EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0845*
SENATE BILL 845
J1 3lr1624
SB 701/20 – JPR CF HB 933
By: Senators Waldstreicher, Kagan, King, West, Lam, Hettleman, Elfreth, Zucker,
Smith, Lewis Young, Kramer, Feldman, and Guzzone
Introduced and read first time: February 6, 2023
Assigned to: Judicial Proceedings
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
Article – Health – Genera l 26
Section 5–6A–01 through 5–6A–16 to be under the new subtitle “Subtitle 6A. The 27
Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass 28 2 SENATE BILL 845
End–of–Life Option Act” 1
Annotated Code of Maryland 2
(2019 Replacement Volume and 2022 Supplement) 3
BY adding to 4
Article – Insurance 5
Section 27–208.1 6
Annotated Code of Maryland 7
(2017 Replacement Volume and 2022 Supplement) 8
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 9
That the Laws of Maryland read as follows: 10
Article – Criminal Law 11
3–103. 12
(a) A licensed health care professional does not violate § 3–102 of this subtitle by 13
administering or prescribing a procedure or administering, prescribing, or dispensing a 14
medication to relieve pain, even if the medication or procedure may hasten death or 15
increase the risk of death, unless the licensed health care professional knowingly 16
administers or prescribes the procedure or administers, prescribes, or dispenses the 17
medication to cause death. 18
(b) A licensed health care professional does not violate § 3–102 of this subtitle by 19
withholding or withdrawing a medically administered life–sustaining procedure: 20
(1) in compliance with Title 5, Subtitle 6 of the Health – General Article; 21
or 22
(2) in accordance with reasonable medical practice. 23
(C) A LICENSED HEALTH CARE PROFESSIONAL DOES NO T VIOLATE § 3–102 24
OF THIS SUBTITLE BY TAKING ANY ACTION IN ACCORDA NCE WITH TITLE 5, 25
SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 26
[(c)] (D) (1) Unless the family member knowingly administers a procedure or 27
administers or dispenses a medication to cause death, a family member does not violate 28
§ 3–102 of this subtitle if the family member: 29
(i) is a caregiver for a patient enrolled in a licensed hospice program; 30
and 31
(ii) administers the procedure or administers or dispenses the 32
medication to relieve pain under the supervision of a health care professional. 33
(2) Paragraph (1) of this subsection applies even if the medication or 34 SENATE BILL 845 3
procedure hastens death or increases the risk of death. 1
Article – Health – General 2
SUBTITLE 6A. THE HONORABLE ELIJAH E. CUMMINGS AND THE HONORABLE 3
SHANE E. PENDERGRASS END–OF–LIFE OPTION ACT. 4
5–6A–01. 5
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 6
INDICATED. 7
(B) “AID IN DYING” MEANS THE MEDICAL PR ACTICE OF A PHYSICIA N 8
PRESCRIBING MEDICATI ON TO A QUALIFIED IN DIVIDUAL THAT THE QU ALIFIED 9
INDIVIDUAL MAY SELF –ADMINISTER TO BRING ABOUT THE QUALIFIED INDIVIDUAL’S 10
DEATH. 11
(C) “ATTENDING PHYSICIAN ” MEANS THE LICENSED P HYSICIAN WHO HAS 12
PRIMARY RESPONSIBILI TY FOR THE MEDICAL C ARE OF THE INDIVIDUA L AND 13
TREATMENT OF THE IND IVIDUAL’S TERMINAL ILLNESS . 14
(D) “CAPACITY TO MAKE MEDI CAL DECISIONS” MEANS THE ABILITY OF AN 15
INDIVIDUAL TO: 16
(1) UNDERSTAND THE NATURE AND CONSEQUENCES OF A HEALTH 17
CARE DECISION; 18
(2) UNDERSTAND THE SIGNIF ICANT BENEFITS , RISKS, AND 19
ALTERNATIVES OF A HE ALTH CARE DECISION ; AND 20
(3) MAKE AND COMMUNICATE AN INFORM ED DECISION TO HEALT H 21
CARE PROVIDERS , INCLUDING COMMUNICAT ION THROUGH ANOTHER INDIVIDUAL 22
FAMILIAR WITH THE IN DIVIDUAL’S MANNER OF COMMUNIC ATING, IF THE OTHER 23
INDIVIDUAL IS AVAILA BLE. 24
(E) “CONSULTING PHYSICIAN ” MEANS A LICENSED PHY SICIAN WHO IS 25
QUALIFIED BY SPECIALTY OR EXPE RIENCE TO CONFIRM A PROFESSIONAL 26
