Maryland 2023 Regular Session

Maryland Senate Bill SB845 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 MAT TER ADDED TO EXISTIN G LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	sb0845
6	6
7	7	SENATE BILL 845
8	8	J1 3lr1624
9	9	SB 701/20 – JPR CF HB 933
10	10	By: Senators Waldstreicher, Kagan, King, West, Lam, Hettleman, Elfreth, Zucker,
11	11	Smith, Lewis Young, Kramer, Feldman, and Guzzone
12	12	Introduced and read first time: February 6, 2023
13	13	Assigned to: Judicial Proceedings
14	14
15	15	A BILL ENTITLED
16	16
17	17	AN ACT concerning 1
18	18
19	19	End–of–Life Option Act 2
20	20	(The Honorable Elijah E. Cummings and the Honorable Shane E. 3
21	21	Pendergrass Act) 4
22	22
23	23	FOR the purpose of authorizing an individual to request aid in dying by making certain 5
24	24	requests; establishing requirements and prohibitions governing aid in dying, 6
25	25	including requirements related to requests for aid in dying, consulting physicians, 7
26	26	mental health assessments, the disposal of drugs prescribed for aid in dying, health 8
27	27	care facility policies, and the effect of aid in dying on insurance policies; authorizing 9
28	28	a pharmacist to dispense medication for aid in dying only to certain individuals 10
29	29	under certain circumstances; providing that the death of a qualified individual by 11
30	30	reason of self–administration of certain medication shall be deemed to be a death 12
31	31	from certain natural causes for certain purposes; providing that this Act does not 13
32	32	authorize certain individuals to end another individual’s life by certain means; 14
33	33	providing that participation by a health care provider in aid in dying is voluntary; 15
34	34	authorizing the Maryland Insurance Commissioner to enforce certain provisions of 16
35	35	this Act; establishing that a licensed health care professional does not violate the 17
36	36	statutory prohibition on assisted suicide by taking certain actions in accordance with 18
37	37	this Act; and generally relating to aid in dying. 19
38	38
39	39	BY repealing and reenacting, with amendments, 20
40	40	Article – Criminal Law 21
41	41	Section 3–103 22
42	42	Annotated Code of Maryland 23
43	43	(2021 Replacement Volume and 2022 Supplement) 24
44	44
45	45	BY adding to 25
46	46	Article – Health – Genera l 26
47	47	Section 5–6A–01 through 5–6A–16 to be under the new subtitle “Subtitle 6A. The 27
48	48	Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass 28 2 SENATE BILL 845
49	49
50	50
51	51	End–of–Life Option Act” 1
52	52	Annotated Code of Maryland 2
53	53	(2019 Replacement Volume and 2022 Supplement) 3
54	54
55	55	BY adding to 4
56	56	Article – Insurance 5
57	57	Section 27–208.1 6
58	58	Annotated Code of Maryland 7
59	59	(2017 Replacement Volume and 2022 Supplement) 8
60	60
61	61	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 9
62	62	That the Laws of Maryland read as follows: 10
63	63
64	64	Article – Criminal Law 11
65	65
66	66	3–103. 12
67	67
68	68	(a) A licensed health care professional does not violate § 3–102 of this subtitle by 13
69	69	administering or prescribing a procedure or administering, prescribing, or dispensing a 14
70	70	medication to relieve pain, even if the medication or procedure may hasten death or 15
71	71	increase the risk of death, unless the licensed health care professional knowingly 16
72	72	administers or prescribes the procedure or administers, prescribes, or dispenses the 17
73	73	medication to cause death. 18
74	74
75	75	(b) A licensed health care professional does not violate § 3–102 of this subtitle by 19
76	76	withholding or withdrawing a medically administered life–sustaining procedure: 20
77	77
78	78	(1) in compliance with Title 5, Subtitle 6 of the Health – General Article; 21
79	79	or 22
80	80
81	81	(2) in accordance with reasonable medical practice. 23
82	82
83	83	(C) A LICENSED HEALTH CARE PROFESSIONAL DOES NO T VIOLATE § 3–102 24
84	84	OF THIS SUBTITLE BY TAKING ANY ACTION IN ACCORDA NCE WITH TITLE 5, 25
85	85	SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 26
86	86
87	87	[(c)] (D) (1) Unless the family member knowingly administers a procedure or 27
88	88	administers or dispenses a medication to cause death, a family member does not violate 28
89	89	§ 3–102 of this subtitle if the family member: 29
90	90
91	91	(i) is a caregiver for a patient enrolled in a licensed hospice program; 30
92	92	and 31
93	93
94	94	(ii) administers the procedure or administers or dispenses the 32
95	95	medication to relieve pain under the supervision of a health care professional. 33
96	96
97	97	(2) Paragraph (1) of this subsection applies even if the medication or 34 SENATE BILL 845 3
98	98
99	99
100	100	procedure hastens death or increases the risk of death. 1
101	101
102	102	Article – Health – General 2
103	103
104	104	SUBTITLE 6A. THE HONORABLE ELIJAH E. CUMMINGS AND THE HONORABLE 3
105	105	SHANE E. PENDERGRASS END–OF–LIFE OPTION ACT. 4
106	106
107	107	5–6A–01. 5
108	108
109	109	(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 6
110	110	INDICATED. 7
111	111
112	112	(B) “AID IN DYING” MEANS THE MEDICAL PR ACTICE OF A PHYSICIA N 8
113	113	PRESCRIBING MEDICATI ON TO A QUALIFIED IN DIVIDUAL THAT THE QU ALIFIED 9
114	114	INDIVIDUAL MAY SELF –ADMINISTER TO BRING ABOUT THE QUALIFIED INDIVIDUAL’S 10
115	115	DEATH. 11
116	116
117	117	(C) “ATTENDING PHYSICIAN ” MEANS THE LICENSED P HYSICIAN WHO HAS 12
