Maryland 2024 Regular Session

Maryland Senate Bill SB443 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	sb0443
6	6
7	7	SENATE BILL 443
8	8	J1 4lr0404
9	9	SB 845/23 – JPR CF HB 403
10	10	By: Senators Waldstreicher, Lam, Elfreth, Gile, Kelly, Lewis Young, Smith, West,
11	11	and M. Washington
12	12	Introduced and read first time: January 22, 2024
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 2023 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 443
49	49
50	50
51	51	End–of–Life Option Act” 1
52	52	Annotated Code of Maryland 2
53	53	(2023 Replacement Volume) 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 2023 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 ACCORDANCE 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 443 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 FOLLOWI NG WORDS HAVE THE ME ANINGS 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 INFORMED DECISION TO HEALTH 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 SPECIAL TY OR EX PERIENCE 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 443
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 HEALT H 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 PSYCHOLOGIST . 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 IMPAI RED JUDGMENT DUE 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 INDI VIDUAL’S SUFFERING 30 SENATE BILL 443 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 INDIVID UAL; 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 TREA TMENT OPTIONS AVAILA BLE TO THE INDIVIDUA L, 8
204	204	INCLUDING HOSPICE CA RE AND COMPREHENSIVE PA IN 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 DECISI ONS; 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 443
238	238
239	239
240	240	PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING ABOUT THE 1
241	241	INDIVIDUAL’S DEATH. 2
242	242
243	243	(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAKING MED ICATION 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 PROGNOSIS 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 THE IND IVIDUAL’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 AT 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 ATTORNEY 21
272	272	IN FACT UNDER A DURA BLE POWER OF ATTORNE Y, 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 443 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 T HE INDIVIDUAL; AND 3
290	290
291	291	(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUALS WH O, 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 WITNESSES UND ER SUBSECTION (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
322	322	I AM A RESIDENT OF THE STATE OF MARYLAND. 24
323	323
324	324	I AM SUFFERING FROM __________________________, WHICH MY ATTENDING 25
325	325	PHYSICIAN HAS DETERMINED WILL , MORE LIKELY THAN NOT , RESULT IN DEATH 26
326	326	WITHIN 6 MONTHS. I HAVE BEEN FULLY INFO RMED OF MY DIAGNOSIS , MY 27
327	327	PROGNOSIS, THE NATURE OF MEDICA TION TO BE PRESCRIBE D TO AID ME IN DYING , 28
328	328	THE POTENTIAL ASSOCI ATED RISKS, THE EXPECTED RESULT , THE FEASIBLE 29
329	329	ALTERNATIVES , AND THE ADDITIONAL H EALTH CARE TREATMENT OPTIONS, 30 8 SENATE BILL 443
330	330
331	331
332	332	INCLUDING PALLIATIVE CARE AND HOSPICE . 1
333	333
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 REQU EST. 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
341	341	_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINI ONS 7
342	342	INTO CONSIDERATION . 8
343	343	_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 9
344	344	_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION . 10
345	345
346	346	I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 11
347	347
348	348	I UNDERSTAND THE FULL IMPORT OF THIS REQUE ST AND I EXPECT TO DIE IF AND 12
349	349	WHEN I TAKE THE MEDICATIO N TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 13
350	350	ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 14
351	351	AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 15
352	352
353	353	I MAKE THIS REQUEST VO LUNTARILY AND WITHOU T RESERVATION , AND I ACCEPT 16
354	354	FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 17
355	355
356	356	SIGNED: _______________________________________ DATED: _____________________ 18
357	357
358	358	DECLARATION OF WITNESSES 19
359	359
360	360	I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 20
361	361	MEDICATION FOR AID I N DYING MAY NOT BE THE I NDIVIDUAL’S ATTENDING 21
362	362	PHYSICIAN. FURTHER, ONLY ONE OF THE WITN ESSES MAY BE: 22
363	363
364	364	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 23
