Maryland 2023 Regular Session

Maryland House Bill HB933 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	hb0933
6	6
7	7	HOUSE BILL 933
8	8	J1 3lr0429
9	9	HB 643/20 – HGO & JUD CF SB 845
10	10	By: Delegates Pena–Melnyk, Alston, Bagnall, Bartlett, Barve, Boyce,
11	11	Charkoudian, Crutchfield, Cullison, Feldmark, Fennell, Forbes,
12	12	Fraser–Hidalgo, Guzzone, S. Johnson, Kaufman, Lehman, R. Lewis, Lopez,
13	13	Love, Palakovich Carr, Rosenberg, Shetty, Solomon, Stein, Taveras,
14	14	Terrasa, Williams, and Wu
15	15	Introduced and read first time: February 10, 2023
16	16	Assigned to: Health and Government Operations and Judiciary
17	17
18	18	A BILL ENTITLED
19	19
20	20	AN ACT concerning 1
21	21
22	22	End–of–Life Option Act 2
23	23	(The Honorable Elijah E. Cummings and the Honorable Shane E. 3
24	24	Pendergrass Act) 4
25	25
26	26	FOR the purpose of authorizing an individual to request aid in dying by making certain 5
27	27	requests; establishing requirements and prohibitions governing aid in dying, 6
28	28	including requirements related to requests for aid in dying, consulting physicians, 7
29	29	mental health assessments, the disposal of drugs prescribed for aid in dying, health 8
30	30	care facility policies, and the effect of aid in dying on insurance policies; authorizing 9
31	31	a pharmacist to dispense medication for aid in dying only to certain individuals 10
32	32	under certain circumstances; providing that the death of a qualified individual by 11
33	33	reason of self–administration of certain medication shall be deemed to be a death 12
34	34	from certain natural causes for certain purposes; providing that this Act does not 13
35	35	authorize certain individuals to end another individual’s life by certain means; 14
36	36	providing that participation by a health care provider in aid in dying is voluntary; 15
37	37	authorizing the Maryland Insurance Commissioner to enforce certain provisions of 16
38	38	this Act; establishing that a licensed health care professional does not violate the 17
39	39	statutory prohibition on assisted suicide by taking certain actions in accordance with 18
40	40	this Act; and generally relating to aid in dying. 19
41	41
42	42	BY repealing and reenacting, with amendments, 20
43	43	Article – Criminal Law 21
44	44	Section 3–103 22
45	45	Annotated Code of Maryland 23
46	46	(2021 Replacement Volume and 2022 Supplement) 24
47	47
48	48	BY adding to 25 2 HOUSE BILL 933
49	49
50	50
51	51	Article – Health – Genera l 1
52	52	Section 5–6A–01 through 5–6A–16 to be under the new subtitle “Subtitle 6A. The 2
53	53	Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass 3
54	54	End–of–Life Option Act” 4
55	55	Annotated Code of Maryland 5
56	56	(2019 Replacement Volume and 2022 Supplement) 6
57	57
58	58	BY adding to 7
59	59	Article – Insurance 8
60	60	Section 27–208.1 9
61	61	Annotated Code of Maryland 10
62	62	(2017 Replacement Volume and 2022 Supplement) 11
63	63
64	64	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 12
65	65	That the Laws of Maryland read as follows: 13
66	66
67	67	Article – Criminal Law 14
68	68
69	69	3–103. 15
70	70
71	71	(a) A licensed health care professional does not violate § 3–102 of this subtitle by 16
72	72	administering or prescribing a procedure or administering, prescribing, or dispensing a 17
73	73	medication to relieve pain, even if the medication or procedure may hasten death or 18
74	74	increase the risk of death, unless the licensed health care professional knowingly 19
75	75	administers or prescribes the procedure or administers, prescribes, or dispenses the 20
76	76	medication to cause death. 21
77	77
78	78	(b) A licensed health care professional does not violate § 3–102 of this subtitle by 22
79	79	withholding or withdrawing a medically administered life–sustaining procedure: 23
80	80
81	81	(1) in compliance with Title 5, Subtitle 6 of the Health – General Article; 24
82	82	or 25
83	83
84	84	(2) in accordance with reasonable medical practice. 26
85	85
86	86	(C) A LICENSED HEALTH CARE PROFESSIONAL DOES NO T VIOLATE § 3–102 27
87	87	OF THIS SUBTITLE BY TAKING ANY ACTION IN ACCORDANCE WITH TITLE 5, 28
88	88	SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 29
89	89
90	90	[(c)] (D) (1) Unless the family member knowingly administers a procedure or 30
91	91	administers or dispenses a medication to cause death, a family member does not violate 31
92	92	§ 3–102 of this subtitle if the family member: 32
93	93
94	94	(i) is a caregiver for a patient enrolled in a licensed hospice program; 33
95	95	and 34
96	96
97	97	(ii) administers the procedure or administers or dispenses the 35 HOUSE BILL 933 3
98	98
99	99
100	100	medication to relieve pain under the supervision of a health care professional. 1
101	101
102	102	(2) Paragraph (1) of this subsection applies even if the medication or 2
103	103	procedure hastens death or increases the risk of death. 3
104	104
105	105	Article – Health – General 4
106	106
107	107	SUBTITLE 6A. THE HONORABLE ELIJAH E. CUMMINGS AND THE HONORABLE 5
108	108	SHANE E. PENDERGRASS END–OF–LIFE OPTION ACT. 6
109	109
110	110	5–6A–01. 7
111	111
112	112	(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 8
113	113	INDICATED. 9
114	114
115	115	(B) “AID IN DYING” MEANS THE MEDICAL PR ACTICE OF A PHYSICIAN 10
116	116	PRESCRIBING MEDICATI ON TO A QUALIFIED IN DIVIDUAL THAT THE QU ALIFIED 11
117	117	INDIVIDUAL MAY SELF –ADMINISTER TO BRING ABOUT THE QUALIFIED INDIVIDUAL’S 12