118	118	PRIMARY RESPONSIBILI TY FOR THE MEDICAL C ARE OF THE INDIVIDUA L AND 13
119	119	TREATMENT OF THE IND IVIDUAL’S TERMINAL ILLNESS . 14
120	120
121	121	(D) “CAPACITY TO MAKE MEDI CAL DECISIONS” MEANS THE ABILITY OF AN 15
122	122	INDIVIDUAL TO: 16
123	123
124	124	(1) UNDERSTAND THE NATURE AND CONSEQUENCES OF A HEALTH 17
125	125	CARE DECISION; 18
126	126
127	127	(2) UNDERSTAND THE SIGNIF ICANT BENEFITS , RISKS, AND 19
128	128	ALTERNATIVES OF A HE ALTH CARE DECISION ; AND 20
129	129
130	130	(3) MAKE AND COMMUNICATE AN INFORM ED DECISION TO HEALT H 21
131	131	CARE PROVIDERS , INCLUDING COMMUNICAT ION THROUGH ANOTHER INDIVIDUAL 22
132	132	FAMILIAR WITH THE IN DIVIDUAL’S MANNER OF COMMUNIC ATING, IF THE OTHER 23
133	133	INDIVIDUAL IS AVAILA BLE. 24
134	134
135	135	(E) “CONSULTING PHYSICIAN ” MEANS A LICENSED PHY SICIAN WHO IS 25
136	136	QUALIFIED BY SPECIALTY OR EXPE RIENCE TO CONFIRM A PROFESSIONAL 26
137	137	DIAGNOSIS AND PROGNO SIS REGARDING AN IND IVIDUAL’S TERMINAL ILLNESS . 27
138	138
139	139	(F) “HEALTH CARE FACILITY ” MEANS: 28
140	140
141	141	(1) A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE; 29
142	142
143	143	(2) A HOSPICE FACILITY , AS DEFINED IN § 19–901 OF THIS ARTICLE; 30
144	144	4 SENATE BILL 845
145	145
146	146
147	147	(3) AN ASSISTED LIVING PR OGRAM, AS DEFINED IN § 19–1801 OF THIS 1
148	148	ARTICLE; OR 2
149	149
150	150	(4) A NURSING HOME , AS DEFINED IN § 19–1401 OF THIS ARTICLE. 3
151	151
152	152	(G) “HEALTH CARE PROVIDER ” MEANS AN INDIVIDUAL LICENSED OR 4
153	153	CERTIFIED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HE ALTH 5
154	154	CARE OR DISPENSE MED ICATION IN THE ORDIN ARY COURSE OF BUSINE SS OR 6
155	155	PRACTICE OF A PROFES SION. 7
156	156
157	157	(H) “INFORMED DECISION ” MEANS A DECISION BY AN INDIVIDUAL THAT I S: 8
158	158
159	159	(1) BASED ON AN UNDERSTAN DING AND ACKNOWLEDGM ENT OF THE 9
160	160	RELEVANT FACTS ; AND 10
161	161
162	162	(2) MADE AFTER RECEIVING THE INFORMATION REQU IRED UNDER 11
163	163	§ 5–6A–04(C) OF THIS SUBTITLE. 12
164	164
165	165	(I) “LICENSED MENTAL HEALT H PROFESSIONAL ” MEANS A LICENSED 13
166	166	PSYCHIATRIST OR A LI CENSED PSYC HOLOGIST. 14
167	167
168	168	(J) “LICENSED PHYSICIAN ” MEANS A PHYSICIAN WH O IS LICENSED TO 15
169	169	PRACTICE MEDICINE IN THE STATE. 16
170	170
171	171	(K) “LICENSED PSYCHIATRIST ” MEANS A PSYCHIATRIST WHO IS LICENSED 17
172	172	TO PRACTICE MEDICINE IN THE STATE. 18
173	173
174	174	(L) “LICENSED PSYCHOLOGIST ” MEANS A PSYCHOLOGIST WHO IS LICENSED 19
175	175	TO PRACTICE PSYCHOLO GY IN THE STATE. 20
176	176
177	177	(M) “MENTAL HEALTH PROFESS IONAL ASSESSMENT ” MEANS ONE OR MORE 21
178	178	CONSULTATIONS BETWEE N AN INDIVIDUAL AND A LICENSED MENTAL HE ALTH 22
179	179	PROFESSIONAL FOR THE PURPOSE OF DETERMINI NG THAT THE INDIVIDU AL: 23
180	180
181	181	(1) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; AND 24
182	182
183	183	(2) IS NOT SUFFERING FROM IMPAIRED JUDGMENT DU E TO A MENTAL 25
184	184	DISORDER. 26
185	185
186	186	(N) “PALLIATIVE CARE ” MEANS HEALTH CARE CE NTERED ON A 27
187	187	TERMINALLY ILL INDIV IDUAL AND THE INDIVI DUAL’S FAMILY THAT: 28
188	188
189	189	(1) OPTIMIZES THE INDIVID UAL’S QUALITY OF LIFE BY 29
190	190	ANTICIPATING, PREVENTING , AND TREATING THE IND IVIDUAL’S SUFFERING 30 SENATE BILL 845 5
191	191
192	192
193	193	THROUGHOUT THE CONTI NUUM OF THE INDIVIDU AL’S TERMINAL ILLNESS ; 1
194	194
195	195	(2) ADDRESSES THE PHYSICA L, EMOTIONAL, SOCIAL, AND SPIRITUAL 2
196	196	NEEDS OF THE INDI VIDUAL; 3
197	197
198	198	(3) FACILITATES INDIVIDUA L AUTONOMY , THE INDIVIDUAL ’S ACCESS 4
199	199	TO INFORMATION , AND INDIVIDUAL CHOIC E; AND 5
200	200
201	201	(4) INCLUDES DISCUSSIONS BETWEEN THE INDIVIDU AL AND A 6
202	202	HEALTH CARE PROVIDER CONCERNING THE INDIV IDUAL’S GOALS FOR TREATMEN T 7
203	203	AND APPROPRIATE TREATMENT OPTIONS AV AILABLE TO THE INDIV IDUAL, 8
204	204	INCLUDING HOSPICE CA RE AND COMPREHENSIVE PAIN AND SYMPTOM 9
205	205	MANAGEMENT . 10
206	206
207	207	(O) “PHARMACIST” MEANS A PHARMACIST W HO IS LICENSED TO PR ACTICE 11
208	208	PHARMACY IN THE STATE. 12
209	209
210	210	(P) “QUALIFIED INDIVIDUAL ” MEANS AN INDIVIDUAL WHO: 13
211	211
212	212	(1) IS AN ADULT; 14
213	213
214	214	(2) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; 15
215	215
216	216	(3) IS A RESIDENT OF THE STATE; 16
217	217
218	218	(4) HAS A TERMINAL ILLNES S; AND 17
219	219
220	220	(5) HAS THE ABILITY TO SE LF–ADMINISTER MEDICATIO N. 18
221	221
222	222	(Q) “RELATIVE” MEANS: 19
223	223
224	224	(1) A SPOUSE; 20
225	225
226	226	(2) A CHILD; 21
227	227
228	228	(3) A GRANDCHILD ; 22
229	229
230	230	(4) A SIBLING; 23
231	231
232	232	(5) A PARENT; OR 24
233	233
234	234	(6) A GRANDPARENT . 25
235	235
236	236	(R) (1) “SELF–ADMINISTER” MEANS A QUALIFIED IN DIVIDUAL’S 26
237	237	AFFIRMATIVE, CONSCIOUS, AND VOLUNTARY ACT OF INGESTING MEDICATION 27 6 SENATE BILL 845
238	238
239	239
240	240	PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING AB OUT THE 1
241	241	INDIVIDUAL’S DEATH. 2
242	242
243	243	(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAK ING MEDICATION BY 3
244	244	PARENTERAL INJECTION OR INFUSION. 4
245	245
246	246	(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 5
247	247	REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOS IS FOR AN INDIVIDUAL 6
248	248	THAT LIKELY WILL RES ULT IN THE INDIVIDUA L’S DEATH WITHIN 6 MONTHS. 7
249	249
