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After months of heated debate the controversial legislation cleared what most consider the final hurdle today, with Victoria now poised to become the first Australian state to legalise such a scheme.
The final tick is due next week with the lower house expected to approve amendments before an 18-month turnaround, meaning the scheme can be operational by 2019.
"This is a momentous day in the parliament of Victoria," Labor MP Gavin Jennings told the legislative council after the narrow vote.
The chamber started sitting at midday yesterday and took only a short break for lunch today during the marathon sitting.
"I haven't had a wink of sleep," the Liberal's Inga Peulich told the legislative council after 27 hours of back-and-forth, as the government-proposed bill neared a vote.
"And that is why I've been critical of the process. These issues are far too important to do on a run and a hop."
Emotions were raw when the vote was finalised.
"You've made a terrible mistake," anti-voluntary assisted dying campaigner Frances Beaumont yelled at MPs.
Euthanasia advocate and media identity Andrew Denton left parliament after the vote without comment, saying he would leave the commentary to the politicians.
ABBOTT SLAMS DECISION
Former Prime Minister Tony Abbott slammed the legalisation in Victoria as a "dreadful moral watershed" in Australia's history.
Abbott made the comments as his 93-year-old father, Richard, lay in hospital following an apparent serious stroke on Monday morning.
His family has since been keeping a bedside vigil at Sydney Adventist Hospital in Wahroonga.
"This is the vigil that families from time to time have to keep over a loved one - it's the respect of the living over the dying," he told Sydney's 2GB today.
He said he was shocked to hear that Victoria's upper house had earlier voted in favour of voluntary assisted dying.
"People who are gravely ill should have their pain relieved, not their lives ended," Mr Abbott said.
"This is a dreadful moral watershed in our country's life."
Abbott said the debate around same-sex marriage had distracted from the push to legalise doctor-assisted dying.
He hopes a future Victorian parliament reverses the move.