118	118	DEATH. 13
119	119
120	120	(C) “ATTENDING PHYSICIAN ” MEANS THE LICENSED P HYSICIAN WHO HAS 14
121	121	PRIMARY RESPONSIBILI TY FOR THE MEDICAL CARE OF THE INDIVIDU AL AND 15
122	122	TREATMENT OF THE IND IVIDUAL’S TERMINAL ILLNESS . 16
123	123
124	124	(D) “CAPACITY TO MAKE MEDI CAL DECISIONS” MEANS THE ABILITY OF AN 17
125	125	INDIVIDUAL TO: 18
126	126
127	127	(1) UNDERSTAND THE NATURE AND CONSEQUENCES OF A HEALTH 19
128	128	CARE DECISION; 20
129	129
130	130	(2) UNDERSTAND THE SIGNIF ICANT BENEFITS , RISKS, AND 21
131	131	ALTERNATIVES OF A HE ALTH CARE DECISION ; AND 22
132	132
133	133	(3) MAKE AND COMMUNICATE AN INFORMED DECISION TO HEALTH 23
134	134	CARE PROVIDERS , INCLUDING COMMUNICAT ION THROUGH ANOTHER INDIVIDUAL 24
135	135	FAMILIAR WITH THE IN DIVIDUAL’S MANNER OF COMMUNICATING , IF THE OTHER 25
136	136	INDIVIDUAL IS AVAILA BLE. 26
137	137
138	138	(E) “CONSULTING PHYSICIAN ” MEANS A LICENSED PHY SICIAN WHO IS 27
139	139	QUALIFIED BY SPECIAL TY OR EXPERIENCE TO CONFIRM A PROFESSION AL 28
140	140	DIAGNOSIS AND PROGNO SIS REGARDING AN IND IVIDUAL’S TERMINAL ILLNESS . 29
141	141
142	142	(F) “HEALTH CARE FACILITY ” MEANS: 30
143	143
144	144	(1) A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE; 31 4 HOUSE BILL 933
145	145
146	146
147	147
148	148	(2) A HOSPICE FACILITY , AS DEFINED IN § 19–901 OF THIS ARTICLE; 1
149	149
150	150	(3) AN ASSISTED LIVING PR OGRAM, AS DEFINED IN § 19–1801 OF THIS 2
151	151	ARTICLE; OR 3
152	152
153	153	(4) A NURSING HOME, AS DEFINED IN § 19–1401 OF THIS ARTICLE. 4
154	154
155	155	(G) “HEALTH CARE PROVIDER ” MEANS AN INDIVIDUAL LICENSE D OR 5
156	156	CERTIFIED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HE ALTH 6
157	157	CARE OR DISPENSE MED ICATION IN THE ORDIN ARY COURSE OF BUSINE SS OR 7
158	158	PRACTICE OF A PRO FESSION. 8
159	159
160	160	(H) “INFORMED DECISION ” MEANS A DECISION BY AN INDIVIDUAL THAT I S: 9
161	161
162	162	(1) BASED ON AN UNDERSTAN DING AND ACKNOWLEDGM ENT OF THE 10
163	163	RELEVANT FACTS ; AND 11
164	164
165	165	(2) MADE AFTER RECEIVING THE INFORMATION REQU IRED UNDER 12
166	166	§ 5–6A–04(C) OF THIS SUBTITLE. 13
167	167
168	168	(I) “LICENSED MENTAL HEALT H PROFESSIONAL ” MEANS A LICENSED 14
169	169	PSYCHIATRIST OR A LI CENSED PSYCHOLOGIST . 15
170	170
171	171	(J) “LICENSED PHYSICIAN ” MEANS A PHYSICIAN WH O IS LICENSED TO 16
172	172	PRACTICE MEDICINE IN THE STATE. 17
173	173
174	174	(K) “LICENSED PSYCHIATRIST ” MEANS A PSYCHIATRIST WHO IS LICENS ED 18
175	175	TO PRACTICE MEDICINE IN THE STATE. 19
176	176
177	177	(L) “LICENSED PSYCHOLOGIST ” MEANS A PSYCHOLOGIST WHO IS LICENSED 20
178	178	TO PRACTICE PSYCHOLO GY IN THE STATE. 21
179	179
180	180	(M) “MENTAL HEALTH PROFESS IONAL ASSESSMENT ” MEANS ONE OR MORE 22
181	181	CONSULTATIONS BETWEE N AN INDIVIDUAL AND A LICENSED MENTAL HEALTH 23
182	182	PROFESSIONAL FOR THE PURPOSE OF DETERMINI NG THAT THE INDIVIDU AL: 24
183	183
184	184	(1) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; AND 25
185	185
186	186	(2) IS NOT SUFFERING FROM IMPAIRED JUDGMENT DU E TO A MENTAL 26
187	187	DISORDER. 27
188	188
189	189	(N) “PALLIATIVE CARE ” MEANS HEALTH CARE CE NTERED ON A 28
190	190	TERMINALLY ILL INDIV IDUAL AND THE INDIVI DUAL’S FAMILY THAT: 29
191	191	HOUSE BILL 933 5
192	192
193	193
194	194	(1) OPTIMIZES THE INDIVID UAL’S QUALITY OF LIFE BY 1
195	195	ANTICIPATING, PREVENTING , AND TREATING THE IND IVIDUAL’S SUFFERING 2
196	196	THROUGHOUT THE CONTI NUUM OF THE INDIVIDU AL’S TERMINAL ILLNESS ; 3
197	197
198	198	(2) ADDRESSES THE PHYSICA L, EMOTIONAL, SOCIAL, AND SPIRITUAL 4
199	199	NEEDS OF THE INDIVID UAL; 5
200	200
201	201	(3) FACILITATES INDIVIDUA L AUTONOMY , THE INDIVIDUAL ’S ACCESS 6
202	202	TO INFORMATION , AND INDIVIDUAL CHOIC E; AND 7
203	203
204	204	(4) INCLUDES DISCUSSIONS BETWEEN THE INDIVIDU AL AND A 8
205	205	HEALTH CARE PROVIDER CONCER NING THE INDIVIDUAL ’S GOALS FOR TREATMEN T 9
206	206	AND APPROPRIATE TREA TMENT OPTIONS AVAILA BLE TO THE INDIVIDUA L, 10
207	207	INCLUDING HOSPICE CA RE AND COMPREHENSIVE PAIN AND SYMPTOM 11
208	208	MANAGEMENT . 12
209	209
210	210	(O) “PHARMACIST” MEANS A PHARMACIST W HO IS LICENSED TO PR ACTICE 13
211	211	PHARMACY IN THE STATE. 14
212	212
213	213	(P) “QUALIFIED INDIVIDUAL ” MEANS AN INDIVIDUAL WHO: 15
214	214
215	215	(1) IS AN ADULT; 16
216	216
217	217	(2) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; 17
218	218
219	219	(3) IS A RESIDENT OF THE STATE; 18
220	220
221	221	(4) HAS A TERMINAL ILLNES S; AND 19
222	222
223	223	(5) HAS THE ABILITY TO SE LF–ADMINISTER MEDICATIO N. 20
224	224
225	225	(Q) “RELATIVE” MEANS: 21
226	226
227	227	(1) A SPOUSE; 22
228	228
229	229	(2) A CHILD; 23
230	230
231	231	(3) A GRANDCHILD ; 24
232	232
233	233	(4) A SIBLING; 25
234	234
235	235	(5) A PARENT; OR 26
236	236
237	237	(6) A GRANDPARENT . 27
238	238	6 HOUSE BILL 933
239	239
240	240
241	241	(R) (1) “SELF–ADMINISTER” MEANS A QUALIFIED IN DIVIDUAL’S 1
242	242	AFFIRMATIVE, CONSCIOUS, AND VOLUNTARY ACT OF INGESTING MEDICATION 2
243	243	PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING ABOUT THE 3
244	244	INDIVIDUAL’S DEATH. 4
245	245
246	246	(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAKING MEDICATION BY 5
247	247	PARENTERAL INJECTION OR INFUSION. 6
248	248
249	249	(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 7
250	250	REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOSIS FOR AN INDIVIDUAL 8