250	250	(T) “WRITTEN REQUEST ” MEANS A WRITTEN REQU EST FOR AID IN DYING . 8
251	251
252	252	5–6A–02. 9
253	253
254	254	(A) AN INDIVIDUAL MAY REQ UEST AID IN DYING BY : 10
255	255
256	256	(1) MAKING AN INITIAL ORA L REQUEST TO TH E INDIVIDUAL ’S 11
257	257	ATTENDING PHYSICIAN ; 12
258	258
259	259	(2) AFTER MAKING AN INITI AL ORAL REQUEST , MAKING A WRITTEN 13
260	260	REQUEST TO THE INDIV IDUAL’S ATTENDING PHYSICIA N, IN ACCORDANCE WITH 14
261	261	§ 5–6A–03 OF THIS SUBTITLE; AND 15
262	262
263	263	(3) MAKING A SECOND ORAL REQUEST TO THE INDIV IDUAL’S 16
264	264	ATTENDING PHYSICIAN A T LEAST: 17
265	265
266	266	(I) 15 DAYS AFTER MAKING TH E INITIAL ORAL REQUE ST; AND 18
267	267
268	268	(II) 48 HOURS AFTER MAKING T HE WRITTEN REQUEST . 19
269	269
270	270	(B) NOTWITHSTANDING ANY O THER PROVISION OF LA W, NO OTHER 20
271	271	INDIVIDUAL, INCLUDING AN AGENT U NDER AN ADVANCE DIRE CTIVE, AN 21
272	272	ATTORNEY IN FACT UND ER A DURABLE POWER O F ATTORNEY, A GUARDIAN, OR A 22
273	273	CONSERVATOR , MAY REQUEST AID IN D YING ON BEHALF OF AN INDIVIDUAL. 23
274	274
275	275	(C) AT LEAST ONE OF THE O RAL REQUESTS MADE UN DER SUBSECTION (A) 24
276	276	OF THIS SECTION SHAL L BE MADE WHILE THE INDIVIDUAL IS ALONE WITH THE 25
277	277	ATTENDING PHYSICIAN . 26
278	278
279	279	5–6A–03. 27
280	280
281	281	(A) A WRITTEN REQUEST FOR AID IN DYING REQUIRE D UNDER 28
282	282	§ 5–6A–02(A)(2) OF THIS SUBTITLE SHA LL BE: 29
283	283	SENATE BILL 845 7
284	284
285	285
286	286	(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 1
287	287	(C) OF THIS SECTION; 2
288	288
289	289	(2) SIGNED AND DATED BY THE IND IVIDUAL; AND 3
290	290
291	291	(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUAL S WHO, IN THE 4
292	292	PRESENCE OF THE INDI VIDUAL, ATTEST THAT TO THE B EST OF THEIR KNOWLED GE 5
293	293	AND BELIEF THE INDIV IDUAL IS: 6
294	294
295	295	(I) OF SOUND MIND; AND 7
296	296
297	297	(II) ACTING VOLUNTARILY AN D NOT BEING COERCED TO SIGN 8
298	298	THE WRITTEN REQUEST . 9
299	299
300	300	(B) (1) ONLY ONE OF THE WITNE SSES UNDER SUBSECTIO N (A)(3) OF THIS 10
301	301	SECTION MAY BE : 11
302	302
303	303	(I) A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR 12
304	304	ADOPTION; OR 13
305	305
306	306	(II) AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE 14
307	307	INDIVIDUAL, ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 15
308	308
309	309	(2) THE INDIVIDUAL ’S ATTENDING PHYSICIA N MAY NOT BE A 16
310	310	WITNESS. 17
311	311
312	312	(C) A WRITTEN REQUEST UNDE R THIS SECTION SHALL BE IN 18
313	313	SUBSTANTIALLY THE FO LLOWING FORM : 19
314	314
315	315	MARYLAND REQUEST FOR MEDICATION FOR AID IN DYING 20
316	316
317	317	BY: _______________________________ DATE OF BIRTH: ____________________ 21
318	318	(PRINT NAME) (MONTH/DAY/YEAR) 22
319	319
320	320	I, ______________________________________, AM AN ADULT OF SOUND MIND. 23
321	321	I AM A RESIDENT OF THE STATE OF MARYLAND. 24
322	322	I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 25
323	323	PHYSICIAN HAS DETERM INED WILL, MORE LIKELY THAN NOT , RESULT IN DEATH 26
324	324	WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 27
325	325	PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING, 28
326	326	THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 29
327	327	ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 30
328	328	INCLUDING PALLIATIVE CARE AND HOSPICE . 31
329	329	I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 32 8 SENATE BILL 845
330	330
331	331
332	332	MEDICATION TH AT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 1
333	333	THIS REQUEST . I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 2
334	334	PHARMACIST TO FILL T HE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 3
335	335
336	336	INITIAL ONE: 4
337	337	_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINIO NS 5
338	338	INTO CONSIDERATION . 6
339	339	_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 7
340	340	_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION . 8
341	341
342	342	I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 9
343	343	I UNDERSTAND THE FULL IMPORT OF THIS REQUEST AND I EXPECT TO DIE IF AND 10
344	344	WHEN I TAKE THE MEDICATION TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 11
345	345	ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 12
346	346	AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 13
347	347	I MAKE THIS REQUEST VOLU NTARILY AND WITHOUT RESERVATION , AND I ACCEPT 14
348	348	FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 15
349	349
350	350	SIGNED: _______________________________________ DATED: _____________________ 16
351	351
352	352	DECLARATION OF WITNESSES 17
353	353
354	354	I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 18
355	355	MEDICATION FOR AID I N DYING MAY NOT BE T HE INDIVIDUAL ’S ATTENDING 19
356	356	PHYSICIAN. FURTHER, ONLY ONE OF THE WITN ESSES MAY BE: 20
357	357
358	358	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 21
359	359	OR 22
360	360
361	361	2. AT THE TIME THE WRI TTEN REQUEST IS SIGN ED BY THE INDIVIDUAL , 23
362	362	ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 24
363	363
364	364	BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS , I DECLARE 25
365	365	THAT: 26
366	366
367	367	THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 27
368	368
369	369	1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PR OOF OF IDENTITY; 28
