A decade-long fight over whether to let terminally ill patients hasten their deaths with physician oversight returned Monday in a two-hour House hearing, but lawmakers again said the Senate is likely to be the stumbling block this year.

“The votes aren’t there. Not in committee and not on the floor,” Senate Judicial Proceedings Chair Will Smith (D-Montgomery) said Monday evening.

His comments came just hours after a joint hearing by the House Judiciary and the Government and Operations committees on House Bill 1328 , the End of Life Option Act, which would allow certain terminally ill patients to request medical aid in dying with the help of a physician.

In order to qualify under the bill, patients would have to have the capacity to make their own medical decisions and have less than six months to live. The legislation requires both an oral request and written request with two witnesses and a required wait time to ensure that the patient wants to go through with the measure, among other restrictions.

Debate on the bill is often emotionally charged, a challenge to lawmakers’ moral values that does not cut cleanly on party lines. But the bill’s main sponsor, Del. Terri Hill (D-Howard), says it provides “compassion and autonomy to those facing imminent death.”

Medical aid-in-dying has had a dramatic history in the General Assembly over the past decade. In 2019, the bill failed on a 23-23 tie in the Senate after one senator opted to not vote , saying he “could not bring myself” to vote one way or the other. In 2024, advocates and Senate leadership thought it would come to the floor, but it stalled Judicial Proceedings amid concerns that there were not enough votes to pass it out of committee .

Smith, who is sponsoring the legislation in the Senate this year, said changes in the membership of the Senate and his committee do not appear to have improved its chances this year. It will still have a hearing next week in Judicial Proceedings next week, Smith said, giving lawmakers a little time to consider the legislation. But Smith says medical aid-in-dying is not an issue you can “twist arms on.”