DIAGNOSIS AND PROGNO SIS REGARDING AN IND IVIDUAL’S TERMINAL ILLNESS . 27
(F) “HEALTH CARE FACILITY ” MEANS: 28
(1) A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE; 29
(2) A HOSPICE FACILITY , AS DEFINED IN § 19–901 OF THIS ARTICLE; 30
4 SENATE BILL 845
(3) AN ASSISTED LIVING PR OGRAM, AS DEFINED IN § 19–1801 OF THIS 1
ARTICLE; OR 2
(4) A NURSING HOME , AS DEFINED IN § 19–1401 OF THIS ARTICLE. 3
(G) “HEALTH CARE PROVIDER ” MEANS AN INDIVIDUAL LICENSED OR 4
CERTIFIED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HE ALTH 5
CARE OR DISPENSE MED ICATION IN THE ORDIN ARY COURSE OF BUSINE SS OR 6
PRACTICE OF A PROFES SION. 7
(H) “INFORMED DECISION ” MEANS A DECISION BY AN INDIVIDUAL THAT I S: 8
(1) BASED ON AN UNDERSTAN DING AND ACKNOWLEDGM ENT OF THE 9
RELEVANT FACTS ; AND 10
(2) MADE AFTER RECEIVING THE INFORMATION REQU IRED UNDER 11
§ 5–6A–04(C) OF THIS SUBTITLE. 12
(I) “LICENSED MENTAL HEALT H PROFESSIONAL ” MEANS A LICENSED 13
PSYCHIATRIST OR A LI CENSED PSYC HOLOGIST. 14
(J) “LICENSED PHYSICIAN ” MEANS A PHYSICIAN WH O IS LICENSED TO 15
PRACTICE MEDICINE IN THE STATE. 16
(K) “LICENSED PSYCHIATRIST ” MEANS A PSYCHIATRIST WHO IS LICENSED 17
TO PRACTICE MEDICINE IN THE STATE. 18
(L) “LICENSED PSYCHOLOGIST ” MEANS A PSYCHOLOGIST WHO IS LICENSED 19
TO PRACTICE PSYCHOLO GY IN THE STATE. 20
(M) “MENTAL HEALTH PROFESS IONAL ASSESSMENT ” MEANS ONE OR MORE 21
CONSULTATIONS BETWEE N AN INDIVIDUAL AND A LICENSED MENTAL HE ALTH 22
PROFESSIONAL FOR THE PURPOSE OF DETERMINI NG THAT THE INDIVIDU AL: 23
(1) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; AND 24
(2) IS NOT SUFFERING FROM IMPAIRED JUDGMENT DU E TO A MENTAL 25
DISORDER. 26
(N) “PALLIATIVE CARE ” MEANS HEALTH CARE CE NTERED ON A 27
TERMINALLY ILL INDIV IDUAL AND THE INDIVI DUAL’S FAMILY THAT: 28
(1) OPTIMIZES THE INDIVID UAL’S QUALITY OF LIFE BY 29
ANTICIPATING, PREVENTING , AND TREATING THE IND IVIDUAL’S SUFFERING 30 SENATE BILL 845 5
THROUGHOUT THE CONTI NUUM OF THE INDIVIDU AL’S TERMINAL ILLNESS ; 1
(2) ADDRESSES THE PHYSICA L, EMOTIONAL, SOCIAL, AND SPIRITUAL 2
NEEDS OF THE INDI VIDUAL; 3
(3) FACILITATES INDIVIDUA L AUTONOMY , THE INDIVIDUAL ’S ACCESS 4
TO INFORMATION , AND INDIVIDUAL CHOIC E; AND 5
(4) INCLUDES DISCUSSIONS BETWEEN THE INDIVIDU AL AND A 6
HEALTH CARE PROVIDER CONCERNING THE INDIV IDUAL’S GOALS FOR TREATMEN T 7
AND APPROPRIATE TREATMENT OPTIONS AV AILABLE TO THE INDIV IDUAL, 8
INCLUDING HOSPICE CA RE AND COMPREHENSIVE PAIN AND SYMPTOM 9
MANAGEMENT . 10
(O) “PHARMACIST” MEANS A PHARMACIST W HO IS LICENSED TO PR ACTICE 11
PHARMACY IN THE STATE. 12
(P) “QUALIFIED INDIVIDUAL ” MEANS AN INDIVIDUAL WHO: 13
(1) IS AN ADULT; 14
(2) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; 15
(3) IS A RESIDENT OF THE STATE; 16
(4) HAS A TERMINAL ILLNES S; AND 17
(5) HAS THE ABILITY TO SE LF–ADMINISTER MEDICATIO N. 18
(Q) “RELATIVE” MEANS: 19
(1) A SPOUSE; 20
(2) A CHILD; 21
(3) A GRANDCHILD ; 22
(4) A SIBLING; 23
(5) A PARENT; OR 24
(6) A GRANDPARENT . 25
(R) (1) “SELF–ADMINISTER” MEANS A QUALIFIED IN DIVIDUAL’S 26
AFFIRMATIVE, CONSCIOUS, AND VOLUNTARY ACT OF INGESTING MEDICATION 27 6 SENATE BILL 845
PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING AB OUT THE 1
INDIVIDUAL’S DEATH. 2
(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAK ING MEDICATION BY 3
PARENTERAL INJECTION OR INFUSION. 4
(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 5
REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOS IS FOR AN INDIVIDUAL 6
THAT LIKELY WILL RES ULT IN THE INDIVIDUA L’S DEATH WITHIN 6 MONTHS. 7
(T) “WRITTEN REQUEST ” MEANS A WRITTEN REQU EST FOR AID IN DYING . 8
5–6A–02. 9
(A) AN INDIVIDUAL MAY REQ UEST AID IN DYING BY : 10
(1) MAKING AN INITIAL ORA L REQUEST TO TH E INDIVIDUAL ’S 11
ATTENDING PHYSICIAN ; 12
