After a round of emotional floor speeches, the Hawaii House voted 39-12 Tuesday in favor of legalizing medical aid in dying for terminally ill adults.

Reps. Henry Aquino, Romy Cachola, Isaac Choy, Ty Cullen, Sharon Har, Aaron Ling Johanson, Sam Kong, Bob McDermott, Sean Quinlan, Justin Woodson, Andria Tupola and Gene Ward voted against House Bill 2739.

It marked the first time the 51-member chamber had taken a final vote on the issue since 2002, when the so-called Death with Dignity bill went on to die in the Senate by three votes. The measure is also referred to as physician-assisted suicide.

Cory Lum/Civil Beat

This year is shaping up to be a different story. The Senate overwhelmingly passed a similar measure last session. And although the current version may have too many safeguards for some members, the support for the issue is there.

House Bill 2739 Safeguards Must be a Hawaii resident

Prognosis of six months or less to live

Diagnosis of a terminal illness

Mentally capable of deciding

Confirmation by two health care providers of the diagnosis, prognosis, medical competence and voluntariness of the patient’s request

Two oral requests, separated by 20 days

One written request, witnessed by two people (one not related to the patient)

One counseling session with qualified person (telehealth allowed, such as by phone or Internet technologies)

Patient must self-administer the lethal drugs

48-hour waiting period between written request and making the prescription available

Gov. David Ige has signaled his intention to sign it into law if it reaches his desk.

The Senate will work on HB 2739, authored primarily by Rep. Della Au Belatti and branded as the Our Care, Our Choice Act, over the coming weeks. If the full chamber passes a different version than the House, the final details will be negotiated in a joint conference committee in April.

“This is the defining civil rights struggle of our time,” said Rep. John Mizuno, who chairs the Health and Human Services Committee. “We listened to the voices of the people.”

He said few issues are more personal or more spiritual than medical aid in dying.

Rep. Sam Kong, a fellow Democrat who has struggled with his own health issues, spoke in opposition.

“Suicide is not something we take lightly,” Kong said. “It’s a struggle, each and every moment.”

The audience in the House chamber was much smaller and more subdued than last month when the measure cleared a key committee hurdle. At that time, more than 100 people testified for and against the bill in a packed auditorium at the Capitol.

On Tuesday, there were about 50 opponents, wearing blue shirts and “No Aloha In Suicide” stickers, and about 14 supporters wearing yellow “Compassion & Choices” shirts.

Cory Lum/Civil Beat

Eva Andrade, president of the Hawaii Family Forum, a faith-based group opposed to medical aid in dying, said after the vote that she continues to be concerned about potential abuse of the elderly and the message this measure sends to children about suicide. She said the group plans to fight against it when it moves through the Senate.

“We will be here till the fat lady sings, and we do not believe she’s even warming up yet,” Andrade said.

Scott Foster, volunteer communications director for the Hawaii Death with Dignity Society, said after the vote that he felt “numb.”

He said he sat watching it happen in the chamber gallery, recalling all the people who have fought for the right since the 1990s when he got involved.

Cory Lum/Civil Beat

“It’s been a long 16 years since then,” Foster said.

MarshaRose Joyner, who volunteers with Foster, said she literally jumped with joy after the vote. She’s been fighting for civil rights for decades in Hawaii and considers this fundamentally important.

She thanked Mizuno for considering the bill in a joint hearing Feb. 27 with the Judiciary Committee, chaired by Rep. Scott Nishimoto.

“I was so happy — thrilled — that Mizuno heard my testimony that this is a civil right, a human right,” Joyner said.

Mizuno, in tears after the vote, said he was “pleasantly surprised” that there were only 12 no votes. He had been anticipating 14 to 18 members opposed.

“It’s an emotional issue, whether you’re for it or against it,” he said. “The fact that we only had 12 noes for this entire body shows that we have evolved and I think it represents the desire of the people.”

Cory Lum/Civil Beat

A Civil Beat Poll in late November found 63 percent of Hawaii voters supported legalizing medical aid in dying, with 22 percent opposed, 9 percent unsure and 6 percent not caring either way. Other polls have found support to be as high as 80 percent.

Mizuno received a letter from former Gov. Neil Abercrombie on Monday, expressing his support for the measure and the democratic process that he followed. Abercrombie, who sat in the gallery between two lobbyists Tuesday watching the session unfold, said the hearings leading up to the vote were a “masterpiece of transparent deliberation.”

“HB 2739 addresses issues that are profound in their implications; issues difficult if not impossible to reconcile in that the positions taken are held by many who espouse them to be absent of compromise,” Abercrombie told Mizuno.

Of the five Republican members of the House, two voted in favor of the bill: Rep. Lauren Matsumoto, who noted her reservations, and Rep. Cynthia Thielen.

Tupola, who heads the minority caucus, offered an amendment to add more safeguards but it was opposed by a voice vote.

“We weren’t ready for this legislation last year, and we are not ready for it this year,” she said.

Cory Lum/Civil Beat

Nine Democrats opposed the measure but only a few spoke up on the House floor.

Rep. Romy Cachola said he was against it for two reasons.

“I believe that it is against God’s law,” he said. “And I still believe in miracles.”

The vast majority of floor speeches, some with quavering voices, were made by supporters.

Rep. Jarrett Keohokalole told the story of how his relative suffered with cancerous tumors pressing on a nerve in her back.

“That year was defined by pain,” he said.

The Kaneohe lawmaker said death is not an issue that is talked about in Hawaii from a cultural standpoint but that it needs to be discussed.

“We need to hear these stories so we can understand the consequences of our action or inaction,” Keohokalole said. “No one is immune to this issue, and if we cannot talk about something in this body, it limits our ability to address it in a meaningful way.”

Thoughts on this or any other story? We’re replacing comments with a new letters column. Write a Letter to the Editor. Send to news@civilbeat.org and put Letter in the subject line. 200 words max. You need to use your name and city and include a contact phone for verification purposes.