Maryland 2024 Regular Session

Maryland House Bill HB403 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	hb0403
6	6
7	7	HOUSE BILL 403
8	8	J1 4lr0403
9	9	HB 933/23 – HGO & JUD CF 4lr0404
10	10	By: Delegates Hill, Pena–Melnyk, Alston, Bagnall, Bartlett, Boyce, Charkoudian,
11	11	Crutchfield, Cullison, Ebersole, Feldmark, Foley, Forbes, Fraser–Hidalgo,
12	12	Grossman, Guzzone, A. Johnson, S. Johnson, Kaufman, Korman, Lehman,
13	13	R. Lewis, Love, Martinez, McCaskill, Palakovich Carr, Smith, Solomon,
14	14	Stein, Stewart, Taveras, Terrasa, Vogel, Watson, Wu, and Ziegler
15	15	Introduced and read first time: January 18, 2024
16	16	Assigned to: Health and Government Operations and Judiciary
17	17
18	18	A BILL ENTITLED
19	19
20	20	AN ACT concerning 1
21	21
22	22	End–of–Life Option Act 2
23	23	(The Honorable Elijah E. Cummings and the Honorable Shane E. 3
24	24	Pendergrass Act) 4
25	25
26	26	FOR the purpose of authorizing an individual to request aid in dying by making certain 5
27	27	requests; establishing requirements and prohibitions governing aid in dying, 6
28	28	including requirements related to requests for aid in dying, consulting physicians, 7
29	29	mental health assessments, the disposal of drugs prescribed for aid in dying, health 8
30	30	care facility policies, and the effect of aid in dying on insurance policies; authorizing 9
31	31	a pharmacist to dispense medication for aid in dying only to certain individuals 10
32	32	under certain circumstances; providing that the death of a qualified individual by 11
33	33	reason of self–administration of certain medication shall be deemed to be a death 12
34	34	from certain natural causes for certain purposes; providing that this Act does not 13
35	35	authorize certain individuals to end another individual’s life by certain means; 14
36	36	providing that participation by a health care provider in aid in dying is voluntary; 15
37	37	authorizing the Maryland Insurance Commissioner to enforce certain provisions of 16
38	38	this Act; establishing that a licensed health care professional does not violate the 17
39	39	statutory prohibition on assisted suicide by taking certain actions in accordance with 18
40	40	this Act; and generally relating to aid in dying. 19
41	41
42	42	BY repealing and reenacting, with amendments, 20
43	43	Article – Criminal Law 21
44	44	Section 3–103 22
45	45	Annotated Code of Maryland 23
46	46	(2021 Replacement Volume and 2023 Supplement) 24
47	47
48	48	BY adding to 25 2 HOUSE BILL 403
49	49
50	50
51	51	Article – Health – Genera l 1
52	52	Section 5–6A–01 through 5–6A–16 to be under the new subtitle “Subtitle 6A. The 2
53	53	Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass 3
54	54	End–of–Life Option Act” 4
55	55	Annotated Code of Maryland 5
56	56	(2023 Replacement Volume) 6
57	57
58	58	BY adding to 7
59	59	Article – Insurance 8
60	60	Section 27–208.1 9
61	61	Annotated Code of Maryland 10
62	62	(2017 Replacement Volume and 2023 Supplement) 11
63	63
64	64	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 12
65	65	That the Laws of Maryland read as follows: 13
66	66
67	67	Article – Criminal Law 14
68	68
69	69	3–103. 15
70	70
71	71	(a) A licensed health care professional does not violate § 3–102 of this subtitle by 16
72	72	administering or prescribing a procedure or administering, prescribing, or dispensing a 17
73	73	medication to relieve pain, even if the medication or procedure may hasten death or 18
74	74	increase the risk of death, unless the licensed health care professional knowingly 19
75	75	administers or prescribes the procedure or administers, prescribes, or dispenses the 20
76	76	medication to cause death. 21
77	77
78	78	(b) A licensed health care professional does not violate § 3–102 of this subtitle by 22
79	79	withholding or withdrawing a medically administered life–sustaining procedure: 23
80	80
81	81	(1) in compliance with Title 5, Subtitle 6 of the Health – General Article; 24
82	82	or 25
83	83
84	84	(2) in accordance with reasonable medical practice. 26
85	85
86	86	(C) A LICENSED HEALTH CARE PROFESSIONAL DOES NO T VIOLATE § 3–102 27
87	87	OF THIS SUBTITLE BY TAKING ANY ACTION IN ACCORDANCE WITH TITLE 5, 28
88	88	SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 29
89	89
90	90	[(c)] (D) (1) Unless the family member knowingly administers a procedure or 30
91	91	administers or dispenses a medication to cause death, a family member does not violate 31
92	92	§ 3–102 of this subtitle if the family member: 32
93	93
94	94	(i) is a caregiver for a patient enrolled in a licensed hospice program; 33
95	95	and 34
96	96
97	97	(ii) administers the procedure or administers or dispenses the 35 HOUSE BILL 403 3
98	98
99	99
100	100	medication to relieve pain under the supervision of a health care professional. 1
101	101
102	102	(2) Paragraph (1) of this subsection applies even if the medication or 2
103	103	procedure hastens death or increases the risk of death. 3
104	104
105	105	Article – Health – General 4
106	106
107	107	SUBTITLE 6A. THE HONORABLE ELIJAH E. CUMMINGS AND THE HONORABLE 5
108	108	SHANE E. PENDERGRASS END–OF–LIFE OPTION ACT. 6
109	109
110	110	5–6A–01. 7
111	111
112	112	(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 8
113	113	INDICATED. 9
114	114
115	115	(B) “AID IN DYING” MEANS THE MEDICAL PR ACTICE OF A PHYSICIA N 10
116	116	PRESCRIBING MEDICATI ON TO A QUALIFIED IN DIVIDUAL THAT THE QU ALIFIED 11