251	251	THAT LIKELY WILL RES ULT IN THE INDIVIDUA L’S DEATH WITHIN 6 MONTHS. 9
252	252
253	253	(T) “WRITTEN REQUEST ” MEANS A WRITTEN REQU EST FOR AID IN DYIN G. 10
254	254
255	255	5–6A–02. 11
256	256
257	257	(A) AN INDIVIDUAL MAY REQ UEST AID IN DYING BY : 12
258	258
259	259	(1) MAKING AN INITIAL ORA L REQUEST TO THE IND IVIDUAL’S 13
260	260	ATTENDING PHYSICIAN ; 14
261	261
262	262	(2) AFTER MAKING AN INITI AL ORAL REQUEST , MAKING A WRITTEN 15
263	263	REQUEST TO THE INDIV IDUAL’S ATTENDING PHYSICIA N, IN ACCORDANCE WITH 16
264	264	§ 5–6A–03 OF THIS SUBTITLE; AND 17
265	265
266	266	(3) MAKING A SECOND ORAL REQUEST TO THE INDIV IDUAL’S 18
267	267	ATTENDING PHYSICIAN AT LEAST: 19
268	268
269	269	(I) 15 DAYS AFTER MAKING TH E INITIAL ORAL REQUE ST; AND 20
270	270
271	271	(II) 48 HOURS AFTER MAKING T HE WRITTEN REQUEST . 21
272	272
273	273	(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW , NO OTHER 22
274	274	INDIVIDUAL, INCLUDING AN AGENT U NDER AN ADVANCE DIRE CTIVE, AN 23
275	275	ATTORNEY IN FACT UNDER A DURABLE POWER OF ATTORNEY , A GUARDIAN, OR A 24
276	276	CONSERVATOR , MAY REQUEST AID IN D YING ON BEHALF OF AN INDIVIDUAL. 25
277	277
278	278	(C) AT LEAST ONE OF THE ORA L REQUESTS MADE UNDE R SUBSECTION (A) 26
279	279	OF THIS SECTION SHAL L BE MADE WHILE THE INDIVIDUAL IS ALONE WITH THE 27
280	280	ATTENDING PHYSICIAN . 28
281	281
282	282	5–6A–03. 29
283	283
284	284	(A) A WRITTEN REQUEST FOR AID IN DYING REQUIRE D UNDER 30 HOUSE BILL 933 7
285	285
286	286
287	287	§ 5–6A–02(A)(2) OF THIS SUBTITLE SHA LL BE: 1
288	288
289	289	(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 2
290	290	(C) OF THIS SECTION; 3
291	291
292	292	(2) SIGNED AND DATED BY T HE INDIVIDUAL; AND 4
293	293
294	294	(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUAL S WHO, IN THE 5
295	295	PRESENCE OF THE INDI VIDUAL, ATTEST THAT TO THE B EST OF THEIR K NOWLEDGE 6
296	296	AND BELIEF THE INDIV IDUAL IS: 7
297	297
298	298	(I) OF SOUND MIND; AND 8
299	299
300	300	(II) ACTING VOLUNTARILY AN D NOT BEING COERCED TO SIGN 9
301	301	THE WRITTEN REQUEST . 10
302	302
303	303	(B) (1) ONLY ONE OF THE WITNE SSES UNDER SUBSECTIO N (A)(3) OF THIS 11
304	304	SECTION MAY BE : 12
305	305
306	306	(I) A RELATIVE OF THE I NDIVIDUAL BY BLOOD , MARRIAGE, OR 13
307	307	ADOPTION; OR 14
308	308
309	309	(II) AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE 15
310	310	INDIVIDUAL, ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 16
311	311
312	312	(2) THE INDIVIDUAL ’S ATTENDING PHYSICIA N MAY NOT BE A 17
313	313	WITNESS. 18
314	314
315	315	(C) A WRITTEN REQUEST UNDER THIS SECTION S HALL BE IN 19
316	316	SUBSTANTIALLY THE FO LLOWING FORM : 20
317	317
318	318	MARYLAND REQUEST FOR MEDICATION FOR AID IN DYING 21
319	319
320	320	BY: _______________________________ DATE OF BIRTH: ____________________ 22
321	321	(PRINT NAME) (MONTH/DAY/YEAR) 23
322	322
323	323	I, ______________________________________, AM AN ADULT OF SOUND MIND. 24
324	324	I AM A RESIDENT OF THE STATE OF MARYLAND. 25
325	325	I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 26
326	326	PHYSICIAN HAS DETERM INED WILL, MORE LIKELY THAN NOT , RESULT IN DEATH 27
327	327	WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 28
328	328	PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING , 29
329	329	THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 30
330	330	ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 31 8 HOUSE BILL 933
331	331
332	332
333	333	INCLUDING PALLIATIVE CARE AND HOSPICE . 1
334	334	I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 2
335	335	MEDICATION THAT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 3
336	336	THIS REQUEST . I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 4
337	337	PHARMACIST TO FILL THE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 5
338	338
339	339	INITIAL ONE: 6
340	340	_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINI ONS 7
341	341	INTO CONSIDERATION . 8
342	342	_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 9
343	343	_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION. 10
344	344
345	345	I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 11
346	346	I UNDERSTAND THE FULL IMPORT OF THIS REQUE ST AND I EXPECT TO DIE IF AND 12
347	347	WHEN I TAKE THE MEDICATION TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 13
348	348	ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 14
349	349	AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 15
350	350	I MAKE THIS REQUEST VO LUNTARILY AND WITHOU T RESERVATION , AND I ACCEPT 16
351	351	FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 17
352	352
353	353	SIGNED: _______________________________________ DATED: _____________________ 18
354	354
355	355	DECLARATION OF WITNESSES 19
356	356
357	357	I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 20
358	358	MEDICATION FOR AID I N DYING MAY NOT BE T HE INDIVIDUAL ’S ATTENDING 21
359	359	PHYSICIAN. FURTHER, ONLY ONE OF THE WITNESSES MAY BE : 22
360	360
361	361	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 23
362	362	OR 24
363	363
364	364	2. AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE INDIVIDUAL , 25
365	365	ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 26
366	366
367	367	BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS, I DECLARE 27
368	368	THAT: 28
369	369
370	370	THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 29
371	371
