MINISTERS were last night trying to reassure Labour MPs that a vote on “right to die” legislation today will not introduce euthanasia by the back door.

Tony Blair was facing a growing backbench revolt over the controversial Mental Capacity Bill as his MPs demanded a free vote. The legislation will give legal status to “living wills” and the power for third parties to tell doctors to withdraw treatment.

It was meant to clear up the rights of patients to demand to die by refusing treatment when facing a terminal decline. But moderate Labour MPs called the Bill a “mess” after their attempt to allay fears about euthanasia by curtailing the powers of third parties was watered down by ministers.

The Bill is intended to codify case law on the right of a patient or the patient’s advocate to refuse treatment and has backing from a range of groups such as Age Concern, Mencap and the Alzheimer’s Society. It states that the patient’s wish to have treatment stopped in the event of loss of mental capacity must guide doctors, provided it is valid and applies to the patient’s specific circumstances. The Bill also enables a third-party advocate to tell doctors that the patient wanted treatment to be stopped, but without requiring written proof of the request.

A pro-life amendment to prevent any medical intervention leading to a patient’s death, led by Iain Duncan Smith, the former Tory leader, has attracted more than a dozen Labour supporters. Many more Labour MPs are backing a cross-party measure led by the Labour MP George Howarth, which is aimed at making the preservation of life the main assumption in almost all circumstances when a third party is involved.

Mr Howarth’s amendment tells doctors that “where the determination relates to life-sustaining treatment, begin by assuming that it will be in the person’s best interests for his life to continue”. However, a further amendment by David Lammy, the minister for the Bill, was seen as weakening the defence because it removes the word “best”. Stephen Pound, Labour MP for Ealing North, a backer of the Howarth amendment, said: “This is a sane and sensible piece of legislation that sadly may contain within it the germ of something deeply disturbing, and we would like to see that cut out.

“This Bill is not about euthanasia but there is sufficient concern around for the need to make it absolutely clear that it is not about euthanasia. We are in a real mess on this one because a lot of us were mollified by the Howarth amendment. But if the Government is not going to accept that, this is one of those odd things where MPs do have a conscience and we are genuinely worried about this.

“We do not want to lose the body of the Bill but we do not want to be seen to be opening the door to the say-so of a third party — imagine the pressure on families.” Mr Howarth, Labour MP for Knowsley North and Sefton East, said: “My effort was to put it beyond doubt that people would want to live if the option was between life and death — but at the same time not pressure the medical profession or patient advocates to feel that they ought to in every circumstance attach people to tubes.”

He said that Mr Duncan Smith’s amendment would leave doctors with no alternative but to keep people alive as long as possible. Mr Howarth added: “I am trying to seek a humane balance which does not end up with people being connected to tubes in the last few hours of their life to any useful purpose. To be honest, I think most people are taking the view that they are going to vote whatever they think is right.”

Labour Party managers last night insisted that backbenchers will be whipped to vote with the Government today, to the fury of senior MPs who believe the Bill is a matter of conscience. But managers said that if they withdrew the whip it would concede that the Bill was about euthanasia — which they are adamant it is not.

Mr Duncan Smith’s amendment would prevent doctors from taking any action that would hasten the end to a person’s life.

Claire Curtis-Thomas, the Labour MP for Crosby who backs Mr Duncan Smith’s move, said: “The amount of disquiet about this Bill has been growing over a long period of time as people have begun to examine the ramifications. Instead of having Labour MPs all filing into the lobby people are beginning to say ‘no’. Is it euthanasia by stealth? I do not think MPs have received an answer to this that reassures them.”

She said that the “advance decision” introduced by the Bill — the so-called living will — could involve a conversation ten years ago and did not need to be witnessed by a third party. Diane Pretty, who suffered from motor neurone disease, failed in her legal bid to be allowed to commit suicide. She died shortly after she lost her case in 2002.

A coalition of leading charities claimed that fears that the Bill will legalise euthanasia were “misplaced and misguided”. The Making Decisions Alliance, which includes the Alzheimer’s Society, Age Concern, Mencap and the National Autistic Society, called on MPs to support the Bill.

It said: “It will not change the current law on euthanasia and will actually provide a series of better safeguards when decisions are made for people who lack capacity. Fears that the Bill will legalise euthanasia (are) misplaced and misguided.”

The alliance says that the safeguards include: that an individual must allowed to appoint a person of his choice to make decisions on his behalf in the event of future incapacity; an individual’s family or carers must be consulted before decisions are made about treatment; and a presumption for the preservation of life to be mandatory if there is any doubt.

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