AUGUSTA — Gov. Janet Mills signed into law on Wednesday a bill allowing terminally ill patients to obtain prescriptions for lethal doses of drugs, making Maine the latest state to legalize medication-assisted suicide.

Mills acknowledged the “moral dilemma” posed by a bill that supporters say offers “death with dignity” to individuals in their final months but that opponents equate to state-sanctioned suicide. A former Maine attorney general, Mills said she considered the emotional, personal testimonies of individuals and legal issues as she weighed the hardest decision of her 5-month-old administration.

“It is my hope that this law, while respecting the right of personal liberty, will be used sparingly and that we will respect the life of every citizen with the utmost concern for their spiritual and physical well-being,” Mills said in her State House office. “And that as a society that we will be as vigorous in providing full comfort, hospice and palliative care to all persons – regardless of their status, location or financial ability – as we are in respecting their right to make this ultimate decision over the own fate, of their own free will.”

The medication-assisted suicide bill sparked some of the most emotional debate of the 2019 legislative session. The measure passed by a single vote – 73 to 72 – in the Maine House last week and by three votes in the Senate. Mills’ decision to sign the bill into law will also pre-empt an anticipated ballot referendum on the issue.

Gov. Mills Radio Address June 12

Listen to Gov. Mills explain her rationale for signing the bill.

The bill signed by Mills, L.D. 1313, allows 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 request the medication three times – twice verbally and once in writing – as well as have the physical capability to take the medication on his or her own.

The physician will be required 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. Doctors will not be obligated to write prescriptions for lethal doses of drugs, but the law will legally insulate doctors who do by creating an “affirmative defense” against charges of murder or assisting in suicide.

Maine will join seven other states plus the District of Columbia in allowing some form of medication-assisted suicide, sometimes referred to as medical aid in dying and as “death with dignity” by supporters.

The law will take effect 90 days after the Legislature’s anticipated adjournment later this month. But Mills also signed an executive order on Wednesday directing the Maine Department of Health and Human Services to begin emergency rulemaking to implement the law.

The accompanying executive order also directs DHHS to “monitor the impact of the law” through extensive data collection and trend analysis as Mainers avail themselves of the law. Mills said that process was important both to document any trends “and to safeguard our responsibility” to ensure palliative or hospice care is provided to those who require it.

Bill sponsor Sen. Patricia Hymanson, D-York, supported Mills’ executive order speeding up the collection of data. A retired physician, Hymanson said this is the first bill in her three terms in the Legislature where people stop her on the street even outside of her district to express their gratitude.

“That’s been very rewarding,” Hymanson said. “So to see it come through, and for the governor to have heard the same message, makes it feel very complete.”

More than 100 people testified or submitted comments on both sides of the issue, with many sharing deeply personal stories about why they supported or opposed the measure. Among them was Terry Moore, a Stetson resident who has lost more than 30 family members to a type of ALS, familial amyotrophic lateral sclerosis, that is genetic.

Moore said she has watched close family members succumb to a disease that gradually robs individuals of their ability to move, to speak and to care for themselves but leaves their mind largely in tact. That process is painful to not only the dying individual but the family members who struggle to care for their loved ones.

Now 65, Moore said she is still unsure whether she will contract ALS. But because of the high likelihood, she and her husband have taken every step they could to prepare. She had even thought about moving back to Vermont because that state allows terminally ill patients to obtain lethal prescriptions.

Moore said, to her, the issue is “about having a choice” even if she ultimately chooses not to exercise it.

“And now, the death with dignity bill gives me the final piece,” Moore said in a phone interview. “To me, it is freedom and it is peace of mind. … I know not every member of my family would choose to use the death with dignity option, but I know a lot of them would have.”

Bishop Robert Deeley of the Roman Catholic Diocese of Portland called the bill’s passage a “sad day for Maine.”

“Suicide is always a tragedy,” he said in a statement emailed Wednesday night. “Allowing doctors to prescribe deadly medications to hasten a person’s death is a horrendous wound to the dignity of the human person.”

During the weekslong legislative debate, opponents cited religious objections to what they saw as the state helping individuals commit suicide. They also warned that the law could lead to guilt-induced suicide by individuals who do not want to become a burden on their families or prompt others to kill themselves rather than explore treatment that could prove effective.

In her remarks to reporters and a subsequent radio address, Mills laid out in significant detail the moral, legal and emotional arguments on both sides of the complex issue. She had not taken a position on the bill during the legislative process, and she gave no public indication of her position prior to signing it into law on Wednesday.

The former attorney general and district attorney also referred to a more than 30-year-old Maine Supreme Court decision that affirmed an individual’s right to decline “life-sustaining” medical care.

Mills said a law that permits a terminally ill person to commit suicide “might be seen as an abdication of that responsibility” of state government to its people.

“On the other hand, there are those who say that what government provides – and all that it should provide – is the protection of personal liberty to the extent that the exercise of that liberty does not infringe on the rights and security of others,” Mills said. “The opportunity for someone of sound mind facing imminent death to avoid further suffering is viewed purely as an act of personal liberty by some, a decision with which government should not interfere.”