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Medical aid-in-dying legislation teetering as undecided senators deliberate how they’ll vote

Sen. William C. Smith Jr. (D) represents a portion of southeast Montgomery County in the Maryland Senate and is chair of the Judicial Proceedings Committee. Photo by Danielle E. Gaines.

A controversial bill that would allow qualifying terminally ill patients to prompt their own death with the help of a physician might be in trouble again, after Senate President Bill Ferguson (D-Baltimore City) indicated Friday the legislation may not have enough support.

Advocates have been hopeful that 2024 would be the year that the Maryland General Assembly would pass medical aid-in-dying, after several unsuccessful attempts in previous sessions. And a recent poll suggests that a majority of Maryland voters would be supportive of having what the legislation calls “end-of-life options.”

Ferguson has previously said that he suspected the bill would receive a full Senate vote this year. Now it seems he’s less sure, creating an unclear future for the highly-controversial bill.

“If you don’t see it come to the [Senate] floor, it’s because we don’t have the votes in the committee or the floor to get there,” Ferguson told reporters Friday.

Discussions over medical aid-in-dying legislation tend to be highly emotional and sensitive, with hours of testimony from spouses and friends of those who have passed away from terminal illnesses on either side of the issue. Religious leaders and medical professionals are also divided on medical aid-in-dying legislation.

And the bill has received both bipartisan support and bipartisan opposition in previous sessions.

Ferguson said that he is regularly having discussions with senators to see where they stand on the contentious legislation, and that he is generally in favor of medical aid-in-dying options. But he’s not going to push for the bill to come to a vote unless he is sure that there are enough members in support.

“I think it’s one of those issues where if people don’t have to really think about it, they don’t think about it. Because it’s a hard concept and it’s an upsetting concept for a lot of people,” Ferguson said.

“So, it’s close, and I think there are some people who are trying to see, with the right protections, could they get there,” he added.

Both versions of the bill, SB 443 and HB 403, have been discussed in committee hearings, but neither have come to a vote.

The hold-up may be in the Senate Judicial Proceedings Committee, as some members grapple with whether physicians should be allowed to help terminally ill patients with less than six months to live hasten their own death.

Patient protections are major concern at emotional hearing on medical aid-in-dying bill

SB 433 would need a simple majority vote from the 11-member committee before it would go before the full Senate for debate and consideration.

“It’s very close,” Judicial Proceedings Chair William C. Smith Jr. (D-Montgomery) told Maryland Matters Friday.

Smith said there are a couple of committee members who are unsure if they would support the legislation, but he’s urging them to make a decision soon, one way or another.

“They’re wrestling with the issue. Rightfully so,” Smith said. “I’ve given folks the weekend to make the decision.”

Smith sponsored similar Medical aid-in-dying legislation back in 2019. That year, the bill passed narrowly in the House and then came to an end on the Senate floor when one senator chose not to vote at all, in violation of Senate rules, leading to a 23-23 tie vote and the bill’s demise.

“There’s a shadow over these discussions,” Smith said, reflecting on the fate of the 2019 legislation. “But it’s also instructive as to how difficult the issue is…which is why I am not pressuring anyone. Just ‘Hey, you got all the stuff you need. We do need to make a decision at some point.’ If they can just tell me and do so confidentially, I will keep that confidence.”

“In someone’s career, this is amongst one of the most challenging votes that we’ll undertake, as evidenced when I was a sponsor of this bill, when it failed to prevail… because one person, at the end of the day, couldn’t decide. And so I fully understand the pressure of the vote,” Smith said.

Similar to Ferguson, Smith said that he is giving the undecided members space to come to their own decision on the matter.

“This is something that, for me, I’ve not pressured any member on, I just want to know where they are, because this is a vote of conscience. You can’t try to persuade someone politically,” Smith said. “It’s something they just have to come to on their own.”

Sen. Jeff Waldstreicher (D-Montgomery), the bill’s chief sponsor and vice chair of Judicial Proceedings, said he is having conversations with his fellow committee members on the bill and that “many of them want to find a way to ‘yes.'”

Waldstreicher has eight co-sponsors, including Republican Sen. Chris West (Baltimore and Carroll), who serves on the panel. Smith and Sen. Ariana B. Kelly (D-Montgomery) are the other co-sponsors from the Judicial Proceedings Committee.

“This bill has a lot of guardrails and logistics attached to it,” Waldstreicher said. “That’s a good thing. That provides protections that we need to have in the bill. But it’s a big bill. It’s a lot of content, and I think members of my committee want to feel comfortable with every piece of the legislation before we take any vote.”

The House bill is not moving either at the moment. According to the bill sponsor of HB 403, Del. Terri Hill (D-Howard), the Health and Government Operations Committee is not going to act unless the Senate does.

“When the Senate moves it, we will move it,” said Hill, who is a physician. “I still think it’s an important piece of legislation and I hope we’re going to get it across the finish line this year.”

Bryan P. Sears contributed to this report.


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Medical aid-in-dying legislation teetering as undecided senators deliberate how they’ll vote