AUGUSTA — The Maine Senate gave preliminary approval to a bill that would allow terminally ill patients to obtain life-ending drugs, voting 19-16 Thursday after lawmakers on both sides of the issue shared emotional, personal stories.

The vote came two days after the so-called “Death with Dignity” bill passed the much larger Maine House by just four votes. The controversial bill faces additional votes, and Democratic Gov Janet Mills has yet to take a position on the issue.

But if the measure is enacted, Maine would join seven other states plus the District of Columbia in approving some type of assisted suicide law.

“Sometimes the best form of compassionate care is care that which, in those very real instances, preserves autonomy and dignity,” said Sen. Ned Claxton, D-Auburn, a retired physician.

The bill under consideration, 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.

Additionally, physicians would need to affirm that the patient is not suffering from depression or any other psychological disorder that could impair the person’s judgment. 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.

But opponents cited religious objections to what they view as state-sanctioned suicide and warned that some ill individuals – but particularly elderly Mainers – could feel pressured to end their lives to spare their loved ones the expense or burden of caring for them.

“We may not hear of the abuses, but the abuses will be there – silently taking place in the form of guilt-induced suicide,” said Sen. Stacey Guerin, R-Glenburn.

The 19-16 vote divided both parties with several exceptions. Three Democrats joined most Republicans in opposing the bill, while one Republican joined the other 18 Democrats in supporting the measure.

The bill now heads back to the House, where its final disposition is still up in the air. Eleven lawmakers were either absent or excused on Tuesday when the measure gained initial approval by just four votes in the 151-seat chamber.

Oregon was the first state to pass an assisted suicide law in 1994 via a ballot initiative. Since then, Oregon has been joined by Washington, California, Colorado, Hawaii, Vermont, New Jersey and the District of Columbia in allowing terminally ill patients to request medications to end their lives.

Maine lawmakers have rejected several medication-assisted suicide proposals in the past on a bipartisan basis, most recently in 2017 when the bill failed in the House on an 85-61 vote. But last Tuesday’s vote suggests that supporters could be gaining momentum. And supporters of the issue have been working to gather the signatures for a “Death with Dignity Act” ballot measure if the Legislature does not act.

The lone Republican senator to vote in support of the bill on Thursday, Sen. Marianne Moore of Calais, said states with assisted suicide laws have 40 years of combined experience showing that the laws work “as intended with no evidence of abuse, undue influence or coercion.”

Like many senators on both sides, Moore couched her position in deeply personal arguments based on her family’s experiences as well as her work with cancer patients as a care coordinator.

Moore recalled watching her father and a close friend endure slow and painful deaths when she knows both would have likely preferred the option offered in the bill. In another instance, Moore shared her experiences as a care coordinator for an 82-year-old man with Stage IV lung cancer.

The man confided to her that he was ready to give up rather than go through more exhausting tests and treatment, but she acted as the dutiful “cheerleader.”

“On the day he was scheduled for another breathing treatment, he drove himself to a back road about five miles from his home and shot himself,” Moore said. “I truly believe that had the death with dignity opportunity been available, his death would have been peaceful, surrounded by loved ones instead of dying alone on the side of a road.”

But opponents said terminal prognoses are not always correct and that some patients miraculously recover from seemingly incurable diseases. Others cited their own painful experiences to support their votes against the bill.

Sen. Lisa Keim, R-Dixfield, said “some of the most memorable, incredible moments” with her late father came during the final stages of his recent health battle.

“Those moments are incredible,” Keim said. “They are precious and they will stay with me for the rest of my life, the words that he spoke to me. So there is value at the last six months and there is value at the last few minutes.”

One lawmaker, Democratic Sen. Bill Diamond of Windham, acknowledged that he voted during the last legislative session to support a “death with dignity” law but will oppose it this year. The reason, Diamond said, was that he felt in retrospect that “it was not something that I had the authority to do.”

But Sen. Brownie Carson, D-Harpswell, said he would support the bill because “if I need it, when I need it, I wish to be able to make that choice for myself and for my family.”

The bill now goes back to the House for enactment.