365	365	OR 24
366	366
367	367	2. AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE INDIVIDUAL , 25
368	368	ENTITLED TO ANY BENE FIT ON THE INDIVIDUAL ’S DEATH. 26
369	369
370	370	BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS , I 27
371	371	DECLARE THAT : 28
372	372
373	373	THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 29
374	374
375	375	1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PROOF OF IDENTITY ; 30 SENATE BILL 443 9
376	376
377	377
378	378
379	379	2. SIGNED THIS REQUEST I N MY PRESENCE ON THE D ATE OF THE 1
380	380	INDIVIDUAL’S SIGNATURE; 2
381	381
382	382	3. APPEARS TO BE OF SOUN D MIND AND NOT UNDER DURESS, FRAUD, OR 3
383	383	UNDUE INFLUENCE ; AND 4
384	384
385	385	4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTENDING PHY SICIAN. 5
386	386
387	387	WITNESS 1 6
388	388	(CHECK ONE) 7
389	389
390	390	_____________ I AM: 8
391	391
392	392	_____________ I AM NOT: 9
393	393
394	394	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 10
395	395	OR 11
396	396
397	397	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 12
398	398	THE INDIVIDUAL ’S DEATH. 13
399	399
400	400	PRINTED NAME OF WITNESS 1 ______________________________ 14
401	401	SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 15
402	402
403	403	WITNESS 2 16
404	404	(CHECK ONE) 17
405	405
406	406	_____________ I AM: 18
407	407
408	408	_____________ I AM NOT: 19
409	409
410	410	1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 20
411	411	OR 21
412	412
413	413	2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENEFIT ON 22
414	414	THE INDIVIDUAL ’S DEATH. 23
415	415
416	416	PRINTED NAME OF WITNESS 2 _______________________________ 24
417	417	SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 25
418	418
419	419	5–6A–04. 26
420	420
421	421	(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 27
422	422	INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 28 10 SENATE BILL 443
423	423
424	424
425	425	WHETHER THE INDIVIDU AL: 1
426	426
427	427	(I) IS A QUALIFIED INDIVI DUAL; 2
428	428
429	429	(II) HAS MADE AN INFORMED DECISION; AND 3
430	430
431	431	(III) HAS VOLUNTARILY REQUE STED AID IN DYING. 4
432	432
433	433	(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVI DUAL SOLELY DUE TO 5
434	434	AGE, DISABILITY, OR A SPECIFIC ILLNES S. 6
435	435
436	436	(B) FOR PURPOSES OF DETER MINING THAT AN INDIV IDUAL IS A QUALIFIED 7
437	437	INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 8
438	438	INDIVIDUAL’S RESIDENCY IN THE STATE: 9
439	439
440	440	(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 10
441	441	IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION ; 11
442	442
443	443	(2) REGISTRATION TO VOTE IN THE STATE; 12
444	444
445	445	(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 13
446	446
447	447	(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 14
448	448	RECENT TAX YEAR ; OR 15
449	449
450	450	(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 16
451	451	RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 17
452	452	INDIVIDUAL’S RESIDENCY IN THE STATE. 18
453	453
454	454	(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 19
455	455	AN INFORMED DECISION BY INF ORMING THE INDIVIDUA L OF: 20
456	456
457	457	(1) THE INDIVIDUAL’S MEDICAL DIAGNOSIS ; 21
458	458
459	459	(2) THE INDIVIDUAL’S PROGNOSIS; 22
460	460
461	461	(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERING 23
462	462	THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 24
463	463
464	464	(4) THE PROBABLE RESULT OF SELF –ADMINISTERING THE 25
465	465	MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 26
466	466
467	467	(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 27
468	468	OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE . 28
469	469	SENATE BILL 443 11
470	470
471	471
472	472	(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 1
473	473	PHYSICIAN DETERMINES THA T AN INDIVIDUAL IS A QUALIFIED INDIVIDUAL , HAS 2
474	474	MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 3
475	475	THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONS ULTING 4
476	476	PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 5
477	477	SUBTITLE. 6
478	478
479	479	5–6A–05. 7
480	480
481	481	A CONSULTING PHYSICIAN TO WHOM AN INDIVIDUA L HAS BEEN REFERRED 8
482	482	UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 9
483	483
484	484	(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL ’S RELEVANT 10
485	485	MEDICAL RECORDS ; 11
486	486
487	487	(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 12
488	488	INDIVIDUAL HAS A TER MINAL ILLNESS; 13
