The Belgian Parliament has adopted a controversial bill extending the right to euthanasia to terminally ill children, the Parliament announced Thursday via Twitter.

The bill easily passed the Belgian House of Representatives 86 to 44, following a vote by the country’s Senate in December in support of the measure. The bill is expected to be signed by King Philippe, making Belgium the first country in the world to remove age limits to the practice.

“Our responsibility is to allow everybody to live, but also to die, in dignity,” said Karine Lalieux, a Socialist member of the House of Representatives, according to The Associated Press.

Under amendments to the country’s 2002 euthanasia law, a child of any age may be helped to die under strict conditions: the child must be terminally ill, close to death and suffering a great amount of pain. Counseling by doctors and a psychiatrist or psychologist is required, as is approval by parents or guardians. The child must possess the “capacity of discernment and be conscious” of requesting death.

Socialist Senator Philippe Mahoux, sponsor of the country’s 2002 “right to die” legislation, called for the law’s expansion because he said doctors have been illegally helping sick children die. Mahoux, a trained surgeon, called euthanasia “the ultimate gesture of humanity,” according to Agence France-Presse. “The scandal is illness and the death of children from disease.”

Opponents, including religious leaders and some medical professionals, argue that children are not capable of making such difficult decisions. “The law says adolescents cannot make important decisions on economic or emotional issues, but suddenly they’ve become able to decide that someone should make them die,” Brussels Archbishop Andre-Joseph Leonard said at a prayer vigil last week, according to the BBC.

On Wednesday, 160 pediatricians petitioned lawmakers to postpone the vote arguing the bill is unnecessary. “Pain can be eased nowadays; there’s been huge progress in palliative care,” Nadine Francotte, a cancer specialist in the city of Liege, told AFP.

In 2012, euthanasia accounted for 2 percent of all deaths in Belgium, up 25 percent to nearly 1,400 cases. A terminally ill person may drink a barbiturate-laden syrup, or a doctor can administer the drug through an intravenous tube to induce death.

Belgium is one of a handful of European countries where euthanasia is legal. The Netherlands legalized euthanasia in 2002, even allowing it in some cases for seriously ill minors 12 and older. Luxembourg allows euthanasia for adults; Switzerland allows doctors to help patients die in some circumstances.

Euthanasia is banned in the U.S., but physician-assisted suicide, or “Death with Dignity,” is legal in four states: Oregon, Washington, Vermont and Montana.