117	117	INDIVIDUAL MAY SELF –ADMINISTER TO BRING ABOUT THE QU ALIFIED INDIVIDUAL ’S 12
118	118	DEATH. 13
119	119
120	120	(C) “ATTENDING PHYSICIAN ” MEANS THE LICENSED P HYSICIAN WHO HAS 14
121	121	PRIMARY RESPONSIBILI TY FOR THE MEDICAL C ARE OF THE INDIVIDUA L AND 15
122	122	TREATMENT OF THE IND IVIDUAL’S TERMINAL ILLNESS . 16
123	123
124	124	(D) “CAPACITY TO MAKE MEDI CAL DECISIONS” MEANS THE ABILITY OF AN 17
125	125	INDIVIDUAL TO: 18
126	126
127	127	(1) UNDERSTAND THE NATURE AND CONSEQUENCES OF A HEALTH 19
128	128	CARE DECISION; 20
129	129
130	130	(2) UNDERSTAND THE SIGNIF ICANT BENEFITS , RISKS, AND 21
131	131	ALTERNATIVES OF A HE ALTH CARE DECISION ; AND 22
132	132
133	133	(3) MAKE AND COMMUNICATE AN INFORMED DECISION TO HEALTH 23
134	134	CARE PROVIDERS , INCLUDING COMMUNICAT ION THROUGH ANOTHER INDIVIDUAL 24
135	135	FAMILIAR WITH THE IN DIVIDUAL’S MANNER OF COMMUNIC ATING, IF THE OTHER 25
136	136	INDIVIDUAL IS AVAILA BLE. 26
137	137
138	138	(E) “CONSULTING PHYSICIAN ” MEANS A LICENSED PHY SICIAN WHO IS 27
139	139	QUALIFIED BY SPECIAL TY OR EXPERIENCE TO CON FIRM A PROFESSIONAL 28
140	140	DIAGNOSIS AND PROGNO SIS REGARDING AN IND IVIDUAL’S TERMINAL ILLNESS . 29
141	141
142	142	(F) “HEALTH CARE FACILITY ” MEANS: 30
143	143
144	144	(1) A HOSPITAL, AS DEFINED IN § 19–301 OF THIS ARTICLE; 31 4 HOUSE BILL 403
145	145
146	146
147	147
148	148	(2) A HOSPICE FACILITY , AS DEFINED IN § 19–901 OF THIS ARTICLE; 1
149	149
150	150	(3) AN ASSISTED LIVING PR OGRAM, AS DEFINED IN § 19–1801 OF THIS 2
151	151	ARTICLE; OR 3
152	152
153	153	(4) A NURSING HOME , AS DEFINED IN § 19–1401 OF THIS ARTICLE. 4
154	154
155	155	(G) “HEALTH CARE PROVIDER ” MEANS AN INDIVIDUAL LICENSED OR 5
156	156	CERTIFIED UNDER THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HE ALTH 6
157	157	CARE OR DISPENSE MED ICATION IN THE ORDIN ARY COURSE OF BUSINE SS OR 7
158	158	PRACTICE OF A PROFES SION. 8
159	159
160	160	(H) “INFORMED DECISION ” MEANS A DECISION BY AN INDIVIDUAL THAT I S: 9
161	161
162	162	(1) BASED ON AN UNDERSTAN DING AND ACKNOWLEDGM ENT OF THE 10
163	163	RELEVANT FACTS ; AND 11
164	164
165	165	(2) MADE AFTER RECEIVING THE INFORMATION REQU IRED UNDER 12
166	166	§ 5–6A–04(C) OF THIS SUBTITLE. 13
167	167
168	168	(I) “LICENSED MENTAL HEALT H PROFESSIONAL ” MEANS A LICENSED 14
169	169	PSYCHIATRIST OR A LI CENSED PSYC HOLOGIST. 15
170	170
171	171	(J) “LICENSED PHYSICIAN ” MEANS A PHYSICIAN WH O IS LICENSED TO 16
172	172	PRACTICE MEDICINE IN THE STATE. 17
173	173
174	174	(K) “LICENSED PSYCHIATRIST ” MEANS A PSYCHIATRIST WHO IS LICENSED 18
175	175	TO PRACTICE MEDICINE IN THE STATE. 19
176	176
177	177	(L) “LICENSED PSYCHOLOGIST ” MEANS A PSYCHOLOGI ST WHO IS LICENSED 20
178	178	TO PRACTICE PSYCHOLO GY IN THE STATE. 21
179	179
180	180	(M) “MENTAL HEALTH PROFESS IONAL ASSESSMENT ” MEANS ONE OR MORE 22
181	181	CONSULTATIONS BETWEE N AN INDIVIDUAL AND A LICENSED MENTAL HE ALTH 23
182	182	PROFESSIONAL FOR THE PURPOSE OF DETERMINI NG THAT THE INDIVIDU AL: 24
183	183
184	184	(1) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; AND 25
185	185
186	186	(2) IS NOT SUFFERING FROM IMPAIRED JUDGMENT DU E TO A MENTAL 26
187	187	DISORDER. 27
188	188
189	189	(N) “PALLIATIVE CARE ” MEANS HEALTH CARE CE NTERED ON A 28
190	190	TERMINALLY ILL INDIV IDUAL AND THE INDIVI DUAL’S FAMILY THAT: 29
191	191	HOUSE BILL 403 5
192	192
193	193
194	194	(1) OPTIMIZES THE INDIVIDUAL ’S QUALITY OF LIFE BY 1
195	195	ANTICIPATING, PREVENTING , AND TREATING THE IND IVIDUAL’S SUFFERING 2
196	196	THROUGHOUT THE CONTI NUUM OF THE INDIVIDU AL’S TERMINAL ILLNESS ; 3
197	197
198	198	(2) ADDRESSES THE PHYSICA L, EMOTIONAL, SOCIAL, AND SPIRITUAL 4
199	199	NEEDS OF THE INDIVID UAL; 5
200	200
201	201	(3) FACILITATES INDIVIDUA L AUTONOMY , THE INDIVIDUAL ’S ACCESS 6
202	202	TO INFORMATION , AND INDIVIDUAL CHOIC E; AND 7
203	203
204	204	(4) INCLUDES DISCUSSIONS BETWEEN THE INDIVIDU AL AND A 8
205	205	HEALTH CARE PROVIDER CONCERNING THE INDIV IDUAL’S GOALS FOR TREATMEN T 9
206	206	AND APPROPRIATE TREA TMENT OPTIONS AVAILABLE TO THE INDIVIDUAL , 10
207	207	INCLUDING HOSPICE CA RE AND COMPREHENSIVE PAIN AND SYMPTOM 11
208	208	MANAGEMENT . 12
209	209
210	210	(O) “PHARMACIST” MEANS A PHARMACIST W HO IS LICENSED TO PR ACTICE 13
211	211	PHARMACY IN THE STATE. 14
212	212
213	213	(P) “QUALIFIED INDIVIDUAL ” MEANS AN INDIVIDUAL WHO: 15
214	214
215	215	(1) IS AN ADULT; 16
216	216
217	217	(2) HAS THE CAPACITY TO M AKE MEDICAL DECISION S; 17
218	218
219	219	(3) IS A RESIDENT OF THE STATE; 18
220	220
221	221	(4) HAS A TERMINAL ILLNES S; AND 19
222	222
223	223	(5) HAS THE ABILITY TO SE LF–ADMINISTER MEDICATIO N. 20
224	224
225	225	(Q) “RELATIVE” MEANS: 21
226	226
227	227	(1) A SPOUSE; 22
228	228
229	229	(2) A CHILD; 23
230	230
231	231	(3) A GRANDCHILD ; 24
232	232
233	233	(4) A SIBLING; 25
234	234
235	235	(5) A PARENT; OR 26
236	236
237	237	(6) A GRANDPARENT . 27
238	238	6 HOUSE BILL 403
239	239
240	240
241	241	(R) (1) “SELF–ADMINISTER” MEANS A QUALIFIED IN DIVIDUAL’S 1
242	242	AFFIRMATIVE, CONSCIOUS, AND VOLUNTARY ACT OF INGESTING MEDICATION 2
243	243	PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING ABOUT THE 3
244	244	INDIVIDUAL’S DEATH. 4
245	245
246	246	(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAK ING MEDICATION BY 5
247	247	PARENTERAL INJECTION OR INFUSION. 6
248	248
249	249	(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 7
250	250	REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOSIS FOR AN INDIVIDU AL 8