370	370
371	371	2. SIGNED THIS REQUEST I N MY PRESENCE ON THE DATE OF THE 29
372	372	INDIVIDUAL’S SIGNATURE; 30
373	373
374	374	3. APPEARS TO BE OF SOUN D MIND AND NOT UNDER DURESS, FRAUD, OR 31
375	375	UNDUE INFLUENCE ; AND 32 SENATE BILL 845 9
376	376
377	377
378	378
379	379	4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTEND ING PHYSICIAN. 1
380	380
381	381	WITNESS 1 2
382	382	(CHECK ONE) 3
383	383
384	384	_____________ I AM: 4
385	385
386	386	_____________ I AM NOT: 5
387	387
388	388	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 6
389	389	OR 7
390	390
391	391	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 8
392	392	THE INDIVIDUAL ’S DEATH. 9
393	393
394	394	PRINTED NAME OF WITNESS 1 ______________________________ 10
395	395	SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 11
396	396
397	397
398	398	WITNESS 2 12
399	399	(CHECK ONE) 13
400	400
401	401	_____________ I AM: 14
402	402
403	403	_____________ I AM NOT: 15
404	404
405	405	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 16
406	406	OR 17
407	407
408	408	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 18
409	409	THE INDIVIDUAL ’S DEATH. 19
410	410
411	411	PRINTED NAME OF WITNESS 2 _______________________________ 20
412	412	SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 21
413	413
414	414	5–6A–04. 22
415	415
416	416	(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 23
417	417	INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 24
418	418	WHETHER THE INDIVIDU AL: 25
419	419
420	420	(I) IS A QUALIFIED INDIVI DUAL; 26
421	421
422	422	(II) HAS MADE AN INFORMED DECISION; AND 27 10 SENATE BILL 845
423	423
424	424
425	425
426	426	(III) HAS VOLUNTARILY REQUESTED AID IN DYI NG. 1
427	427
428	428	(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVIDU AL SOLELY DUE TO 2
429	429	AGE, DISABILITY, OR A SPECIFIC ILLNES S. 3
430	430
431	431	(B) FOR PURPOSES OF DETER MINING THAT AN INDIV IDUAL IS A QUALIFIED 4
432	432	INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 5
433	433	INDIVIDUAL’S RESIDENCY IN THE STATE: 6
434	434
435	435	(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 7
436	436	IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION ; 8
437	437
438	438	(2) REGISTRATION TO VOTE IN THE STATE; 9
439	439
440	440	(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 10
441	441
442	442	(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 11
443	443	RECENT TAX YEAR ; OR 12
444	444
445	445	(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 13
446	446	RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 14
447	447	INDIVIDUAL’S RESIDENCY IN THE STATE. 15
448	448
449	449	(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 16
450	450	AN INFORMED DECISION BY INFORMING THE IND IVIDUAL OF: 17
451	451
452	452	(1) THE INDIVIDUAL’S MEDICAL DIAGNOSIS ; 18
453	453
454	454	(2) THE INDIVIDUAL’S PROGNOSIS; 19
455	455
456	456	(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERIN G 20
457	457	THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 21
458	458
459	459	(4) THE PROBABLE RESULT O F SELF–ADMINISTERING THE 22
460	460	MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 23
461	461
462	462	(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 24
463	463	OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE. 25
464	464
465	465	(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 26
466	466	PHYSICIAN DETERMINES THAT AN INDIVIDUAL I S A QUALIFIED INDIVI DUAL, HAS 27
467	467	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 28
468	468	THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONSULT ING 29 SENATE BILL 845 11
469	469
470	470
471	471	PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 1
472	472	SUBTITLE. 2
473	473
474	474	5–6A–05. 3
475	475
476	476	A CONSULTING PHYSICIAN TO WHOM AN INDIVIDUA L HAS BEEN REFERRED 4
477	477	UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 5
478	478
479	479	(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL’S RELEVANT 6
480	480	MEDICAL RECORDS ; 7
481	481
482	482	(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 8
483	483	INDIVIDUAL HAS A TER MINAL ILLNESS; 9
484	484
485	485	(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 10
486	486	INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 11
487	487
488	488	(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 12
489	489	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 13
490	490	AND 14
491	491
492	492	(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 15
493	493	DUTIES UNDER THIS SE CTION IN WRITING . 16
494	494
495	495	5–6A–06. 17
496	496
497	497	(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 18
498	498	CONSULTING PHYSICIAN , AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 19
499	499	THAT IS CAUSING IMPA IRED JUDGMENT OR OTH ERWISE DOES NOT HAVE THE 20
500	500	CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 21
501	501	CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 22
502	502	HEALTH PROFESSIONAL FOR A MENTAL HEALTH PROFESSIONAL ASSESSM ENT. 23
503	503
504	504	(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 24
505	505	ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICIA N 25
506	506	MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING U NTIL THE 26
507	507	LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEA LTH 27
508	508	PROFESSIONAL ASSESSM ENT: 28
509	509
