacted, but the vote in favour of the second reading, 17 to seven, was welcomed by right to die campaigners as a “historic step”. The campaign group Dignity in Dying said it was a “turning point in the movement for assisted dying” that the Westminster government should heed. Trevor Moore, the chair of the My Death, My Decision campaign, also said the Isle of Man was on the way to “giving mentally competent adults who are incurably suffering the choice of a dignified death”. But the anti-assisted dying campaign group Care Not Killing branded it a “dangerous and ideological policy” and claimed “by allowing the deliberate ending of human life with death row drugs, many vulnerable people will feel pressured into ending their lives”. Unlike in Canada, parts of the US, the Netherlands, most of Australia, New Zealand, Luxembourg, Colombia, Switzerland, Austria, Spain and Portugal, assisted dying remains illegal in the UK. Polling for the Guardian in August found 65% of people in the UK believe it should become legal for a doctor to assist an adult of sound mind with less than six months to live to voluntarily end their own life, subject to high court confirmation. The plan in the Isle of Man is to not involve the courts. In an often emotional five-hour debate, the Isle of Man parliament heard how loved ones of people who die painful deaths suffer “nightmares and panic attacks, thinking back and remembering the pain and the suffering” loved ones went through. More than 3,000 people responded to a public consultation. Comments ranged from “As a Christian I feel it’s murder” to “Mum’s death was awful, I don’t want to have to suffer in the same way.” The bill states that people choosing assisted dying “must have capacity and have a clear and settled intention to end their life”. A person lacks capacity if they are unable to make a decision for themselves “because of an impairment of, or a disturbance in the functioning of, the mind or brain”. Two registered medical practitioners, working independently, must witness the person’s clear and settled intention and must both be satisfied the person has been informed of palliative and hospice care options. They must also be satisfied the person has reached their decision voluntarily. A psychiatrist can be called if there is any doubt about the person’s capacity to make the decision. But Alfred Cannan, the chief minister, warned the bill would mean politicians “playing God with other people’s lives”. Another elected member, Julie Edge, described the legislation as “the kill bill”. In tears, she warned that if mistakes are made people’s lives could be wrongly taken away from them. The vote comes as Westminster MPs prepare to make recommendations to the government about possible law changes after a parliamentary inquiry. In June the Royal College of Surgeons dropped its opposition to legalising assisted dying, moving to a position of neutrality.