WASHINGTON (AP) - John McCain faced a choice that balanced friendship, party loyalty and his convictions. He made the decision some of his closest advisers expected.
Looking at the twilight of his career and a grim cancer diagnosis, the Republican senator from Arizona who prides himself on an independent streak could not be moved to go along with a last-ditch GOP push to overhaul the nation's health care system.
Those close to him said he wrestled with the choice - the legislation was championed by his best friend in the Senate - but rarely strayed from his intention to send a message to the institution where he's spent three decades.
That message was bipartisanship and what he cast as the integrity of the Senate process that insists on debate and often yields compromise. The call for "regular order" isn't the stuff of campaign bumper stickers, but it has become McCain's mission since he's returned to Washington, to keep up his work and treatment for an often fatal brain tumor.
"If he supported this, then he guts his whole message that he's been trying to give his colleagues, both Democrats and Republicans," said Rick Davis, who managed McCain's two presidential campaigns and remains close to the lawmaker.
Davis said Sen. Lindsay Graham, R-S.C., "made his pitch" to his longtime friend, but McCain was motivated by "his drive to move the Senate toward more comity and bipartisanship."
McCain's decision probably will kill the bill and crush the GOP's hopes for repealing the Obama health law this year. Republicans have tried to go it alone in overhauling the Affordable Care Act, speeding two attempts at passage along with minimal hearings and debate.
McCain's statement declaring his opposition to the legislation Friday was the second time he derailed the effort.
In July, bearing a fresh surgery scar over his left eye, McCain scolded lawmakers from the Senate floor. Incremental progress isn't glamorous or exciting, and it can be "less satisfying than winning," said the man who won his party's nomination but lost the White House in 2008. He struck a similar tone Friday in a written statement, saying he believed "we could do better working together, Republicans and Democrats, and have not yet really tried."
That McCain is well enough to play this central figure in the Republican health care efforts is a surprise to many given the gravity of his diagnosis. He announced this summer he had an aggressive and usually fatal tumor called glioblastoma, the same type of tumor that killed Sen. Edward M. Kennedy, D-Mass., in 2009 and Beau Biden, son of then-Vice President Joe Biden, in 2015.
Biden is among the many longtime colleagues who has been in touch with McCain since his diagnosis, and the two are scheduled to reunite next month, when Biden presents the senator with the National Constitution Center's Liberty Medal.
McCain has privately bristled at his return to Washington being covered like a melodrama, and his friends have steadfastly tried to avoid treating him like a man nearing the end of his life. When McCain's children and some colleagues flocked to his Arizona ranch this summer, the mood was upbeat and the senator often joined his guests for hikes.