EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0443*
SENATE BILL 443
J1 4lr0404
SB 845/23 – JPR CF HB 403
By: Senators Waldstreicher, Lam, Elfreth, Gile, Kelly, Lewis Young, Smith, West,
and M. Washington
Introduced and read first time: January 22, 2024
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 2023 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 443
End–of–Life Option Act” 1
Annotated Code of Maryland 2
(2023 Replacement Volume) 3
BY adding to 4
Article – Insurance 5
Section 27–208.1 6
Annotated Code of Maryland 7
(2017 Replacement Volume and 2023 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 ACCORDANCE 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 443 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 FOLLOWI NG WORDS HAVE THE ME ANINGS 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 INFORMED DECISION TO HEALTH 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 SPECIAL TY OR EX PERIENCE 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 443
(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 HEALT H 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 PSYCHOLOGIST . 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 IMPAI RED JUDGMENT DUE 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 INDI VIDUAL’S SUFFERING 30 SENATE BILL 443 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 INDIVID UAL; 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 TREA TMENT OPTIONS AVAILA BLE TO THE INDIVIDUA L, 8
INCLUDING HOSPICE CA RE AND COMPREHENSIVE PA IN 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 DECISI ONS; 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 443
PRESCRIBED UNDER § 5–6A–07(A) OF THIS SUBTITLE TO BRING ABOUT THE 1
INDIVIDUAL’S DEATH. 2
(2) “SELF–ADMINISTER” DOES NOT INCLUDE TAKING MED ICATION BY 3
PARENTERAL INJECTION OR INFUSION. 4
(S) “TERMINAL ILLNESS ” MEANS A MEDICAL COND ITION THAT, WITHIN 5
REASONABLE MEDICAL J UDGMENT, INVOLVES A PROGNOSIS 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 THE IND IVIDUAL’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 AT 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 ATTORNEY 21
IN FACT UNDER A DURA BLE POWER OF ATTORNE Y, 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 443 7
(1) IN SUBSTANTIALLY THE SAME FORM SET FORTH IN SUBSECTION 1
(C) OF THIS SECTION; 2
(2) SIGNED AND DATED BY T HE INDIVIDUAL; AND 3