251	251	THAT LIKELY WILL RES ULT IN THE INDIVIDUA L’S DEATH WITHIN 6 MONTHS. 9
252	252
253	253	(T) “WRITTEN REQUEST ” MEANS A WRITTEN REQU EST FOR AID IN DYING . 10
254	254
255	255	5–6A–02. 11
256	256
257	257	(A) AN INDIVIDUAL MAY REQ UEST AID IN DYING BY : 12
258	258
259	259	(1) MAKING AN INITIAL ORA L REQUEST TO THE IND IVIDUAL’S 13
260	260	ATTENDING PHYSICIAN ; 14
261	261
262	262	(2) AFTER MAKING AN INITI AL ORAL REQUEST , MAKING A WRITTEN 15
263	263	REQUEST TO THE INDIV IDUAL’S ATTENDING PHYSICIA N, IN ACCORDANCE WITH 16
264	264	§ 5–6A–03 OF THIS SUBTITLE; AND 17
265	265
266	266	(3) MAKING A SECOND ORAL REQUEST TO THE INDIV IDUAL’S 18
267	267	ATTENDING PHYSIC IAN AT LEAST: 19
268	268
269	269	(I) 15 DAYS AFTER MAKING TH E INITIAL ORAL REQUE ST; AND 20
270	270
271	271	(II) 48 HOURS AFTER MAKING T HE WRITTEN REQUEST . 21
272	272
273	273	(B) NOTWITHSTANDING ANY O THER PROVISION OF LA W, NO OTHER 22
274	274	INDIVIDUAL, INCLUDING AN AGENT U NDER AN ADVANCE DIRE CTIVE, AN ATTORNEY 23
275	275	IN FACT UNDER A DURAB LE POWER OF ATTORNEY , A GUARDIAN , OR A 24
276	276	CONSERVATOR , MAY REQUEST AID IN D YING ON BEHALF OF AN INDIVIDUAL. 25
277	277
278	278	(C) AT LEAST ONE OF THE O RAL REQUESTS MADE UN DER SUBSECTION (A) 26
279	279	OF THIS SECTION SHAL L BE MADE WHILE THE INDIVIDUAL IS ALONE WITH THE 27
280	280	ATTENDING PHYSICIAN . 28
281	281
282	282	5–6A–03. 29
283	283
284	284	(A) A WRITTEN REQUEST FOR AID IN DYING REQUIRE D UNDER 30 HOUSE BILL 403 7
285	285
286	286
287	287	§ 5–6A–02(A)(2) OF THIS SUBTITLE SHA LL BE: 1
288	288
289	289	(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 2
290	290	(C) OF THIS SECTION; 3
291	291
292	292	(2) SIGNED AND DATED BY T HE INDIVIDUAL; AND 4
293	293
294	294	(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUAL S WHO, IN THE 5
295	295	PRESENCE OF THE INDI VIDUAL, ATTEST THAT TO THE B EST OF THEIR KNOWLED GE 6
296	296	AND BELIEF THE INDIV IDUAL IS: 7
297	297
298	298	(I) OF SOUND MIND; AND 8
299	299
300	300	(II) ACTING VOLUNTARILY AN D NOT BEING COERCED TO SIGN 9
301	301	THE WRITTEN REQUEST . 10
302	302
303	303	(B) (1) ONLY ONE OF THE WITNE SSES UNDER SUBSECTIO N (A)(3) OF THIS 11
304	304	SECTION MAY BE : 12
305	305
306	306	(I) A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR 13
307	307	ADOPTION; OR 14
308	308
309	309	(II) AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE 15
310	310	INDIVIDUAL, ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 16
311	311
312	312	(2) THE INDIVIDUAL ’S ATTENDING PHYSICIA N MAY NOT BE A 17
313	313	WITNESS. 18
314	314
315	315	(C) A WRITTEN REQUEST UNDE R THIS SECTION SHALL BE IN 19
316	316	SUBSTANTIALLY THE FO LLOWING FORM : 20
317	317
318	318	MARYLAND REQUEST FOR MEDICATION FOR AID IN DYING 21
319	319
320	320	BY: _______________________________ DATE OF BIRTH: ____________________ 22
321	321	(PRINT NAME) (MONTH/DAY/YEAR) 23
322	322
323	323	I, ______________________________________, AM AN ADULT OF SOUND MIND. 24
324	324	I AM A RESIDENT OF THE STATE OF MARYLAND. 25
325	325	I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 26
326	326	PHYSICIAN HAS DETERM INED WILL, MORE LIKELY THAN NOT , RESULT IN DEATH 27
327	327	WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 28
328	328	PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING, 29
329	329	THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 30
330	330	ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 31 8 HOUSE BILL 403
331	331
332	332
333	333	INCLUDING PALLIATIVE CARE AND HOSPICE . 1
334	334	I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 2
335	335	MEDICATION THAT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 3
336	336	THIS REQUEST . I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 4
337	337	PHARMACIST TO FILL T HE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 5
338	338
339	339	INITIAL ONE: 6
340	340	_____ I HAVE INFORMED MY FAM ILY OF MY DECISI ON AND TAKEN THEIR O PINIONS 7
341	341	INTO CONSIDERATION . 8
342	342	_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 9
343	343	_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION . 10
344	344
345	345	I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 11
346	346	I UNDERSTAND THE FULL IMPORT OF THIS REQUEST AND I EXPECT TO DIE IF AND 12
347	347	WHEN I TAKE THE MEDICATION TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 13
348	348	ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 14
349	349	AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 15
350	350	I MAKE THIS REQUEST VO LUNTARILY AND WITHOU T RESERVATION , AND I ACCEPT 16
351	351	FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 17
352	352
353	353	SIGNED: _______________________________________ DATED: _____________________ 18
354	354
355	355	DECLARATION OF WITNESSES 19
356	356
357	357	I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 20
358	358	MEDICATION FOR AID I N DYING MAY NOT BE T HE INDIVIDUAL ’S ATTENDING 21
359	359	PHYSICIAN. FURTHER, ONLY ONE OF THE WITN ESSES MAY BE: 22
360	360
361	361	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 23
362	362	OR 24
363	363
364	364	2. AT THE TIME THE WRITTEN REQUEST IS SIGNED BY THE IND IVIDUAL, 25
365	365	ENTITLED TO ANY BENE FIT ON THE INDIVIDUA L’S DEATH. 26
366	366
367	367	BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS , I DECLARE 27
368	368	THAT: 28
369	369
370	370	THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 29
