AUGUSTA, Maine (AP) - The Maine Legislature voted Tuesday to legalize assisted suicide, with supporters declaring it in line with the state's tradition of individualism and opponents insisting the practice tempts fate.
The bill now goes to Democratic Gov. Janet Mills, who has not indicated whether she will let it become law. Her office said she has not yet taken a position.
The proposal had failed once in a statewide vote and at least seven previous times in the Legislature. If Mills signs it, Maine would join seven other states, including New Jersey this year, and Washington, D.C., with similar laws, according to the Death With Dignity National Center and the Death With Dignity Political Fund.
Maine's bill would allow doctors to prescribe terminally ill people a fatal dose of medication. The bill declares that obtaining or administering life-ending medication is not suicide under state law. Still, it effectively legalizes it.
The proposal passed the Democratic-led state Senate 19-16 on Tuesday after lawmakers recounted the last days of their own loved ones. The Democratic-led House had approved it Monday by the narrowest of margins - 73-72.
Maine has the oldest average state population. But as in other states, the proposal has exposed divisions regardless of party line.
"I hope you will come down on the side of the terminally ill, people who don't seem to be asking for too much: the right to choose their own end of life care," said Republican Sen. Marianne Moore, a supporter who pointed to the bill's pages of protections for terminally ill patients.
That captures the spirit of the "libertarian Maine tradition" of individual rights and individual autonomy, she said.
Critics argue that doctors can make mistakes and that the bill could have unintended consequences. Republican Sen. Scott Cyrway said he has had relatives live for years longer than expected after being told they had a few months to live.
"There's several instances like that where hope is everything," he said. "If we go and take this hope away, that's what we're doing when we push this button."
The bill's Democratic sponsor said the latest language addresses criticism of past efforts that have failed in Maine.
The legislation defines "terminal disease" as an "incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within 6 months."
The bill requires a second opinion by a consulting physician, along with one written and two verbal requests. A patient making an initial verbal request must wait 15 days before signing a written request, and then wait another 48 hours for the writing of a prescription for life-ending medication.
A person's request for life-ending medication couldn't affect insurance rates or be a condition in a will or contract. Maine would criminalize coercing someone to request life-ending medication, as well as forging a request for life-ending medication without the person's knowledge.
Physicians would screen patients for conditions that could impair judgment, such as depression. Physicians must then send patients with such a condition for evaluation and treatment by a state-licensed mental health professional, who could allow the patient to receive life-ending medication only after deciding the patient's judgment isn't impaired by such a disorder.
An individual health care provider may choose not to participate in providing medication to end a qualified patient's life but, if the patient requests the medical records be provided to another health care provider, the records must be transferred.
At least 18 states considered such legislation this year, including pending bills in such states as Delaware, Kansas, Iowa, Massachusetts, Minnesota, New York and Rhode Island.
In 1997, Oregon became the first state to provide an end-of-life option. California's law went into effect in 2016.
The Associated Press contributed to this report.