(3) WITNESSED BY AT LEAST TWO OTHER INDIVIDUALS WH O, 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 WITNESSES UND ER SUBSECTION (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 DETERMINED 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 8 SENATE BILL 443
INCLUDING PALLIATIVE CARE AND HOSPICE . 1
I HAVE ORALLY REQUESTE D THAT MY ATTENDING PHYSICIAN PRESCRIBE 2
MEDICATION THAT I MAY SELF–ADMINISTER FOR AID I N DYING, AND I NOW CONFIRM 3
THIS REQU EST. I AUTHORIZE MY ATTENDI NG PHYSICIAN TO CONT ACT A 4
PHARMACIST TO FILL T HE PRESCRIPTION FOR THE MEDICATION ON MY REQUEST. 5
INITIAL ONE: 6
_____ I HAVE INFORMED MY FAM ILY OF MY DECISION A ND TAKEN THEIR OPINI ONS 7
INTO CONSIDERATION . 8
_____ I HAVE DECIDED NOT TO INFORM MY FAMILY OF MY DECISION. 9
_____ I HAVE NO FAMILY TO IN FORM OF MY DECISION . 10
I UNDERSTAND THAT I HAVE THE RIGHT TO RE SCIND THIS REQUEST A T ANY TIME. 11
I UNDERSTAND THE FULL IMPORT OF THIS REQUE ST AND I EXPECT TO DIE IF AND 12
WHEN I TAKE THE MEDICATIO N TO BE PRESCRIBED . I FURTHER UNDERSTAND T HAT, 13
ALTHOUGH MOST DEATHS OCCUR WITHIN 3 HOURS, MY DEATH MAY TAKE LO NGER, 14
AND MY ATTENDING PHY SICIAN HAS COUNSELED ME ABOUT THIS POSSIB ILITY. 15
I MAKE THIS REQUEST VO LUNTARILY AND WITHOU T RESERVATION , AND I ACCEPT 16
FULL RESPONSIBILITY FOR MY DECISION TO R EQUEST AID IN DYING . 17
SIGNED: _______________________________________ DATED: _____________________ 18
DECLARATION OF WITNESSES 19
I UNDERSTAND THAT , UNDER MARYLAND LAW , A WITNESS TO A REQUE ST FOR 20
MEDICATION FOR AID I N DYING MAY NOT BE THE I NDIVIDUAL’S ATTENDING 21
PHYSICIAN. FURTHER, ONLY ONE OF THE WITN ESSES MAY BE: 22
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 23
OR 24
2. AT THE TIME THE WRITT EN REQUEST IS SIGNED BY THE INDIVIDUAL , 25
ENTITLED TO ANY BENE FIT ON THE INDIVIDUAL ’S DEATH. 26
BY SIGNING BELOW ON T HE DATE THE INDIVIDU AL NAMED ABOVE SIGNS , I 27
DECLARE THAT : 28
THE INDIVIDUAL MAKING AND SIGNING THE ABOV E REQUEST: 29
1. IS PERSONALLY KNOWN T O ME OR HAS PROVIDED PROOF OF IDENTITY ; 30 SENATE BILL 443 9
2. SIGNED THIS REQUEST I N MY PRESENCE ON THE D ATE OF THE 1
INDIVIDUAL’S SIGNATURE; 2
3. APPEARS TO BE OF SOUN D MIND AND NOT UNDER DURESS, FRAUD, OR 3
UNDUE INFLUENCE ; AND 4
4. IS NOT AN INDIVIDUAL FOR WHOM I AM THE ATTENDING PHY SICIAN. 5
WITNESS 1 6
(CHECK ONE) 7
_____________ I AM: 8
_____________ I AM NOT: 9
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 10
OR 11
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENE FIT ON 12
THE INDIVIDUAL ’S DEATH. 13
