France’s controversial end-of-life bill moved a step closer to becoming law on Tuesday after the National Assembly voted for the third time in two years to legalize euthanasia and assisted suicide.

MPs approved the legislation by 295 votes to 232 on June 30, narrowing the margin from previous votes and paving the way for what is expected to be a final showdown later this month.

The bill will now return to the Senate, where the centre-right majority is expected to reject it again after previously refusing to back the proposal. Under France’s constitutional procedure, however, the government can allow the National Assembly to have the final say, with a decisive vote expected on July 15. If approved, the law could come into force before the end of 2026.

The legislation would create a legal “right to aid in dying” for some patients suffering from serious, incurable illnesses that are life-threatening and in an advanced or terminal stage. To qualify, applicants would have to experience unbearable physical or psychological suffering linked to their condition and be capable of making a free and informed decision.

Supporters describe the eligibility criteria as strict safeguards and say the bill is the product of years of parliamentary debate and more than 10,000 proposed amendments.

Opponents, however, argue that the legislation goes far beyond what President Emmanuel Macron originally promised. Dr. Ségolène Perruchio, president of the French Society for Palliative Care, said the bill had been drafted against the wishes of a large majority of healthcare professionals and warned it creates a new legal “right to aid in dying” after Macron had pledged not to establish such a right. She also argued that earlier safeguards have been weakened, potentially making thousands more patients eligible.

The debate has also centred on freedom of conscience after lawmakers last week rejected a proposal that would have allowed private hospitals and care institutions to refuse to provide euthanasia or assisted suicide on ethical or religious grounds. If the law is adopted, religious and other private healthcare institutions would no longer be able to opt out on the basis of their founding principles.

Bishop Matthieu Rougé of Nanterre said the decision was “not a question of secularism but of freedom,” arguing that many healthcare providers should be allowed to refuse participation in euthanasia or assisted suicide while remaining faithful to their founding principles and the convictions of those they serve. He accused the government of abandoning earlier support for a conscience clause and warned that the legislation reflected an “ideological” approach that overrides differing ethical convictions.