In a tight vote on Monday, State Senate Democrats approved controversial legislation that permits terminally ill individuals to end their own lives with the assistance of physicians. The decision now falls to Gov. Kathy Hochul on whether to enact the law.

State Senator Brad Hoylman-Sigal (D-Manhattan), who introduced the bill in the Senate, praised the bill as a significant social reform for the state, likening it to the landmark legalization of same-sex marriage.

“This is about personal autonomy, this is about liberty, this is about exercising one’s own freedom to control one’s body,” Hoylman-Sigal continued.

The bill was passed with a narrow margin of 35 to 27, as six Democratic senators — April Baskin, Siela Bynoe, Cordelle Cleare, Monica Martinez, Roxanne Persaud, and Sam Sutton — voted against it.

“The governor will review the legislation,” a spokesperson for Hochul said.

The bill’s passage follows a years-long campaign that was fought tooth and nail by a diverse group of critics, including disability rights activists and the Catholic church, as well as many black and Orthodox Jewish communities.

“The Governor still has the opportunity to uphold New York’s commitment to suicide prevention, protect vulnerable communities, and affirm that every life—regardless of disability, age, or diagnosis—is worthy of care, dignity, and protection,” The New York Alliance Against Assisted Suicide wrote in a statement following the vote.

A Catholic group slammed the bill’s passing as “a dark day for New York” and also called on Hochul to refuse to sign it.

“For the first time in its history, New York is on the verge of authorizing doctors to help their patients commit suicide. Make no mistake – this is only the beginning, and the only person standing between New York and the assisted suicide nightmare unfolding in Canada is Governor Hochul,” Dennis Poust, Executive Director of the New York State Catholic Conference, wrote in a statement.

Ahead of the vote, the nearly three-hour debate on the Senate floor got emotional, with several lawmakers holding back tears as they explained their votes.

Syracuse-area state Sen. Rachel May (D-Onondaga) shared the story of her late husband, who was receiving morphine in the final stages of his battle with cancer, which he eventually succumbed to at 32 years old.

“I don’t know if the last largest dose he took also took his life, but I know that he died in peace,” May said.

“It isn’t about controlling the disease or controlling the pain, it’s about having control at the end of your life,” she said before voting in favor.

Critics fear the legislation lacks critical safeguards over how doctors approve patients looking to receive the prescription for a lethal cocktail of drugs, such as a statutory waiting period, establishing clear chain of custody for the pills, mandating the doctor and recipient meet in-person, and requiring a disclosure that someone indeed used the drugs to take their own life.

Under the bill, recipients would need approval from two doctors and a sign-off from two independent witnesses, after which they would receive a prescription for drugs they could use to take their life at a time of their choosing.

Doctors also do not have to conduct a mental health screening for each patient, but may refer a patient for one under the legislation.

“I don’t think requesting end-of-life medication when an individual is suffering and in pain and dying suggests a mental health condition, if anything, I think it’s quite rational,” Hoylman-Sigal said.

Hoylman vowed the bill would not lead to such “unintended consequences.”

“It was a professional organization that provided us crucial guidance, that helped us develop the state-of-the-art safeguards in this legislation that gave my colleagues and the general public, I believe, the assurance that there will not be unintended consequences,” he said.

The legislation is referred to by its supporters as the “Medical Aid in Dying” bill.

“The option of medical aid in dying provides comfort, allowing those who are dying to live their time more fully and peacefully until the end. I am profoundly grateful to Senate Majority Leader Stewart-Cousins for giving her conference the space to have this important and emotional discussion,” Corinne Carey, Senior Campaign Director of Compassion and Choices, the main group driving the effort to pass the bill, wrote in a statement.