PRINTED NAME OF WITNESS 1 ______________________________ 14
SIGNATURE OF WITNESS 1 ____________________________ DATE _______________. 15
WITNESS 2 16
(CHECK ONE) 17
_____________ I AM: 18
_____________ I AM NOT: 19
1. A RELATIVE OF THE INDI VIDUAL BY BLOOD , MARRIAGE, OR ADOPTION; 20
OR 21
2. AT THE TIME THE REQUE ST IS SIGNED, ENTITLED TO ANY BENEFIT ON 22
THE INDIVIDUAL ’S DEATH. 23
PRINTED NAME OF WITNESS 2 _______________________________ 24
SIGNATURE OF WITNESS 2 ____________________________ DATE _______________. 25
5–6A–04. 26
(A) (1) WHEN AN ATTENDING PHY SICIAN IS PRESENTED WITH AN 27
INDIVIDUAL’S WRITTEN REQUEST , THE ATTENDING PHYSIC IAN SHALL DETERMINE 28 10 SENATE BILL 443
WHETHER THE INDIVIDU AL: 1
(I) IS A QUALIFIED INDIVI DUAL; 2
(II) HAS MADE AN INFORMED DECISION; AND 3
(III) HAS VOLUNTARILY REQUE STED AID IN DYING. 4
(2) AN INDIVIDUAL IS NOT A QUALIFIED INDIVI DUAL SOLELY DUE TO 5
AGE, DISABILITY, OR A SPECIFIC ILLNES S. 6
(B) FOR PURPOSES OF DETER MINING THAT AN INDIV IDUAL IS A QUALIFIED 7
INDIVIDUAL, AN ATTENDING PHYSICI AN SHALL ACCEPT AS P ROOF OF THE 8
INDIVIDUAL’S RESIDENCY IN THE STATE: 9
(1) POSSESSION OF A VALID MARYLAND DRIVER ’S LICENSE OR 10
IDENTIFICATION CARD ISSUED BY THE MOTOR VEHICLE ADMINISTRATION ; 11
(2) REGISTRATION TO VOTE IN THE STATE; 12
(3) EVIDENCE OF OWNING OR LEASING PROPERTY IN THE STATE; 13
(4) A COPY OF A MARYLAND RESIDENT TAX RETURN FOR THE MOST 14
RECENT TAX YEAR ; OR 15
(5) BASED ON THE INDIVIDU AL’S TREATMENT HISTORY AND MEDICAL 16
RECORDS, THE ATTENDING PHYSIC IAN’S PERSONAL KNOWLEDGE OF THE 17
INDIVIDUAL’S RESIDENCY IN THE STATE. 18
(C) AN ATTENDING PHYSICIA N SHALL ENSURE THAT AN INDIVIDUAL MAKES 19
AN INFORMED DECISION BY INF ORMING THE INDIVIDUA L OF: 20
(1) THE INDIVIDUAL’S MEDICAL DIAGNOSIS ; 21
(2) THE INDIVIDUAL’S PROGNOSIS; 22
(3) THE POTENTIAL RISKS A SSOCIATED WITH SELF –ADMINISTERING 23
THE MEDICATION TO BE PRESCRIBED FOR AID I N DYING; 24
(4) THE PROBABLE RESULT OF SELF –ADMINISTERING THE 25
MEDICATION TO BE PRE SCRIBED FOR AID IN D YING; AND 26
(5) ANY FEASIBLE ALTERNAT IVES AND HEALTH CARE TREATMENT 27
OPTIONS, INCLUDING PALLIATIVE CARE AND HOSPICE . 28
SENATE BILL 443 11
(D) SUBJECT TO § 5–6A–06 OF THIS SUBTITLE , IF THE ATTENDING 1
PHYSICIAN DETERMINES THA T AN INDIVIDUAL IS A QUALIFIED INDIVIDUAL , HAS 2
MADE AN INFORMED DEC ISION, AND HAS VOLUNTARILY REQUESTED AID IN DYI NG, 3
THE ATTENDING PHYSIC IAN SHALL REFER THE INDIVIDUAL TO A CONS ULTING 4
