French MPs have voted to allow some people in the last stages of a terminal illness the right to assisted dying.
The National Assembly approved the bill, which is backed by President Emmanuel Macron, by 305 votes to 199. It will now go to the upper house, the Senate, before a second reading in the National Assembly. Supporters hope it will become law by 2027.
It would make France the eighth country in the European Union to allow a version of assisted dying.
As currently framed, the French version would be not as permissive as in the Netherlands or neighbouring Belgium, which were the first countries in Europe to legalise assisted dying.
A separate bill creating a right to palliative care went through unopposed. It is estimated that 48% of French patients who require palliative care do not get it.
Macron said the decision to approve both bills was "an important step" in a social media post on Tuesday.
"With respect for sensitivities, doubts and hopes, the path of fraternity that I hoped for is gradually opening up", he wrote on X.
Much of the two-week debate in the Assembly had focused on the conditions under which a patient could qualify for assisted dying.
The approved formula is for "people struck by a serious and incurable disease" that is "life-threatening and in its advanced or terminal phases", who are in "constant physical or psychological suffering".
The patient would have to be able to "freely manifest his or her intention". They would have to wait 48 hours and then confirm it.
Once authorised, the lethal dose would be self-administered by the patient; or by a medical assistant if the patient were incapable.
Authorisation would be provided by a doctor, but only after consultation with peers.
MPs were allowed a free vote on the bill – a reflection of how differences of opinion on the matter defy party lines. Broadly though, the measure was backed by the centre and left and opposed on the right and populist right.
Conservative critics – echoing views of the once-dominant Catholic Church – were concerned that definitions in the bill were too broad, opening the way for assisted dying for patients who might have years to live.
As in other countries where the ethical issues have been hotly debated, opponents fear that vulnerable elderly people could feel under pressure to die in order to remove a burden from their families.
In a demonstration against the bill outside the National Assembly on Saturday, one 44-year-old woman suffering from Parkinson's disease said it would be like a "loaded pistol left on my bedside table".
Some left-wingers wanted to toughen the government's bill by widening access to assisted dying to minors, non-French nationals and patients who leave instructions before going into a coma.
Under the bill, medical staff who oppose assisted dying would not be obliged to carry it out. However, it would be a crime punishable by two years in jail to try to block an act of assisted dying.
Conservatives wanted to create another crime – of incitement to assisted dying. But this amendment was rejected by MPs.
Prime Minister François Bayrou, who is a practising Catholic, said that if he had a vote on the bill he would abstain. As he is not an MP, he did not have a vote.