489	489
490	490	(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 14
491	491	INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 15
492	492
493	493	(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 16
494	494	MADE AN INFO RMED DECISION , AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 17
495	495	AND 18
496	496
497	497	(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 19
498	498	DUTIES UNDER THIS SE CTION IN WRITING . 20
499	499
500	500	5–6A–06. 21
501	501
502	502	(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 22
503	503	CONSULTING PHYSI CIAN, AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 23
504	504	THAT IS CAUSING IMPA IRED JUDGMENT OR OTH ERWISE DOES NOT HAVE THE 24
505	505	CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 25
506	506	CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 26
507	507	HEALTH PROFESSIONAL F OR A MENTAL HEALTH P ROFESSIONAL ASSESSME NT. 27
508	508
509	509	(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 28
510	510	ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICI AN 29
511	511	MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING UNTIL THE 30
512	512	LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEA LTH 31
513	513	PROFESSIONAL ASSESSM ENT: 32
514	514
515	515	(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 33 12 SENATE BILL 443
516	516
517	517
518	518	MEDICAL DECISIONS AN D IS NOT SUFFERING F ROM A CONDITION THAT IS CAUSING 1
519	519	IMPAIRED JUDGME NT; AND 2
520	520
521	521	(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 3
522	522	PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 4
523	523
524	524	5–6A–07. 5
525	525
526	526	(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 6
527	527	HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 7
528	528	SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 8
529	529	REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 9
530	530	THE ATTENDING PHYSIC IAN SHALL: 10
531	531
532	532	(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 11
533	533	THE QUALIFIED I NDIVIDUAL AS TO WHET HER AND WHEN TO SELF –ADMINISTER THE 12
534	534	MEDICATION PRESCRIBE D FOR AID IN DYING; 13
535	535
536	536	(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 14
537	537	INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KI N OF THE REQUEST FOR AID IN DYING; 15
538	538	AND 16
539	539
540	540	(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FAILURE TO 17
541	541	NOTIFY NEXT OF KIN I S NOT A BASIS FOR DE NIAL OF THE REQUEST FOR AID IN 18
542	542	DYING; 19
543	543
544	544	(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 20
545	545	IMPORTANCE OF : 21
546	546
547	547	(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 22
548	548	QUALIFIED INDIVID UAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 23
549	549	AID IN DYING; 24
550	550
551	551	(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 25
552	552
553	553	(III) PARTICIPATING IN A HO SPICE PROGRAM ; 26
554	554
555	555	(4) ENCOURAGE THE QUALIFI ED INDIVIDUAL TO PRE PARE AN 27
556	556	ADVANCE DIRECTIVE ; 28
557	557
558	558	(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 29
559	559	NOT ARISE FROM COERC ION OR UNDUE INFLUEN CE BY ANOTHER INDIVI DUAL BY 30
560	560	DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 31
561	561	OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 32 SENATE BILL 443 13
562	562
563	563
564	564	INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 1
565	565	INDIVIDUAL; 2
566	566
567	567	(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 3
568	568	INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 4
569	569	MANNER; 5
570	570
571	571	(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPTION F OR 6
572	572	MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 7
573	573	INFORMED DECISION ; 8
574	574
575	575	(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 9
576	576	UNDER § 5–6A–08 OF THIS SUBTITLE; AND 10
577	577
578	578	(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPENSING 11
579	579	PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 12
580	580	MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 13
581	581
582	582	1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 14
583	583	AND 15
584	584
585	585	2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIM IZE 16
586	586	THE QUALIFIED IND IVIDUAL’S DISCOMFORT ; OR 17
587	587
588	588	(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 18
589	589	DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 19