PHYSICIAN TO CARRY O UT THE DUTIES REQUIR ED UNDER § 5–6A–05 OF THIS 5
SUBTITLE. 6
5–6A–05. 7
A CONSULTING PHYSICIAN TO WHOM AN INDIVIDUA L HAS BEEN REFERRED 8
UNDER § 5–6A–04(D) OF THIS SUBTITLE SHA LL: 9
(1) EXAMINE THE INDIVIDUA L AND THE INDIVIDUAL ’S RELEVANT 10
MEDICAL RECORDS ; 11
(2) CONFIRM THE ATTENDING PHYSICIAN’S DIAGNOSIS THAT THE 12
INDIVIDUAL HAS A TER MINAL ILLNESS; 13
(3) IF REQUIRED UNDER § 5–6A–06 OF THIS SUBTITLE , REFER THE 14
INDIVIDUAL FOR A MEN TAL HEALTH PROFESSIO NAL ASSESSMENT ; 15
(4) VERIFY THAT THE INDIV IDUAL IS A QUALIFIED INDIVIDUAL, HAS 16
MADE AN INFO RMED DECISION , AND HAS VOLUNTARILY REQUESTED AID IN DYI NG; 17
AND 18
(5) DOCUMENT THE FULFILLM ENT OF THE CONSULTIN G PHYSICIAN’S 19
DUTIES UNDER THIS SE CTION IN WRITING . 20
5–6A–06. 21
(A) IF, IN THE MEDICAL OPINI ON OF THE ATTENDING PHYSICIAN OR THE 22
CONSULTING PHYSI CIAN, AN INDIVIDUAL MAY BE SUFFERING FROM A CON DITION 23
THAT IS CAUSING IMPA IRED JUDGMENT OR OTH ERWISE DOES NOT HAVE THE 24
CAPACITY TO MAKE MED ICAL DECISIONS , THE ATTENDING PHYSIC IAN OR THE 25
CONSULTING PHYSICIAN SHALL REFER THE INDI VIDUAL TO A LICENSED MENTAL 26
HEALTH PROFESSIONAL F OR A MENTAL HEALTH P ROFESSIONAL ASSESSME NT. 27
(B) IF AN INDIVIDUAL IS R EFERRED FOR A MENTAL HEALTH PROFESSIONAL 28
ASSESSMENT UNDER SUB SECTION (A) OF THIS SECTION, AN ATTENDING PHYSICI AN 29
MAY NOT PROVIDE THE INDIVIDUAL MEDICATIO N FOR AID IN DYING UNTIL THE 30
LICENSED MENTAL HEAL TH PROFESSIONAL PROV IDING THE MENTAL HEA LTH 31
PROFESSIONAL ASSESSM ENT: 32
(1) DETERMINES THAT THE I NDIVIDUAL HAS THE CA PACITY TO MAKE 33 12 SENATE BILL 443
MEDICAL DECISIONS AN D IS NOT SUFFERING F ROM A CONDITION THAT IS CAUSING 1
IMPAIRED JUDGME NT; AND 2
(2) COMMUNICATES THIS DET ERMINATION TO THE AT TENDING 3
PHYSICIAN AND THE CO NSULTING PHYSICIAN I N WRITING. 4
5–6A–07. 5
(A) AFTER THE ATTENDING P HYSICIAN AND THE CON SULTING PHYSICIAN 6
HAVE FULFILLED THE R EQUIREMENTS UNDER §§ 5–6A–04 AND 5–6A–05 OF THIS 7
SUBTITLE, AND AFTER THE QUALIF IED INDIVIDUAL SUBMI TS A SECOND ORAL 8
REQUEST FOR AID IN D YING, AS REQUIRED UNDER § 5–6A–02 OF THIS SUBTITLE , 9
THE ATTENDING PHYSIC IAN SHALL: 10
(1) INFORM THE QUALIFIED INDIVIDUAL THAT IT I S THE DECISION OF 11
THE QUALIFIED I NDIVIDUAL AS TO WHET HER AND WHEN TO SELF –ADMINISTER THE 12
MEDICATION PRESCRIBE D FOR AID IN DYING; 13
(2) (I) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 14
INDIVIDUAL MAY WISH TO NOTIFY NEXT OF KI N OF THE REQUEST FOR AID IN DYING; 15
AND 16
