France approves strict assisted dying law, sending it to constitutional review

France's National Assembly has voted 291 to 241 to create a right to assisted dying, advancing legislation that has spent years stalled by political deadlock. The bill permits adults with incurable, terminal illnesses causing constant, unbearable suffering to request a lethal substance.

The proposed system requires patients to clearly state their intention to a doctor, who then has 15 days to make a decision. After a mandatory two-day reflection period, the patient must self-administer the substance, though a doctor or nurse can step in if they are physically unable. A physician must verify the decision on the actual day of the procedure.

The bill's passage does not guarantee it will become law. Prime Minister Sébastien Lecornu will refer key provisions to the Constitutional Council before implementation.

Lecornu's office stated the Senate had not been allowed adequate scrutiny to meet "both the aspirations of its supporters and concerns of those worried about its implementation." He has specifically asked the nine-member council to examine three areas: whether the two-day reflection period is sufficient, how the law applies to patients under legal protection due to impaired judgement, and the requirement for palliative care facilities to participate.

The legislation has exposed a sharp divide between public sentiment and political institutions. While opinion polls indicate strong public support for giving terminally ill patients a choice, the right-dominated Senate has rejected the bill three times. President Emmanuel Macron has long championed the reform, but his decision to call snap elections two years ago delayed the process, and recent prime ministers have shown reluctance.

A successful implementation would bring France in line with several European peers. The Netherlands and Belgium legalised physician-administered assisted dying for unbearable suffering in 2002, and Switzerland has long permitted assisted suicide. The French vote also contrasts with the UK, where a similar bill for England and Wales stalled this year and is not expected back until September.

Domestic opposition remains fierce, driven by the Catholic Church and sceptical factions within the medical profession. The outcome of the Constitutional Council's review will ultimately determine whether France's legislative marathon ends in a permanent change to the country's healthcare landscape.