France’s National Assembly approved a bill on Wednesday legalizing medically assisted dying for adults suffering from incurable and terminal illnesses, marking a significant shift in the country’s end-of-life care legislation. The measure passed with a vote of 291 to 241, overriding opposition from the conservative-majority Senate, which had voted against the bill.

The new law permits doctors to assist patients who meet specific criteria, including being French citizens or legal residents living in France on a stable basis, being adults with a serious, incurable illness in an advanced or terminal phase, experiencing unbearable or treatment-resistant suffering, and being capable of freely and consciously expressing their will. In such cases, patients can request a lethal substance, which they may self-administer. If physically unable, medical professionals such as doctors or nurses may administer it on their behalf.

The process involves a mandatory 15-day evaluation period by a physician and a specialist panel after the initial request, followed by a minimum two-day reflection period before patients can proceed. The legislation excludes individuals with certain conditions, such as severe psychiatric disorders or neurodegenerative diseases like Alzheimer’s, from accessing assisted dying.

Before this law, French medical practice allowed terminally ill patients to refuse treatment or to be sedated but did not permit active assistance in hastening death. The legislation, originally promised by President Emmanuel Macron during his 2022 re-election campaign, was described by him as the result of a careful, open debate on an issue involving life, suffering, and dignity. Shortly after the bill's passage, Macron expressed that the commitment had been fulfilled with “solemnity, humility, and full respect for our democracy.”

Public support for the law is strong, with polls indicating that approximately 84% of the French population favor legalizing assisted dying. Advocates argue it provides a measure of autonomy and relief for those facing unbearable suffering while maintaining strict safeguards to prevent misuse.

However, the bill has faced considerable opposition. Critics include religious groups, some health care professionals, and conservative politicians, particularly in the Senate. Opponents have raised concerns about the adequacy of protective measures, fearing possible risks to vulnerable populations. An open letter signed by health professionals cautioned that the law contained “uncertainties” and could threaten the lives of the most vulnerable. Conservative voices have also expressed reservations about the ethical implications and societal impact of the new legislation.

The bill now faces potential review by France’s Constitutional Council, which has the authority to invalidate or amend legislation if it is found inconsistent with the Constitution. Prime Minister Sébastien Lecornu confirmed that he would submit the law for this constitutional scrutiny.

France joins a small but growing group of countries that have legalized medically assisted dying, including Switzerland, Belgium, the Netherlands, Spain, and several U.S. states. The move ends a long debate within France, where previously, patients seeking assistance in dying sometimes traveled abroad, notably to Switzerland, where such practices have been legal since 1942.

The adoption of this law represents a major transformation in French social policy, reflecting evolving public attitudes towards end-of-life care amid an aging population and increased prevalence of chronic illnesses.