510	510	(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 29
511	511	MEDICAL DECISIONS AND IS NOT SUFFERING FROM A CON DITION THAT IS CAUSI NG 30
512	512	IMPAIRED JUDGMENT ; AND 31
513	513
514	514	(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 32 12 SENATE BILL 845
515	515
516	516
517	517	PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 1
518	518
519	519	5–6A–07. 2
520	520
521	521	(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 3
522	522	HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 4
523	523	SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 5
524	524	REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 6
525	525	THE ATTENDING PHYSIC IAN SHALL: 7
526	526
527	527	(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 8
528	528	THE QUALIFIED INDIVI DUAL AS TO WHETHER A ND WHEN TO SELF –ADMINISTER THE 9
529	529	MEDICATION PRESCRIBE D FOR AID IN DYING; 10
530	530
531	531	(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 11
532	532	INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KIN OF THE REQUEST FOR A ID IN DYING; 12
533	533	AND 13
534	534
535	535	(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FA ILURE TO 14
536	536	NOTIFY NEXT OF KIN I S NOT A BASIS FOR DE NIAL OF THE REQUEST FOR AID IN 15
537	537	DYING; 16
538	538
539	539	(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 17
540	540	IMPORTANCE OF: 18
541	541
542	542	(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 19
543	543	QUALIFIED INDIVIDUAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 20
544	544	AID IN DYING; 21
545	545
546	546	(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 22
547	547
548	548	(III) PARTICIPATING IN A HO SPICE PROGRAM ; 23
549	549
550	550	(4) ENCOURAGE THE QUALIFIE D INDIVIDUAL TO PREP ARE AN 24
551	551	ADVANCE DIRECTIVE ; 25
552	552
553	553	(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 26
554	554	NOT ARISE FROM COERC ION OR UNDUE INFLUEN CE BY ANOTHER INDIVI DUAL BY 27
555	555	DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 28
556	556	OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 29
557	557	INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 30
558	558	INDIVIDUAL; 31
559	559
560	560	(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 32 SENATE BILL 845 13
561	561
562	562
563	563	INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 1
564	564	MANNER; 2
565	565
566	566	(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPT ION FOR 3
567	567	MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 4
568	568	INFORMED DECISION ; 5
569	569
570	570	(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 6
571	571	UNDER § 5–6A–08 OF THIS SUBTITLE; AND 7
572	572
573	573	(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPEN SING 8
574	574	PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 9
575	575	MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 10
576	576
577	577	1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 11
578	578	AND 12
579	579
580	580	2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIM IZE 13
581	581	THE QUALIFIED INDIVI DUAL’S DISCOMFORT ; OR 14
582	582
583	583	(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 15
584	584	DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 16
585	585	DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AND P ROVIDES WRITTEN 17
586	586	CONSENT FOR THE MEDI CATION FOR AID IN DY ING TO BE DISPENSED BY A 18
587	587	PHARMACIST : 19
588	588
589	589	1. CONTACT A PHARMACIST ; 20
590	590
591	591	2. INFORM THE PHARMACIST OF THE PRESCRIPTION 21
592	592	FOR MEDICATION FOR A ID IN DYING; AND 22
593	593
594	594	3. SUBMIT THE PRESCRI PTION FOR MEDICATION FOR 23
595	595	AID IN DYING TO THE PHARMACIST BY ANY ME ANS AUTHORIZED BY LA W. 24
596	596
597	597	(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 25
598	598	ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 26
599	599	PRESCRIPTION FOR MED ICATION FOR AID IN DYING IN ACCORDAN CE WITH THE 27
600	600	REQUIREMENTS OF SUBS ECTION (A) OF THIS SECTION MAY DISPENSE THE 28
601	601	MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 29
602	602	QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 30
603	603	AGENT OF THE QUAL IFIED INDIVIDUAL. 31
604	604
605	605	(C) IF A QUALIFIED INDIVI DUAL SELF–ADMINISTERS MEDICATI ON FOR AID 32
606	606	IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 33 14 SENATE BILL 845
607	607
608	608
609	609	INDIVIDUAL’S DEATH CERTIFICATE . 1
610	610
611	611	5–6A–08. 2
612	612
613	613	(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID IN 3
614	614	DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THA T THE MEDICAL RECORD OF 4
615	615	THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 5
616	616
617	617	(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 6
618	618	IS AN ADULT AND A RE SIDENT OF THE STATE; 7
619	619
620	620	(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUALIFIED 8
621	621	INDIVIDUAL FOR MEDIC ATION FOR AID IN DYI NG; 9
622	622
623	623	(3) THE ATTENDING PHYSICI AN’S: 10
624	624
625	625	(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 11
626	626	ILLNESS AND PROGNOSI S; AND 12
627	627
628	628	(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 13
629	629	THE CAPACITY TO MAKE MED ICAL DECISIONS, HAS MADE AN INFORMED DECISION, 14
630	630	AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 15
631	631