590	590	DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AN D PROVIDES WRITTEN 20
591	591	CONSENT FOR THE MEDI CATION FOR AID IN DY ING TO BE DISPENSED BY A 21
592	592	PHARMACIST : 22
593	593
594	594	1. CONTACT A PHARMACIST ; 23
595	595
596	596	2. INFORM THE PHARMACIST OF THE PRESCRIPTION 24
597	597	FOR MEDICATION FOR A ID IN DYING; AND 25
598	598
599	599	3. SUBMIT THE PRESCRIPTI ON FOR MEDICATION FO R 26
600	600	AID IN DYING TO THE PHARMACIST BY ANY ME ANS AUTHORIZED BY LAW . 27
601	601
602	602	(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 28
603	603	ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 29
604	604	PRESCRIPTION FOR MED ICATION FOR AID IN D YING IN ACCORDANCE W ITH THE 30
605	605	REQUIREMENTS OF SUBS ECTION (A) OF THIS SECTION MAY DISPEN SE THE 31
606	606	MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 32
607	607	QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 33 14 SENATE BILL 443
608	608
609	609
610	610	AGENT OF THE QUALIFI ED INDIVIDUAL. 1
611	611
612	612	(C) IF A QUALIFIED INDIVI DUAL SELF–ADMINISTERS ME DICATION FOR AID 2
613	613	IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 3
614	614	INDIVIDUAL’S DEATH CERTIFICATE . 4
615	615
616	616	5–6A–08. 5
617	617
618	618	(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID I N 6
619	619	DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THA T THE MEDICAL RECORD OF 7
620	620	THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 8
621	621
622	622	(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 9
623	623	IS AN ADULT AND A RE SIDENT OF THE STATE; 10
624	624
625	625	(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUAL IFIED 11
626	626	INDIVIDUAL FOR MEDIC ATION FOR AID IN DYI NG; 12
627	627
628	628	(3) THE ATTENDING PHYSICI AN’S: 13
629	629
630	630	(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 14
631	631	ILLNESS AND PROGNOSI S; AND 15
632	632
633	633	(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 16
634	634	THE CAPACITY TO MAKE MEDICAL DECISIONS , HAS MADE AN INFORMED DECISION, 17
635	635	AND HAS VOLUNTARILY REQUES TED AID IN DYING; 18
636	636
637	637	(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 19
638	638	FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 20
639	639	SUBTITLE; 21
640	640
641	641	(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 22
642	642	DURING THE MENTAL HE ALTH PROFESSIONAL ASSESSMEN T IF: 23
643	643
644	644	(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 24
645	645	HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 25
646	646	SUBTITLE; AND 26
647	647
648	648	(II) THE MENTAL HEALTH PRO FESSIONAL ASSESSMENT WAS 27
649	649	PROVIDED; 28
650	650
651	651	(6) DOCUMENTATION OF THE ATTENDING PHYSIC IAN’S OFFER TO 29
652	652	THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 30
653	653	FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 31 SENATE BILL 443 15
654	654
655	655
656	656	WROTE THE PRESCRIPTI ON FOR THE MEDICATIO N FOR THE QUALIFIED INDIVIDUAL; 1
657	657	AND 2
658	658
659	659	(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 3
660	660
661	661	(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 4
662	662	UNDER THIS SUBTITLE HAVE BEEN MET ; AND 5
663	663
664	664	(II) SPECIFYING THE STEPS TAKEN TO CARRY OUT T HE 6
665	665	QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICATION 7
666	666	PRESCRIBED FOR AID I N DYING. 8
667	667
668	668	(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 9
669	669	INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 10
670	670	REGULATIONS ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 11
671	671
672	672	5–6A–09. 12
673	673
674	674	(A) THE DEPARTME NT SHALL ADOPT REGUL ATIONS TO FACILITATE THE 13
675	675	COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 14
676	676
677	677	(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 15
678	678	PUBLIC AN ANNUAL STA TISTICAL REPORT OF I NFORMATION COLLECTED UNDER 16
679	679	SUBSECTION (A) OF THIS SECTION. 17
680	680
681	681	(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 18
682	682	SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 19
683	683	INTRODUCED INTO EVID ENCE IN ANY JUDICIAL OR ADMINISTRATIVE PR OCEEDING, 20
684	684	EXCEPT TO RESOLVE MA TTERS CONCERNING COM PLIANCE WITH THIS SUBTIT LE OR 21
685	685	AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 22
686	686
687	687	5–6A–10. 23
688	688
689	689	A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 24
690	690	OF MEDICATION PRESCR IBED FOR AID IN DYIN G THAT HAS NOT BEEN 25
691	691	SELF–ADMINISTERED SHALL D ISPOSE OF THE MEDIC ATION IN A LAWFUL MA NNER. 26
692	692
693	693	5–6A–11. 27
694	694
695	695	(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 28
696	696	PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 29
697	697	WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEATH OF A 30
698	698	QUALIFIED INDIVIDUAL BY REASON OF THE SELF–ADMINISTRATION OF ME DICATION 31
699	699	PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 32 16 SENATE BILL 443
700	700
701	701
702	702	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 1
703	703	WHICH THE QUALIFIED INDIVIDUAL SUFFERED . 2
704	704
705	705	(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEGAL INSTRU MENT THAT 3
706	706	IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 4
707	707
708	708	(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 5
709	709	PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 6
710	710	IF THE PERSON , WITH THE INTENT OR E FFECT OF CAUSING THE INDIVI DUAL’S 7
711	711	DEATH: 8
712	712
713	713	(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 9
714	714
715	715	(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 10
716	716	DYING; 11
717	717
718	718	(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 12
719	719	COMPLETE A REQUEST F OR AID IN DYING; OR 13
720	720
721	721	(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 14
722	722	DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 15
723	723
724	724	(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENS ED PHYSICIAN OR 16
725	725	ANY OTHER PERSON TO END AN INDIVIDUAL ’S LIFE BY LETHAL INJ ECTION, MERCY 17
726	726	KILLING, OR ACTIVE EUTHANASIA . 18
727	727
728	728	(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 19
729	729	FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 20
730	730	HOMICIDE. 21
731	731
732	732	5–6A–12. 22
733	733
734	734	(A) A PROVISION IN AN INSU RANCE POLICY , AN ANNUITY, A CONTRACT, OR 23
735	735	ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2024, IS NOT 24
736	736	VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 25
737	737	OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 26
738	738	RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTIT LE. 27
739	739
740	740	(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2024, 28
741	741	MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 29
742	742	REQUEST FOR AID IN D YING UNDER THIS SUBT ITLE. 30
743	743
744	744	(C) A QUALIFIED INDIVIDUAL ’S ACT OF SELF–ADMINISTERING MEDICATION 31
745	745	FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 32 SENATE BILL 443 17
746	746
747	747
748	748	HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 1
749	749	DIFFERS FROM THE EFF ECT UNDER THE POLICY OR CONTRACT OF THE Q UALIFIED 2
750	750	INDIVIDUAL’S DEATH FROM NATUR AL CAUSES. 3
751	751
752	752	5–6A–13. 4
753	753
754	754	(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 5
755	755
756	756	(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 6
757	757	OR PROFESSIONAL DISC IPLINARY ACTION FOR PARTICIPATING IN GOO D–FAITH 7
758	758	COMPLIANCE WITH THIS SUBTITLE, INCLUDING B EING PRESENT WHEN A QUALIFIED 8
759	759	INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 9
760	760
761	761	(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 10
762	762	CARE PROVIDER , OR A HEALTH OCCUPATI ON BOARD MAY NOT SUB JECT A PERSON 11
763	763	TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 12
764	764	LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 13
765	765	TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 14
766	766
767	767	(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDIN G 15
768	768	PHYSICIAN’S PRESCRIPTION OF MEDICA TION MADE IN GOOD –FAITH COMPLIANCE 16
769	769	WITH THIS SUBTITLE D OES NOT: 17
770	770
771	771	(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 18
772	772
773	773	(2) PROVIDE THE SOLE BASI S FOR THE APPOINTMEN T OF A 19
774	774	GUARDIAN OR CONSERVA TOR. 20
775	775
776	776	5–6A–14. 21
777	777
778	778	(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 22
779	779	INDICATED. 23
780	780
781	781	(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 24
782	782	WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 25
783	783	CARE PROVIDER , BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 26
784	784	DYING, OF A HEALTH CARE FACILI TY’S POLICY ABOUT PARTI CIPATION IN AID IN 27
785	785	DYING. 28
786	786
787	787	(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 29
788	788	DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICI AN, OR A LICENSED 30
789	789	MENTAL HEALTH PROFES SIONAL UNDER THIS SU BTITLE. 31
790	790