(II) INFORM THE QUALIFIED INDIVIDUAL THAT A FAILURE TO 17
NOTIFY NEXT OF KIN I S NOT A BASIS FOR DE NIAL OF THE REQUEST FOR AID IN 18
DYING; 19
(3) COUNSEL THE QUALIFIED INDIVIDUAL CONCERNIN G THE 20
IMPORTANCE OF : 21
(I) HAVING ANOTHER INDIVI DUAL PRESENT WHEN TH E 22
QUALIFIED INDIVID UAL SELF–ADMINISTERS THE MEDI CATION PRESCRIBED FO R 23
AID IN DYING; 24
(II) NOT TAKING THE MEDICA TION IN A PUBLIC PLA CE; AND 25
(III) PARTICIPATING IN A HO SPICE PROGRAM ; 26
(4) ENCOURAGE THE QUALIFI ED INDIVIDUAL TO PRE PARE AN 27
ADVANCE DIRECTIVE ; 28
(5) CONFIRM THAT THE QUAL IFIED INDIVIDUAL ’S REQUEST DOES 29
NOT ARISE FROM COERC ION OR UNDUE INFLUEN CE BY ANOTHER INDIVI DUAL BY 30
DISCUSSING WITH THE QUALIFIED INDIVIDUAL , OUTSIDE THE PRESENCE OF ANY 31
OTHER INDIVIDUAL EXC EPT FOR AN INTERPRET ER, WHETHER THE QUALIFIE D 32 SENATE BILL 443 13
INDIVIDUAL IS FEELIN G COERCED OR UNDULY INFLUENCED BY ANOTHE R 1
INDIVIDUAL; 2
(6) INFORM THE QUALIFIED INDIVIDUAL THAT THE QUALIFIED 3
INDIVIDUAL MAY RESCI ND THE REQUEST FOR A ID IN DYING AT ANY TIME AND IN ANY 4
MANNER; 5
(7) VERIFY, IMMEDIATELY BEFORE W RITING THE PRESCRIPTION F OR 6
MEDICATION FOR AID I N DYING, THAT THE QUALIFIED I NDIVIDUAL IS MAKING AN 7
INFORMED DECISION ; 8
(8) FULFILL THE DOCUMENTA TION REQUIREMENTS ES TABLISHED 9
UNDER § 5–6A–08 OF THIS SUBTITLE; AND 10
(9) (I) IF THE ATTENDING PHYS ICIAN HOLDS A DISPENSING 11
PERMIT FROM THE STATE BOARD OF PHYSICIANS AND WISHES TO DISPENSE THE 12
MEDICATION, DISPENSE TO THE QUAL IFIED INDIVIDUAL: 13
1. THE PRESCRIBED MEDICA TION FOR AID IN DYIN G; 14
AND 15
2. ANY ANCILLARY MEDICAT IONS NEEDED TO MINIM IZE 16
THE QUALIFIED IND IVIDUAL’S DISCOMFORT ; OR 17
(II) IF THE ATTENDING PHYS ICIAN DOES NOT HOLD A 18
DISPENSING PERMIT OR DOES NOT WISH TO DIS PENSE THE MEDICATION FOR AID IN 19
DYING, AND THE QUALIFIED IN DIVIDUAL REQUESTS AN D PROVIDES WRITTEN 20
CONSENT FOR THE MEDI CATION FOR AID IN DY ING TO BE DISPENSED BY A 21
PHARMACIST : 22
1. CONTACT A PHARMACIST ; 23
2. INFORM THE PHARMACIST OF THE PRESCRIPTION 24
FOR MEDICATION FOR A ID IN DYING; AND 25
3. SUBMIT THE PRESCRIPTI ON FOR MEDICATION FO R 26
AID IN DYING TO THE PHARMACIST BY ANY ME ANS AUTHORIZED BY LAW . 27
(B) A PHARMACIST WHO HAS B EEN CONTACTED AND IN FORMED BY AN 28
ATTENDING PHYSICIAN AND TO WHOM AN ATTEN DING PHYSICIAN HAS S UBMITTED A 29
PRESCRIPTION FOR MED ICATION FOR AID IN D YING IN ACCORDANCE W ITH THE 30
REQUIREMENTS OF SUBS ECTION (A) OF THIS SECTION MAY DISPEN SE THE 31
