France’s National Assembly has voted to create a right to assisted dying under strict conditions, after years of debate and changes to the proposals.

MPs voted by 291 to 241 to back the bill, which had been rejected three times by the upper house of parliament, the Senate.

Prime Minister Sébastien Lecornu is set to refer parts of the bill to France’s Constitutional Council for examination before it can become law.

It would allow assisted dying for French adults with a “serious and incurable” life-threatening illness “in an advanced or terminal stage”. The illness would need to leave them in constant physical or psychological suffering that is unbearable or resistant to treatment.

The patient would need to “freely manifest his or her intention” to a doctor, who would then make a decision after consultation within 15 days.

After two days of reflection, the patient would have to administer a lethal substance themselves. If they were unable to do so, it could be done by a doctor or nurse.

The patient’s decision to go ahead with the procedure would have to be verified by the physician on the day.

Wednesday’s vote means France could join several other European countries that have decriminalised assisted dying in some form.

A similarly lengthy debate has been taking place in the UK. A bill to legalise assisted dying in England and Wales stalled earlier this year and is set to return to Parliament in September.

The Netherlands and Belgium legalised assisted dying in 2002 for people with unbearable suffering from incurable illness, allowing it to be administered by a physician.

Several other European countries have since passed legislation, and Switzerland has long allowed assisted suicide if the person assisting acts unselfishly.

In France, the issue has been highly contentious politically, drawing opposition from the Catholic Church and parts of the medical profession.

Although it has now been approved four times in the National Assembly, an upper house dominated by right-wing parties has three times rejected it.

However, opinion polls suggest a large majority of the French people support giving terminally ill people a choice of palliative care or assisted dying.

On the eve of the vote, the French prime minister made clear he intended to submit some of the provisions of the bill to the constitutional council – a nine-member authority that checks whether a law complies with the constitution.

President Emmanuel Macron has long backed end-of-life legislation, but his decision to call snap elections two years ago caused a significant delay to the process.

Since 2024, there has been some reluctance from France’s prime ministers to proceed with the assisted dying bill and Lecornu is known to have his own reservations about its terms.

In a statement ahead of the vote, his office said although the lower house had extensively debated the bill, the Senate had not allowed for scrutiny that met “both the aspirations of its supporters and concerns of those worried about its implementation”.

Lecornu has asked the constitutional council to focus on three aspects of the law: