Watered-Down Aid-in-Dying Bill Clears Senate Committee

Sen. William C. Smith Jr. (D-Montgomery) is the lead Senate sponsor of aid-in-dying legislation. Photo by Bruce DePuyt

A key Senate committee voted Friday afternoon to send an aid-in-dying bill to the chamber floor, but advocates on both sides are unhappy with the legislation.

The Senate Judicial Proceedings Committee considered more than 50 proposed amendments to the bill and incorporated about two dozen changes.

The bill, which has failed to gain traction in three of the past four years, was passed out of the House of Delegates earlier this month after an emotional 74-66 vote.

The bill is expected to reach the Senate floor on Monday night.

In general, the bill allows terminally ill competent patients to access a lethal dose of medication to end their own lives, but the Senate version of the legislation is substantially different than the measure passed by the House.

The Senate committee added amendments that raise the age limit for access to the prescription to 21; mandate a mental health assessment; require doctors to provide patients with a list of all other available treatment opportunities; and remove immunity clauses for doctors who choose to offer the prescriptions.

Physicians and pharmacists are not required to take part in writing or filling a prescription, but must transfer all medical records upon a patient’s request.

The Senate also included a more robust definition of “terminal illness.”

Kim Callinan, CEO of the advocacy group Compassion & Choices, said the combined effects of the amendments could have a chilling effect. If a doctor fails to list one clinical trial someplace far away on a list of other medical assistance available, that now opens him or her up to a lawsuit, she said.

Callinan said some terminally ill patients seek such prescriptions for peace of mind, without ever taking the medication.

Instead of having that, they’re getting roadblock after roadblock.

“When you erect barrier after barrier after barrier for a dying person, the end result of that is not full of compassion,” she said of the Senate committee’s bill.

If the Senate version of the legislation were to pass, “Maryland would have the most senseless regulatory roadblocks of any state,” Callinan said. “It really would create false promises for dying patients.”

Washington, D.C., and seven states have authorized medical aid in dying. In 1999, Maryland became the 38th state in the country to outlaw physician assisted suicide, part of a national response to the highly publicized work of Dr. Jack Kevorkian, who assisted in the suicide of a Michigan man suffering from amyotrophic lateral sclerosis.

Three of four Republican members of the Senate committee voted against the legislation Friday: Sens. Robert Cassilly (R-Harford), Michael Hough (R-Frederick) and Justin Ready (R-Carroll). Sen. Christopher R. West (R-Baltimore County) has sponsored the legislation in the past and voted in favor of the committee report.

Cassilly said the state has worked hard in the past to invest in programs that provide hospice care at the end of life. Providing this as an option as well will discourage funding for hospice, he said.

“This steps in at a stage of the dying process far earlier than where we are now. It’s a really scary thing to do,” Cassilly said.

Ande Kolp, executive director of The Arc Maryland, was dismayed to see the bill advance through committee. There aren’t enough amendments possible to adequately protect people with disabilities, she said.

“There’s historic discrimination in health care against people with intellectual and developmental disabilities that continue today,” she said. “…We’re worried that people are going to have a tougher time accessing appropriate medical care if doctors perceive that this might be a good options.”

Committee Chairman Robert A. Zirkin (D-Baltimore County) said the panel was never going to move a bill out of committee that provided blanket immunity for people who take part in a lethal prescription program, and the committee sought to add protections for vulnerable populations.

He said the committee invested hours to take a bill that was “flawed to its core” and turn it into something that was “a lot better.”

The committee’s work ultimately compelled him to vote in favor of moving the bill to the Senate floor.

“For the person who is truly suffering, who is truly, truly at the end of their life with no other options, I don’t want to be the person standing in the way of them taking responsibility for their own decisions,” Zirkin said.

Sen. William C. Smith Jr. (D-Montgomery), the Senate’s sponsor, thanked committee members for their work on the bill. While he didn’t agree with all of the amendments that added additional hurdles, Smith said he understood his colleagues’ concerns about attempting to protect vulnerable populations.