(2) AFTER MAKING AN INITI AL ORAL REQUEST , MAKING A WRITTEN 13
REQUEST TO THE INDIV IDUAL’S ATTENDING PHYSICIA N, IN ACCORDANCE WITH 14
§ 5–6A–03 OF THIS SUBTITLE; AND 15
(3) MAKING A SECOND ORAL REQUEST TO THE INDIV IDUAL’S 16
ATTENDING PHYSICIAN A T LEAST: 17
(I) 15 DAYS AFTER MAKING TH E INITIAL ORAL REQUE ST; AND 18
(II) 48 HOURS AFTER MAKING T HE WRITTEN REQUEST . 19
(B) NOTWITHSTANDING ANY O THER PROVISION OF LA W, NO OTHER 20
INDIVIDUAL, INCLUDING AN AGENT U NDER AN ADVANCE DIRE CTIVE, AN 21
ATTORNEY IN FACT UND ER A DURABLE POWER O F ATTORNEY, A GUARDIAN, OR A 22
CONSERVATOR , MAY REQUEST AID IN D YING ON BEHALF OF AN INDIVIDUAL. 23
(C) AT LEAST ONE OF THE O RAL REQUESTS MADE UN DER SUBSECTION (A) 24
OF THIS SECTION SHAL L BE MADE WHILE THE INDIVIDUAL IS ALONE WITH THE 25
ATTENDING PHYSICIAN . 26
5–6A–03. 27
(A) A WRITTEN REQUEST FOR AID IN DYING REQUIRE D UNDER 28
§ 5–6A–02(A)(2) OF THIS SUBTITLE SHA LL BE: 29
SENATE BILL 845 7
(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 1
(C) OF THIS SECTION; 2
(2) SIGNED AND DATED BY THE IND IVIDUAL; AND 3
(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUAL S WHO, IN THE 4
PRESENCE OF THE INDI VIDUAL, ATTEST THAT TO THE B EST OF THEIR KNOWLED GE 5
AND BELIEF THE INDIV IDUAL IS: 6
(I) OF SOUND MIND; AND 7
(II) ACTING VOLUNTARILY AN D NOT BEING COERCED TO SIGN 8
THE WRITTEN REQUEST . 9
(B) (1) ONLY ONE OF THE WITNE SSES UNDER SUBSECTIO N (A)(3) OF THIS 10
SECTION MAY BE : 11
(I) A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR 12
ADOPTION; OR 13
(II) AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE 14
INDIVIDUAL, ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 15
(2) THE INDIVIDUAL ’S ATTENDING PHYSICIA N MAY NOT BE A 16
WITNESS. 17
(C) A WRITTEN REQUEST UNDE R THIS SECTION SHALL BE IN 18
SUBSTANTIALLY THE FO LLOWING FORM : 19
MARYLAND REQUEST FOR MEDICATION FOR AID IN DYING 20
BY: _______________________________ DATE OF BIRTH: ____________________ 21
(PRINT NAME) (MONTH/DAY/YEAR) 22
I, ______________________________________, AM AN ADULT OF SOUND MIND. 23
I AM A RESIDENT OF THE STATE OF MARYLAND. 24
I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 25
PHYSICIAN HAS DETERM INED WILL, MORE LIKELY THAN NOT , RESULT IN DEATH 26
WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 27
PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING, 28
THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 29
ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 30
INCLUDING PALLIATIVE CARE AND HOSPICE . 31
I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 32 8 SENATE BILL 845
MEDICATION TH AT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 1
THIS REQUEST . I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 2
PHARMACIST TO FILL T HE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 3
INITIAL ONE: 4
_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINIO NS 5
INTO CONSIDERATION . 6
_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 7
_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION . 8
I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 9
I UNDERSTAND THE FULL IMPORT OF THIS REQUEST AND I EXPECT TO DIE IF AND 10
WHEN I TAKE THE MEDICATION TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 11
ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 12
AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 13
I MAKE THIS REQUEST VOLU NTARILY AND WITHOUT RESERVATION , AND I ACCEPT 14
FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 15
SIGNED: _______________________________________ DATED: _____________________ 16
DECLARATION OF WITNESSES 17
I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 18
MEDICATION FOR AID I N DYING MAY NOT BE T HE INDIVIDUAL ’S ATTENDING 19
PHYSICIAN. FURTHER, ONLY ONE OF THE WITN ESSES MAY BE: 20
