Senators grapple with potential misuse of medical aid-in-dying; bill stuck in committee for now

Medical aid-in-dying legislation is on its last stand of the 2024 legislative session, with a handful of senators still struggling to support a bill that would allow a terminally-ill patient to ask for a prescription that would hasten their death with the help of a physician.

“I am sympathetic to how other people feel and the concerns they bring. But just for me personally, it’s something that I can’t necessarily support,” said Sen. Nick Charles (D-Prince George’s).

Charles is a member of the Senate Judicial Proceedings Committee, where Senate Bill 443, known as the “End-of-Life Options Act,” is currently bottled up.

Gov. Wes Moore (D) told reporters Wednesday that he would likely sign the medical aid-in-dying legislation if it makes it to his desk — but it does not appear if he is lobbying lawmakers to support it.

“This is a very difficult and challenging issue. It is a bill that I will see what the final mechanisms of the bill are, but it’s a bill that, if it makes it to my desk, I will sign it,” Moore said. “But I also respect the legislative process, to see where exactly it is right now and where it’s going to be.”

Senate leaders do not want to bring the legislation up for a vote if it is unlikely to pass, and there is concern that the legislation doesn’t have enough support in the Judicial Proceedings Committee.

The bill sponsor, Sen. Jeff Waldstreicher (D-Montgomery) said this week he does not think it’s the end of the line for medical aid-in-dying just yet.

“We’re in active conversations with folks who have expressed their concerns,” he said. “These are deep, ongoing conversations.”

Committee members were given an internal deadline this past weekend to decide whether they would support medical aid-in-dying if it came to a vote.

On Monday, Committee Chair William C. Smith Jr. (D-Montgomery) told Maryland Matters that the measure was “one or two” votes shy of passing in his committee. Then, Senate President Bill Ferguson (D-Baltimore City) informed reporters Tuesday that the internal deadline has now been set for Friday.

“If people stay where I think they are now, we probably won’t vote it this year. But if there is a change of heart or a decision to have a different approach, then we will. But this week is the last week we keep it on the table,” Ferguson said.

The House version of the bill, HB 403, is not going to receive a vote unless the Senate bill moves, according to House Health and Government Operations Committee Chair Joseline A. Peña-Melnyk (D-Prince George’s and Anne Arundel).

Conversations around medical aid-in-dying legislation are sensitive and highly emotional. Support or opposition for the measure does not fall on clean party lines.

For example, SB 443 has a Republican co-sponsor: Sen. Chris West (R-Baltimore and Carroll). But one of his Republican peers on the Judicial Proceedings Committee, Sen. Mike McKay (R-Western Maryland), said he would “probably not” vote for the bill due to potential misuse of medical aid-in-dying procedures.

And there are several Democrats who oppose the bill.

Charles said part of his opposition is based on the potential for patients to be manipulated into requesting medical aid-in-dying.

“There’s a lot of really bad people in the world…a lot of times I get scared of what the manipulation looks like from other people,” he said. “I know they try to put safeguards in the bill to try to address manipulation.”

2019 votes

This is not the first year that some of the members of the Senate Judicial Proceedings Committee have had to consider medical aid-in-dying legislation. Members of the House and Senate filed medical aid-in-dying legislation during the 2020 and 2023 legislative sessions, but none of the attempts those years were voted on in committee.

The most successful run for the legislation occurred in 2019. The full House passed its version of medical aid-in-dying legislation, HB 399, on a 74-66 vote.

Charles’ current opposition to the bill is consistent with his previous voting record on the matter. Charles was a delegate at the time, and voted “no” when the measure hit the House floor.

Sen. Charles E. Sydnor III (D-Baltimore County) also voted against the legislation as a delegate in 2019. Five years later, the Judicial Proceedings member is still against the measure.

“If this would have come up for a vote, I would not support the medical aid-in-dying legislation this year…While I sympathize with people who are dealing with extremely difficult medical conditions, I have been and am concerned about vulnerable people and have been unable to convince myself that this is the answer here in Maryland,” he said in an email to Maryland Matters.

Another member of Judicial Proceedings, Sen. Ariana B. Kelly (D-Montgomery), was also a delegate in 2019, and she voted in favor of the legislation. She is a co-sponsor of the current Senate bill.

While the 2019 bill ultimately passed in the House, the legislation’s momentum came to a sudden halt on a 23-23 tie vote in the Senate, as then-Sen. Obie Patterson, a Democrat representing Prince George’s County at the time, withheld his vote on SB 311, against chamber rules.

Four current Judicial Proceedings members took part in the 2019 tied Senate vote. That year, Smith, Waldstreicher and West voted to support the aid-in-dying legislation.

Also voting in the affirmative that year was Sen. Jill P. Carter (D-Baltimore City), but it’s unclear if she maintains that position this session.

“I haven’t said yes or no. It really depends on the posture of the bill… and if good amendments were added, I could consider it,” Carter said.

“I don’t think anyone really addresses the truth…there’s great disparities in health care and treatment along race and economic lines,” she added. “And where there are well-off people who find this to be a very desirable option, there are less well-off people that don’t. That are afraid of it.”

“So there’s a lot of issues to be considered is my thing,” she said.

Another member of Judicial Proceedings, Sen. William Folden (R-Frederick), did not disclose his stance on the legislation when asked Wednesday. But he agreed that the question of medical aid-in-dying is challenging and crosses party lines.

“It’s not a party issue. It’s a personal issue…it’s a personal liberty issue,” Folden said.

The other two members of Judicial Proceedings, Sen. Mary-Dulany James (D-Harford) and Sen. C. Anthony Muse (D-Prince George’s) did not respond to requests for comment.

It’s possible that if the bill does not have enough support in Judicial Proceedings or in the Senate this year, it may be difficult for the initiative to get another chance next year — or for the rest of this legislative term.

“If the votes aren’t there, the votes aren’t there…I don’t think that we’ll keep bringing it up unless we have an affirmative clarity that somebody changed their position on it,” Ferguson said. “It’s unlikely that it would come up if we don’t have the votes this year.”

In recent conversations with reporters, Ferguson suggested that some of his colleagues may have reexamined their position on the legislation when it became apparent that the measure might pass.

“I think it really forced people to kind of do some introspection of where they personally are and talk to their constituents and such, and I think some folks really landed in a different place than maybe they had been previously,” he said.

Josh Kurtz contributed to this report.

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