791	791	(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 32 18 SENATE BILL 443
792	792
793	793
794	794
795	795	1. MAKING AN INITIAL DET ERMINATION THAT AN 1
796	796	INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 2
797	797	MEDICAL PROGNOSIS ; 3
798	798
799	799	2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 4
800	800	AN INDIVIDUAL ON THE REQUEST OF TH E INDIVIDUAL; OR 5
801	801
802	802	3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 6
803	803	INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 7
804	804
805	805	(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALT H CARE 8
806	806	PROVIDER FROM PARTIC IPATING IN AID IN DY ING UNDER THIS SUBTITLE ON THE 9
807	807	PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROH IBITING 10
808	808	HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 11
809	809	PRIVILEGES TO PRACTI CE ON THE PREMISES O F THE PROHIBITING HE ALTH CARE 12
810	810	FACILITY’S POLICY REGARDING P ARTICIPATING IN AID IN DYING. 13
811	811
812	812	(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 14
813	813	PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 15
814	814	PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIV IDUAL. 16
815	815
816	816	(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 17
817	817	THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACIL ITY HAS 18
818	818	NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 19
819	819	HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 20
820	820	HEALTH CARE FACILITY PROHIBITS PARTICIPATION IN AID IN DYING: 21
821	821
822	822	(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 22
823	823	SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 23
824	824	PROCEDURES OF THE SA NCTIONING HEALTH CAR E FACILITY IF THE SA NCTIONED 24
825	825	HEALTH CARE PROVIDER IS A MEMBER OF THE SANCTION ING HEALTH CARE 25
826	826	FACILITY’S MEDICAL STAFF AND PARTICIPATES IN AID IN DYING WHILE ON TH E 26
827	827	PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 27
828	828
829	829	(2) TERMINATION OF A LEAS E OR ANY OTHER PROPE RTY CONTRACT 28
830	830	OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PROPERTY 29
831	831	CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 30
832	832	OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 31
833	833	PROVIDER PARTICIPATE S IN AID IN DYING WH ILE ON THE PREMISES OF THE 32
834	834	SANCTIONING HEALTH C ARE FACILITY OR ON PR OPERTY THAT IS OWNED BY OR 33
835	835	UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACI LITY; OR 34
836	836
837	837	(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 35 SENATE BILL 443 19
838	838
839	839
840	840	REMEDIES PROVIDED BY A CONTRACT IF THE SA NCTIONED HEALTH CARE PROVIDER 1
841	841	PARTICIPATES IN AID IN DYING WHILE A CTING IN THE COURSE AND SCOPE OF THE 2
842	842	SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 3
843	843	INDEPENDENT CONTRACT OR OF THE SANCTIONIN G HEALTH CARE FACILI TY. 4
844	844
845	845	(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 5
846	846
847	847	(1) A HEALTH C ARE PROVIDER FROM PA RTICIPATING IN AID I N 6
848	848	DYING: 7
849	849
850	850	(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 8
851	851	HEALTH CARE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 9
852	852	CONTRACTOR OF THE SA NCTIONING HEALTH CAR E FACILITY; OR 10
853	853
854	854	(II) OFF THE PREMISES OF T HE SANCTIONING HEALTH C ARE 11
855	855	FACILITY OR OFF ANY PROPERTY THAT IS OWN ED BY OR UNDER THE D IRECT 12
856	856	CONTROL OF THE SANCT IONING HEALTH CARE F ACILITY; OR 13
857	857
858	858	(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE I NDIVIDUAL’S 14
859	859	ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUT SIDE THE COURSE 15
860	860	AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 16
861	861	CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SAN CTIONING 17
862	862	HEALTH CARE FACILITY . 18
863	863
864	864	5–6A–15. 19
865	865
866	866	(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 20
867	867	UNDER THIS SUBTITLE IS VOLUN TARY. 21
868	868
869	869	(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 22
870	870	THE MEDICAL STAFF OF THE HEALTH CARE FACI LITY TO PARTICIPATE IN AID IN 23
871	871	DYING. 24
872	872
873	873	(B) IF AN INDIVIDUAL REQU ESTS OR INDICATES AN INTEREST IN AID IN 25
874	874	DYING, AND THE ATTEND ING PHYSICIAN OF THE INDIVIDUAL DOES NOT WISH TO 26
875	875	PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 27
876	876	INDIVIDUAL THAT THE ATTENDING PHYSICIAN DOES NOT WISH TO PAR TICIPATE. 28
877	877
