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A bill to legalize physician-assisted death in Hawaii for adults with fewer than six months to live cleared its final committee hurdle Friday in the Senate.

The , chaired by Sen. Brian Taniguchi, passed  unamended in a 4-1 vote. Sens. Karl Rhoads, Donna Mercado Kim, Laura Thielen and Taniguchi voted in favor and Sen. Mike Gabbard voted against it. 

The measure is headed to a vote by the full Senate as early as next week. If no changes are made, it would then go to Gov. David Ige for his approval.

“There’s a lot of hopes and fears on both sides,” Thielen said before the vote. “The dignity part is what’s missing in the choices people are making today.”

Ige has already indicated that he would sign the bill into law, which would make Hawaii the sixth state to allow medical aid in dying under certain conditions.

More than 700 pages of  were submitted prior to the short morning hearing but the public was not afforded a chance to comment in person. It was also not broadcast on television.

The crowds of supporters and opponents have thinned as the bill has made its way through the legislative process. The hundreds who rallied at the first public hearing last month have dwindled to a couple dozen, many still wearing their yellow shirts in favor or blue shirts against.

Last year, a similar measure sailed through the Senate but stalled in the House. Gabbard and Sens. Gil Riviere and Breene Harimoto cast the lone “no” votes on it last session.

Gabbard said Friday that he has heard from residents who do not want government getting involved in this very personal issue. He said there are some amendments he had considered but decided not to put forward at this time.

Kim, who voted against a so-called death with dignity bill several years ago, said her concerns about safeguards have been addressed in this bill.

“It is a matter of choice. It is a matter of dignity,” she said. “We’re not forcing anybody.”

The bill requires the patient to self-administer the lethal dose and there are several hurdles before that can happen.

Aside from needing two medical providers confirming the terminal diagnoses, the six-months-or-less-to-live prognosis and medical competence, the patient must also undergo counseling by a doctor, psychologist or psychiatrist, but could do so by phone.

Hawaii would be the first state to require counseling. There’s a tele-health provision would help make it easier for residents in Hawaii to comply with the counseling requirement, recognizing that some live in rural areas far from doctors.

The amended version also lengthened the time the patient must wait between making two verbal requests for medically assisted death. Instead of 14 days, the amended version now calls for 20 days. One signed written request, witnessed by two people (one unrelated to the patient), is also required.

Rhoads, who introduced the bill last year that died in the House, said before the vote that medical aid in dying is an important option.

“I hope I never have to use this legislation that we’re about to pass,” he said. “But I want it to be there for me as an option for me if that time ever comes and I want it to be there as an option for my loved ones.”