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Britain’s MPs have voted to legalise assisted dying after an emotional and momentous House of Commons debate, heralding one of the biggest social changes the country has seen in decades.

The vote to change the law to allow terminally ill people to end their lives was carried by 330 to 275 in a move that polls suggest is overwhelmingly backed by the public.

The measure will be scrutinised by MPs and in the House of Lords. Although it is not guaranteed to become law, Friday’s vote to give the bill a second reading is a clear signal of parliament’s intent.

Ministers will now prepare for a profound change to the operation of health and judicial systems, including drawing up an impact assessment of the likely consequences of the reform.

The bill proposes allowing people in England and Wales to end their life if they have been given six months left to live, provided their decision is signed off by two doctors and a High Court judge.

The safeguards, intended to allay concerns that people could be coerced into taking their lives, have been criticised by some former judges as inadequate.

Kim Leadbeater, the Labour MP who has brought forward the legislation, opened a five-hour debate by pleading with colleagues to back the change in the law and “end the brutal and cruel reality of the status quo”.

The vote just before 2.30pm on Friday took place against a backdrop of demonstrations outside Westminster by proponents and opponents of assisted dying.

Leadbeater gave harrowing accounts of the suffering endured by terminally ill people and denied that her terminally ill adults (end of life) bill would be the start of a “slippery slope”.

“This bill has the most robust and strongest set of safeguards in the world,” Leadbeater said.

But Barry Gardiner, another Labour MP, spoke for opponents of the bill when he said the legislation would open a question of “Ought I?” for terminally ill patients, who would find themselves asking if they should end their lives for the sake of their families.

Conservative MP Danny Kruger said: “Let today not be a vote for despair but the start of a proper debate about dying well in which we have a better idea than a state suicide service.”

Their opening remarks highlighted how the bill has sown division across parliament and split the cabinet and major parties, while creating unlikely alliances across party lines.

Among the cabinet ministers to oppose the bill was health secretary Wes Streeting, who has warned that any new assisted dying service could come at the expense of other competing pressures and priorities facing the NHS.

A number of former UK prime ministers took positions on the legislation in the run-up to the vote.

Gordon Brown, Baroness Theresa May, Liz Truss and Boris Johnson — who did not have a vote as they are no longer MPs — said they opposed the measure, while Lord David Cameron this week said he had changed his mind and supported it.

Several opponents have raised concerns about the process underpinning the proposed legislation, arguing that an impact assessment was not provided ahead of a second reading of the private members’ bill, and that there has not been sufficient time for debate.

But proponents have argued that it will ultimately be properly scrutinised at the committee stage and in the Lords. They also pointed out that laws allowing abortion and decriminalising homosexuality were passed in the UK by private members’ bills.

Leadbeater said the bill would be subject to intense further parliamentary scrutiny and that assisted dying would not commence for up to two years.

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