632	632	(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 16
633	633	FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 17
634	634	SUBTITLE; 18
635	635
636	636	(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 19
637	637	DURING THE MENTAL HE ALTH PROFESSIONAL AS SESSMENT IF: 20
638	638
639	639	(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 21
640	640	HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 22
641	641	SUBTITLE; AND 23
642	642
643	643	(II) THE MENTAL HEALTH PROFES SIONAL ASSESSMENT WA S 24
644	644	PROVIDED; 25
645	645
646	646	(6) DOCUMENTATION OF THE ATTENDING PHYSICIAN ’S OFFER TO 26
647	647	THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 27
648	648	FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 28
649	649	WROTE THE PRESCRIPTION FOR THE MEDICATION FOR T HE QUALIFIED INDIVID UAL; 29
650	650	AND 30
651	651
652	652	(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 31 SENATE BILL 845 15
653	653
654	654
655	655
656	656	(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 1
657	657	UNDER THIS SUBTITLE HAVE BEEN MET ; AND 2
658	658
659	659	(II) SPECIFYING THE STEPS TAKEN TO CA RRY OUT THE 3
660	660	QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICA TION 4
661	661	PRESCRIBED FOR AID I N DYING. 5
662	662
663	663	(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 6
664	664	INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 7
665	665	REGULATION S ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 8
666	666
667	667	5–6A–09. 9
668	668
669	669	(A) THE DEPARTMENT SHALL ADOP T REGULATIONS TO FAC ILITATE THE 10
670	670	COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 11
671	671
672	672	(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 12
673	673	PUBLIC AN ANNUAL STATISTICAL R EPORT OF INFORMATION COLLECTED UNDER 13
674	674	SUBSECTION (A) OF THIS SECTION. 14
675	675
676	676	(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 15
677	677	SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 16
678	678	INTRODUCED INTO EVID ENCE IN ANY JUDICI AL OR ADMINISTRATIVE PROCEEDING , 17
679	679	EXCEPT TO RESOLVE MA TTERS CONCERNING COM PLIANCE WITH THIS SU BTITLE OR 18
680	680	AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 19
681	681
682	682	5–6A–10. 20
683	683
684	684	A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 21
685	685	OF MEDICATION PRESCR IBED FOR AID IN DYING THAT HA S NOT BEEN 22
686	686	SELF–ADMINISTERED SHALL D ISPOSE OF THE MEDICA TION IN A LAWFUL MAN NER. 23
687	687
688	688	5–6A–11. 24
689	689
690	690	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 25
691	691	PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 26
692	692	WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEATH OF A 27
693	693	QUALIFIED INDIVIDUAL BY REASON OF THE SEL F–ADMINISTRATION OF ME DICATION 28
694	694	PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 29
695	695	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 30
696	696	WHICH THE QUALIFIED I NDIVIDUAL SUFFERED . 31
697	697
698	698	(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEG AL INSTRUMENT THAT 32 16 SENATE BILL 845
699	699
700	700
701	701	IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 1
702	702
703	703	(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 2
704	704	PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 3
705	705	IF THE PERSON , WITH THE INTENT OR E FFECT OF CAUSING THE INDIVIDUAL’S 4
706	706	DEATH: 5
707	707
708	708	(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 6
709	709
710	710	(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 7
711	711	DYING; 8
712	712
713	713	(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 9
714	714	COMPLETE A REQUEST F OR AID IN DYING; OR 10
715	715
716	716	(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 11
717	717	DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 12
718	718
719	719	(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENSED PHYSICIAN O R 13
720	720	ANY OTHER PERSON TO END AN INDIVIDUAL ’S LIFE BY LETHAL INJ ECTION, MERCY 14
721	721	KILLING, OR ACTIVE EUTHANASIA . 15
722	722
723	723	(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 16
724	724	FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 17
725	725	HOMICIDE. 18
726	726
727	727	5–6A–12. 19
728	728
729	729	(A) A PROVISION IN AN INSU RANCE POLICY , AN ANNUITY, A CONTRACT, OR 20
730	730	ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2023, IS NOT 21
731	731	VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 22
732	732	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 23
733	733	RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTITLE. 24
734	734
735	735	(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2023, 25
736	736	MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 26
737	737	REQUEST FOR AID IN DYING UNDER THIS SUBTITLE. 27
738	738
739	739	(C) A QUALIFIED INDIVIDUAL ’S ACT OF SELF–ADMINISTERING MEDICA TION 28
740	740	FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 29
741	741	HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 30
742	742	DIFFERS FROM THE EF FECT UNDER THE POLIC Y OR CONTRACT OF THE QUALIFIED 31
743	743	INDIVIDUAL’S DEATH FROM NATURAL CAUSES. 32
744	744	SENATE BILL 845 17
745	745
746	746
747	747	5–6A–13. 1
748	748
749	749	(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 2
750	750
751	751	(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 3