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 21
OR 22
2. AT THE TIME THE WRI TTEN REQUEST IS SIGN ED BY THE INDIVIDUAL , 23
ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 24
BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS , I DECLARE 25
THAT: 26
THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 27
1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PR OOF OF IDENTITY; 28
2. SIGNED THIS REQUEST I N MY PRESENCE ON THE DATE OF THE 29
INDIVIDUAL’S SIGNATURE; 30
3. APPEARS TO BE OF SOUN D MIND AND NOT UNDER DURESS, FRAUD, OR 31
UNDUE INFLUENCE ; AND 32 SENATE BILL 845 9
4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTEND ING PHYSICIAN. 1
WITNESS 1 2
(CHECK ONE) 3
_____________ I AM: 4
_____________ I AM NOT: 5
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 6
OR 7
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 8
THE INDIVIDUAL ’S DEATH. 9
PRINTED NAME OF WITNESS 1 ______________________________ 10
SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 11
WITNESS 2 12
(CHECK ONE) 13
_____________ I AM: 14
_____________ I AM NOT: 15
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 16
OR 17
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 18
THE INDIVIDUAL ’S DEATH. 19
PRINTED NAME OF WITNESS 2 _______________________________ 20
SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 21
5–6A–04. 22
(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 23
INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 24
WHETHER THE INDIVIDU AL: 25
(I) IS A QUALIFIED INDIVI DUAL; 26
(II) HAS MADE AN INFORMED DECISION; AND 27 10 SENATE BILL 845
(III) HAS VOLUNTARILY REQUESTED AID IN DYI NG. 1
(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVIDU AL SOLELY DUE TO 2
AGE, DISABILITY, OR A SPECIFIC ILLNES S. 3
(B) FOR PURPOSES OF DETER MINING THAT AN INDIV IDUAL IS A QUALIFIED 4
INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 5
INDIVIDUAL’S RESIDENCY IN THE STATE: 6
(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 7
IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION ; 8
(2) REGISTRATION TO VOTE IN THE STATE; 9
(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 10
(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 11
RECENT TAX YEAR ; OR 12
(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 13
RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 14
INDIVIDUAL’S RESIDENCY IN THE STATE. 15
(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 16
AN INFORMED DECISION BY INFORMING THE IND IVIDUAL OF: 17
(1) THE INDIVIDUAL’S MEDICAL DIAGNOSIS ; 18
(2) THE INDIVIDUAL’S PROGNOSIS; 19
(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERIN G 20
THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 21
(4) THE PROBABLE RESULT O F SELF–ADMINISTERING THE 22
MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 23
(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 24
OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE. 25
(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 26
PHYSICIAN DETERMINES THAT AN INDIVIDUAL I S A QUALIFIED INDIVI DUAL, HAS 27
MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 28
THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONSULT ING 29 SENATE BILL 845 11
PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 1
SUBTITLE. 2
5–6A–05. 3
A CONSULTING PHYSICIAN TO WHOM AN INDIVIDUA L HAS BEEN REFERRED 4
UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 5
(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL’S RELEVANT 6
MEDICAL RECORDS ; 7
(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 8
INDIVIDUAL HAS A TER MINAL ILLNESS; 9
(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 10
INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 11