372	372	1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PROOF OF IDENTITY ; 30
373	373
374	374	2. SIGNED THIS REQUEST I N MY PRESENCE ON THE DATE OF THE 31
375	375	INDIVIDUAL’S SIGNATURE; 32
376	376	HOUSE BILL 933 9
377	377
378	378
379	379	3. APPEARS TO BE OF S OUND MIND AND NOT UN DER DURESS, FRAUD, OR 1
380	380	UNDUE INFLUENCE ; AND 2
381	381
382	382	4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTENDING PHY SICIAN. 3
383	383
384	384	WITNESS 1 4
385	385	(CHECK ONE) 5
386	386
387	387	_____________ I AM: 6
388	388
389	389	_____________ I AM NOT: 7
390	390
391	391	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 8
392	392	OR 9
393	393
394	394	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 10
395	395	THE INDIVIDUAL ’S DEATH. 11
396	396
397	397	PRINTED NAME OF WITNESS 1 ______________________________ 12
398	398	SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 13
399	399
400	400
401	401	WITNESS 2 14
402	402	(CHECK ONE) 15
403	403
404	404	_____________ I AM: 16
405	405
406	406	_____________ I AM NOT: 17
407	407
408	408	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 18
409	409	OR 19
410	410
411	411	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 20
412	412	THE INDIVIDUAL ’S DEATH. 21
413	413
414	414	PRINTED NAME OF WITNESS 2 _______________________________ 22
415	415	SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 23
416	416
417	417	5–6A–04. 24
418	418
419	419	(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 25
420	420	INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 26
421	421	WHETHER THE INDIVIDU AL: 27
422	422
423	423	(I) IS A QUALIFIED INDIVI DUAL; 28 10 HOUSE BILL 933
424	424
425	425
426	426
427	427	(II) HAS MADE AN INFORMED DECISION; AND 1
428	428
429	429	(III) HAS VOLUNTARILY REQUE STED AID IN DYING. 2
430	430
431	431	(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVIDU AL SOLELY DUE TO 3
432	432	AGE, DISABILITY, OR A SPECIFIC ILLNES S. 4
433	433
434	434	(B) FOR PURPOSES OF DETERMINING THAT AN INDIVIDUAL IS A QUAL IFIED 5
435	435	INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 6
436	436	INDIVIDUAL’S RESIDENCY IN THE STATE: 7
437	437
438	438	(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 8
439	439	IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION; 9
440	440
441	441	(2) REGISTRATION TO VOTE IN THE STATE; 10
442	442
443	443	(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 11
444	444
445	445	(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 12
446	446	RECENT TAX YEAR ; OR 13
447	447
448	448	(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 14
449	449	RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 15
450	450	INDIVIDUAL’S RESIDENCY IN THE STATE. 16
451	451
452	452	(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 17
453	453	AN INFORMED DECISION BY INFORMING THE IND IVIDUAL OF: 18
454	454
455	455	(1) THE INDIVIDUAL’S MEDICAL DIA GNOSIS; 19
456	456
457	457	(2) THE INDIVIDUAL’S PROGNOSIS; 20
458	458
459	459	(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERING 21
460	460	THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 22
461	461
462	462	(4) THE PROBABLE RESULT O F SELF–ADMINISTERING THE 23
463	463	MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 24
464	464
465	465	(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 25
466	466	OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE . 26
467	467
468	468	(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 27
469	469	PHYSICIAN DETERMINES THAT AN INDIVIDUAL I S A QUALIFIED INDIVI DUAL, HAS 28
470	470	MADE AN INFO RMED DECISION , AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 29 HOUSE BILL 933 11
471	471
472	472
473	473	THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONS ULTING 1
474	474	PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 2
475	475	SUBTITLE. 3
476	476
477	477	5–6A–05. 4
478	478
479	479	A CONSULTING PHYSICIAN TO WHOM AN INDIVID UAL HAS BEEN REFERRE D 5
480	480	UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 6
481	481
482	482	(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL ’S RELEVANT 7
483	483	MEDICAL RECORDS ; 8
484	484
485	485	(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 9
486	486	INDIVIDUAL HAS A TER MINAL ILLNESS; 10
487	487
488	488	(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 11
489	489	INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 12
490	490
491	491	(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 13
492	492	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 14
493	493	AND 15
494	494
495	495	(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 16
496	496	DUTIES UNDER THIS SE CTION IN WRITING . 17
497	497
498	498	5–6A–06. 18
499	499
500	500	(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 19
501	501	CONSULTING PHYSICIAN , AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 20
502	502	THAT IS CAUS ING IMPAIRED JUDGMEN T OR OTHERWISE DOES NOT HAVE THE 21
503	503	CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 22
504	504	CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 23
505	505	HEALTH PROFESSIONAL FOR A MENTAL HEALTH PROFESSIONAL ASSESSM ENT. 24
506	506
507	507	(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 25
508	508	ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICIAN 26
509	509	MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING U NTIL THE 27
510	510	LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEALTH 28
