EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW.
[Brackets] indicate matter deleted from existing law.
*hb0933*
HOUSE BILL 933
J1 3lr0429
HB 643/20 – HGO & JUD CF SB 845
By: Delegates Pena–Melnyk, Alston, Bagnall, Bartlett, Barve, Boyce,
Charkoudian, Crutchfield, Cullison, Feldmark, Fennell, Forbes,
Fraser–Hidalgo, Guzzone, S. Johnson, Kaufman, Lehman, R. Lewis, Lopez,
Love, Palakovich Carr, Rosenberg, Shetty, Solomon, Stein, Taveras,
Terrasa, Williams, and Wu
Introduced and read first time: February 10, 2023
Assigned to: Health and Government Operations and Judiciary
A BILL ENTITLED
AN ACT concerning 1
End–of–Life Option Act 2
(The Honorable Elijah E. Cummings and the Honorable Shane E. 3
Pendergrass Act) 4
FOR the purpose of authorizing an individual to request aid in dying by making certain 5
requests; establishing requirements and prohibitions governing aid in dying, 6
including requirements related to requests for aid in dying, consulting physicians, 7
mental health assessments, the disposal of drugs prescribed for aid in dying, health 8
care facility policies, and the effect of aid in dying on insurance policies; authorizing 9
a pharmacist to dispense medication for aid in dying only to certain individuals 10
under certain circumstances; providing that the death of a qualified individual by 11
reason of self–administration of certain medication shall be deemed to be a death 12
from certain natural causes for certain purposes; providing that this Act does not 13
authorize certain individuals to end another individual’s life by certain means; 14
providing that participation by a health care provider in aid in dying is voluntary; 15
authorizing the Maryland Insurance Commissioner to enforce certain provisions of 16
this Act; establishing that a licensed health care professional does not violate the 17
statutory prohibition on assisted suicide by taking certain actions in accordance with 18
this Act; and generally relating to aid in dying. 19
BY repealing and reenacting, with amendments, 20
Article – Criminal Law 21
Section 3–103 22
Annotated Code of Maryland 23
(2021 Replacement Volume and 2022 Supplement) 24
BY adding to 25 2 HOUSE BILL 933
Article – Health – Genera l 1
Section 5–6A–01 through 5–6A–16 to be under the new subtitle “Subtitle 6A. The 2
Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass 3
End–of–Life Option Act” 4
Annotated Code of Maryland 5
(2019 Replacement Volume and 2022 Supplement) 6
BY adding to 7
Article – Insurance 8
Section 27–208.1 9
Annotated Code of Maryland 10
(2017 Replacement Volume and 2022 Supplement) 11
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 12
That the Laws of Maryland read as follows: 13
Article – Criminal Law 14
3–103. 15
(a) A licensed health care professional does not violate § 3–102 of this subtitle by 16
administering or prescribing a procedure or administering, prescribing, or dispensing a 17
medication to relieve pain, even if the medication or procedure may hasten death or 18
increase the risk of death, unless the licensed health care professional knowingly 19
administers or prescribes the procedure or administers, prescribes, or dispenses the 20
medication to cause death. 21
(b) A licensed health care professional does not violate § 3–102 of this subtitle by 22
withholding or withdrawing a medically administered life–sustaining procedure: 23
(1) in compliance with Title 5, Subtitle 6 of the Health – General Article; 24
or 25
(2) in accordance with reasonable medical practice. 26
(C) A LICENSED HEALTH CARE PROFESSIONAL DOES NO T VIOLATE § 3–102 27
OF THIS SUBTITLE BY TAKING ANY ACTION IN ACCORDANCE WITH TITLE 5, 28
SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 29
[(c)] (D) (1) Unless the family member knowingly administers a procedure or 30
administers or dispenses a medication to cause death, a family member does not violate 31
§ 3–102 of this subtitle if the family member: 32
(i) is a caregiver for a patient enrolled in a licensed hospice program; 33
and 34
(ii) administers the procedure or administers or dispenses the 35 HOUSE BILL 933 3
medication to relieve pain under the supervision of a health care professional. 1
(2) Paragraph (1) of this subsection applies even if the medication or 2
procedure hastens death or increases the risk of death. 3
Article – Health – General 4
SUBTITLE 6A. THE HONORABLE ELIJAH E. CUMMINGS AND THE HONORABLE 5
SHANE E. PENDERGRASS END–OF–LIFE OPTION ACT. 6
5–6A–01. 7