MEDICATION FOR AID I N DYING AND ANY ANCI LLARY MEDICATION ONL Y TO THE 32
QUALIFIED INDIVIDUAL , THE ATTENDING PHYSIC IAN, OR AN EXPRESSLY IDEN TIFIED 33 14 SENATE BILL 443
AGENT OF THE QUALIFI ED INDIVIDUAL. 1
(C) IF A QUALIFIED INDIVI DUAL SELF–ADMINISTERS ME DICATION FOR AID 2
IN DYING AND DIES , THE ATTENDING PHYSIC IAN MAY SIGN THE QUA LIFIED 3
INDIVIDUAL’S DEATH CERTIFICATE . 4
5–6A–08. 5
(A) WITH RESPECT TO A REQ UEST BY A QUALIFIED INDIVIDUAL FOR AID I N 6
DYING, THE ATTENDING PHYSIC IAN SHALL ENSURE THA T THE MEDICAL RECORD OF 7
THE QUALIFIED INDIVI DUAL DOCUMENTS OR CO NTAINS: 8
(1) THE BASIS FOR DETERMI NING THAT THE QUALIF IED INDIVIDUAL 9
IS AN ADULT AND A RE SIDENT OF THE STATE; 10
(2) ALL ORAL AND WRITTEN REQUESTS BY THE QUAL IFIED 11
INDIVIDUAL FOR MEDIC ATION FOR AID IN DYI NG; 12
(3) THE ATTENDING PHYSICI AN’S: 13
(I) DIAGNOSIS OF THE QUAL IFIED INDIVIDUAL ’S TERMINAL 14
ILLNESS AND PROGNOSI S; AND 15
(II) DETERMINATION THAT TH E QUALIFIED INDIVIDU AL HAS 16
THE CAPACITY TO MAKE MEDICAL DECISIONS , HAS MADE AN INFORMED DECISION, 17
AND HAS VOLUNTARILY REQUES TED AID IN DYING; 18
(4) DOCUMENTATION THAT TH E CONSULTING PHYSICI AN HAS 19
FULFILLED THE CONSUL TING PHYSICIAN ’S DUTIES UNDER § 5–6A–05 OF THIS 20
SUBTITLE; 21
(5) A REPORT OF THE OUTCOM E OF AND DETERMINATI ONS MADE 22
DURING THE MENTAL HE ALTH PROFESSIONAL ASSESSMEN T IF: 23
(I) THE QUALIFIED INDIVID UAL WAS REFERRED FOR A MENTAL 24
HEALTH PROFESSIONAL ASSESSMENT IN ACCORD ANCE WITH § 5–6A–06 OF THIS 25
SUBTITLE; AND 26
(II) THE MENTAL HEALTH PRO FESSIONAL ASSESSMENT WAS 27
PROVIDED; 28
(6) DOCUMENTATION OF THE ATTENDING PHYSIC IAN’S OFFER TO 29
THE QUALIFIED INDIVI DUAL TO RESCIND THE QUALIFIED INDIVIDUAL ’S REQUEST 30
FOR MEDICATION FOR A ID IN DYING AT THE T IME THE ATTENDING PH YSICIAN 31 SENATE BILL 443 15
WROTE THE PRESCRIPTI ON FOR THE MEDICATIO N FOR THE QUALIFIED INDIVIDUAL; 1
AND 2
(7) A STATEMENT BY THE ATT ENDING PHYSICIAN : 3
(I) INDICATING THAT ALL R EQUIREMENTS FOR AID IN DYING 4
UNDER THIS SUBTITLE HAVE BEEN MET ; AND 5
(II) SPECIFYING THE STEPS TAKEN TO CARRY OUT T HE 6
QUALIFIED INDIVIDUAL ’S REQUEST FOR AID IN DYING, INCLUDING THE MEDICATION 7
PRESCRIBED FOR AID I N DYING. 8
(B) THE ATTENDING PHYSICI AN SHALL SUBMIT TO T HE DEPARTMENT ANY 9
INFORMATION REGARDIN G IMPLEMENTATION OF THIS SUBTITLE REQUIR ED BY 10
REGULATIONS ADOPTED UNDER § 5–6A–09(A) OF THIS SUBTITLE. 11
5–6A–09. 12
(A) THE DEPARTME NT SHALL ADOPT REGUL ATIONS TO FACILITATE THE 13
