New York state senators are gearing up for a fight after Albany's late budget chaos ends to consider bringing a bill to the floor to legalize medically assisted suicide in the state.

The Assembly passed legislation Tuesday, known as the Medical Aid in Dying Act, that would allow terminally ill, mentally capable adults who have six months or fewer to live to take their own lives with a cocktail of lethal pharmaceutical drugs prescribed by their doctor.

The legislation has been floated in the state for over a decade, but Tuesday marked the first time the bill was brought to the floor for a vote.

"It just still doesn't feel real," Assembly sponsor Amy Paulin told Spectrum News 1.

Paulin, a Scarsdale Democrat who chairs the Assembly Health Committee, said the bill is about choice, and she passed the measure in memory of her sister, who died after a battle with cancer about a decade ago.

"Let people who want to do it or need to do it because of their own pain thresholds or circumstances to take advantage of this," the assemblywoman said.

Getting the lethal prescription requires multiple medical opinions, and a terminally ill person must be found to be mentally healthy and must choose to take the cocktail of drugs themselves.

A total of 81 Assembly Democrats voted to legalize medically assisted suicide, and 67 lawmakers voted against it.

Now, it's up to state senators to decide its fate before session ends next month. 

Senate Majority Leader Andrea Stewart Cousins told Spectrum News 1's Susan Arbetter on Thursday she estimates 25 Democrats in her conference say they would vote in favor of the bill, which has grown from 17 since 2020. 

But Senate sponsor Brad Hoylman-Sigal said he's confident the upper house will vote to legalize the end-of-life option before session wraps.

"I think we have the votes now," Hoylman-Sigal said Thursday. "I wouldn't be pushing this if I didn't think this bill could pass this session in the Senate."

The tally remains unclear as Senate Democrats have not yet discussed the proposal as a conference this year. 

Lawmakers expect to vote on the late state budget next week, which would leave just over a month left of session to address other business.

But Hoylman-Sigal said that's plenty of time as Senate leadership and members have conversations about getting it to the floor.

"This is about individual choice and agency and having the opportunity to end your life in a dignified manner with your friends and families surrounding you," Hoylman-Sigal said.

A YouGov poll last year found over 70% of New Yorkers support legalizing medically assisted suicide.

But Assembly Republicans and several Democrats voted this week against the measure, which has drawn strong opposition from religious groups and disability advocates.

New York state's Catholic Conference has blasted the proposal, arguing the state should instead strengthen palliative care.

"It tells young people, who everyone knows are in the midst of an unprecedented mental health crisis, that life is disposable and that it’s OK to end your life if you see no hope," Catholic Conference spokesperson Robert Bellafiore said in a statement Tuesday after the bill cleared the Assembly. "It turns medicine on its head from a healing profession into a killing one, which is why the American Medical Association calls it 'fundamentally incompatible' with good medicine."

Republican state Assemblyman Ed Ra is a Roman Catholic, and he said he voted against the bill because it devalues human life.

"I think of doctors as people whose jobs it is to heal and alleviate pain, certainly," Ra said. "I think it's a step too far when we have doctors engage in ending somebody's life."

Critics also argue the bill doesn't have enough safeguards to protect New Yorkers against abuse from for-profit health care systems.

But bill sponsors maintain they've perfected the safeguards over many years, and if a terminally ill person is morally against medically assisted suicide, they don't have to do it.

"People can decide to go off dialysis and they can die," Paulin said. "People stop eating and drinking and die after two weeks of a painful process. We should offer this end-of-life option for New Yorkers."

If the Senate passes the bill and the governor signs it into law, the end-of-life option would become immediately available to terminally ill New Yorkers.

If it becomes law, New York would become the 11th state to legalize medically assisted suicide.