371	371
372	372	1. IS PERSONALLY KNO WN TO ME OR HAS PROV IDED PROOF OF IDENTI TY; 30
373	373
374	374	2. SIGNED THIS REQUEST I N MY PRESENCE ON THE DATE OF THE 31
375	375	INDIVIDUAL’S SIGNATURE; 32
376	376	HOUSE BILL 403 9
377	377
378	378
379	379	3. APPEARS TO BE OF SOUN D MIND AND NOT UNDER DURESS, FRAUD, OR 1
380	380	UNDUE INFLUENCE ; AND 2
381	381
382	382	4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTENDING PHYSICIAN . 3
383	383
384	384	WITNESS 1 4
385	385	(CHECK ONE) 5
386	386
387	387	_____________ I AM: 6
388	388
389	389	_____________ I AM NOT: 7
390	390
391	391	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 8
392	392	OR 9
393	393
394	394	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 10
395	395	THE INDIVIDUAL ’S DEATH. 11
396	396
397	397	PRINTED NAME OF WITNESS 1 ______________________________ 12
398	398	SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 13
399	399
400	400	WITNESS 2 14
401	401	(CHECK ONE) 15
402	402
403	403	_____________ I AM: 16
404	404
405	405	_____________ I AM NOT: 17
406	406
407	407	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 18
408	408	OR 19
409	409
410	410	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 20
411	411	THE INDIVIDUAL ’S DEATH. 21
412	412
413	413	PRINTED NAME OF WITNESS 2 _______________________________ 22
414	414	SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 23
415	415
416	416	5–6A–04. 24
417	417
418	418	(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 25
419	419	INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 26
420	420	WHETHER THE INDIVIDU AL: 27
421	421
422	422	(I) IS A QUALIFIED INDIVI DUAL; 28
423	423	10 HOUSE BILL 403
424	424
425	425
426	426	(II) HAS MADE AN INFORMED DECISION; AND 1
427	427
428	428	(III) HAS VOLUNTARILY REQUESTED AID IN DYI NG. 2
429	429
430	430	(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVIDU AL SOLELY DUE TO 3
431	431	AGE, DISABILITY, OR A SPECIFIC ILLNES S. 4
432	432
433	433	(B) FOR PURPOSES OF DETER MINING THAT AN INDIV IDUAL IS A QUALIFIED 5
434	434	INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 6
435	435	INDIVIDUAL’S RESIDENCY IN THE STATE: 7
436	436
437	437	(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 8
438	438	IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION ; 9
439	439
440	440	(2) REGISTRATION TO VOTE IN THE STATE; 10
441	441
442	442	(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 11
443	443
444	444	(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 12
445	445	RECENT TAX YEAR ; OR 13
446	446
447	447	(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 14
448	448	RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 15
449	449	INDIVIDUAL’S RESIDENCY IN THE STATE. 16
450	450
451	451	(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 17
452	452	AN INFORMED DECISION BY INFORMING THE IND IVIDUAL OF: 18
453	453
454	454	(1) THE INDIVIDUAL’S MEDICAL DIAGNOSIS ; 19
455	455
456	456	(2) THE INDIVIDUAL’S PROGNOSIS; 20
457	457
458	458	(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERING 21
459	459	THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 22
460	460
461	461	(4) THE PROBABLE RESULT O F SELF–ADMINISTERING THE 23
462	462	MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 24
463	463
464	464	(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 25
465	465	OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE. 26
466	466
467	467	(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 27
468	468	PHYSICIAN DETERMINES THAT AN INDIVIDUAL I S A QUALIFIED INDIVI DUAL, HAS 28
469	469	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 29 HOUSE BILL 403 11
470	470
471	471
472	472	THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONSULT ING 1
473	473	PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 2
474	474	SUBTITLE. 3
475	475
476	476	5–6A–05. 4
477	477
478	478	A CONSULTING PHYSICIAN TO WHOM AN INDIVIDUA L HAS BEEN REFERRED 5
479	479	UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 6
480	480
481	481	(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL’S RELEVANT 7
482	482	MEDICAL RECORDS ; 8
483	483
484	484	(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 9
485	485	INDIVIDUAL HAS A TER MINAL ILLNESS; 10
486	486
487	487	(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 11
488	488	INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 12
489	489
490	490	(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 13
491	491	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 14
492	492	AND 15
493	493
494	494	(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 16
495	495	DUTIES UNDER THIS SE CTION IN WRITING . 17
496	496
497	497	5–6A–06. 18
498	498
499	499	(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 19
500	500	CONSULTING PHYSICIAN , AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 20
501	501	THAT IS CAUSING IMPA IRED JUDGMENT OR OTH ERWISE DOES NOT HAVE THE 21
502	502	CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 22
503	503	CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 23
504	504	HEALTH PROFESSIONAL FOR A MENTAL HEALTH PROFESSIONAL ASSESSM ENT. 24
505	505
506	506	(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 25
507	507	ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICI AN 26
508	508	MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING U NTIL THE 27
509	509	LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEA LTH 28
