French lawmakers approve assisted dying bill

French lawmakers have approved a bill that would create a legal right to assisted dying for adults with incurable, life-threatening illnesses, moving the country closer to joining a group of nations that allow the practice under strict conditions.

The National Assembly voted 291 to 241 on Wednesday to adopt the legislation after years of ethical and political debate. The bill has been rejected three times by the Senate, where the conservative right holds a majority, but the lower house has the final word. It still faces review by France’s Constitutional Council before it can become law.

The measure would apply to French adults, including citizens or legal residents, who have a “serious and incurable” illness that is life-threatening and in an advanced or terminal stage. Patients would also have to be experiencing constant physical or psychological suffering that is unbearable or resistant to treatment, and they must be capable of making a “free and informed” decision.

Under the bill, a patient would have to “freely manifest his or her intention” to a doctor. The doctor would then make a decision after consultation within 15 days. If the request is approved, the patient would have two days to reflect before proceeding. The lethal substance would generally have to be self-administered, but a doctor or nurse could administer it if the patient is physically unable to do so. The physician would have to verify the patient’s decision on the day of the procedure.

President Emmanuel Macron, who has long backed end-of-life legislation, said the debate required time and care. “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,” he wrote on X.

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

Supporters say the bill gives people facing unbearable suffering more control at the end of life while preserving safeguards. “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,” said Anne Raynaud, a representative of France’s association for the right to die in dignity.

Opposition has come from the Catholic Church, parts of the medical profession, religious groups and some lawmakers, including sections of the far-right National Rally party. Critics argue that legalising assisted dying could lead to abuse. One bishop has threatened to deny communion to lawmakers who support the measure, Al Jazeera reported.

“A society grounded in fraternity supports, protects, and cares for people,” conservative presidential candidate Bruno Retailleau wrote on X. “It never gives up on the most fragile among us.”

Prime Minister Sébastien Lecornu plans to refer parts of the bill to the Constitutional Council, a nine-member body that reviews whether laws comply with the constitution. His office said the Senate had not allowed scrutiny that met “both the aspirations of its supporters and concerns of those worried about its implementation.”

Lecornu has asked the council to examine three issues: whether the two-day reflection period is too short, whether patients under legal protection because of impaired judgment can give free and informed consent, and how assisted dying would apply in health and social care facilities whose purpose is to provide palliative care for terminally ill people.

If approved, France would join countries including the Netherlands, Belgium, Switzerland and Canada in allowing assisted dying in some form. The Netherlands and Belgium legalised assisted dying in 2002 for people with unbearable suffering from incurable illness, while Switzerland has long allowed assisted suicide if the person assisting acts unselfishly.