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 8
INDICATED. 9
(B) “AID IN DYING” MEANS THE MEDICAL PR ACTICE OF A PHYSICIAN 10
PRESCRIBING MEDICATI ON TO A QUALIFIED IN DIVIDUAL THAT THE QU ALIFIED 11
INDIVIDUAL MAY SELF –ADMINISTER TO BRING ABOUT THE QUALIFIED INDIVIDUAL’S 12
DEATH. 13
(C) “ATTENDING PHYSICIAN ” MEANS THE LICENSED P HYSICIAN WHO HAS 14
PRIMARY RESPONSIBILI TY FOR THE MEDICAL CARE OF THE INDIVIDU AL AND 15
TREATMENT OF THE IND IVIDUAL’S TERMINAL ILLNESS . 16
(D) “CAPACITY TO MAKE MEDI CAL DECISIONS” MEANS THE ABILITY OF AN 17
INDIVIDUAL TO: 18
(1) UNDERSTAND THE NATURE AND CONSEQUENCES OF A HEALTH 19
CARE DECISION; 20
(2) UNDERSTAND THE SIGNIF ICANT BENEFITS , RISKS, AND 21
ALTERNATIVES OF A HE ALTH CARE DECISION ; AND 22
(3) MAKE AND COMMUNICATE AN INFORMED DECISION TO HEALTH 23
CARE PROVIDERS , INCLUDING COMMUNICAT ION THROUGH ANOTHER INDIVIDUAL 24
FAMILIAR WITH THE IN DIVIDUAL’S MANNER OF COMMUNICATING , IF THE OTHER 25
INDIVIDUAL IS AVAILA BLE. 26
(E) “CONSULTING PHYSICIAN ” MEANS A LICENSED PHY SICIAN WHO IS 27
QUALIFIED BY SPECIAL TY OR EXPERIENCE TO CONFIRM A PROFESSION AL 28
DIAGNOSIS AND PROGNO SIS REGARDING AN IND IVIDUAL’S TERMINAL ILLNESS . 29
(F) “HEALTH CARE FACILITY ” MEANS: 30
(1) A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE; 31 4 HOUSE BILL 933
(2) A HOSPICE FACILITY , AS DEFINED IN § 19–901 OF THIS ARTICLE; 1
(3) AN ASSISTED LIVING PR OGRAM, AS DEFINED IN § 19–1801 OF THIS 2
ARTICLE; OR 3
(4) A NURSING HOME, AS DEFINED IN § 19–1401 OF THIS ARTICLE. 4
(G) “HEALTH CARE PROVIDER ” MEANS AN INDIVIDUAL LICENSE D OR 5
CERTIFIED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HE ALTH 6
CARE OR DISPENSE MED ICATION IN THE ORDIN ARY COURSE OF BUSINE SS OR 7
PRACTICE OF A PRO FESSION. 8
(H) “INFORMED DECISION ” MEANS A DECISION BY AN INDIVIDUAL THAT I S: 9
(1) BASED ON AN UNDERSTAN DING AND ACKNOWLEDGM ENT OF THE 10
RELEVANT FACTS ; AND 11
(2) MADE AFTER RECEIVING THE INFORMATION REQU IRED UNDER 12
§ 5–6A–04(C) OF THIS SUBTITLE. 13
(I) “LICENSED MENTAL HEALT H PROFESSIONAL ” MEANS A LICENSED 14
PSYCHIATRIST OR A LI CENSED PSYCHOLOGIST . 15
(J) “LICENSED PHYSICIAN ” MEANS A PHYSICIAN WH O IS LICENSED TO 16
PRACTICE MEDICINE IN THE STATE. 17
(K) “LICENSED PSYCHIATRIST ” MEANS A PSYCHIATRIST WHO IS LICENS ED 18
TO PRACTICE MEDICINE IN THE STATE. 19
(L) “LICENSED PSYCHOLOGIST ” MEANS A PSYCHOLOGIST WHO IS LICENSED 20
TO PRACTICE PSYCHOLO GY IN THE STATE. 21
(M) “MENTAL HEALTH PROFESS IONAL ASSESSMENT ” MEANS ONE OR MORE 22
CONSULTATIONS BETWEE N AN INDIVIDUAL AND A LICENSED MENTAL HEALTH 23
PROFESSIONAL FOR THE PURPOSE OF DETERMINI NG THAT THE INDIVIDU AL: 24
(1) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; AND 25
(2) IS NOT SUFFERING FROM IMPAIRED JUDGMENT DU E TO A MENTAL 26
DISORDER. 27
(N) “PALLIATIVE CARE ” MEANS HEALTH CARE CE NTERED ON A 28
TERMINALLY ILL INDIV IDUAL AND THE INDIVI DUAL’S FAMILY THAT: 29
HOUSE BILL 933 5
(1) OPTIMIZES THE INDIVID UAL’S QUALITY OF LIFE BY 1
ANTICIPATING, PREVENTING , AND TREATING THE IND IVIDUAL’S SUFFERING 2
THROUGHOUT THE CONTI NUUM OF THE INDIVIDU AL’S TERMINAL ILLNESS ; 3
(2) ADDRESSES THE PHYSICA L, EMOTIONAL, SOCIAL, AND SPIRITUAL 4
NEEDS OF THE INDIVID UAL; 5
(3) FACILITATES INDIVIDUA L AUTONOMY , THE INDIVIDUAL ’S ACCESS 6
TO INFORMATION , AND INDIVIDUAL CHOIC E; AND 7
(4) INCLUDES DISCUSSIONS BETWEEN THE INDIVIDU AL AND A 8
HEALTH CARE PROVIDER CONCER NING THE INDIVIDUAL ’S GOALS FOR TREATMEN T 9
AND APPROPRIATE TREA TMENT OPTIONS AVAILA BLE TO THE INDIVIDUA L, 10
INCLUDING HOSPICE CA RE AND COMPREHENSIVE PAIN AND SYMPTOM 11
MANAGEMENT . 12
(O) “PHARMACIST” MEANS A PHARMACIST W HO IS LICENSED TO PR ACTICE 13
PHARMACY IN THE STATE. 14
(P) “QUALIFIED INDIVIDUAL ” MEANS AN INDIVIDUAL WHO: 15
(1) IS AN ADULT; 16
(2) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; 17
(3) IS A RESIDENT OF THE STATE; 18
(4) HAS A TERMINAL ILLNES S; AND 19
(5) HAS THE ABILITY TO SE LF–ADMINISTER MEDICATIO N. 20
(Q) “RELATIVE” MEANS: 21
(1) A SPOUSE; 22
(2) A CHILD; 23
(3) A GRANDCHILD ; 24
(4) A SIBLING; 25
(5) A PARENT; OR 26
(6) A GRANDPARENT . 27
6 HOUSE BILL 933
(R) (1) “SELF–ADMINISTER” MEANS A QUALIFIED IN DIVIDUAL’S 1
AFFIRMATIVE, CONSCIOUS, AND VOLUNTARY ACT OF INGESTING MEDICATION 2
PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING ABOUT THE 3
INDIVIDUAL’S DEATH. 4
(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAKING MEDICATION BY 5
PARENTERAL INJECTION OR INFUSION. 6
(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 7
REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOSIS FOR AN INDIVIDUAL 8
THAT LIKELY WILL RES ULT IN THE INDIVIDUA L’S DEATH WITHIN 6 MONTHS. 9
(T) “WRITTEN REQUEST ” MEANS A WRITTEN REQU EST FOR AID IN DYIN G. 10
5–6A–02. 11
(A) AN INDIVIDUAL MAY REQ UEST AID IN DYING BY : 12
(1) MAKING AN INITIAL ORA L REQUEST TO THE IND IVIDUAL’S 13
ATTENDING PHYSICIAN ; 14
(2) AFTER MAKING AN INITI AL ORAL REQUEST , MAKING A WRITTEN 15
REQUEST TO THE INDIV IDUAL’S ATTENDING PHYSICIA N, IN ACCORDANCE WITH 16
§ 5–6A–03 OF THIS SUBTITLE; AND 17
(3) MAKING A SECOND ORAL REQUEST TO THE INDIV IDUAL’S 18
ATTENDING PHYSICIAN AT LEAST: 19
(I) 15 DAYS AFTER MAKING TH E INITIAL ORAL REQUE ST; AND 20
(II) 48 HOURS AFTER MAKING T HE WRITTEN REQUEST . 21
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW , NO OTHER 22
INDIVIDUAL, INCLUDING AN AGENT U NDER AN ADVANCE DIRE CTIVE, AN 23
ATTORNEY IN FACT UNDER A DURABLE POWER OF ATTORNEY , A GUARDIAN, OR A 24
CONSERVATOR , MAY REQUEST AID IN D YING ON BEHALF OF AN INDIVIDUAL. 25
(C) AT LEAST ONE OF THE ORA L REQUESTS MADE UNDE R SUBSECTION (A) 26
OF THIS SECTION SHAL L BE MADE WHILE THE INDIVIDUAL IS ALONE WITH THE 27
ATTENDING PHYSICIAN . 28
5–6A–03. 29
(A) A WRITTEN REQUEST FOR AID IN DYING REQUIRE D UNDER 30 HOUSE BILL 933 7
§ 5–6A–02(A)(2) OF THIS SUBTITLE SHA LL BE: 1
(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 2
(C) OF THIS SECTION; 3
(2) SIGNED AND DATED BY T HE INDIVIDUAL; AND 4
(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUAL S WHO, IN THE 5
PRESENCE OF THE INDI VIDUAL, ATTEST THAT TO THE B EST OF THEIR K NOWLEDGE 6
AND BELIEF THE INDIV IDUAL IS: 7
(I) OF SOUND MIND; AND 8
(II) ACTING VOLUNTARILY AN D NOT BEING COERCED TO SIGN 9
THE WRITTEN REQUEST . 10
(B) (1) ONLY ONE OF THE WITNE SSES UNDER SUBSECTIO N (A)(3) OF THIS 11
SECTION MAY BE : 12
(I) A RELATIVE OF THE I NDIVIDUAL BY BLOOD , MARRIAGE, OR 13
ADOPTION; OR 14
(II) AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE 15
INDIVIDUAL, ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 16
(2) THE INDIVIDUAL ’S ATTENDING PHYSICIA N MAY NOT BE A 17
WITNESS. 18
(C) A WRITTEN REQUEST UNDER THIS SECTION S HALL BE IN 19
SUBSTANTIALLY THE FO LLOWING FORM : 20
MARYLAND REQUEST FOR MEDICATION FOR AID IN DYING 21
BY: _______________________________ DATE OF BIRTH: ____________________ 22
(PRINT NAME) (MONTH/DAY/YEAR) 23
I, ______________________________________, AM AN ADULT OF SOUND MIND. 24
I AM A RESIDENT OF THE STATE OF MARYLAND. 25
I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 26
PHYSICIAN HAS DETERM INED WILL, MORE LIKELY THAN NOT , RESULT IN DEATH 27
WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 28
PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING , 29
THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 30
ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 31 8 HOUSE BILL 933
INCLUDING PALLIATIVE CARE AND HOSPICE . 1
I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 2
MEDICATION THAT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 3
THIS REQUEST . I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 4
PHARMACIST TO FILL THE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 5
INITIAL ONE: 6
_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINI ONS 7
INTO CONSIDERATION . 8
_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 9
_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION. 10
I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 11
I UNDERSTAND THE FULL IMPORT OF THIS REQUE ST AND I EXPECT TO DIE IF AND 12
WHEN I TAKE THE MEDICATION TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 13
ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 14
AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 15
I MAKE THIS REQUEST VO LUNTARILY AND WITHOU T RESERVATION , AND I ACCEPT 16
FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 17
SIGNED: _______________________________________ DATED: _____________________ 18
DECLARATION OF WITNESSES 19
I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 20
MEDICATION FOR AID I N DYING MAY NOT BE T HE INDIVIDUAL ’S ATTENDING 21
PHYSICIAN. FURTHER, ONLY ONE OF THE WITNESSES MAY BE : 22
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 23
OR 24
2. AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE INDIVIDUAL , 25
ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 26
BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS, I DECLARE 27
THAT: 28
THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 29
1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PROOF OF IDENTITY ; 30
2. SIGNED THIS REQUEST I N MY PRESENCE ON THE DATE OF THE 31
INDIVIDUAL’S SIGNATURE; 32
HOUSE BILL 933 9
3. APPEARS TO BE OF S OUND MIND AND NOT UN DER DURESS, FRAUD, OR 1
UNDUE INFLUENCE ; AND 2
4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTENDING PHY SICIAN. 3
WITNESS 1 4
(CHECK ONE) 5
_____________ I AM: 6
_____________ I AM NOT: 7
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 8
OR 9
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 10
THE INDIVIDUAL ’S DEATH. 11
PRINTED NAME OF WITNESS 1 ______________________________ 12
SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 13
WITNESS 2 14
(CHECK ONE) 15
_____________ I AM: 16
_____________ I AM NOT: 17
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 18
OR 19
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 20
THE INDIVIDUAL ’S DEATH. 21
PRINTED NAME OF WITNESS 2 _______________________________ 22
SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 23
5–6A–04. 24
(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 25
INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 26
WHETHER THE INDIVIDU AL: 27
(I) IS A QUALIFIED INDIVI DUAL; 28 10 HOUSE BILL 933
(II) HAS MADE AN INFORMED DECISION; AND 1
(III) HAS VOLUNTARILY REQUE STED AID IN DYING. 2
(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVIDU AL SOLELY DUE TO 3
AGE, DISABILITY, OR A SPECIFIC ILLNES S. 4
(B) FOR PURPOSES OF DETERMINING THAT AN INDIVIDUAL IS A QUAL IFIED 5
INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 6
INDIVIDUAL’S RESIDENCY IN THE STATE: 7
(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 8
IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION; 9
(2) REGISTRATION TO VOTE IN THE STATE; 10
(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 11
(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 12
RECENT TAX YEAR ; OR 13
(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 14
RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 15
INDIVIDUAL’S RESIDENCY IN THE STATE. 16
(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 17
AN INFORMED DECISION BY INFORMING THE IND IVIDUAL OF: 18
(1) THE INDIVIDUAL’S MEDICAL DIA GNOSIS; 19
(2) THE INDIVIDUAL’S PROGNOSIS; 20
(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERING 21
THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 22
(4) THE PROBABLE RESULT O F SELF–ADMINISTERING THE 23
MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 24
(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 25
OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE . 26
(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 27
PHYSICIAN DETERMINES THAT AN INDIVIDUAL I S A QUALIFIED INDIVI DUAL, HAS 28
MADE AN INFO RMED DECISION , AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 29 HOUSE BILL 933 11
THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONS ULTING 1
PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 2
SUBTITLE. 3
5–6A–05. 4
A CONSULTING PHYSICIAN TO WHOM AN INDIVID UAL HAS BEEN REFERRE D 5
UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 6
(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL ’S RELEVANT 7
MEDICAL RECORDS ; 8
(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 9
INDIVIDUAL HAS A TER MINAL ILLNESS; 10
(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 11
INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 12
(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 13
MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 14
AND 15
(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 16
DUTIES UNDER THIS SE CTION IN WRITING . 17
5–6A–06. 18
(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 19
CONSULTING PHYSICIAN , AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 20
THAT IS CAUS ING IMPAIRED JUDGMEN T OR OTHERWISE DOES NOT HAVE THE 21
CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 22
CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 23
HEALTH PROFESSIONAL FOR A MENTAL HEALTH PROFESSIONAL ASSESSM ENT. 24
(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 25
ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICIAN 26
MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING U NTIL THE 27
LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEALTH 28
PROFESSIONAL ASSESSM ENT: 29
(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 30
