ANNAPOLIS, Md. >> A measure to allow the terminally ill to end their lives with a doctor’s help cleared a Maryland Senate committee today, but the leader of a national advocacy group said she could no longer support it because added requirements would prevent most patients from having the option.

The bill would allow adults to obtain a prescription for life-ending drugs. The physician must certify that the person has the capacity to make the decision, and the prescription can only be self-administered.

The measure approved by the Senate Judicial Proceedings Committee includes more than 30 changes to the initial proposal. One of the most significant strips out provisions allowing doctors to have immunity from lawsuits. It also tightened the definition for terminally ill to say the medical condition must be irreversible. Also, patients would only be eligible if they have six months to live, within a reasonable degree of medical certainty. Senators also changed the bill to require a mental health evaluation.

“When you’re dealing with death, you want to be cautious, so I think everybody on our committee would prefer to err on the side of caution and going slow rather than make mistakes,” Sen. Robert Zirkin, a Democrat who chairs the committee, said after the vote.

Kim Callinan, the CEO of a national advocacy group called Compassion & Choices, said so many regulatory road blocks were added that it would create “false hopes” for the dying. She said she “would not be supportive of this bill,” if it isn’t changed.

“Very few people would be able to access the option, from what I saw,” Callinan said.

Sen. Will Smith, a Democrat who sponsored the measure, said it was a difficult issue.

“The bill sets a very deliberative process, a number of protections for vulnerable populations and frankly the bill does shift more toward implementing more steps to go through to avail oneself of this option, and maybe that’s a good thing and maybe it’s not,” Smith said.

Despite the changes, opponents said they were devastated the bill moved forward at all. They said it would be dangerous to vulnerable people like the elderly or the mentally ill.

“Our psychiatric concerns are that these bills do not adequately protect people with undiagnosed mental illness,” said Annette Hanson, of the Maryland Psychiatric Society.

The bill now goes to the Senate.

The House of Delegates already has passed a version of the legislation on a 74-66 vote. It differs significantly from the Senate bill. The Senate president has said he expects the bill approved by the panel Friday to pass the full Senate, but by a narrow margin. The two chambers would have until the end of the legislative session on April 8 to reconcile differences between the two bills and send the legislation to Gov. Larry Hogan.

The Republican governor has said it’s an issue that he wrestles with and that he would take a close look at the measure, if the General Assembly passes it.

Laws allowing medical aid in dying are legal in seven states — California, Colorado, Hawaii, Montana, Oregon, Vermont and Washington — as well as the District of Columbia.