Spain’s Congress of Deputies (lower house of Parliament) on Thursday gave its definitive approval to a law that makes euthanasia legal in the country.

The motion, which was passed with 202 votes in favor, 141 against and two abstentions, makes Spain the fourth European nation (along with Belgium, Luxembourg and the Netherlands) to approve such a measure.

Euthanasia will be available in the Spanish public health system for a person of legal age who is suffering from “a serious and incurable disease” or a “serious, chronic and incapacitating condition” that affects autonomy and causes “constant and intolerable physical or mental suffering.” The law will come into effect three months after its publication in the Official State Gazette (BOE).

During these three months, each of Spain’s 17 autonomous communities have to set up Guarantee and Evaluation Commissions, consisting of doctors, nursing professionals and legal experts.

The law specifies a series of steps a patient must go through to be granted permission to undergo euthanasia, starting with a written request that has to be submitted twice within a fortnight.

In this request, the patient (who can end the process at will) has to show a clear determination to end their lives and demonstrate they have been given the correct information on their condition and the options open to them.

Upon receipt of the second request, the case has to be passed on to the corresponding commission, which will appoint two experts not connected to the case to make their recommendation. If permission is granted, a person has the right to die in a public or private health center or at home.

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