After months of intense public debate, with Granite Staters on both sides of the legislation that would allow medical aid in dying, packing the room at every public hearing, the Senate voted on Thursday to kill the bill.

“I think that the tragedy is that there are a lot of people who are going to be suffering and dying before this bill comes back,” said Rebecca Brown, the executive director of the New Hampshire Alliance for End of Life Options, after watching the vote to kill House Bill 1283 from the Senate gallery. She has been working to give people the option to end their life with dignity.

The bill, which was struck down in the senate with a vote of 17-7 and referred to an interim study, proposed granting individuals aged 18 and above, diagnosed with a terminal illness and a prognosis of six months or less, and having sound mental capacity, the option to end their lives without suffering from the disease.

But Sen. Ruth Ward, a retired nurse practitioner drawing from her experience caring for terminally ill patients, emphasized their fear – a painful death. She opposed the bill, asserting that with adequate medical attention, individuals can find comfort in their final days.

“You don’t inject them with something to end their life,” said Sen. Ward. “You never know what the end of life is going to mean to somebody else who is there. Let them live the last days and hours in comfort and have somebody be there for them.”

But advocates for the bill argue that palliative care like anti-nausea drugs and pain medications like morphine, have its limitations, and cannot improve quality of life, such as being linked to a feeding tube or using a catheter to empty the bladder.

There have been attempts in the legislature to legalize medical aid in dying since 2010 but this is the first time the bill has passed an elected body, the House of Representatives.

“These bills, always take time to pass, this is no surprise to us,” said Brown. “But we’re thrilled that we got through the house and we will be supporting people in the upcoming elections who are in favor of this bill.”

From the time the bill was introduced, legislators said they were flooded with testimonies both in favor of and against it. According to the state website, 658 individuals voiced their support, while 1,125 testified against it.

Like New Hampshire, 10 other states, including Rhode Island, Massachusetts, and New York, have proposed legislation this year to allow medical aid in dying. Vermont and Oregon are two states that have approved laws allowing medical aid in dying while also extending the statute to nonresidents.

New Hampshire’s bill also did not have a residency restriction, which was a point of worry for senators who voted against the bill during the Senate session.

“We’ve discussed in this chamber passing legislation to prevent us from becoming magnets for crime, drugs, human trafficking and more,” said Sen. Regina Birdsell, asking the Senate to refer it to an interim study. “This bill because it has no residency requirements would make our state a magnet for a much more tragic purpose.”

The question of whether this law is assisted suicide or a humane way to die has dominated the debate in New Hampshire for the past few months and this was evident in Thursday’s senate session.

Sen. Carrie Gendreau shared that her father endured the agonizing stages of cancer two years ago. Although he could have considered this option, not having it allowed their family to provide support and cherish precious moments together, she expressed.

“I just want to put that out there that suicide is a permanent solution for potentially a short-term problem,” she said in opposition to the bill. “When we leave this earth, it is either going to be heaven or hell.”

As per the bill’s provisions, before being prescribed the medication, individuals desiring the end-of-life option must undergo verification of their mental competency by two healthcare providers, among other criteria.

Both healthcare providers must ensure the individual understands the risks and alternatives to medically assisted dying. If there are any doubts about the person’s mental competency, the case must be referred to a state-licensed mental health professional. If the person is found to be mentally unsound and unable to make a clear judgment, they will no longer be eligible under the bill.

Other concerns about the bill stem from Canada’s decision to extend medical aid in dying to even individuals without a terminal illness. While New Hampshire’s legislation imposes safeguards, includes provisions for self-administration of medication to prevent potential abuse among the disabled population, critics fear future expansions. They worry that similar to developments in Canada, eligibility criteria could be broadened beyond the original scope.

But Sen. Keith Murphy shared a personal story illustrating the need for the bill, highlighting how individuals with terminal illnesses, like his aunt whose stomach cancer progressed to a terminal stage after initially being in remission, often endure painful and lonely deaths. Unable to bear the pain caused by cancer, she ended her life by suicide.

Had this legislation been enacted at the time, Sen. Murphy said, his aunt’s children would have been spared the heartbreaking sight of finding her remains in the kitchen, resembling a crime scene, and they would have had the opportunity to bid her farewell with an open casket.

“We respected her right to make the decision she made,” said Sen. Murphy, emphasizing that this bill marked the most important vote during his term. “I’m voting for the right of terminally ill people, not healthy people, to end their lives quickly and peacefully rather than choosing between a grisly end or a drawn-out painful one.”

Although medical aid in dying won’t reach the governor’s desk this year, advocates emphasize that the push to legalize it in New Hampshire will persist, asserting that the decision to conclude one’s life with dignity should remain within the individual’s control.

“Here is the universal truth, death is coming for all of us,” said Sen. Debra Altschiller. “In the final moments of a person’s life, the government shouldn’t be dictating those last breaths.”