752	752	OR PROFESSIONAL DISC IPLINARY ACTION FOR PARTICIPAT ING IN GOOD–FAITH 4
753	753	COMPLIANCE WITH THIS SUBTITLE, INCLUDING BEING PRES ENT WHEN A QUALIFIED 5
754	754	INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 6
755	755
756	756	(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 7
757	757	CARE PROVIDER , OR A HEALTH OCCUPATI ON BOARD MAY NOT SUB JECT A PERSON 8
758	758	TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 9
759	759	LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 10
760	760	TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 11
761	761
762	762	(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDIN G 12
763	763	PHYSICIAN’S PRESCRIPTION OF ME DICATION MADE IN GOO D–FAITH COMPLIANCE 13
764	764	WITH THIS SUBTITLE D OES NOT: 14
765	765
766	766	(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 15
767	767
768	768	(2) PROVIDE THE SOLE BASI S FOR THE APPOINTMENT OF A 16
769	769	GUARDIAN OR CONSERVA TOR. 17
770	770
771	771	5–6A–14. 18
772	772
773	773	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 19
774	774	INDICATED. 20
775	775
776	776	(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 21
777	777	WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 22
778	778	CARE PROVIDER, BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 23
779	779	DYING, OF A HEALTH CARE FAC ILITY’S POLICY ABOUT PARTI CIPATION IN AID IN 24
780	780	DYING. 25
781	781
782	782	(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 26
783	783	DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICIAN, OR A LICENSED 27
784	784	MENTAL HEALTH PROFES SIONAL UNDER THIS SU BTITLE. 28
785	785
786	786	(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 29
787	787
788	788	1. MAKING AN INITIAL DET ERMINATION THAT AN 30
789	789	INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 31
790	790	MEDICAL PROGNOSIS; 32 18 SENATE BILL 845
791	791
792	792
793	793
794	794	2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 1
795	795	AN INDIVIDUAL ON THE REQUEST OF THE INDIV IDUAL; OR 2
796	796
797	797	3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 3
798	798	INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 4
799	799
800	800	(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALTH CARE 5
801	801	PROVIDER FROM PARTIC IPATING IN AID IN DY ING UNDER THIS SUBTI TLE ON THE 6
802	802	PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROH IBITING 7
803	803	HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 8
804	804	PRIVILEGES TO PRACTI CE ON THE PREMISES OF THE PROHI BITING HEALTH CARE 9
805	805	FACILITY’S POLICY REGARDING P ARTICIPATING IN AID IN DYING. 10
806	806
807	807	(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 11
808	808	PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 12
809	809	PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIVIDUAL. 13
810	810
811	811	(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 14
812	812	THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACIL ITY HAS 15
813	813	NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 16
814	814	HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 17
815	815	HEALTH CARE FACILITY PROHIBITS PARTICIPAT ION IN AID IN DYING: 18
816	816
817	817	(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 19
818	818	SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 20
819	819	PROCEDURES OF THE SA NCTIONING HEALTH CARE FACILITY IF THE SANC TIONED 21
820	820	HEALTH CARE PROVIDER IS A MEMBER OF THE S ANCTIONING HEALTH CA RE 22
821	821	FACILITY’S MEDICAL STAFF AND PARTICIPATES IN AID IN DYING WHILE ON TH E 23
822	822	PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 24
823	823
824	824	(2) TERMINATION OF A LEASE OR ANY OTHER P ROPERTY CONTRACT 25
825	825	OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PRO PERTY 26
826	826	CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 27
827	827	OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 28
828	828	PROVIDER PAR TICIPATES IN AID IN DYING WHILE ON THE P REMISES OF THE 29
829	829	SANCTIONING HEALTH C ARE FACILITY OR ON P ROPERTY THAT IS OWNE D BY OR 30
830	830	UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACI LITY; OR 31
831	831
832	832	(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 32
833	833	REMEDIES PROVIDED BY A CONTRA CT IF THE SANCTIONED HEALTH CARE PROVIDER 33
834	834	PARTICIPATES IN AID IN DYING WHILE ACTIN G IN THE COURSE AND SCOPE OF THE 34
835	835	SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 35
836	836	INDEPENDENT CONTRACT OR OF THE SANCTIONIN G HEALTH CARE FACILI TY. 36 SENATE BILL 845 19
837	837
838	838
839	839
840	840	(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 1
841	841
842	842	(1) A HEALTH CARE PROVIDER FROM PARTICIPATING I N AID IN 2
843	843	DYING: 3
844	844
845	845	(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 4
846	846	HEALTH CARE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 5
847	847	CONTRACTOR OF THE SANCTIONING H EALTH CARE FACILITY ; OR 6
848	848
849	849	(II) OFF THE PREMISES OF T HE SANCTIONING HEALT H CARE 7
850	850	FACILITY OR OFF ANY PROPERTY THAT IS OWN ED BY OR UNDER THE D IRECT 8
851	851	CONTROL OF THE SANCT IONING HEALTH CARE F ACILITY; OR 9
852	852
853	853	(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE INDIVIDUAL ’S 10
854	854	ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUTSIDE T HE COURSE 11