511	511	PROFESSIONAL ASSESSM ENT: 29
512	512
513	513	(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 30
514	514	MEDICAL DECISIONS AN D IS NOT SUFFERING F ROM A CONDITION THAT IS CAUSING 31
515	515	IMPAIRED JUDGMENT ; AND 32
516	516	12 HOUSE BILL 933
517	517
518	518
519	519	(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 1
520	520	PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 2
521	521
522	522	5–6A–07. 3
523	523
524	524	(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 4
525	525	HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 5
526	526	SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 6
527	527	REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 7
528	528	THE ATTENDING PHYSIC IAN SHALL: 8
529	529
530	530	(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 9
531	531	THE QUALIFIED INDIVI DUAL AS TO WHETHER A ND WHEN TO SELF –ADMINISTER THE 10
532	532	MEDICATION PRESCRIBED FOR AID I N DYING; 11
533	533
534	534	(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 12
535	535	INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KI N OF THE REQUEST FOR AID IN DYING; 13
536	536	AND 14
537	537
538	538	(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FA ILURE TO 15
539	539	NOTIFY NEXT OF KIN I S NOT A BASIS FOR DENIAL O F THE REQUEST FOR AI D IN 16
540	540	DYING; 17
541	541
542	542	(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 18
543	543	IMPORTANCE OF : 19
544	544
545	545	(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 20
546	546	QUALIFIED INDIVIDUAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 21
547	547	AID IN DYING; 22
548	548
549	549	(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 23
550	550
551	551	(III) PARTICIPATING IN A HO SPICE PROGRAM ; 24
552	552
553	553	(4) ENCOURAGE THE QUALIFI ED INDIVIDUAL TO PRE PARE AN 25
554	554	ADVANCE DIRECTIVE ; 26
555	555
556	556	(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 27
557	557	NOT ARISE FROM CO ERCION OR UNDUE INFL UENCE BY ANOTHER IND IVIDUAL BY 28
558	558	DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 29
559	559	OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 30
560	560	INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 31
561	561	INDIVIDUAL; 32
562	562	HOUSE BILL 933 13
563	563
564	564
565	565	(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 1
566	566	INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 2
567	567	MANNER; 3
568	568
569	569	(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPT ION FOR 4
570	570	MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 5
571	571	INFORMED DECISION ; 6
572	572
573	573	(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 7
574	574	UNDER § 5–6A–08 OF THIS SUBTITLE; AND 8
575	575
576	576	(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPEN SING 9
577	577	PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 10
578	578	MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 11
579	579
580	580	1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 12
581	581	AND 13
582	582
583	583	2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIMIZE 14
584	584	THE QUALIFIED INDIVI DUAL’S DISCOMFORT ; OR 15
585	585
586	586	(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 16
587	587	DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 17
588	588	DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AN D PROVIDES WRITTEN 18
589	589	CONSENT FOR THE MEDICATION FOR AID IN DYING TO BE DISPENSED BY A 19
590	590	PHARMACIST : 20
591	591
592	592	1. CONTACT A PHARMACIST ; 21
593	593
594	594	2. INFORM THE PHARMACIST OF THE PRESCRIPTION 22
595	595	FOR MEDICATION FOR A ID IN DYING; AND 23
596	596
597	597	3. SUBMIT THE PRESCRIPTI ON FOR MEDICATION FO R 24
598	598	AID IN DYING TO THE PHARMACIST BY ANY MEANS AUTHORIZED BY LAW. 25
599	599
600	600	(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 26
601	601	ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 27
602	602	PRESCRIPTION FOR MED ICATION FOR AID IN D YING IN ACCORDANCE W ITH THE 28
603	603	REQUIREMEN TS OF SUBSECTION (A) OF THIS SECTION MAY DISPENSE THE 29
604	604	MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 30
605	605	QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 31
606	606	AGENT OF THE QUALIFI ED INDIVIDUAL. 32
607	607
608	608	(C) IF A QUALIFIED IND IVIDUAL SELF–ADMINISTERS MEDICATI ON FOR AID 33 14 HOUSE BILL 933
609	609
610	610
611	611	IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 1
612	612	INDIVIDUAL’S DEATH CERTIFICATE . 2
613	613
614	614	5–6A–08. 3
615	615
616	616	(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID I N 4
617	617	DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THAT TH E MEDICAL RECORD OF 5
618	618	THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 6
619	619
620	620	(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 7
621	621	IS AN ADULT AND A RE SIDENT OF THE STATE; 8
622	622
623	623	(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUAL IFIED 9
624	624	INDIVIDUAL FOR MEDICATION FOR A ID IN DYING; 10
625	625
626	626	(3) THE ATTENDING PHYSICI AN’S: 11
627	627
628	628	(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 12
629	629	ILLNESS AND PROGNOSI S; AND 13
630	630
631	631	(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 14
632	632	THE CAPACITY TO MAKE MEDICAL DECISIONS , HAS MADE AN INFORMED DECISI ON, 15
633	633	AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 16
