LISBON, Portugal — Portugal’s parliament voted for the third time in just over a year Thursday in favor of allowing euthanasia, though like the previous two attempts, the country’s Constitutional Court or president could lawmakers’ support from becoming law.

Lawmakers approved four bills that would permit euthanasia and physician-assisted suicide in Portugal. A bill introduced by the governing center-left Socialist Party passed on a 128-88 vote, with five abstentions. The other three bills, from smaller center-left parties, carried by almost identical margins.

A few dozen people held a silent protest outside the parliament building in Lisbon, the capital, while the debate and votes took place.

The bills require the head of state’s approval to become law. President Marcelo Rebelo de Sousa could choose to block the legislation again or to send it once more to the Constitutional Court for vetting. The rejection of the previous two bills was largely due to unclear wording.

Euthanasia is when a doctor directly administers fatal drugs to a patient. Medically assisted suicide is when patients administer the lethal drug themselves, under medical supervision.

Isabel Moreira, a Socialist lawmaker who championed the legislation, said the law “is an invitation to understand others: When in doubt, show tolerance.”

Paulo Rios, of the main opposition Social Democratic Party, opposed the bill, asking: “Aren’t we overlooking other answers to serious and incurable diseases?”

Portugal’s top court blocked a bill in March 2021, saying its wording was “imprecise.” In November, the president vetoed a second parliament-sanctioned bill.

He said further clarification was needed about whether the proposed law would apply only to incurable illnesses or whether it could be extended to fatal or serious illnesses.

But none of the four new bills addresses Rebelo de Sousa’s specific concerns. Instead, they attempt to simplify circumstances where euthanasia and physician-assisted suicide are justified by referring to “a situation of intolerable suffering, with a definitive injury of extreme seriousness or a serious and incurable disease.”

That omission is unlikely to please the president.

The four bills next go to a committee stage, where they likely will be blended into one, before being voted on again and sent to the head of state. That process could take months.

Left-of-center parties in the mostly Catholic country backed the euthanasia bills, as they did with laws allowing abortion in 2007 and same-sex marriages in 2010.