MEDICAL DECISIONS AN D IS NOT SUFFERING F ROM A CONDITION THAT IS CAUSING 31
IMPAIRED JUDGMENT ; AND 32
12 HOUSE BILL 933
(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 1
PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 2
5–6A–07. 3
(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 4
HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 5
SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 6
REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 7
THE ATTENDING PHYSIC IAN SHALL: 8
(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 9
THE QUALIFIED INDIVI DUAL AS TO WHETHER A ND WHEN TO SELF –ADMINISTER THE 10
MEDICATION PRESCRIBED FOR AID I N DYING; 11
(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 12
INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KI N OF THE REQUEST FOR AID IN DYING; 13
AND 14
(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FA ILURE TO 15
NOTIFY NEXT OF KIN I S NOT A BASIS FOR DENIAL O F THE REQUEST FOR AI D IN 16
DYING; 17
(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 18
IMPORTANCE OF : 19
(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 20
QUALIFIED INDIVIDUAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 21
AID IN DYING; 22
(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 23
(III) PARTICIPATING IN A HO SPICE PROGRAM ; 24
(4) ENCOURAGE THE QUALIFI ED INDIVIDUAL TO PRE PARE AN 25
ADVANCE DIRECTIVE ; 26
(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 27
NOT ARISE FROM CO ERCION OR UNDUE INFL UENCE BY ANOTHER IND IVIDUAL BY 28
DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 29
OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 30
INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 31
INDIVIDUAL; 32
HOUSE BILL 933 13
(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 1
INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 2
MANNER; 3
(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPT ION FOR 4
MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 5
INFORMED DECISION ; 6
(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 7
UNDER § 5–6A–08 OF THIS SUBTITLE; AND 8
(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPEN SING 9
PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 10
MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 11
1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 12
AND 13
2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIMIZE 14
THE QUALIFIED INDIVI DUAL’S DISCOMFORT ; OR 15
(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 16
DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 17
DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AN D PROVIDES WRITTEN 18
CONSENT FOR THE MEDICATION FOR AID IN DYING TO BE DISPENSED BY A 19
PHARMACIST : 20
1. CONTACT A PHARMACIST ; 21
2. INFORM THE PHARMACIST OF THE PRESCRIPTION 22
FOR MEDICATION FOR A ID IN DYING; AND 23
3. SUBMIT THE PRESCRIPTI ON FOR MEDICATION FO R 24
AID IN DYING TO THE PHARMACIST BY ANY MEANS AUTHORIZED BY LAW. 25
(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 26
ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 27
PRESCRIPTION FOR MED ICATION FOR AID IN D YING IN ACCORDANCE W ITH THE 28
REQUIREMEN TS OF SUBSECTION (A) OF THIS SECTION MAY DISPENSE THE 29
MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 30
QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 31
AGENT OF THE QUALIFI ED INDIVIDUAL. 32
(C) IF A QUALIFIED IND IVIDUAL SELF–ADMINISTERS MEDICATI ON FOR AID 33 14 HOUSE BILL 933
IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 1
INDIVIDUAL’S DEATH CERTIFICATE . 2
5–6A–08. 3
(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID I N 4
DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THAT TH E MEDICAL RECORD OF 5
THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 6
(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 7
IS AN ADULT AND A RE SIDENT OF THE STATE; 8
(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUAL IFIED 9
INDIVIDUAL FOR MEDICATION FOR A ID IN DYING; 10
(3) THE ATTENDING PHYSICI AN’S: 11
(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 12
ILLNESS AND PROGNOSI S; AND 13
(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 14
THE CAPACITY TO MAKE MEDICAL DECISIONS , HAS MADE AN INFORMED DECISI ON, 15
AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 16
(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 17
FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 18
SUBTITLE; 19
