France has moved a step closer to legalising assisted dying after lawmakers approved landmark legislation that would allow some terminally ill adults to end their lives under strict conditions.

The bill, adopted by the National Assembly on Wednesday by 291 votes to 241, follows years of ethical and political debate over end-of-life care.

It would create a legal right to assisted dying for eligible adults suffering from incurable illnesses, while introducing safeguards aimed at protecting vulnerable patients.

Although the legislation has cleared its final parliamentary hurdle, it could still be reviewed by France's Constitutional Council before becoming law.

Under the proposed law, only French citizens or legal residents aged 18 and over would qualify.

Applicants must have a serious and incurable illness that is life-threatening and in an advanced or terminal stage. They must also be experiencing constant physical or psychological suffering linked to their condition that cannot be relieved, and be capable of making a free and informed decision.

If approved, patients would receive a lethal substance that they could administer themselves. Where a patient is physically unable to do so, a doctor or nurse would be permitted to administer it.

Strict safeguards

The legislation sets out a multi-step approval process.

Patients would first need to submit a request to a doctor, who would assess their eligibility alongside at least one other physician and another healthcare professional.

If the request is approved, the patient would then have to confirm their decision after a mandatory reflection period of at least two days.

Healthcare professionals who object to assisted dying on ethical or personal grounds would not be required to take part. However, they would have to refer patients to another medical professional willing to assist.

Macron: 'Life, suffering and dignity'

President Emmanuel Macron welcomed the vote, describing it as the culmination of a careful national conversation.

"On this issue, which is as personal as it is serious, and which concerns life, suffering and dignity, there was only one possible approach: to take the time to listen, engage in dialogue and hold a debate," Macron wrote on X.

He added: "In 2022, I made a commitment to forge this path together with the French people. With seriousness, humility and full respect for our democracy, I have honoured that commitment."

A deeply divisive issue

The debate has exposed sharp divisions across French society.

Supporters argue that the law would give terminally ill people greater autonomy over how they die while ensuring robust safeguards remain in place.

"Can it still be called a life when the suffering is so great that you can no longer do anything?" said Anne Raynaud, a representative of the Association for the Right to Die with Dignity (ADMD).

"People will be able to decide for themselves when and how they want to die once their suffering has become unbearable and can no longer be relieved."

Opponents, including parts of the medical profession and religious organisations, warn that legalising assisted dying could place subtle pressure on vulnerable people to end their lives.

Former interior minister Bruno Retailleau, a conservative presidential hopeful, criticised the legislation, saying:

"A society grounded in fraternity supports, protects, and cares for people. It never gives up on the most fragile among us."

The Catholic Church also strongly opposes the bill, with one bishop saying lawmakers who backed it could be denied Holy Communion.

Public support remains strong

Despite the controversy, opinion polls suggest the proposal enjoys broad public backing.

An Ifop poll published in February found that 84% of respondents supported legalising assisted dying under the conditions set out in the bill.

Several European countries, including Switzerland, Belgium and the Netherlands, already permit assisted dying under different legal frameworks. Some U.S. states also allow medically assisted dying for terminally ill patients.

France's Senate, where conservatives hold a majority, voted against the legislation. However, under France's legislative process, the National Assembly had the final say, allowing the bill to pass despite upper-house opposition.

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