France's National Assembly has given its definitive backing to legislation granting terminally ill adults the right to end their lives with medical assistance, bringing to a close a protracted and often fraught political battle.
MPs voted Wednesday 291 to 241 in favour, the fourth time the lower house has approved the text. The bill also cleared the Assembly in a vote last year but was rejected by the Senate.
Given that resistance, the government eventually allowed the lower chamber to have the final say without the upper house's consent, a mechanism permitted under the constitution.
President Emmanuel Macron, who promised to pursue the reform during his re-election campaign in 2022, welcomed what he called lawmakers' considered and respectful debate on the issue.
Olivier Falorni, the former MP – now a mayor – who authored and steered the bill through parliament, described the process to French news agency AFP as "a marathon with hurdles".
Despite Wednesday's vote, the law is not yet settled. Prime Minister Sébastien Lecornu intends to refer the text to the Constitutional Council, France's highest constitutional authority, for review.
His office said the referral followed a lack of proper debate in the right-leaning Senate, which meant the text fell short of a version that could satisfy both the bill's supporters and those anxious about how it would be put into practice.
The Constitutional Council's rulings are binding. It can strike down the whole law in extreme cases, or raise objections to particular provisions.
Opposition has been fiercest among senior figures on the traditional right, drawn largely from Les Républicains, the largest party in the Senate.
Multiple criteria
The right would be reserved for adults suffering from an incurable condition, who are able to express their wishes in a free and informed manner, and who are experiencing physical pain.
That pain must either fail to respond to treatment or, in the patient's own judgement, be unbearable, in cases where they have chosen to refuse or discontinue care.
A physician would first be responsible for confirming the patient's eligibility, after which a panel would assess the case against the criteria.
The final decision rests with the doctor alone, and the patient would remain free to withdraw their consent at any stage.
Ordinarily the patient would administer the lethal substance themselves. Where they are physically unable to do so, a doctor or nurse would be permitted to assist.
A long-running debate
By various estimates, assisted dying is currently accessible to around 300 million people worldwide, with euthanasia permitted under certain conditions in some countries and assisted suicide allowed in others, including several states in the United States.
France, a country with strong Catholic traditions and a rapidly ageing population, has long grappled with the legal, medical, moral and religious dimensions of end-of-life care.
Existing law already allows doctors to keep terminally ill patients sedated in their final days, but stops short of permitting assisted suicide or euthanasia.
Many French citizens have travelled to neighbouring countries where such practices are legal, Switzerland chief among them.
Euthanasia involves a doctor or other healthcare professional administering a lethal injection at the patient's request, while medically assisted suicide typically involves the patient voluntarily taking lethal medication that a doctor has prescribed.
The question is also under debate in the United Kingdom. A bill to legalise assisted dying in England and Wales is due to return formally to parliament on 11 September, five months after MPs ran out of time to vote on it in the previous session.
(with newswires)