(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 20
DURING THE MENTAL HE ALTH PROFESSIONAL AS SESSMENT IF: 21
(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 22
HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 23
SUBTITLE; AND 24
(II) THE MENTAL HEALTH PRO FESSIONAL ASSESSMENT WAS 25
PROVIDED; 26
(6) DOCUMENTATION OF THE ATTENDING PHYSICIAN ’S OFFER TO 27
THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 28
FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 29
WROTE THE PRESCRIPTI ON FOR THE MEDICATIO N FOR THE QUALIFIED INDIVIDUAL ; 30
AND 31
HOUSE BILL 933 15
(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 1
(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 2
UNDER THIS SUBTITLE HAVE BEEN MET ; AND 3
(II) SPECIFYING THE STEPS TAKEN TO CARRY OUT T HE 4
QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICA TION 5
PRESCRIBED FOR AID I N DYING. 6
(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 7
INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 8
REGULATIONS ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 9
5–6A–09. 10
(A) THE DEPARTMENT SHALL ADOP T REGULATIONS TO FAC ILITATE THE 11
COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 12
(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 13
PUBLIC AN ANNUAL STA TISTICAL REPORT OF I NFORMATION COLLECTED UNDER 14
SUBSECTION (A) OF THIS SECTION. 15
(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 16
SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 17
INTRODUCED INTO EVID ENCE IN ANY JUDICIAL OR ADMINISTRATIVE PR OCEEDING, 18
EXCEPT TO RESOLVE MATTERS C ONCERNING COMPLIANCE WITH THIS SUBTITLE O R 19
AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 20
5–6A–10. 21
A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 22
OF MEDICATION PRESCR IBED FOR AID IN DYIN G THAT HAS NOT BEEN 23
SELF–ADMINISTERED SHALL DIS POSE OF THE MEDICATI ON IN A LAWFUL MANNE R. 24
5–6A–11. 25
(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 26
PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 27
WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEAT H OF A 28
QUALIFIED INDIVIDUAL BY REASON OF THE SEL F–ADMINISTRATION OF ME DICATION 29
PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 30
NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 31
WHICH THE QUALIFIED INDIVIDUAL SUFFERED . 32
16 HOUSE BILL 933
(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEG AL INSTRUMENT THAT 1
IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 2
(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 3
PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 4
IF THE PERSON, WITH THE INTENT OR E FFECT OF CAUSING THE INDIVIDUAL’S 5
DEATH: 6
(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 7
(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 8
DYING; 9
(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 10
COMPLETE A REQUEST F OR AID IN DYING; OR 11
(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 12
DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 13
(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENS ED PHYSICIAN OR 14
ANY OTHER PERSON TO END AN INDIVIDUAL’S LIFE BY LETHAL INJ ECTION, MERCY 15
KILLING, OR ACTIVE EUTHANASIA . 16
(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 17
FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 18
HOMICIDE. 19
5–6A–12. 20
(A) A PROVISION IN AN INSURANCE POLICY , AN ANNUITY, A CONTRACT, OR 21
ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2023, IS NOT 22
VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 23
OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 24
RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTITLE. 25
(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2023, 26
MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 27
REQUEST FOR AID IN D YING UNDER THIS SUBT ITLE. 28
(C) A QUALIFIED INDIVIDUAL’S ACT OF SELF–ADMINISTERING MEDICA TION 29
FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 30
HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 31
DIFFERS FROM THE EFF ECT UNDER THE POLICY OR CONTRACT OF THE Q UALIFIED 32
INDIVIDUAL’S DEATH FROM NATURAL CAUSES. 33 HOUSE BILL 933 17
5–6A–13. 1
(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 2
(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 3
OR PROFESSIONAL DISC IPLINARY ACTION FOR PARTICIPATING IN GOO D–FAITH 4
COMPLIANCE WITH THIS SUBTITLE , INCLUDING BEING PRES ENT WHEN A QUALIFIED 5
INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 6
(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 7
CARE PROVIDER , OR A HEALTH OCCUPATI ON BOARD MAY NOT SUB JECT A PERSON 8
TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 9
LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 10
TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 11
(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDING 12
PHYSICIAN’S PRESCRIPTION OF ME DICATION MADE IN GOO D–FAITH COMPLIANCE 13
WITH THIS SUBTITLE D OES NOT: 14
(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 15
(2) PROVIDE THE SOLE BASI S FOR THE APPOINTMEN T OF A 16
GUARDIAN OR CONSERVA TOR. 17
5–6A–14. 18
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 19
INDICATED. 20
(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 21
WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 22
CARE PROVIDER , BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 23
DYING, OF A HEALTH CARE FACILI TY’S POLICY ABOUT PARTICI PATION IN AID IN 24
DYING. 25
(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 26
DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICI AN, OR A LICENSED 27
MENTAL HEALTH PRO FESSIONAL UNDER THIS SUBTITLE. 28
(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 29
1. MAKING AN INITIAL DET ERMINATION THAT AN 30
INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 31 18 HOUSE BILL 933
MEDICAL PROGNOSIS ; 1
2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 2
AN INDIVIDUAL ON THE REQUEST OF THE INDIV IDUAL; OR 3
3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 4
INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 5
(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALT H CARE 6
PROVIDER FROM PARTIC IPATING IN AID IN DYI NG UNDER THIS SUBTIT LE ON THE 7
PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROHIBITING 8
HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 9
PRIVILEGES TO PRACTI CE ON THE PREMISES O F THE PROHIBITING HE ALTH CARE 10
FACILITY’S POLICY REGARDING PAR TICIPATING IN AID IN DYING. 11
(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 12
PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 13
PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIV IDUAL. 14
(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 15
THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACILITY HAS 16
NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 17
HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 18
HEALTH CARE FACILITY PROHIBITS PARTICIPAT ION IN AID IN DYING: 19
(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 20
SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 21
PROCEDURES OF THE SA NCTIONING HEALTH CAR E FACILITY IF THE SANCT IONED 22
HEALTH CARE PROVIDER IS A MEMBER OF THE S ANCTIONING HEALTH CA RE 23
FACILITY’S MEDICAL STAFF AND PA RTICIPATES IN AID IN DYING WHILE ON THE 24
PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 25
(2) TERMINATION OF A LEAS E OR ANY OTHER PROPE RTY CONTRACT 26
OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PRO PERTY 27
CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 28
OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 29
PROVIDER PARTICIPATE S IN AID IN DYING WH ILE ON THE PREMISES OF THE 30
SANCTIONING HEALTH C ARE FACILITY OR ON PROPERTY THAT IS OWNED BY OR 31
UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACILITY; OR 32
(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 33
REMEDIES PROVIDED BY A CONTRACT IF THE SA NCTIONED HEALTH CARE PROVIDER 34
PARTICIPATES IN AID IN DYING WHILE ACTIN G IN THE COURSE AND SCOPE OF THE 35
SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 36 HOUSE BILL 933 19
INDEPENDENT CONTRACTOR O F THE SANCTIONING HE ALTH CARE FACILITY. 1
(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 2
(1) A HEALTH CARE PROVIDER FROM PARTICIPATING I N AID IN 3
DYING: 4
(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 5
HEALTH CARE PROVI DER’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 6
CONTRACTOR OF THE SA NCTIONING HEALTH CAR E FACILITY; OR 7
(II) OFF THE PREMISES OF T HE SANCTIONING HEALT H CARE 8
FACILITY OR OFF ANY PROPERTY THAT IS OWNED BY OR UNDER THE DIRECT 9
CONTROL OF THE SANCT IONING HEALTH CARE FACILITY; OR 10
(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE I NDIVIDUAL’S 11
ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUTSIDE T HE COURSE 12
AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 13
CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SANCT IONING 14
