In what he called a “difficult vote,” state Sen. George Borrello voted against the Medical Aid in Dying Act late Monday, a measure the state Senate passed and that would allow physician-assisted death.

New York would be the 12th state to legalize ending someone’s life — if doctors estimate they have six months or less to live due to a terminal illness — should Gov. Kathy Hochul now sign the legislation into law. The governor has not made her position known on the legislation, which unexpectedly passed in the Assembly in April.

Borrello, who said he knows the issue is personal for many, stated Tuesday that he listened to both sides of the debate.

“However, after reviewing the bill and listening to the concerns raised by disability advocates, medical professionals — including the American Medical Association which remains opposed — and members of my community, I was compelled to vote ‘no,’” the Chautauqua County Republican said.

The measure passed in the Senate by a 35-27 vote, with six Democrats voting with the entire Republican minority against the bill. In the Assembly, several Democrats also voted against the bill earlier this spring, a rare show of division from that party’s bloc.

Borrello said the legislation is missing basic safeguards — pointing out there is no waiting period, as most other states do.

“It doesn’t require a prior relationship between the patient and the doctor,” he said. “It allows lethal medication to be prescribed through telehealth, with no in-person exam. There’s no process in place to track or secure the drugs once they’re dispensed.

“And there’s no requirement for a mental health evaluation to ensure the patient is of sound mind,” the senator said, “just an optional assessment that can also be done remotely.”

Borrello said he’s particularly concerned about how this could affect vulnerable New Yorkers — people with disabilities, the elderly and those in rural or low-income areas with limited access to hospice or palliative care.

“We should be focused on making sure every New Yorker gets the best possible care and support at the end of life, not opening the door to a system that could be misused,” he said.

Lawmakers supporting physician-assisted death — mostly Democrats — pledged there would be no “unintended consequences” from legalizing the life-ending medical care, the Times Union of Albany reported. The final vote tally wasn’t immediately available but most Republicans were voting to reject the measure while Democrats rallied behind it, though many acknowledged the internal moral and religious hurdles they had to overcome.

“We are the guardians of the slippery slope,” said state Sen. Brad Hoylman-Sigal, a Manhattan Democrat who defended the legislation in the state Senate on Monday night. “We would be the ones to expand this law, not the courts, and we should not.”

The Times Union reported the New York State Catholic Conference and many disability rights advocates have said they fear a “slippery slope” effect from the legislation and have pointed to reports from Canada, which legalized physician-assisted death decades ago and which has expanded the criteria for the treatment to include certain mental health conditions.