Parliament is set to hold a final and historic vote on legalising euthanasia, handing the decision to the public.

The End of Life Choice Bill is widely expected to pass its third reading on Wednesday, its last hurdle in the House after nearly two years of fierce, and at-times emotional, debate among politicians.

If it does get the 61 votes needed, a public referendum will be held alongside next year's general election, setting the stage for heated and public campaigning.

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The euthanasia debate: An in-depth look into the End of Life Choice Bill

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The bill is the fourth to try to legalise assisted dying – starting with one in 1995 – and the only one to clear even a single reading. Since it was first introduced in 2017, Parliament has held seven debates and received 39,000 public submissions on the legislation.

It passed its second vote 70 votes to 50. While a number of MPs who have been on the fence have declined to confirm their position ahead of Wednesday's decision, only a small number of MPs are expected to shift. That would suggest the bill will pass its third reading reasonably safely.

The man behind the bill, Act leader David Seymour, says while he believes he's managed to win a few more last-minute votes, he isn't counting his chickens.

"We're not making any predictions and we're not taking anyone for granted," he said.

Act Party leader David Seymour says he isn't taking any votes for granted ahead of the final reading. Photo / Paul Taylor
Act Party leader David Seymour says he isn't taking any votes for granted ahead of the final reading. Photo / Paul Taylor

Lobbying by opponents has ramped again in recent days and an alliance of critics of the legislation is promising a protest of Parliament's lawn on Wednesday ahead of the vote.

Groups representing palliative care workers were brought into the Beehive on Tuesday for a last-minute appeal and 1500 doctors opposed to the changes have returned to headlines with an open letter to MPs.

Critics of the bill have raised a wide array of concerns, most often that it could see vulnerable people, particularly the elderly, coerced into requesting assisted dying out of fear of being a burden or after pressure from families.

National MP Chris Penk – one of the most outspoken MPs against the legislation – was on Tuesday still optimistic of narrowing the vote. The bill cleared its first reading 74 votes to 44 and Penk says the trend may continue.

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"As further scrutiny has gone on the proposed legislation, there's been less support as the implications have become clear," he said.

Seymour has argued the bill's safeguards - which require the euthanasia process to stop if coercion is detected - are enough to make it safe.

He also says after 23 months of debate, he's not convinced last-minute lobbying efforts by opponents will make much of a difference, with the vast majority of the issues already hammered out.

The bill has undergone considerable changes to the legislation since it was first introduced in order to convince MPs who were unsure about its safety during its second reading.

The most significant is that it will go to referendum – a decision demanded by NZ First for its support and begrudgingly backed many of those in favour of the bill as the only means by which to get the legislation over the line.

The other is the legislation now only applies to those as diagnosed as having less than six months left to live, where is at previous included those with grievous and irremediable medical conditions.

That change was made to gain the support of the Green Party, in reaction to concerns about what the legislation would mean for those with disabilities.

If the bill does make it to a referendum, historical polling would suggest it would pass unless there was a significant change in public sentiment.

Polling in July found there was 72 per cent support for some kind of assisted dying for the terminally ill. Historically, support over the past 20 years has averaged to about 68 per cent.

The referendum would be held alongside a separate plebiscite on legalising recreational cannabis and experts have raised concerns the questions could take away attention from other election issues next year.