MPs have clashed over issues including the role of doctors in assisted dying as they debate proposed changes to a bill which would legalise the practice in England and Wales.

The legislation would allow terminally ill adults who are expected to die within six months to seek help to end their own life.

The bill passed its first stage in the Commons last November – but since then the details have been pored over and dozens of amendments added by both sides.

Further changes being considered by MPs include ensuring there is no obligation on anyone to provide assistance in the process and preventing medical staff from raising the option of assisted dying with a patient first.

A vote to pass or reject the bill as a whole is not likely to take place on Friday, but rather in June.

Opening the debate, Kim Leadbeater, the Labour MP behind the bill, said the draft law had been “strengthened”.

She said many people had “lost loved ones in deeply difficult and traumatic circumstances”.

The MP for Spen Valley said: “Put simply, if we do not vote to change the law, we are essentially saying that the status quo is acceptable.”

Conservative MP Rebecca Paul said she opposed the bill and argued there should be a focus on improving end-of-life care, rather than assisted dying.

“It will harm far more people than it will help,” Paul said.

“And those people who will be harmed are among the most vulnerable in our communities and I’m not willing to accept this collateral damage.”

During an emotionally charged debate, Labour MP Jess Asato accused campaigner and broadcaster Dame Esther Rantzen of being “distasteful and disrespectful” for accusing the bill’s opponents of having “undeclared personal religious beliefs which mean no precautions would satisfy” their concerns.

However, Dame Esther’s daughter, Rebecca Wilcox told BBC Breakfast she was worried about the “scaremongering”, “blatant lies” and “myths” circulating about the bill.

She said that while she appreciated there were concerns over coercion and how the proposed legislation could affect vulnerable or disabled people, the bill was “full of safeguards”.

Labour former minister Anneliese Dodds was among those to raise fears people could feel under pressure to go through with an assisted death because they do not want to be a “burden”.

Labour MP Dame Meg Hillier argued doctors should not be allowed to raise the option of assisted dying with patients first.

She told the Commons this “presents a serious risk that terminally ill patients already highly vulnerable will feel pressured into ending their lives”.

Several MPs raised concerns people with anorexia could be considered terminally ill and eligible for assisted dying if they refuse to eat or drink.

However, Leadbeater argued this risk was “negligible”.

“Not only would someone with severe anorexia be highly unlikely to be assessed to have capacity to make a decision about assisted dying, the other tragic reality is that if a patient was so ill as a result of not eating and drinking for whatever reason, they would die before the process of assisted dying would be able to take place,” she told MPs.

Others gave emotional speeches in support of the bill, with Liberal Democrat MP Christine Jardine saying her position was influenced by her experience of watching a family member die with motor neurone disease.

Close to tears, Jardine said: “we do not want to go down the slippery slope” but suggested extending the bill to cover degenerative diseases.

“I would not want anyone to go through what I witnessed without the choice to end it,” she added.

MPs will vote on a number of proposed changes to the bill later.

They have been given a free vote, meaning they can decide based on their conscience rather than having to follow a party line.

Leadbeater’s Terminally Ill Adults (End of Life) Bill cleared its first parliamentary hurdle by 330 to 275 votes back in November.

Since then, the bill has gone through six months of intense scrutiny by a parliamentary committee and several changes, including removing the need for a High Court judge to sign off each request for an assisted death. Instead, a panel of experts – including a legal professional, psychiatrist and social worker – would oversee the process.

The issue has split Parliament, with strong opinions on both sides.

Those opposed to assisted dying say the mood has altered among MPs, but so far only a handful have said they have changed their minds since November and it would take dozens to block the bill.

Labour MP Jonathan Hinder is the latest to reveal he will no longer support the bill, saying his concerns have “deepened” as the bill has progressed.

He gave the example of removing the role of a High Court judge as one reason he had changed his mind, adding that more work was needed to make the bill “practicable and safe”.

The Commons is unlikely to vote to give the bill final approval until 13 June at the earliest.