France’s parliament has voted in favour of a bill to legalise assisted dying, paving the way for caregivers to help patients end their lives under what campaigners say would still be some of the strictest conditions in Europe.
After a sometimes emotional session, deputies passed the first reading of the bill by a vote of 305 to 199. They also unanimously backed a less contentious law establishing a right to palliative care in specialist end-of-life institutions.
Both votes are the start of a long parliamentary process that will require the bills to move on to the Senate – the upper house – and then back to the lower house – the National Assembly – for a second reading, meaning they are unlikely to become law before next year.
The government has described the right-to-die law as “an ethical response to the need to support the sick and the suffering”, insisting it was “neither a new right nor a freedom … but a balance between respect and personal autonomy”.
The legislation would allow a medical team to decide if a patient is eligible to “gain access to a lethal substance when they have expressed the wish”. Patients would be able to use it themselves or have it administered by a nurse or doctor “if they are in no condition physically to do so themselves”.
Patients must meet a number of strict conditions: they must be over 18, hold French citizenship or residency and suffer from a “serious and incurable, life-threatening, advanced or terminal illness” that is “irreversible”.
The disease must cause “constant, unbearable physical or psychological suffering” that cannot be addressed by medical treatment, and the patient must be capable of “expressing freely and in an informed manner” their wish to end their life.
The bill – referred to in France as a law on “end of life” or “aid in dying” rather than “assisted dying” or “euthanasia” – was backed by most of Emmanuel Macron’s centrist MPs and their allies and by the left, with most right and far-right deputies voting against.
All parliamentary groups were given a free vote to express their personal convictions. Euthanasia is a highly sensitive subject in France, a country with a longstanding Catholic tradition, and the bill is also opposed by many health workers.
“The French people are ready for this, and we owe them this rendezvous with history,” said Stéphane Delautrette, a Socialist party MP during the session. The laws would be “the measure of this parliament, in the footsteps of major social advances” such as the right to abortion and the abolition of the death penalty, he said.
But Patrick Hetzel, a deputy from the centre-right Les Républicains, said it was “illusory to and even dangerous to even think of debating a legalisation of euthanasia without having first fully deployed proper access to palliative care.”
The prime minister, François Bayrou, a devout Catholic, had said he had “questions” and would abstain if he were an MP, but Macron said last year that France needed the legislation because “there are situations you cannot humanely accept”.
France currently allows passive euthanasia – such as withholding artificial life support – and deep sedation before death, but patients seeking active end-of-life options have no choice but to travel to other countries where euthanasia is legal.
Right-to-die campaigners have welcomed the law, though describing it as relatively modest in scope. “It’s a foot in the door, which will be important for what comes next,” said Stéphane Gemmani of the ADMD association.
“We’ve been waiting for this for decades. Hopefully France will steadily align itself with other European countries,” Gemmani said. “Forcing people to go to Belgium or Switzerland, pay €10,000 or €15,000 … The current situation is just wrong.”
Opinion polls show most French people are in favour of assisted dying, but France has been slower than many European neighbours to legalise it. Others are actively debating the issue, including the UK, where an assisted dying bill is before parliament.
Active euthanasia, where a caregiver induces death at the request of the patient, and assisted suicide, where doctors provide the patient with the means to end their life themselves, have been legal in the Netherlands and Belgium since 2002.
Both countries apply roughly similar conditions – a doctor and an independent expert must agree the patient is suffering unbearably and without hope of improvement – and have since extended the right to children under 12.
Luxembourg also decriminalised active euthanasia and assisted dying in 2009. Active euthanasia is outlawed in Switzerland, but assisted dying has been legal since the 1940s and organisations such as Exit and Dignitas have helped thousands of Swiss nationals, residents and others to end their lives.
Austria legalised assisted dying in 2022, while Spain adopted a law in 2021 allowing euthanasia and medically assisted dying for people with a serious and incurable illness, providing they are capable and conscious, the request was made in writing, reconfirmed later, and approved by an evaluation committee.
Portugal decriminalised euthanasia in 2023 but the measure has not yet come into force after certain articles were rejected by the constitutional court.
In the UK, MPs approved the legalisation of assisted dying in England and Wales for adults with an incurable illness who have a life expectancy of under six months and are able to take the substance that causes their death themselves, in a first vote in November last year.
MPs must now vote on whether the text, amended in May to allow medics to opt out, is sent to the upper chamber for further scrutiny. The Scottish parliament has also passed its first vote on a bill to legalise assisted dying.
