The bill, introduced by Socialist Prime Minister Pedro Sanchez's minority government, passed with 198 votes in favour and 138 against. There were two abstentions.
It still faces a vote in the Senate early in 2021 where it is also expected to pass.
The draft law will allow someone suffering from a “serious and incurable disease” or from a “debilitating or chronic condition” which the person feels is “unbearable” to receive assistance to die.
El #Pleno ha aprobado el Dictamen de la Comisión de Justicia sobre la Proposición de Ley Orgánica de regulación de la eutanasia, que será remitido al Senado para continuar con su tramitación parlamentaria .
— Congreso (@Congreso_Es) December 17, 2020
The request to die must be made in writing and be reaffirmed two weeks later. The demand must then be accepted by two doctors, then examined by a commission before the green light is given.
The cost of the procedure will be covered by the public health system and medical professionals will have the right to “object on grounds of conscience”.
“As a society, we cannot remain impassive in the face of the intolerable suffering of some people,” Health Minister Salvador Illa said during the debate in parliament before the vote.
But the main opposition conservative Popular Party (PP), which voted against the bill along with the far-right Vox, accused the government of “rushing” the vote to prevent a “serious debate”.
The proposed law is “a defeat for everyone, a failure of our health system and our society,” said PP lawmaker Jose Ignacio Echuniz, who called instead for greater use of palliative care for seriously ill people.
Vox vowed to challenge the law in Spain's constitutional court.
Euthanasia and assisted suicide currently can currently be punished with jail terms of between two to ten years, but the sentence can be reduced if the person is terminally ill or enduring severe suffering and has asked to die.
The parliamentary vote comes 23 years after the death of Ramon Sampedro, a quadriplegic former ship mechanic who for decades fought for the legal right to an assisted suicide and a dignified death.
After the statute of limitations had expired, one of his friends admitted helping him take his own life, with Sampedro's story immortalised in a blockbuster called “The Sea Inside” by director Alejandro Amenabar which won the best foreign film Oscar in 2005.