(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 12
MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 13
AND 14
(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 15
DUTIES UNDER THIS SE CTION IN WRITING . 16
5–6A–06. 17
(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 18
CONSULTING PHYSICIAN , AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 19
THAT IS CAUSING IMPA IRED JUDGMENT OR OTH ERWISE DOES NOT HAVE THE 20
CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 21
CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 22
HEALTH PROFESSIONAL FOR A MENTAL HEALTH PROFESSIONAL ASSESSM ENT. 23
(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 24
ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICIA N 25
MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING U NTIL THE 26
LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEA LTH 27
PROFESSIONAL ASSESSM ENT: 28
(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 29
MEDICAL DECISIONS AND IS NOT SUFFERING FROM A CON DITION THAT IS CAUSI NG 30
IMPAIRED JUDGMENT ; AND 31
(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 32 12 SENATE BILL 845
PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 1
5–6A–07. 2
(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 3
HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 4
SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 5
REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 6
THE ATTENDING PHYSIC IAN SHALL: 7
(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 8
THE QUALIFIED INDIVI DUAL AS TO WHETHER A ND WHEN TO SELF –ADMINISTER THE 9
MEDICATION PRESCRIBE D FOR AID IN DYING; 10
(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 11
INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KIN OF THE REQUEST FOR A ID IN DYING; 12
AND 13
(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FA ILURE TO 14
NOTIFY NEXT OF KIN I S NOT A BASIS FOR DE NIAL OF THE REQUEST FOR AID IN 15
DYING; 16
(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 17
IMPORTANCE OF: 18
(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 19
QUALIFIED INDIVIDUAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 20
AID IN DYING; 21
(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 22
(III) PARTICIPATING IN A HO SPICE PROGRAM ; 23
(4) ENCOURAGE THE QUALIFIE D INDIVIDUAL TO PREP ARE AN 24
ADVANCE DIRECTIVE ; 25
(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 26
NOT ARISE FROM COERC ION OR UNDUE INFLUEN CE BY ANOTHER INDIVI DUAL BY 27
DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 28
OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 29
INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 30
INDIVIDUAL; 31
(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 32 SENATE BILL 845 13
INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 1
MANNER; 2
(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPT ION FOR 3
MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 4
INFORMED DECISION ; 5
(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 6
UNDER § 5–6A–08 OF THIS SUBTITLE; AND 7
(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPEN SING 8
PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 9
MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 10
1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 11
AND 12
2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIM IZE 13
THE QUALIFIED INDIVI DUAL’S DISCOMFORT ; OR 14
(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 15
DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 16
DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AND P ROVIDES WRITTEN 17
CONSENT FOR THE MEDI CATION FOR AID IN DY ING TO BE DISPENSED BY A 18
PHARMACIST : 19
1. CONTACT A PHARMACIST ; 20
2. INFORM THE PHARMACIST OF THE PRESCRIPTION 21
