AUGUSTA — A bill to legalize medication-assisted suicide for terminally ill patients received final approval in the Maine House by a single vote on Monday.

House Speaker Sara Gideon, D-Freeport, held the vote open for 18 minutes – an unusually long roll call in Augusta – to ensure every vote was counted on an assisted suicide bill that has stirred strong emotions on both sides.

The final tally of 73-72 means the bill will now receive a final vote in the Senate, where it received preliminary approval last week on a vote of 19-16.

If the bill is passed by the Senate and signed by Democratic Gov. Janet Mills – who has yet to take a public position on the issue – Maine will become the eighth state to legalize some form of assisted-suicide for terminally ill patients.

To supporters, the so-called “Death With Dignity” bill empowers terminally ill but clear-minded patients.

“No one knows better how precious life is than the dying patient who has exhausted every available means of prolonging the life they cherish,” said Rep. Michele Meyer, D-Eliot, a registered nurse. “These dying patients recognize with clarity that they have no hope for the long life we all dream of. They wish to avoid unbearable suffering by choosing the option to die in peace and with dignity.”

Opponents, meanwhile, take moral issue with the concept of assisted suicide and warned of the potential for abuse or misdiagnosis.

“Life is precious, no matter what the end result is,” said Rep. Josanne Dolloff, R-Rumford. “Doctors do make mistakes. They could tell the patient, ‘This is the end’ and it really is not the end. So please, vote this down.”

The bill, L.D. 1313, would allow terminally ill adults with less than six months of life expectancy to request a prescription for a lethal dose of medication. The individual would have to make the request verbally twice and once in writing as well as have the physical capability to take the medication on his or her own.

A physician would need to affirm that the patient is not suffering from depression or any other psychological impairment and is not being coerced by family members or others to take his or her life. Physicians would not be obligated to write prescriptions for lethal doses of drugs, but the bill would legally insulate doctors who do by creating an “affirmative defense” against charges of murder or assisting in suicide.

Laws differ by state, but medication-assisted suicide is now legal in Oregon, Washington, California, Colorado, Hawaii, Vermont and New Jersey, as well as the District of Columbia.

Oregon, with a population of roughly 4 million, has the longest history with medication-assisted suicide laws. Between 1997 and 2017, 1,275 terminally ill patients died after ingesting drugs obtained through that state’s “Death With Dignity” law. A total of 1,967 people had prescriptions for lethal doses written under the law during that period, according to a February 2018 report by the state.

Opponent Rep. Beth O’Connor, R-Berwick, said the bill is simply not compatible with Maine values particularly considering what she said were high rates of elder abuse in the state.

“This is not death with dignity,” O’Connor said during a floor speech. “It’s a desperate effort to further a dangerous law and give it mainstream credibility for larger states with no disregard for the harm it causes.”

As in earlier debates, lawmakers on both sides shared personal stories on Monday to explain their support or opposition to the bill.

Rep. Seth Berry, D-Bowdoinham, recalled how a close friend who grew up in Maine but lived in Washington chronicled his own battle with cancer. Berry said his friend, Ethan, displayed a “clarity of mind” in his decision with his family to avail himself of Washington’s law and the debate surrounding the issue.

“While he was very respectful that, ultimately, it is a very personal decision whether to take one’s life with the help of modern medicine, or not to do so, he simply asked that someone else not make that decision for him,” Berry said.

The bill had received initial approval in the House last week on a 72-68 vote. But 11 lawmakers were absent or excused that day, and advocates have been lobbying hard on the emotional issue since then.

On Monday, only one Republican lawmaker, Rep. Dennis Keschl of Belgrade, voted in support of the bill while 17 Democrats opposed it. The Senate could take up the bill on “final enactment” later this week.