634	634
635	635	(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 17
636	636	FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 18
637	637	SUBTITLE; 19
638	638
639	639	(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 20
640	640	DURING THE MENTAL HE ALTH PROFESSIONAL AS SESSMENT IF: 21
641	641
642	642	(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 22
643	643	HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 23
644	644	SUBTITLE; AND 24
645	645
646	646	(II) THE MENTAL HEALTH PRO FESSIONAL ASSESSMENT WAS 25
647	647	PROVIDED; 26
648	648
649	649	(6) DOCUMENTATION OF THE ATTENDING PHYSICIAN ’S OFFER TO 27
650	650	THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 28
651	651	FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 29
652	652	WROTE THE PRESCRIPTI ON FOR THE MEDICATIO N FOR THE QUALIFIED INDIVIDUAL ; 30
653	653	AND 31
654	654	HOUSE BILL 933 15
655	655
656	656
657	657	(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 1
658	658
659	659	(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 2
660	660	UNDER THIS SUBTITLE HAVE BEEN MET ; AND 3
661	661
662	662	(II) SPECIFYING THE STEPS TAKEN TO CARRY OUT T HE 4
663	663	QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICA TION 5
664	664	PRESCRIBED FOR AID I N DYING. 6
665	665
666	666	(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 7
667	667	INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 8
668	668	REGULATIONS ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 9
669	669
670	670	5–6A–09. 10
671	671
672	672	(A) THE DEPARTMENT SHALL ADOP T REGULATIONS TO FAC ILITATE THE 11
673	673	COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 12
674	674
675	675	(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 13
676	676	PUBLIC AN ANNUAL STA TISTICAL REPORT OF I NFORMATION COLLECTED UNDER 14
677	677	SUBSECTION (A) OF THIS SECTION. 15
678	678
679	679	(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 16
680	680	SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 17
681	681	INTRODUCED INTO EVID ENCE IN ANY JUDICIAL OR ADMINISTRATIVE PR OCEEDING, 18
682	682	EXCEPT TO RESOLVE MATTERS C ONCERNING COMPLIANCE WITH THIS SUBTITLE O R 19
683	683	AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 20
684	684
685	685	5–6A–10. 21
686	686
687	687	A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 22
688	688	OF MEDICATION PRESCR IBED FOR AID IN DYIN G THAT HAS NOT BEEN 23
689	689	SELF–ADMINISTERED SHALL DIS POSE OF THE MEDICATI ON IN A LAWFUL MANNE R. 24
690	690
691	691	5–6A–11. 25
692	692
693	693	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 26
694	694	PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 27
695	695	WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEAT H OF A 28
696	696	QUALIFIED INDIVIDUAL BY REASON OF THE SEL F–ADMINISTRATION OF ME DICATION 29
697	697	PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 30
698	698	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 31
699	699	WHICH THE QUALIFIED INDIVIDUAL SUFFERED . 32
700	700	16 HOUSE BILL 933
701	701
702	702
703	703	(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEG AL INSTRUMENT THAT 1
704	704	IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 2
705	705
706	706	(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 3
707	707	PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 4
708	708	IF THE PERSON, WITH THE INTENT OR E FFECT OF CAUSING THE INDIVIDUAL’S 5
709	709	DEATH: 6
710	710
711	711	(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 7
712	712
713	713	(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 8
714	714	DYING; 9
715	715
716	716	(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 10
717	717	COMPLETE A REQUEST F OR AID IN DYING; OR 11
718	718
719	719	(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 12
720	720	DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 13
721	721
722	722	(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENS ED PHYSICIAN OR 14
723	723	ANY OTHER PERSON TO END AN INDIVIDUAL’S LIFE BY LETHAL INJ ECTION, MERCY 15
724	724	KILLING, OR ACTIVE EUTHANASIA . 16
725	725
726	726	(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 17
727	727	FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 18
728	728	HOMICIDE. 19
729	729
730	730	5–6A–12. 20
731	731
732	732	(A) A PROVISION IN AN INSURANCE POLICY , AN ANNUITY, A CONTRACT, OR 21
733	733	ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2023, IS NOT 22
734	734	VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 23
735	735	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 24
736	736	RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTITLE. 25
737	737
738	738	(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2023, 26
739	739	MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 27
740	740	REQUEST FOR AID IN D YING UNDER THIS SUBT ITLE. 28
741	741
742	742	(C) A QUALIFIED INDIVIDUAL’S ACT OF SELF–ADMINISTERING MEDICA TION 29
743	743	FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 30
744	744	HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 31
745	745	DIFFERS FROM THE EFF ECT UNDER THE POLICY OR CONTRACT OF THE Q UALIFIED 32
746	746	INDIVIDUAL’S DEATH FROM NATURAL CAUSES. 33 HOUSE BILL 933 17
747	747
748	748
749	749
750	750	5–6A–13. 1
751	751
752	752	(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 2
753	753
754	754	(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 3