FOR MEDICATION FOR A ID IN DYING; AND 22
3. SUBMIT THE PRESCRI PTION FOR MEDICATION FOR 23
AID IN DYING TO THE PHARMACIST BY ANY ME ANS AUTHORIZED BY LA W. 24
(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 25
ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 26
PRESCRIPTION FOR MED ICATION FOR AID IN DYING IN ACCORDAN CE WITH THE 27
REQUIREMENTS OF SUBS ECTION (A) OF THIS SECTION MAY DISPENSE THE 28
MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 29
QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 30
AGENT OF THE QUAL IFIED INDIVIDUAL. 31
(C) IF A QUALIFIED INDIVI DUAL SELF–ADMINISTERS MEDICATI ON FOR AID 32
IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 33 14 SENATE BILL 845
INDIVIDUAL’S DEATH CERTIFICATE . 1
5–6A–08. 2
(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID IN 3
DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THA T THE MEDICAL RECORD OF 4
THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 5
(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 6
IS AN ADULT AND A RE SIDENT OF THE STATE; 7
(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUALIFIED 8
INDIVIDUAL FOR MEDIC ATION FOR AID IN DYI NG; 9
(3) THE ATTENDING PHYSICI AN’S: 10
(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 11
ILLNESS AND PROGNOSI S; AND 12
(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 13
THE CAPACITY TO MAKE MED ICAL DECISIONS, HAS MADE AN INFORMED DECISION, 14
AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 15
(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 16
FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 17
SUBTITLE; 18
(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 19
DURING THE MENTAL HE ALTH PROFESSIONAL AS SESSMENT IF: 20
(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 21
HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 22
SUBTITLE; AND 23
(II) THE MENTAL HEALTH PROFES SIONAL ASSESSMENT WA S 24
PROVIDED; 25
(6) DOCUMENTATION OF THE ATTENDING PHYSICIAN ’S OFFER TO 26
THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 27
FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 28
WROTE THE PRESCRIPTION FOR THE MEDICATION FOR T HE QUALIFIED INDIVID UAL; 29
AND 30
(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 31 SENATE BILL 845 15
(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 1
UNDER THIS SUBTITLE HAVE BEEN MET ; AND 2
(II) SPECIFYING THE STEPS TAKEN TO CA RRY OUT THE 3
QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICA TION 4
PRESCRIBED FOR AID I N DYING. 5
(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 6
INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 7
REGULATION S ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 8
5–6A–09. 9
(A) THE DEPARTMENT SHALL ADOP T REGULATIONS TO FAC ILITATE THE 10
COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 11
(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 12
PUBLIC AN ANNUAL STATISTICAL R EPORT OF INFORMATION COLLECTED UNDER 13
SUBSECTION (A) OF THIS SECTION. 14
(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 15
SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 16
INTRODUCED INTO EVID ENCE IN ANY JUDICI AL OR ADMINISTRATIVE PROCEEDING , 17
EXCEPT TO RESOLVE MA TTERS CONCERNING COM PLIANCE WITH THIS SU BTITLE OR 18
AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 19
5–6A–10. 20
A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 21
OF MEDICATION PRESCR IBED FOR AID IN DYING THAT HA S NOT BEEN 22
SELF–ADMINISTERED SHALL D ISPOSE OF THE MEDICA TION IN A LAWFUL MAN NER. 23
5–6A–11. 24
(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 25
PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 26
WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEATH OF A 27