510	510	PROFESSIONAL ASSESSM ENT: 29
511	511
512	512	(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 30
513	513	MEDICAL DEC ISIONS AND IS NOT SU FFERING FROM A CONDI TION THAT IS CAUSING 31
514	514	IMPAIRED JUDGMENT ; AND 32
515	515	12 HOUSE BILL 403
516	516
517	517
518	518	(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 1
519	519	PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 2
520	520
521	521	5–6A–07. 3
522	522
523	523	(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 4
524	524	HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 5
525	525	SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 6
526	526	REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 7
527	527	THE ATTENDING PHYSIC IAN SHALL: 8
528	528
529	529	(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 9
530	530	THE QUALIFIED INDIVI DUAL AS TO WHETHER A ND WHEN TO SELF –ADMINISTER THE 10
531	531	MEDICATION PRESCRIBE D FOR AID IN DYING; 11
532	532
533	533	(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 12
534	534	INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KIN OF THE REQUEST FOR AID IN DYING; 13
535	535	AND 14
536	536
537	537	(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FA ILURE TO 15
538	538	NOTIFY NEXT OF KIN I S NOT A BASIS FOR DE NIAL OF THE REQUEST FOR AID IN 16
539	539	DYING; 17
540	540
541	541	(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 18
542	542	IMPORTANC E OF: 19
543	543
544	544	(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 20
545	545	QUALIFIED INDIVIDUAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 21
546	546	AID IN DYING; 22
547	547
548	548	(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 23
549	549
550	550	(III) PARTICIPATING IN A HO SPICE PROGRAM ; 24
551	551
552	552	(4) ENCOURAGE THE QUALIFIED I NDIVIDUAL TO PREPARE AN 25
553	553	ADVANCE DIRECTIVE ; 26
554	554
555	555	(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 27
556	556	NOT ARISE FROM COERC ION OR UNDUE INFLUEN CE BY ANOTHER INDIVI DUAL BY 28
557	557	DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 29
558	558	OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 30
559	559	INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 31
560	560	INDIVIDUAL; 32
561	561	HOUSE BILL 403 13
562	562
563	563
564	564	(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 1
565	565	INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN AN Y 2
566	566	MANNER; 3
567	567
568	568	(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPT ION FOR 4
569	569	MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 5
570	570	INFORMED DECISION ; 6
571	571
572	572	(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 7
573	573	UNDER § 5–6A–08 OF THIS SUBTITLE; AND 8
574	574
575	575	(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPEN SING 9
576	576	PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 10
577	577	MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 11
578	578
579	579	1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 12
580	580	AND 13
581	581
582	582	2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIM IZE 14
583	583	THE QUALIFIED INDIVI DUAL’S DISCOMFORT ; OR 15
584	584
585	585	(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 16
586	586	DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 17
587	587	DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AND P ROVIDES WRITTEN 18
588	588	CONSENT FOR THE MEDI CATION FOR AID IN DY ING TO BE DISPENSED BY A 19
589	589	PHARMACIST : 20
590	590
591	591	1. CONTACT A PHARMACIST ; 21
592	592
593	593	2. INFORM THE PHARMACIST OF THE PRESCRIPTION 22
594	594	FOR MEDICATION FOR A ID IN DYING; AND 23
595	595
596	596	3. SUBMIT THE PRESCRIPTION FOR MED ICATION FOR 24
597	597	AID IN DYING TO THE PHARMACIST BY ANY ME ANS AUTHORIZED BY LA W. 25
598	598
599	599	(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 26
600	600	ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 27
601	601	PRESCRIPTION FOR MED ICATION FOR AID IN DYING IN A CCORDANCE WITH THE 28
602	602	REQUIREMENTS OF SUBS ECTION (A) OF THIS SECTION MAY DISPENSE THE 29
603	603	MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 30
604	604	QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 31
605	605	AGENT OF THE QUALIFIED INDIVID UAL. 32
606	606
607	607	(C) IF A QUALIFIED INDIVI DUAL SELF–ADMINISTERS MEDICATI ON FOR AID 33 14 HOUSE BILL 403
608	608
609	609
610	610	IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 1
611	611	INDIVIDUAL’S DEATH CERTIFICATE . 2
612	612
613	613	5–6A–08. 3
614	614
615	615	(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID IN 4
616	616	DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THA T THE MEDICAL RECORD OF 5
617	617	THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 6
618	618
619	619	(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 7
620	620	IS AN ADULT AND A RE SIDENT OF THE STATE; 8
621	621
622	622	(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUALIFIED 9
623	623	INDIVIDUAL FOR MEDIC ATION FOR AID IN DYI NG; 10
624	624
625	625	(3) THE ATTENDING PHYSICI AN’S: 11
626	626
627	627	(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 12
628	628	ILLNESS AND PROGNOSI S; AND 13
629	629
630	630	(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 14
631	631	THE CAPACITY TO MAKE MEDICAL DECISIONS , HAS MADE AN INFORMED DECISION, 15
632	632	AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 16
