Hawaii would become the fourth state to legalize physician-assisted suicide under a proposal being brought back for debate in the Legislature for the first time in four years.

Senate Health Chairman Josh Green is reviving the issue with a hearing Monday afternoon in the state Capitol auditorium.

Senate Bill 803 would allow a terminally ill, competent adult to receive medication to end life. The bill specifically prohibits mercy killings, lethal injections and active euthanasia, and requires patients to receive informed consent.

Alternate doctors would be allowed to substitute for those who decline to participate, and the law also would provide immunity from civil and criminal liability for acts taken in good faith.

Green, an emergency room doctor in Kona, said he supports palliative and hospice care, but he believes the testimony is compelling on both sides of the argument.

"I’m very sensitive to the concerns of everyone involved in this issue — from those suffering with terminal conditions and their families, to those who provide them with medical care," he said. "We need to find a way to support those dealing with end-of-life decisions with the greatest possible compassion and respect."

An assisted-suicide proposal introduced in the House has not been scheduled for a hearing.

Versions of the doctor-assisted suicide proposal have been floated at the Legislature since 1999.

Green (D, Milolii-Waimea) was the last committee chairman to hear it in either chamber, doing so as the House health chairman in 2007 and 2005. The bill failed to make it out of his committee both years, most recently with members voting 6-1 to hold the measure.

Green has said that with so much turnover in the Legislature, he feels it is healthy to have fresh debate on difficult issues.

Hearings have been characterized by emotional testimony, bringing many to tears as they have recounted tales of loved ones suffering near the end of life.

The issue was last heard in the Senate in 2002, when it came to the chamber floor for a final vote on the final day of the session. Four senators changed their votes between second and third reading — three from "yes" to "no" — as the measure failed 14-11.

Former Gov. Linda Lingle opposed the legislation. During the 2010 campaign, Gov. Neil Abercrombie said physician-assisted suicide would be too divisive an issue and urged lawmakers to focus on hospice and palliative care.

Passage of the bill would make Hawaii the second legislature to approve physician-assisted suicide, following Oregon’s landmark 1997 Death with Dignity Act, which was upheld by the U.S. Supreme Court in 2006.

Washington voters in 2008 approved a ballot measure patterned after Oregon’s law, and in 2009 the Montana Supreme Court ruled there was nothing in state law that prevented patients from seeking physician-assisted suicide, making it the third state to allow the procedure.