878	878	(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 29
879	879	TRANSFER A COPY OF AN INDI VIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 30
880	880	ATTENDING PHYSICIAN IF: 31
881	881
882	882	(1) THE INDIVIDUAL REQUES TS OR INDICATES AN I NTEREST IN AID IN 32
883	883	DYING; 33 20 SENATE BILL 443
884	884
885	885
886	886
887	887	(2) THE ORIGINAL ATTENDIN G PHYSICIAN IS UNABL E OR UNWILLING 1
888	888	TO PARTICIPATE IN AI D IN DYING FOR THE INDIVIDUAL ; AND 2
889	889
890	890	(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 3
891	891	ANOTHER ATTENDING PH YSICIAN. 4
892	892
893	893	(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 5
894	894	A LICENSED PHYSICIAN ASSOCIATED WITH THE HEALTH CARE FACILITY FROM 6
895	895	PARTICIPATING IN AID IN DYING , IN ACCORDANCE WITH § 5–6A–14 OF THIS 7
896	896	SUBTITLE. 8
897	897
898	898	5–6A–16. 9
899	899
900	900	(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FOR GES A WRITTEN 10
901	901	REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 11
902	902	OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WITHOUT THE 12
903	903	AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 13
904	904	THE INDIVIDUAL ’S DEATH IS GUILTY OF A FELONY AND ON CONV ICTION IS SUBJECT 14
905	905	TO IMPRISONMENT NOT EXCEEDING 10 YEARS OR A FINE NOT EXCEEDING $10,000 15
906	906	OR BOTH. 16
907	907
908	908	(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 17
909	909	INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 18
910	910	THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVIDUAL ’S LIFE OR TO 19
911	911	DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FE LONY AND ON 20
912	912	CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 21
913	913	NOT EXCEEDING $10,000 OR BOTH. 22
914	914
915	915	(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 23
916	916	SEPARATE FROM AND CO NSECUTIVE TO OR CONC URRENT WITH A SENTEN CE FOR 24
917	917	ANY CRIME BASED ON THE ACT ESTABLISH ING THE VIOLATION OF THIS SECTION. 25
918	918
919	919	(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMAGES 26
920	920	RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONAL MI SCONDUCT 27
921	921	BY ANY PERSON . 28
922	922
923	923	Article – Insurance 29
924	924
925	925	27–208.1. 30
926	926
927	927	(A) FOR ALL LEGA L RIGHTS AND OBLIGAT IONS AND OTHER PURPO SES 31
928	928	GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 32
929	929	SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 33 SENATE BILL 443 21
930	930
931	931
932	932	6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 1
933	933	NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 2
934	934	WHICH THE INDIVIDUAL SUFFERED. 3
935	935
936	936	(B) ACTIONS TAKEN IN ACCO RDANCE WITH TITLE 5, SUBTITLE 6A OF THE 4
937	937	HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 5
938	938	ASSISTED SUICIDE , MERCY KILLING, OR HOMICIDE. 6
939	939
940	940	(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 7
941	941	CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2024, IS NOT VALID TO 8
942	942	THE EXTENT THAT THE PROVISION WOULD ATTA CH CONSEQUENCES TO O R 9
943	943	OTHERWISE RESTRICT O R INFLUENCE AN INDIVIDUAL ’S DECISION TO MAKE O R 10
944	944	RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 11
945	945	HEALTH – GENERAL ARTICLE. 12
946	946
947	947	(D) AN OBLIGATION UNDER A N INSURANCE POLICY O R CONTRACT OR AN 13
948	948	ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2024, MAY NOT BE CONDITIONED ON 14
949	949	OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 15
950	950	UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 16
951	951
952	952	(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 17
953	953	AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 18
954	954	MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 19
955	955	POLICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 20
956	956	EFFECT UNDER THE POL ICY OR CONTRACT OF T HE INSURED’S OR ANNUITANT ’S 21
957	957	DEATH FROM NATURAL C AUSES. 22
958	958
959	959	SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 23
960	960	the application thereof to any person or circumstance is held invalid for any reason in a 24
961	961	court of competent jurisdiction, the invalidity does not affect other provisions or any other 25
962	962	application of this Act that can be given effect without the invalid provision or application, 26
963	963	and for this purpose the provisions of this Act are declared severable. 27
964	964
965	965	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 28
966	966	October 1, 2024. 29
967	967