France’s National Assembly has approved a bill that would legalize assisted suicide for certain terminally ill adults, marking a major step after years of political debate.

The legislation passed by 291 votes to 241 and will now undergo a constitutional review before it can take effect.

Under the bill, only adults diagnosed with a serious, incurable, life-threatening illness in an advanced or terminal stage would qualify. Patients must also be experiencing unbearable physical or psychological suffering that cannot be relieved by treatment.

Those seeking assisted suicide would be required to make a voluntary request to a doctor, who must assess eligibility after consulting other medical professionals within 15 days. Following a mandatory two-day reflection period, the patient would generally self-administer the prescribed lethal medication. If physically incapable, a doctor or nurse could administer it on the patient’s behalf after confirming the patient’s decision.

The proposal has sparked strong opposition from religious groups and sections of the medical community, while opinion polls indicate most French citizens support giving terminally ill patients the option of assisted suicide. If enacted, France would join several European countries that have legalized some form of assisted dying under strict safeguards.