The bill is expected to face procedural and policy challenges once it reaches the Senate floor.

Smith, an officer in the U.S. Navy Reserve, will leave session early this year after receiving deployment orders to Afghanistan. His last day is Thursday.

“This might be one of the last things I vote on before I get out of here,” Smith said.

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  1. Maryland is nimble enough to lead the Nation by revealing the pitfalls in all existing Oregon model euthanasia laws. You can fill in the blanks from the Oregon model stats that 1/3 changed their mind and did not use the lethal script It follows that 1/3 of the balance 66% also changed their mind but were forced to satisfy the facilitators.1 in 5 were likely euthanized after changing their minds    The violating States must close this gap in the safety net and they know exactly how to repair the damage…there are no excuses only oppressive intentions.
    There are eleven categories of wrongful deaths..
    A wrong diagnosis
    A wrong prognosis
    Unaware of available treatments
    No access to palliative care
    Denied funding for medical treatment
    Mentally ill at risk
    Ableist judgement of “better off dead”
    Bullying or coercion
    Killed without request or while resisting
    Social contagion of suicide
    Not a rapid or peaceful death
    PS: expect expansion of categories due to “category creep”.
    The time for reasonable and prudent amendments has come. Thanks Maryland!

  2. It seems we are living in a culture of Death. Aid in dying is nothing more than a physician helping a patient commit suicide. Physicians taking part in Murder!! Horrendous! I’ve seen a murder take place with my own eyes! And it was tremendously horrible. Physicians disarmed my fiance’s defribilltor as he was watching t.v. and turned off his breathing machine! When we came back into his room, I saw him looking frightened and experiencing difficulty breathing! Only after a few minutes, did the nurse finish the dirty deed of injecting the fatal dose of morphine.. What kind of dignity was that?!

  3. For four years, the Maryland General Assembly has asked the sponsors and out of state special interest behind the Physician Assisted Suicide bill, Compassion and Choices, to add safeguards to protect patients. For four years, Compassion and Choices have rejected their reasonable requests.

    And now that the Senate JPR Committee has tried to add some consumer protections, Compassion and Choices is likely to withdraw support for their own bill.

    WHY? Because this bill was never about protecting the 1% of patients who might voluntarily choose euthanasia. This bill is about protecting doctors and insurance companies from liability when patient rights are violated resulting in involuntary or non-voluntary euthanasia. This bill is about what happens to the other 99% of us.

    Don’t take my word for it. Hear the truth from Compassion and Choices in their own words….

    o During the House of Delegates joint hearing on the bill February 15th, the CEO of Compassion and Choices, Kim Callinan, said that the safeguards are “unnecessary roadblocks” and that they already are working to remove these safeguards in states where the law is in effect.


    o This callous disregard for the safety and well-being of patients should come as no surprise. More than twenty years ago, the legal counsel for Compassion and Choices, Kathryn Tucker said “a fifteen-day waiting period would be struck down immediately as unduly burdensome….but, to pass, you need to have measures that convince people that it’s suitably protective- so you see a fifteen-day waiting period.”

    o Compassion and Choices also have tried to convince us that they are not asking the General Assembly to legalize euthanasia. But this is exactly how the law is being implemented in other states and countries. In Quebec, Canada, 99% of deaths under this law were “euthanasia” and only 1% “assisted suicide” and 142 deaths were completely unaccounted for. In fact during the House hearing, Michael Strauss, the leading Physician promoting the bill in Maryland, actually admitted that doctors may assist a person to open the pills, mix them in liquid and drink the lethal drugs. This IS euthanasia and an alarming revelation of the true intention of the bill proponents and the practice within Maryland.


    SB311, government- sanctioned assisted suicide, protects doctors and profits- not patients. It shelters doctors from liability and creates a strong economic incentive for insurance companies to deny more costly life-saving treatments to patients in need. For many of our most vulnerable citizens, without financial means or equal bargaining power, the “right to die” will become a “duty to die”. Evidence from other states like Oregon and Washington supports this.


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