633	633
634	634	(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 17
635	635	FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 18
636	636	SUBTITLE; 19
637	637
638	638	(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 20
639	639	DURING THE MENTAL HE ALTH PROFESSIONAL AS SESSMENT IF: 21
640	640
641	641	(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 22
642	642	HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 23
643	643	SUBTITLE; AND 24
644	644
645	645	(II) THE MENTAL HEALTH PROF ESSIONAL ASSESSMENT WAS 25
646	646	PROVIDED; 26
647	647
648	648	(6) DOCUMENTATION OF THE ATTENDING PHYSICIAN ’S OFFER TO 27
649	649	THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 28
650	650	FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 29
651	651	WROTE THE PRESCRIPTION F OR THE MEDICATION FO R THE QUALIFIED INDI VIDUAL; 30
652	652	AND 31
653	653	HOUSE BILL 403 15
654	654
655	655
656	656	(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 1
657	657
658	658	(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 2
659	659	UNDER THIS SUBTITLE HAVE BEEN MET ; AND 3
660	660
661	661	(II) SPECIFYING THE STEPS TAKEN TO CARRY OUT THE 4
662	662	QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICA TION 5
663	663	PRESCRIBED FOR AID I N DYING. 6
664	664
665	665	(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 7
666	666	INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 8
667	667	REGULATIONS ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 9
668	668
669	669	5–6A–09. 10
670	670
671	671	(A) THE DEPARTMENT SHALL ADOP T REGULATIONS TO FAC ILITATE THE 11
672	672	COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 12
673	673
674	674	(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 13
675	675	PUBLIC AN ANNUAL STATISTICAL R EPORT OF INFORMATION COLLECTED UNDER 14
676	676	SUBSECTION (A) OF THIS SECTION. 15
677	677
678	678	(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 16
679	679	SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 17
680	680	INTRODUCED INTO EVID ENCE IN ANY JUDICI AL OR ADMINISTRATIVE PROCEEDING , 18
681	681	EXCEPT TO RESOLVE MA TTERS CONCERNING COM PLIANCE WITH THIS SU BTITLE OR 19
682	682	AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 20
683	683
684	684	5–6A–10. 21
685	685
686	686	A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 22
687	687	OF MEDICATION PRESCR IBED FOR AID IN DYING THAT HA S NOT BEEN 23
688	688	SELF–ADMINISTERED SHALL D ISPOSE OF THE MEDICA TION IN A LAWFUL MAN NER. 24
689	689
690	690	5–6A–11. 25
691	691
692	692	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 26
693	693	PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 27
694	694	WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEATH OF A 28
695	695	QUALIFIED INDIVIDUAL BY REASON OF THE SEL F–ADMINISTRATION OF ME DICATION 29
696	696	PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 30
697	697	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 31
698	698	WHICH THE QUALIFIED I NDIVIDUAL SUFFERED . 32
699	699	16 HOUSE BILL 403
700	700
701	701
702	702	(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEG AL INSTRUMENT THAT 1
703	703	IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 2
704	704
705	705	(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 3
706	706	PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR AT TEMPTED MURDER 4
707	707	IF THE PERSON , WITH THE INTENT OR E FFECT OF CAUSING THE INDIVIDUAL’S 5
708	708	DEATH: 6
709	709
710	710	(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 7
711	711
712	712	(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 8
713	713	DYING; 9
714	714
715	715	(3) COERCES OR EXERTS UNDUE INFLUENCE ON AN INDI VIDUAL TO 10
716	716	COMPLETE A REQUEST F OR AID IN DYING; OR 11
717	717
718	718	(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 12
719	719	DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 13
720	720
721	721	(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENS ED PHYSICIAN OR 14
722	722	ANY OTHER PERSON TO END AN INDIVIDUAL ’S LIFE BY LETHAL INJ ECTION, MERCY 15
723	723	KILLING, OR ACTIVE EUTHANASIA . 16
724	724
725	725	(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 17
726	726	FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 18
727	727	HOMICIDE. 19
728	728
729	729	5–6A–12. 20
730	730
731	731	(A) A PROVISION IN AN INSU RANCE POLICY , AN ANNUITY, A CONTRACT, OR 21
732	732	ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2024, IS NOT 22
733	733	VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 23
734	734	OTHERWISE RESTRICT O R INFLUENCE AN INDIVIDUA L’S DECISION TO MAKE O R 24
735	735	RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTITLE. 25
736	736
737	737	(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2024, 26
738	738	MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 27
739	739	REQUEST FOR AID IN DYING UNDER THIS SUB TITLE. 28
740	740
741	741	(C) A QUALIFIED INDIVIDUAL ’S ACT OF SELF–ADMINISTERING MEDICA TION 29
742	742	FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 30
743	743	HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 31
744	744	DIFFERS FROM THE EFF ECT UNDER THE POLICY OR CONTRACT OF THE QUAL IFIED 32
745	745	INDIVIDUAL’S DEATH FROM NATURAL CAUSES. 33 HOUSE BILL 403 17
746	746
747	747
748	748
749	749	5–6A–13. 1
750	750
751	751	(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 2
752	752
