Maryland Makes 4th Try at Aid-in-Dying Bill

ANNAPOLIS (February 22, 2019)—A bill in the Maryland General Assembly would allow people with a terminal illness six months from the estimated time of their death to end their lives with a lethal dose of prescribed medicine.

Individuals should have the right to choose when they die, supporters said, while opponents of the measure—known variously as "death with dignity," "physician-assisted suicide" and an "end-of-life option"—said public safety could be put at risk if the legislation passes.

An individual would need to consent three times, twice orally and once in writing. At least two doctors would have to confirm that person is of sound mind, if a physician deems a psychological evaluation necessary, under the bill.

"Lethal injection, mercy killing, or euthanasia," would not be legalized, and people who falsify requests or coerce others into ending their lives would be penalized with felony charges under the bill.

Lawmakers in a Senate committee heard testimony on Tuesday on Senate bill 311; delegates heard testimony on its twin, House bill 399, on Feb. 15.

Senate bill 311, or the "End of Life Option Act," was heard in a Senate committee on Tuesday.

California, Colorado, Hawaii, Oregon, Vermont and Washington, as well as the District of Columbia, have legalized physician-assisted suicide, and Montana has no law prohibiting it.

"I'm going to give a lot of heartfelt and thoughtful consideration," to the act, Maryland Gov. Larry Hogan said last week.

Seventy-two percent of Americans would support ending a terminally ill patient's life, according to a 2018 Gallup poll.

The act will "bring about tremendous relief during the most difficult time in a person's life," at almost no cost, Kim Callinan, CEO of Compassion and Choices, told lawmakers.

The Department of Legislative Services estimated costs to the state of $173,700 for fiscal year 2020, and around $80,000 per following year.

The legislation would give people a tool to control not if, but rather how they die, said lead sponsor Delegate Shane Pendergrass, D-Howard.

"I believe people have the right," Pendergrass told Capital News Service. "Why should I stand in their way?"

There are religious arguments for and against the act, but the element of compassion and understanding is not talked about as much, said lead sponsor Sen. William Smith Jr., D-Montgomery.

"If you have a personal reservation for it, then that's fine," said Smith. "But we should still go ahead and make sure that that's available for other folks."

"He was ready to die," said Diane Rehm, former radio host of "The Diane Rehm Show" on WAMU and NPR, speaking of her husband who she said died of Parkinson's disease after refusing to eat, drink and take medication for 10 days due to pain and loss of motor functions.

"Why did laws infringe on an individual's decision to die peacefully, when dying was inevitable within a few months?" Rehm asked lawmakers.

What is being argued for is the right of an individual who is psychiatrically together to make a personal decision, said Rabbi Emeritus Donald Berlin from the Temple Oheb Shalom congregation in Baltimore.

"The end of life is coming soon, the option is just to not make it linger indefinitely," said Berlin, who has testified on the legislation in the past.

A significant update from the last version of the bill, in 2017, states "one of the oral requests must be made while the individual is alone with the attending physician."

However, this year's legislation has not fixed the concerns that have prevented its passing in previous years, opponents said.

Oregon, the first state to legalize assisted suicide, found being a burden to one's family is the most common reason for death, not pain, said Kate Alexander, director of communication and engagement for Maryland Catholic Conference.

Of 143 patients who died in 2017 from lethal medication in Oregon, 55.2 percent reported concerns of being a burden on family, friends or caregivers, according to a report from the Oregon Health Authority. The most common concern reported (more than one could be selected), by 88 percent of patients, was "decreasing ability to participate in activities that made life enjoyable."

A psychological evaluation is very fluid, and a doctor who does not know a person may only see them for the first time in a fragile state, said Therese Hessler, associate director of the Maryland Catholic Conference.

"There is no kind of mental evaluation that could attest for that," Hessler said.

The bill is bad public health policy, said Annette Hanson, chair of the Maryland Psychiatric Society Legislative Committee.

The law would apply to everyone in the state, including people in the public health system who are not educated, lack social support and do not have financial resources, Hanson said.

There is no requirement that a patient's decision-making capacity be assessed at the time of taking the lethal medication, instead it is only once when the medicine is initially prescribed, Hanson said.

A patient must ask twice verbally and once in writing to obtain the medicine, but after a prescription is sent to a pharmacist, the bill does not mandate any further contact between physician and individual.

This session's bill was first introduced in 2015, and was titled the "Richard E. Israel and Roger 'Pip' Moyer Death with Dignity Act."

Israel was a Maryland assistant attorney general and Annapolis alderman, and Moyer was an Annapolis mayor. Both died in 2015 following battles with Parkinson's disease.

Israel was an outspoken supporter for the bill's first introduction to the legislature.

"As the body continues to fail to respond to the mind, life loses its meaning, purpose and hope," Israel said in written testimony to a House committee.

The legislation was an effort to make humanity the master of science in an age when, "modern medicine can keep the heart and lungs working long after the brain has ceased to function," said Israel.

"I can appreciate the irony that if my advocacy is successful … my voice will be forever stilled," Israel wrote. "So be it."

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