COLLECTION OF INFORM ATION UNDER § 5–6A–08(B) OF THIS SUBTITLE. 14
(B) THE DEPARTMENT SHALL PROD UCE AND MAKE AVAILAB LE TO THE 15
PUBLIC AN ANNUAL STA TISTICAL REPORT OF I NFORMATION COLLECTED UNDER 16
SUBSECTION (A) OF THIS SECTION. 17
(C) RECORDS OR INFORMATIO N COLLECTED OR MAINT AINED UNDER THIS 18
SUBTITLE ARE NOT SUB JECT TO SUBPOENA OR DISCOVERY AND MAY NO T BE 19
INTRODUCED INTO EVID ENCE IN ANY JUDICIAL OR ADMINISTRATIVE PR OCEEDING, 20
EXCEPT TO RESOLVE MA TTERS CONCERNING COM PLIANCE WITH THIS SUBTIT LE OR 21
AS OTHERWISE SPECIFI CALLY PROVIDED BY LA W. 22
5–6A–10. 23
A PERSON THAT , AFTER A QUALIFIED IN DIVIDUAL’S DEATH, IS IN POSSESSION 24
OF MEDICATION PRESCR IBED FOR AID IN DYIN G THAT HAS NOT BEEN 25
SELF–ADMINISTERED SHALL D ISPOSE OF THE MEDIC ATION IN A LAWFUL MA NNER. 26
5–6A–11. 27
(A) FOR ALL LEGAL RIGHTS AND OBLIGATIONS , RECORD–KEEPING 28
PURPOSES, AND OTHER PURPOSES G OVERNED BY THE LAWS OF THE STATE, 29
WHETHER CONTRACTUAL , CIVIL, CRIMINAL, OR OTHERWISE , THE DEATH OF A 30
QUALIFIED INDIVIDUAL BY REASON OF THE SELF–ADMINISTRATION OF ME DICATION 31
PRESCRIBED UNDER THI S SUBTITLE SHALL BE DEEMED TO BE A DEATH FROM 32 16 SENATE BILL 443
NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 1
WHICH THE QUALIFIED INDIVIDUAL SUFFERED . 2
(B) A PROVISION IN A CONTR ACT OR ANY OTHER LEGAL INSTRU MENT THAT 3
IS CONTRARY TO SUBSE CTION (A) OF THIS SECTION IS V OID. 4
(C) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO 5
PROHIBIT THE PROSECU TION OF A PERSON FOR MURDER OR ATTEMPTED MURDER 6
IF THE PERSON , WITH THE INTENT OR E FFECT OF CAUSING THE INDIVI DUAL’S 7
DEATH: 8
(1) WILLFULLY ALTERS OR F ORGES A REQUEST FOR AID IN DYING; 9
(2) CONCEALS OR DESTROYS A RESCISSION OF A RE QUEST FOR AID IN 10
DYING; 11
(3) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 12
COMPLETE A REQUEST F OR AID IN DYING; OR 13
(4) COERCES OR EXERTS UND UE INFLUENCE ON AN I NDIVIDUAL TO 14
DESTROY A RESCISSION OF A REQUEST FOR AID IN DYING. 15
(D) (1) THIS SUBTITLE DOES NO T AUTHORIZE A LICENS ED PHYSICIAN OR 16
ANY OTHER PERSON TO END AN INDIVIDUAL ’S LIFE BY LETHAL INJ ECTION, MERCY 17
KILLING, OR ACTIVE EUTHANASIA . 18
(2) ACTIONS TAKEN IN ACCO RDANCE WITH THIS SUB TITLE DO NOT, 19
FOR ANY PURPOSE , CONSTITUTE SUICIDE , ASSISTED SUICIDE , MERCY KILLING , OR 20
HOMICIDE. 21
5–6A–12. 22
(A) A PROVISION IN AN INSU RANCE POLICY , AN ANNUITY, A CONTRACT, OR 23
ANY OTHER AGREEMENT , ISSUED OR MADE ON OR AFTER OCTOBER 1, 2024, IS NOT 24