753	753	(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 3
754	754	OR PROFESSIONAL DISC IPLINARY ACTIO N FOR PARTICIPATING IN GOOD–FAITH 4
755	755	COMPLIANCE WITH THIS SUBTITLE, INCLUDING BEING PRES ENT WHEN A QUALIFIED 5
756	756	INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 6
757	757
758	758	(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 7
759	759	CARE PROVIDER , OR A HEALTH OCCUPATION BOARD MAY NOT SUBJEC T A PERSON 8
760	760	TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 9
761	761	LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 10
762	762	TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 11
763	763
764	764	(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDIN G 12
765	765	PHYSICIAN’S PRESCRIPTION OF ME DICATION MADE IN GOO D–FAITH COMPLIANCE 13
766	766	WITH THIS SUBTITLE D OES NOT: 14
767	767
768	768	(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 15
769	769
770	770	(2) PROVIDE THE SOLE BASI S FOR THE APPO INTMENT OF A 16
771	771	GUARDIAN OR CONSERVA TOR. 17
772	772
773	773	5–6A–14. 18
774	774
775	775	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 19
776	776	INDICATED. 20
777	777
778	778	(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 21
779	779	WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 22
780	780	CARE PROVIDER, BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 23
781	781	DYING, OF A HEALTH CARE FAC ILITY’S POLICY ABOUT PARTI CIPATION IN AID IN 24
782	782	DYING. 25
783	783
784	784	(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 26
785	785	DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICIAN, OR A LICENSED 27
786	786	MENTAL HEALTH PROFES SIONAL UNDER THIS SU BTITLE. 28
787	787
788	788	(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 29
789	789
790	790	1. MAKING AN INITIAL DET ERMINATION THAT AN 30
791	791	INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 31 18 HOUSE BILL 403
792	792
793	793
794	794	MEDICAL PROGNOSIS; 1
795	795
796	796	2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 2
797	797	AN INDIVIDUAL ON THE REQUEST OF THE INDIV IDUAL; OR 3
798	798
799	799	3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 4
800	800	INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 5
801	801
802	802	(B) (1) A HEALTH CARE FACILITY MAY PRO HIBIT A HEALTH CARE 6
803	803	PROVIDER FROM PARTIC IPATING IN AID IN DY ING UNDER THIS SUBTI TLE ON THE 7
804	804	PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROH IBITING 8
805	805	HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 9
806	806	PRIVILEGES TO PRACTI CE ON THE PR EMISES OF THE PROHIB ITING HEALTH CARE 10
807	807	FACILITY’S POLICY REGARDING P ARTICIPATING IN AID IN DYING. 11
808	808
809	809	(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 12
810	810	PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 13
811	811	PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIVIDUAL. 14
812	812
813	813	(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 15
814	814	THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACIL ITY HAS 16
815	815	NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 17
816	816	HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 18
817	817	HEALTH CARE FACILITY PROHIBITS PARTICIPAT ION IN AID IN DYING: 19
818	818
819	819	(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 20
820	820	SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 21
821	821	PROCEDURES OF THE SA NCTIONING HEALTH CARE FACILITY IF THE SANC TIONED 22
822	822	HEALTH CARE PROVIDER IS A MEMBER OF THE S ANCTIONING HEALTH CA RE 23
823	823	FACILITY’S MEDICAL STAFF AND PARTICIPATES IN AID IN DYING WHILE ON TH E 24
824	824	PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 25
825	825
826	826	(2) TERMINATION OF A LEASE OR ANY OTHER P ROPERTY CONTRACT 26
827	827	OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PRO PERTY 27
828	828	CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 28
829	829	OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 29
830	830	PROVIDER PART ICIPATES IN AID IN D YING WHILE ON THE PR EMISES OF THE 30
831	831	SANCTIONING HEALTH C ARE FACILITY OR ON P ROPERTY THAT IS OWNE D BY OR 31
832	832	UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACI LITY; OR 32
833	833
834	834	(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 33
835	835	REMEDIES PR OVIDED BY A CONTRACT IF THE SANCTIONED HE ALTH CARE PROVIDER 34
836	836	PARTICIPATES IN AID IN DYING WHILE ACTIN G IN THE COURSE AND SCOPE OF THE 35
837	837	SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 36 HOUSE BILL 403 19
838	838
839	839
840	840	INDEPENDENT CONTRACT OR OF THE SANCTIONIN G HEALTH CARE FACILI TY. 1
841	841
842	842	(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 2
843	843
844	844	(1) A HEALTH CARE PROVIDER FROM PARTICIPATING I N AID IN 3
845	845	DYING: 4
846	846
847	847	(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 5
848	848	HEALTH CARE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 6
849	849	CONTRACTOR OF THE SANCTIONING HEAL TH CARE FACILITY ; OR 7
850	850
851	851	(II) OFF THE PREMISES OF T HE SANCTIONING HEALT H CARE 8
852	852	FACILITY OR OFF ANY PROPERTY THAT IS OWN ED BY OR UNDER THE D IRECT 9
853	853	CONTROL OF THE SANCT IONING HEALTH CARE F ACILITY; OR 10
854	854
855	855	(2) AN INDIVIDUAL FROM CO NTRACTING W ITH THE INDIVIDUAL ’S 11
856	856	ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUTSIDE T HE COURSE 12