755	755	OR PROFESSIONAL DISC IPLINARY ACTION FOR PARTICIPATING IN GOO D–FAITH 4
756	756	COMPLIANCE WITH THIS SUBTITLE , INCLUDING BEING PRES ENT WHEN A QUALIFIED 5
757	757	INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 6
758	758
759	759	(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 7
760	760	CARE PROVIDER , OR A HEALTH OCCUPATI ON BOARD MAY NOT SUB JECT A PERSON 8
761	761	TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 9
762	762	LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 10
763	763	TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 11
764	764
765	765	(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDING 12
766	766	PHYSICIAN’S PRESCRIPTION OF ME DICATION MADE IN GOO D–FAITH COMPLIANCE 13
767	767	WITH THIS SUBTITLE D OES NOT: 14
768	768
769	769	(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 15
770	770
771	771	(2) PROVIDE THE SOLE BASI S FOR THE APPOINTMEN T OF A 16
772	772	GUARDIAN OR CONSERVA TOR. 17
773	773
774	774	5–6A–14. 18
775	775
776	776	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 19
777	777	INDICATED. 20
778	778
779	779	(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 21
780	780	WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 22
781	781	CARE PROVIDER , BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 23
782	782	DYING, OF A HEALTH CARE FACILI TY’S POLICY ABOUT PARTICI PATION IN AID IN 24
783	783	DYING. 25
784	784
785	785	(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 26
786	786	DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICI AN, OR A LICENSED 27
787	787	MENTAL HEALTH PRO FESSIONAL UNDER THIS SUBTITLE. 28
788	788
789	789	(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 29
790	790
791	791	1. MAKING AN INITIAL DET ERMINATION THAT AN 30
792	792	INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 31 18 HOUSE BILL 933
793	793
794	794
795	795	MEDICAL PROGNOSIS ; 1
796	796
797	797	2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 2
798	798	AN INDIVIDUAL ON THE REQUEST OF THE INDIV IDUAL; OR 3
799	799
800	800	3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 4
801	801	INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 5
802	802
803	803	(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALT H CARE 6
804	804	PROVIDER FROM PARTIC IPATING IN AID IN DYI NG UNDER THIS SUBTIT LE ON THE 7
805	805	PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROHIBITING 8
806	806	HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 9
807	807	PRIVILEGES TO PRACTI CE ON THE PREMISES O F THE PROHIBITING HE ALTH CARE 10
808	808	FACILITY’S POLICY REGARDING PAR TICIPATING IN AID IN DYING. 11
809	809
810	810	(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 12
811	811	PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 13
812	812	PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIV IDUAL. 14
813	813
814	814	(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 15
815	815	THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACILITY HAS 16
816	816	NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 17
817	817	HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 18
818	818	HEALTH CARE FACILITY PROHIBITS PARTICIPAT ION IN AID IN DYING: 19
819	819
820	820	(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 20
821	821	SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 21
822	822	PROCEDURES OF THE SA NCTIONING HEALTH CAR E FACILITY IF THE SANCT IONED 22
823	823	HEALTH CARE PROVIDER IS A MEMBER OF THE S ANCTIONING HEALTH CA RE 23
824	824	FACILITY’S MEDICAL STAFF AND PA RTICIPATES IN AID IN DYING WHILE ON THE 24
825	825	PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 25
826	826
827	827	(2) TERMINATION OF A LEAS E OR ANY OTHER PROPE RTY CONTRACT 26
828	828	OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PRO PERTY 27
829	829	CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 28
830	830	OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 29
831	831	PROVIDER PARTICIPATE S IN AID IN DYING WH ILE ON THE PREMISES OF THE 30
832	832	SANCTIONING HEALTH C ARE FACILITY OR ON PROPERTY THAT IS OWNED BY OR 31
833	833	UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACILITY; OR 32
834	834
835	835	(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 33
836	836	REMEDIES PROVIDED BY A CONTRACT IF THE SA NCTIONED HEALTH CARE PROVIDER 34
837	837	PARTICIPATES IN AID IN DYING WHILE ACTIN G IN THE COURSE AND SCOPE OF THE 35
838	838	SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 36 HOUSE BILL 933 19
839	839
840	840
841	841	INDEPENDENT CONTRACTOR O F THE SANCTIONING HE ALTH CARE FACILITY. 1
842	842
843	843	(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 2
844	844
845	845	(1) A HEALTH CARE PROVIDER FROM PARTICIPATING I N AID IN 3
846	846	DYING: 4
847	847
848	848	(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 5
849	849	HEALTH CARE PROVI DER’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 6
850	850	CONTRACTOR OF THE SA NCTIONING HEALTH CAR E FACILITY; OR 7
851	851
852	852	(II) OFF THE PREMISES OF T HE SANCTIONING HEALT H CARE 8
853	853	FACILITY OR OFF ANY PROPERTY THAT IS OWNED BY OR UNDER THE DIRECT 9
854	854	CONTROL OF THE SANCT IONING HEALTH CARE FACILITY; OR 10
855	855
856	856	(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE I NDIVIDUAL’S 11
857	857	ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUTSIDE T HE COURSE 12