855	855	AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 12
856	856	CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SAN CTIONING 13
857	857	HEALTH CARE FACILITY . 14
858	858
859	859	5–6A–15. 15
860	860
861	861	(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 16
862	862	UNDER THIS SUBTITLE IS VOLUNTARY. 17
863	863
864	864	(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 18
865	865	THE MEDICAL STAFF OF THE HEALTH CARE FACI LITY TO PARTICIPATE IN AID IN 19
866	866	DYING. 20
867	867
868	868	(B) IF AN INDIVIDUAL REQUESTS OR INDICATES AN INTE REST IN AID IN 21
869	869	DYING, AND THE ATTENDING PH YSICIAN OF THE INDIV IDUAL DOES NOT WISH TO 22
870	870	PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 23
871	871	INDIVIDUAL THAT THE ATTENDING PHYSICIAN DOES NOT WISH TO PAR TICIPATE. 24
872	872
873	873	(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 25
874	874	TRANSFER A COPY OF A N INDIVIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 26
875	875	ATTENDING PHYSICIAN IF: 27
876	876
877	877	(1) THE INDIVIDUAL REQUES TS OR INDICATES AN I NTEREST IN AID IN 28
878	878	DYING; 29
879	879
880	880	(2) THE ORIGINAL ATTENDING PHYSICI AN IS UNABLE OR UNWI LLING 30
881	881	TO PARTICIPATE IN AI D IN DYING FOR THE I NDIVIDUAL; AND 31
882	882	20 SENATE BILL 845
883	883
884	884
885	885	(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 1
886	886	ANOTHER ATTENDING PH YSICIAN. 2
887	887
888	888	(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 3
889	889	A LICENSED PHYSICIAN ASSOCIATED WITH THE HEALTH CARE FACILITY FROM 4
890	890	PARTICIPATING IN AID IN DYING, IN ACCORDANCE WITH § 5–6A–14 OF THIS 5
891	891	SUBTITLE. 6
892	892
893	893	5–6A–16. 7
894	894
895	895	(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FOR GES A WRITTEN 8
896	896	REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 9
897	897	OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WI THOUT THE 10
898	898	AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 11
899	899	THE INDIVIDUAL ’S DEATH IS GUILTY OF A FELONY AND ON CONV ICTION IS SUBJECT 12
900	900	TO IMPRISONMENT NOT EXCEED ING 10 YEARS OR A FINE NOT EXCEEDING $10,000 13
901	901	OR BOTH. 14
902	902
903	903	(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 15
904	904	INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 16
905	905	THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVIDUAL’S LIFE OR TO 17
906	906	DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FELON Y AND ON 18
907	907	CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 19
908	908	NOT EXCEEDING $10,000 OR BOTH. 20
909	909
910	910	(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 21
911	911	SEPARATE FROM AND CONSECU TIVE TO OR CONCURREN T WITH A SENTENCE FO R 22
912	912	ANY CRIME BASED ON T HE ACT ESTABLISHING THE VIOLATION OF THI S SECTION. 23
913	913
914	914	(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMAGES 24
915	915	RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONA L MISCONDUCT 25
916	916	BY ANY PERSON . 26
917	917
918	918	Article – Insurance 27
919	919
920	920	27–208.1. 28
921	921
922	922	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS AND OTHER PURPOSES 29
923	923	GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 30
924	924	SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 31
925	925	6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 32
926	926	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 33
927	927	WHICH THE INDIVIDUAL SUFFERED. 34
928	928	SENATE BILL 845 21
929	929
930	930
931	931	(B) ACTIONS TAKEN IN ACCO RDANCE WITH TITLE 5, SUBTITLE 6A OF THE 1
932	932	HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 2
933	933	ASSISTED SUICIDE , MERCY KILLING , OR HOMICIDE. 3
934	934
935	935	(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 4
936	936	CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2023, IS NOT VALID TO 5
937	937	THE EXTE NT THAT THE PROVISIO N WOULD ATTACH CONSE QUENCES TO OR 6
938	938	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 7
939	939	RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 8
940	940	HEALTH – GENERAL ARTICLE. 9
941	941
942	942	(D) AN OBLIGATION UNDER A N INSURANCE POLICY OR CONTRACT O R AN 10
943	943	ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2023, MAY NOT BE CONDITION ED ON 11
944	944	OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 12
945	945	UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 13
946	946
947	947	(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 14
948	948	AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 15
949	949	MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 16
950	950	POLICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 17
951	951	EFFECT UND ER THE POLICY OR CON TRACT OF THE INSURED ’S OR ANNUITANT ’S 18
952	952	DEATH FROM NATURAL C AUSES. 19
953	953
954	954	SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 20
955	955	the application thereof to any person or circumstance is held invalid for any reason in a 21
956	956	court of competent jurisdiction, the invalidity does not affect other provisions or any other 22
957	957	application of this Act that can be given effect without the invalid provision or application, 23
958	958	and for this purpose the provisions of this Act are declared severable. 24
959	959
960	960	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
961	961	October 1, 2023. 26
962	962