QUALIFIED INDIVIDUAL BY REASON OF THE SEL F–ADMINISTRATION OF ME DICATION 28
PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 29
NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 30
WHICH THE QUALIFIED I NDIVIDUAL SUFFERED . 31
(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEG AL INSTRUMENT THAT 32 16 SENATE BILL 845
IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 1
(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 2
PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 3
IF THE PERSON , WITH THE INTENT OR E FFECT OF CAUSING THE INDIVIDUAL’S 4
DEATH: 5
(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 6
(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 7
DYING; 8
(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 9
COMPLETE A REQUEST F OR AID IN DYING; OR 10
(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 11
DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 12
(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENSED PHYSICIAN O R 13
ANY OTHER PERSON TO END AN INDIVIDUAL ’S LIFE BY LETHAL INJ ECTION, MERCY 14
KILLING, OR ACTIVE EUTHANASIA . 15
(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 16
FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 17
HOMICIDE. 18
5–6A–12. 19
(A) A PROVISION IN AN INSU RANCE POLICY , AN ANNUITY, A CONTRACT, OR 20
ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2023, IS NOT 21
VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 22
OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 23
RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTITLE. 24
(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2023, 25
MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 26
REQUEST FOR AID IN DYING UNDER THIS SUBTITLE. 27
(C) A QUALIFIED INDIVIDUAL ’S ACT OF SELF–ADMINISTERING MEDICA TION 28
FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 29
HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 30
DIFFERS FROM THE EF FECT UNDER THE POLIC Y OR CONTRACT OF THE QUALIFIED 31
INDIVIDUAL’S DEATH FROM NATURAL CAUSES. 32
SENATE BILL 845 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 PARTICIPAT ING IN GOOD–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 ATTENDIN G 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 APPOINTMENT 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 FAC ILITY’S POLICY ABOUT PARTI CIPATION 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 PHYSICIAN, OR A LICENSED 27
MENTAL HEALTH PROFES SIONAL UNDER THIS SU BTITLE. 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
MEDICAL PROGNOSIS; 32 18 SENATE BILL 845
2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 1
AN INDIVIDUAL ON THE REQUEST OF THE INDIV IDUAL; OR 2
3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 3
INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 4
(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALTH CARE 5
PROVIDER FROM PARTIC IPATING IN AID IN DY ING UNDER THIS SUBTI TLE ON THE 6
PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROH IBITING 7
HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 8
PRIVILEGES TO PRACTI CE ON THE PREMISES OF THE PROHI BITING HEALTH CARE 9
FACILITY’S POLICY REGARDING P ARTICIPATING IN AID IN DYING. 10
(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 11
PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 12
PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIVIDUAL. 13
(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 14
THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACIL ITY HAS 15
NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 16
HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 17
HEALTH CARE FACILITY PROHIBITS PARTICIPAT ION IN AID IN DYING: 18
(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 19
SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 20
PROCEDURES OF THE SA NCTIONING HEALTH CARE FACILITY IF THE SANC TIONED 21
HEALTH CARE PROVIDER IS A MEMBER OF THE S ANCTIONING HEALTH CA RE 22
FACILITY’S MEDICAL STAFF AND PARTICIPATES IN AID IN DYING WHILE ON TH E 23
PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 24
(2) TERMINATION OF A LEASE OR ANY OTHER P ROPERTY CONTRACT 25
OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PRO PERTY 26
CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 27
OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 28
PROVIDER PAR TICIPATES IN AID IN DYING WHILE ON THE P REMISES OF THE 29
SANCTIONING HEALTH C ARE FACILITY OR ON P ROPERTY THAT IS OWNE D BY OR 30
UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACI LITY; OR 31
(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 32
REMEDIES PROVIDED BY A CONTRA CT IF THE SANCTIONED HEALTH CARE PROVIDER 33
PARTICIPATES IN AID IN DYING WHILE ACTIN G IN THE COURSE AND SCOPE OF THE 34
SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 35
INDEPENDENT CONTRACT OR OF THE SANCTIONIN G HEALTH CARE FACILI TY. 36 SENATE BILL 845 19
(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 1
(1) A HEALTH CARE PROVIDER FROM PARTICIPATING I N AID IN 2
DYING: 3
(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 4
HEALTH CARE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 5
CONTRACTOR OF THE SANCTIONING H EALTH CARE FACILITY ; OR 6
(II) OFF THE PREMISES OF T HE SANCTIONING HEALT H CARE 7
FACILITY OR OFF ANY PROPERTY THAT IS OWN ED BY OR UNDER THE D IRECT 8
CONTROL OF THE SANCT IONING HEALTH CARE F ACILITY; OR 9
(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE INDIVIDUAL ’S 10
ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUTSIDE T HE COURSE 11
AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 12
CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SAN CTIONING 13
HEALTH CARE FACILITY . 14
5–6A–15. 15
(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 16
UNDER THIS SUBTITLE IS VOLUNTARY. 17
(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 18
THE MEDICAL STAFF OF THE HEALTH CARE FACI LITY TO PARTICIPATE IN AID IN 19
DYING. 20
(B) IF AN INDIVIDUAL REQUESTS OR INDICATES AN INTE REST IN AID IN 21
DYING, AND THE ATTENDING PH YSICIAN OF THE INDIV IDUAL DOES NOT WISH TO 22
PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 23
INDIVIDUAL THAT THE ATTENDING PHYSICIAN DOES NOT WISH TO PAR TICIPATE. 24
(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 25
TRANSFER A COPY OF A N INDIVIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 26
ATTENDING PHYSICIAN IF: 27
(1) THE INDIVIDUAL REQUES TS OR INDICATES AN I NTEREST IN AID IN 28
DYING; 29
(2) THE ORIGINAL ATTENDING PHYSICI AN IS UNABLE OR UNWI LLING 30
TO PARTICIPATE IN AI D IN DYING FOR THE I NDIVIDUAL; AND 31
20 SENATE BILL 845
(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 FOR GES 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 FELONY AND ON CONV ICTION IS SUBJECT 12
TO IMPRISONMENT NOT EXCEED ING 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 CONSECU TIVE TO OR CONCURREN T WITH A SENTENCE FO R 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 DAMAGES 24
RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONA L MISCONDUCT 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
SENATE BILL 845 21
(B) ACTIONS TAKEN IN ACCO RDANCE WITH 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 EXTE NT THAT THE PROVISIO N WOULD ATTACH CONSE QUENCES TO OR 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 OR CONTRACT O R 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 CONTRACT , OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 17
EFFECT UND ER THE POLICY OR CON TRACT OF THE 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