A bill to allow terminally ill patients to receive medical assistance to end their lives was approved by a wide margin Thursday in a preliminary vote in the state House, suggesting the measure is gaining momentum in the heavily Democratic state Legislature.

Supporters of the bill contend terminally ill patients ought to have the option of ending their lives peacefully on their own terms rather than enduring a prolonged and painful illness.

House Republicans attempted to amend House Bill 2739 and then tried to recommit the bill to the House Health and Human Services Committee in a maneuver aimed at blocking the measure, but were promptly overruled in a series of voice votes on the House floor.

Rep. Gene Ward (R, Kalama Valley-Queen’s Gate-­Hawaii Kai) said the bill “sends the wrong message to family members, and especially to our youth.”

“The message is it’s going to be an accepted habit or, let’s say, an acceptable exit,” Ward told his colleagues. He said there is already a “suicide crisis” among youth in Hawaii, and “the bill will give a quick way out for the hopeless and depressed, and maybe not with pills, but using a multitude of other options that teenagers are using now.”

Ward cited Centers for Disease Control data that ranks Hawaii 14th in the nation for its per capita suicide rate for people 15 to 24 years old.

Ward also said insurance companies pay a pivotal role in the health care system, and cited “a lot of examples and testimonies of cancer patients in Oregon and in California who are being denied lifesaving treatments and instead are being offered suicide pills as an alternative.”

Ward said examples of those incidents were provided by the Patients’ Rights Action Fund, which seeks to protect the rights of patients and people with disabilities by opposing assisted-suicide legalization efforts.

He added that “the point is, whatever is cheaper appears to be the de facto motto of many insurance companies where assisted suicide becomes another marketing tool rather than saving lives.”

State Rep. Bob McDermott (R, Ewa Beach-Iroquois Point) objected to the process used in a committee vote on the bill Wednesday, saying none of the committee members were given the text of last-minute amendments to the measure until after they had voted on it.

“We had no House draft in front of us — the most important legislation of this session. That’s sloppy work,” McDermott said. “If I did that in my real estate practice, I would be fired — fired.”

The bill would allow patients with less than six months to live to request lethal doses of medication. The patients would need to make two verbal requests a minimum of 20 days apart and one written request to their attending physician for a prescription.

The measure also requires that the written request be witnessed by at least two people who can confirm the patient is of sound mind, is acting voluntarily and is not being coerced. The measure also calls for criminal penalties for coercing a patient to request a prescription.

The Thursday House vote was a procedural step to position the bill for final passage in the House next week, and only a handful of Democrats spoke briefly in favor of the bill. A more extensive debate on the subject is expected in the House next week.

House Health and Human Services Chairman John Mizuno has led the push for the medical aid in dying bill this year, but when one of his colleagues urged Mizuno to speak in favor of the measure Thursday, Mizuno replied that he preferred to “let it go.”

Only 10 lawmakers voted against advancing the bill Thursday, a sign that the measure will likely command a solid majority in a final House vote next week before it moves on to the Senate.

The 51-member state House is dominated by Democrats, who hold 46 seats in the chamber. The 25-member state Senate has no Republicans.

Gov. David Ige, who is also a Democrat, has said he would be “proud and honored” to sign HB 2739 if lawmakers pass the measure.

Voting against the bill Thursday were House Republicans Ward, McDermott and Rep. Andria Tupola; and Democratic Reps. Henry Aquino, Romy Cachola, Isaac Choy, Ty Cullen, Aaron Johanson, Sam Kong and Sean Quinlan.