HEALTH CARE FACILITY. 15
5–6A–15. 16
(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 17
UNDER THIS SUBTITLE IS VOLUNTARY. 18
(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 19
THE MEDICAL STAFF OF THE HEALTH CARE FACILITY TO PAR TICIPATE IN AID IN 20
DYING. 21
(B) IF AN INDIVIDUAL REQU ESTS OR INDICATES AN INTEREST IN AID IN 22
DYING, AND THE ATTENDING PH YSICIAN OF THE INDIV IDUAL DOES NOT WISH TO 23
PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 24
INDIVIDUAL THAT THE ATT ENDING PHYSICIAN DOE S NOT WISH TO PARTIC IPATE. 25
(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 26
TRANSFER A COPY OF A N INDIVIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 27
ATTENDING PHYSICIAN IF: 28
(1) THE INDIVIDUAL REQUES TS OR INDICATES AN INTERES T IN AID IN 29
DYING; 30
(2) THE ORIGINAL ATTENDIN G PHYSICIAN IS UNABL E OR UNWILLING 31
TO PARTICIPATE IN AI D IN DYING FOR THE I NDIVIDUAL; AND 32 20 HOUSE BILL 933
(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 1
ANOTHER ATTENDING PH YSICIAN. 2
(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 3
A LICENSED PHYSICIAN ASSOCIATED WITH THE HEALTH CARE FACILITY FROM 4
PARTICIPATING IN AID IN DYING, IN ACCORDANCE WITH § 5–6A–14 OF THIS 5
SUBTITLE. 6
5–6A–16. 7
(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FORGES A WRITTEN 8
REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 9
OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WI THOUT THE 10
AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 11
THE INDIVIDUAL ’S DEATH IS GUILTY OF A FE LONY AND ON CONVICTI ON IS SUBJECT 12
TO IMPRISONMENT NOT EXCEEDING 10 YEARS OR A FINE NOT EXCEEDING $10,000 13
OR BOTH. 14
(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 15
INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 16
THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVIDUAL ’S LIFE OR TO 17
DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FELON Y AND ON 18
CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 19
NOT EXCEEDING $10,000 OR BOTH. 20
(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 21
SEPARATE FROM AND CO NSECUTIVE TO OR CONC URRENT WITH A SENTEN CE FOR 22
ANY CRIME BASED ON T HE ACT ESTABLISHING THE VIOLATION OF THI S SECTION. 23
(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMA GES 24
RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONAL MI SCONDUCT 25
BY ANY PERSON . 26
Article – Insurance 27
27–208.1. 28
(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS AND OTHER PURPOSES 29
GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 30
SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 31
6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 32
NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 33
WHICH THE INDIVIDUAL SUFFERED. 34 HOUSE BILL 933 21
(B) ACTIONS TAKEN IN ACCORDANCE WI TH TITLE 5, SUBTITLE 6A OF THE 1
HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 2
ASSISTED SUICIDE , MERCY KILLING , OR HOMICIDE. 3
(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 4
CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2023, IS NOT VALID TO 5
THE EXTENT THAT THE PROVISION WOULD ATTA CH CONSEQUENCES TO O R 6
OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 7
RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 8
HEALTH – GENERAL ARTICLE. 9
(D) AN OBLIGATION UNDER A N INSURANCE POLICY O R CONTRACT OR AN 10
ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2023, MAY NOT BE CONDITION ED ON 11
OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 12
UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 13
(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 14
AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 15
MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 16
POLICY OR CONTR ACT, OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 17
EFFECT UNDER THE POL ICY OR CONTRACT OF T HE INSURED’S OR ANNUITANT ’S 18
DEATH FROM NATURAL C AUSES. 19
SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 20
the application thereof to any person or circumstance is held invalid for any reason in a 21
court of competent jurisdiction, the invalidity does not affect other provisions or any other 22
application of this Act that can be given effect without the invalid provision or application, 23
and for this purpose the provisions of this Act are declared severable. 24
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
October 1, 2023. 26