Toby Talbot / AP The Senate bill sits on the speaker's podium on Monday in Montpelier, Vt.

Vermont is poised to become the fourth state to allow doctors to help terminally ill patients die.

A bill approved Monday night by the state House would allow doctors to prescribe lethal doses of medication. The Senate has already approved the bill. It goes to Gov. Peter Shumlin, a strong supporter.

Vermont would join Oregon, Washington and Montana. Oregon and Washington passed similar laws by popular vote, and a court order Montana made it legal there. Vermont would be the first to pass such a law through its legislature.

“It’s huge,” Michael Sirotkin, a lobbyist involved with the issue in Vermont for a decade, told the Burlington Free Press newspaper. “I think it’s going to have a major effect on other states’ willingness to vote on this.”

For the first three years, Vermont would follow the Oregon law, which requires that patients state their wish to die three times, including once in writing, and requires a concurring opinion from a second doctor.

After July 1, 2016, Vermont would require less monitoring and reporting by doctors. Lawmakers could still eliminate those changes and permanently follow the Oregon model.

The law would take effect immediately upon the governor’s signature. Supporters told NBC affiliate WPTZ in Burlington that they expect about 20 people to ask for the lethal dose each year, and roughly six to decide to take it.

Debate in the Vermont Legislature was charged. Supports of the legislation sometimes call it “death with dignity,” and opponents sometimes call it “physician-assisted suicide.”

“I believe this bill is very dangerous bill,” state Rep. Tom Koch told the newspaper. “We have facilitated euthanasia.”

The Associated Press contributed to this report.

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