857	857	AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 13
858	858	CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SAN CTIONING 14
859	859	HEALTH CARE FACILITY . 15
860	860
861	861	5–6A–15. 16
862	862
863	863	(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 17
864	864	UNDER THIS SUBTITLE IS VOLUNTARY. 18
865	865
866	866	(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 19
867	867	THE MEDICAL STAFF OF THE HEALTH CARE FACI LITY TO PARTICIPATE IN AID IN 20
868	868	DYING. 21
869	869
870	870	(B) IF AN INDIVIDUAL REQUESTS O R INDICATES AN INTER EST IN AID IN 22
871	871	DYING, AND THE ATTENDING PH YSICIAN OF THE INDIV IDUAL DOES NOT WISH TO 23
872	872	PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 24
873	873	INDIVIDUAL THAT THE ATTENDING PHYSICIAN DOES NOT WISH TO PAR TICIPATE. 25
874	874
875	875	(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 26
876	876	TRANSFER A COPY OF A N INDIVIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 27
877	877	ATTENDING PHYSICIAN IF: 28
878	878
879	879	(1) THE INDIVIDUAL REQUES TS OR INDICATES AN I NTEREST IN AID IN 29
880	880	DYING; 30
881	881
882	882	(2) THE ORIGINAL ATTENDING PHYSICIAN IS UNABLE OR UNWILLI NG 31
883	883	TO PARTICIPATE IN AI D IN DYING FOR THE I NDIVIDUAL; AND 32 20 HOUSE BILL 403
884	884
885	885
886	886
887	887	(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 1
888	888	ANOTHER ATTENDING PH YSICIAN. 2
889	889
890	890	(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 3
891	891	A LICENSED PHYSICIAN A SSOCIATED WITH THE H EALTH CARE FACILITY FROM 4
892	892	PARTICIPATING IN AID IN DYING, IN ACCORDANCE WITH § 5–6A–14 OF THIS 5
893	893	SUBTITLE. 6
894	894
895	895	5–6A–16. 7
896	896
897	897	(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FOR GES A WRITTEN 8
898	898	REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 9
899	899	OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WI THOUT THE 10
900	900	AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 11
901	901	THE INDIVIDUAL ’S DEATH IS GUILTY OF A FELONY AND ON CONV ICTION IS SUBJECT 12
902	902	TO IMPRISONMENT NOT EXCEEDIN G 10 YEARS OR A FINE NOT EXCEEDING $10,000 13
903	903	OR BOTH. 14
904	904
905	905	(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 15
906	906	INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 16
907	907	THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVID UAL’S LIFE OR TO 17
908	908	DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FELON Y AND ON 18
909	909	CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 19
910	910	NOT EXCEEDING $10,000 OR BOTH. 20
911	911
912	912	(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 21
913	913	SEPARATE FROM AND CONSECUTI VE TO OR CONCURRENT WITH A SENTENCE FOR 22
914	914	ANY CRIME BASED ON T HE ACT ESTABLISHING THE VIOLATION OF THI S SECTION. 23
915	915
916	916	(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMAGES 24
917	917	RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONAL MISCONDUCT 25
918	918	BY ANY PERSON . 26
919	919
920	920	Article – Insurance 27
921	921
922	922	27–208.1. 28
923	923
924	924	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS AND OTHER PURPOSES 29
925	925	GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 30
926	926	SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 31
927	927	6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 32
928	928	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 33
929	929	WHICH THE INDIVIDUAL SUFFERED. 34 HOUSE BILL 403 21
930	930
931	931
932	932
933	933	(B) ACTIONS TAKEN IN ACCO RDANCE WITH TITLE 5, SUBTITLE 6A OF THE 1
934	934	HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 2
935	935	ASSISTED SUICIDE , MERCY KILLING , OR HOMICIDE. 3
936	936
937	937	(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 4
938	938	CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2024, IS NOT VALID TO 5
939	939	THE EXTE NT THAT THE PROVISIO N WOULD ATTACH CONSE QUENCES TO OR 6
940	940	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 7
941	941	RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 8
942	942	HEALTH – GENERAL ARTICLE. 9
943	943
944	944	(D) AN OBLIGATION UNDER A N INSURANCE POLICY OR CONTRACT O R AN 10
945	945	ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2024, MAY NOT BE CONDITION ED ON 11
946	946	OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 12
947	947	UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 13
948	948
949	949	(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 14
950	950	AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 15
951	951	MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 16
952	952	POLICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 17
953	953	EFFECT UND ER THE POLICY OR CON TRACT OF THE INSURED ’S OR ANNUITANT ’S 18
954	954	DEATH FROM NATURAL C AUSES. 19
955	955
956	956	SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 20
957	957	the application thereof to any person or circumstance is held invalid for any reason in a 21
958	958	court of competent jurisdiction, the invalidity does not affect other provisions or any other 22
959	959	application of this Act that can be given effect without the invalid provision or application, 23
960	960	and for this purpose the provisions of this Act are declared severable. 24
961	961
962	962	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
963	963	October 1, 2024. 26
964	964