France’s National Assembly gives final approval to assisted-dying bill after years of debate

PARIS (AP) — France’s National Assembly gave final approval Wednesday to a bill allowing adults with incurable illnesses to receive lethal medication, the culmination of years of debate over end-of-life care.

The lower house of parliament approved the measure in a 291-241 vote, after backing it in three previous readings, completing parliament’s work on the legislation announced by French President Emmanuel Macron more than three years ago.

“In 2022, I committed to opening this path with the French people.” Macron said in a message posted on X. “With seriousness, with humility, and with full respect for our democracy, that commitment has been fulfilled.”

According to various estimates, assisted dying is available to around 300 million people worldwide, with euthanasia legal under certain conditions in some countries and assisted suicide allowed in others and in several U.S. states. France has an increasingly aging population, with growing numbers of patients in the country who require care for chronic illnesses.

France, a traditionally Catholic nation, has grappled with legal, medical, moral and religious questions about end-of-life options, including existing legislation that allows doctors to keep terminally ill patients sedated before death, but stops short of allowing assisted suicide and euthanasia.

“The national representation has risen to the occasion during these debates. This has been the longest debate since the 1980s,” said Yael Braun-Pivet, the president of the National Assembly.

Many French people have traveled to neighboring countries where medically assisted suicide or euthanasia are legal. Medically assisted suicide generally involves a patient voluntarily taking lethal medication prescribed by a doctor. Euthanasia involves a doctor or other health care professional administering a lethal injection at the patient’s request.

End-of-life options are also being debated in the United Kingdom. A bill to legalize assisted dying in England and Wales will formally return to Parliament on Sept. 11, five months after it ran out of time in Parliament’s last session.

The bill sets strict conditions

The proposed measure in France primarily provides for medically assisted suicide, by allowing patients to receive and self-administer lethal medication under strict conditions. Only people whose physical condition prevents them from doing so would be allowed to receive assistance from a doctor or a nurse.

Patients seeking to end their lives would have to be at least 18 years old and either French citizens or legal residents of France.

A doctor would first have to consult a team of health care professionals and then confirm that the patient has a serious and incurable illness that is life-threatening. The patient must be in an advanced or terminal stage, experiencing pain that can’t be relieved or is unbearable, and seeking lethal medication of their own free will.

Lawmakers specified that psychological suffering alone wouldn’t qualify a person for medically assisted dying.

People with severe psychiatric disorders or neurodegenerative diseases such as Alzheimer’s wouldn’t be eligible.

Patients would initiate the request, to be reviewed by health professionals within 15 days, and then confirm it after a period of reflection lasting at least two days.

If approved, they could take the lethal medication at the time and in the place of their choice, including at home or in a health care facility, in the presence of their loved ones if they wish.

On the chosen date, the doctor or nurse would have to verify that the person still wishes to proceed and remain nearby to intervene if complications arise.

France’s national health insurance system would cover all associated costs.

Many French people support the changes

A 2023 report found that most French people are in favor of legalizing end-of-life options, and opinion polls have shown support increasing over the past two decades.

The Association for the Right to Die With Dignity said that the law would allow people “to choose to end unbearable suffering, freely and with full awareness.” Its president, Jonathan Denis, said in a statement that “a law that creates a new right never forces anyone to exercise it. It does, however, ensure that every person … can remain at the heart of medical decisions that concern them and have their wishes respected.”

Opponents argue the measure could put pressure on older people and those living with illness or disabilities.

In an open letter to Macron, the anti-euthanasia group Alliance Vita said that “every effort must be made to ensure that people who are suffering have immediate access to palliative care and support. Presenting death as a desirable solution can never be an acceptable response to suffering and is contrary to human dignity.”

The vote caps a lengthy parliamentary process

The Senate, the upper house where conservatives hold a majority, rejected the bill. But under France’s legislative process, the National Assembly has the final say when the two houses of parliament disagree.

Senate President Gérard Larcher and Prime Minister Sebastien Lecornu said that they would refer the bill to the Constitutional Council, which will have up to a month to determine whether it complies with the Constitution. The law will only take effect once that review has been completed.

“Extensive debates have taken place in the National Assembly on this bill. However, discussions in the Senate did not allow for such an in-depth examination, in order to produce legislation that addresses both the aspirations of its supporters and the concerns of those who are worried about how it will be implemented,” Lecornu said.

In the U.K., opponents of the bill to legalize assisted dying prevented it from passing in the House of Lords, the upper house, by filing more than 1,200 amendments on a range of concerns, including potential coercion of vulnerable people and a lack of safeguards for those with disabilities.

That was in April, after elected representatives in the House of Commons passed it.

The bill that is expected to be presented again proposes allowing adults in England and Wales, with fewer than six months to live, to apply for an assisted death subject to the approval of two doctors and an expert panel. One aim is so people no longer go to other countries, such as Switzerland, for an assisted death.

In Germany, parliament’s lower house, the Bundestag, in 2023 considered two proposals to regulate assisted dying and rejected both of them.

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John Leicester in Paris, Pan Pylas in London and Geir Moulson in Berlin contributed to this report.

Sylvie Corbet And Samuel Petrequin, The Associated Press