858	858	AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 13
859	859	CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SANCT IONING 14
860	860	HEALTH CARE FACILITY. 15
861	861
862	862	5–6A–15. 16
863	863
864	864	(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 17
865	865	UNDER THIS SUBTITLE IS VOLUNTARY. 18
866	866
867	867	(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 19
868	868	THE MEDICAL STAFF OF THE HEALTH CARE FACILITY TO PAR TICIPATE IN AID IN 20
869	869	DYING. 21
870	870
871	871	(B) IF AN INDIVIDUAL REQU ESTS OR INDICATES AN INTEREST IN AID IN 22
872	872	DYING, AND THE ATTENDING PH YSICIAN OF THE INDIV IDUAL DOES NOT WISH TO 23
873	873	PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 24
874	874	INDIVIDUAL THAT THE ATT ENDING PHYSICIAN DOE S NOT WISH TO PARTIC IPATE. 25
875	875
876	876	(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 26
877	877	TRANSFER A COPY OF A N INDIVIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 27
878	878	ATTENDING PHYSICIAN IF: 28
879	879
880	880	(1) THE INDIVIDUAL REQUES TS OR INDICATES AN INTERES T IN AID IN 29
881	881	DYING; 30
882	882
883	883	(2) THE ORIGINAL ATTENDIN G PHYSICIAN IS UNABL E OR UNWILLING 31
884	884	TO PARTICIPATE IN AI D IN DYING FOR THE I NDIVIDUAL; AND 32 20 HOUSE BILL 933
885	885
886	886
887	887
888	888	(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 1
889	889	ANOTHER ATTENDING PH YSICIAN. 2
890	890
891	891	(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 3
892	892	A LICENSED PHYSICIAN ASSOCIATED WITH THE HEALTH CARE FACILITY FROM 4
893	893	PARTICIPATING IN AID IN DYING, IN ACCORDANCE WITH § 5–6A–14 OF THIS 5
894	894	SUBTITLE. 6
895	895
896	896	5–6A–16. 7
897	897
898	898	(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FORGES A WRITTEN 8
899	899	REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 9
900	900	OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WI THOUT THE 10
901	901	AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 11
902	902	THE INDIVIDUAL ’S DEATH IS GUILTY OF A FE LONY AND ON CONVICTI ON IS SUBJECT 12
903	903	TO IMPRISONMENT NOT EXCEEDING 10 YEARS OR A FINE NOT EXCEEDING $10,000 13
904	904	OR BOTH. 14
905	905
906	906	(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 15
907	907	INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 16
908	908	THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVIDUAL ’S LIFE OR TO 17
909	909	DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FELON Y AND ON 18
910	910	CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 19
911	911	NOT EXCEEDING $10,000 OR BOTH. 20
912	912
913	913	(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 21
914	914	SEPARATE FROM AND CO NSECUTIVE TO OR CONC URRENT WITH A SENTEN CE FOR 22
915	915	ANY CRIME BASED ON T HE ACT ESTABLISHING THE VIOLATION OF THI S SECTION. 23
916	916
917	917	(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMA GES 24
918	918	RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONAL MI SCONDUCT 25
919	919	BY ANY PERSON . 26
920	920
921	921	Article – Insurance 27
922	922
923	923	27–208.1. 28
924	924
925	925	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS AND OTHER PURPOSES 29
926	926	GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 30
927	927	SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 31
928	928	6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 32
929	929	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 33
930	930	WHICH THE INDIVIDUAL SUFFERED. 34 HOUSE BILL 933 21
931	931
932	932
933	933
934	934	(B) ACTIONS TAKEN IN ACCORDANCE WI TH TITLE 5, SUBTITLE 6A OF THE 1
935	935	HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 2
936	936	ASSISTED SUICIDE , MERCY KILLING , OR HOMICIDE. 3
937	937
938	938	(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 4
939	939	CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2023, IS NOT VALID TO 5
940	940	THE EXTENT THAT THE PROVISION WOULD ATTA CH CONSEQUENCES TO O R 6
941	941	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 7
942	942	RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 8
943	943	HEALTH – GENERAL ARTICLE. 9
944	944
945	945	(D) AN OBLIGATION UNDER A N INSURANCE POLICY O R CONTRACT OR AN 10
946	946	ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2023, MAY NOT BE CONDITION ED ON 11
947	947	OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 12
948	948	UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 13
949	949
950	950	(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 14
951	951	AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 15
952	952	MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 16
953	953	POLICY OR CONTR ACT, OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 17
954	954	EFFECT UNDER THE POL ICY OR CONTRACT OF T HE INSURED’S OR ANNUITANT ’S 18
955	955	DEATH FROM NATURAL C AUSES. 19
956	956
957	957	SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 20
958	958	the application thereof to any person or circumstance is held invalid for any reason in a 21
959	959	court of competent jurisdiction, the invalidity does not affect other provisions or any other 22
960	960	application of this Act that can be given effect without the invalid provision or application, 23
961	961	and for this purpose the provisions of this Act are declared severable. 24
962	962
963	963	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
964	964	October 1, 2023. 26