VALID TO THE EXTENT THAT THE PROVISION W OULD ATTACH CONSEQUE NCES TO OR 25
OTHERWISE RESTRICT O R INFLUENCE AN INDIV IDUAL’S DECISION TO MAKE O R 26
RESCIND A REQUEST FO R AID IN DYING UNDER THIS SUBTIT LE. 27
(B) AN OBLIGATION UNDER A CONTRACT EXISTING ON OCTOBER 1, 2024, 28
MAY NOT BE CONDITION ED ON OR AFFECTED BY THE MAKING OR RESCIN DING OF A 29
REQUEST FOR AID IN D YING UNDER THIS SUBT ITLE. 30
(C) A QUALIFIED INDIVIDUAL ’S ACT OF SELF–ADMINISTERING MEDICATION 31
FOR AID IN DYING MAY NOT HAVE AN EFFECT U NDER A LIFE INSURANC E POLICY, A 32 SENATE BILL 443 17
HEALTH INSURANCE POL ICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT 1
DIFFERS FROM THE EFF ECT UNDER THE POLICY OR CONTRACT OF THE Q UALIFIED 2
INDIVIDUAL’S DEATH FROM NATUR AL CAUSES. 3
5–6A–13. 4
(A) EXCEPT AS PROVIDED IN § 5–6A–14(C) OF THIS SUBTITLE: 5
(1) A PERSON MAY NOT BE SU BJECT TO CIVIL OR CR IMINAL LIABILITY 6
OR PROFESSIONAL DISC IPLINARY ACTION FOR PARTICIPATING IN GOO D–FAITH 7
COMPLIANCE WITH THIS SUBTITLE, INCLUDING B EING PRESENT WHEN A QUALIFIED 8
INDIVIDUAL SELF –ADMINISTERS MEDICATI ON PRESCRIBED FOR AI D IN DYING; AND 9
(2) A PROFESSIONAL ORGANIZ ATION OR ASSOCIATION , A HEALTH 10
CARE PROVIDER , OR A HEALTH OCCUPATI ON BOARD MAY NOT SUB JECT A PERSON 11
TO CENSURE, DISCIPLINE, SUSPENSION, LOSS OF LICENSE , LOSS OF PRIVILEGES , 12
LOSS OF MEMBERSHIP , OR ANY OTHER PENALTY FOR PARTICIPATING OR REFUSING 13
TO PARTICIPATE IN GO OD–FAITH COMPLIANCE WIT H THIS SUBTITLE. 14
(B) AN INDIVIDUAL’S REQUEST FOR AID IN DYING OR AN ATTENDIN G 15
PHYSICIAN’S PRESCRIPTION OF MEDICA TION MADE IN GOOD –FAITH COMPLIANCE 16
WITH THIS SUBTITLE D OES NOT: 17
(1) CONSTITUTE NEGLECT FO R ANY PURPOSE OF LAW ; OR 18
(2) PROVIDE THE SOLE BASI S FOR THE APPOINTMEN T OF A 19
GUARDIAN OR CONSERVA TOR. 20
5–6A–14. 21
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 22
INDICATED. 23
(2) “NOTIFY” MEANS TO PROVIDE A S EPARATE STATEMENT IN 24
WRITING TO A HEALTH CARE PROVIDER SPECIF ICALLY INFORMING THE HEALTH 25
CARE PROVIDER , BEFORE THE HEALTH CA RE PROVIDER’S PARTICIPATION IN A ID IN 26
DYING, OF A HEALTH CARE FACILI TY’S POLICY ABOUT PARTI CIPATION IN AID IN 27
DYING. 28
(3) (I) “PARTICIPATE IN AID IN DYING” MEANS TO PERFORM THE 29
DUTIES OF AN ATTENDI NG PHYSICIAN, A CONSULTING PHYSICI AN, OR A LICENSED 30
MENTAL HEALTH PROFES SIONAL UNDER THIS SU BTITLE. 31
(II) “PARTICIPATE IN AID IN DYING” DOES NOT INCLUDE : 32 18 SENATE BILL 443
1. MAKING AN INITIAL DET ERMINATION THAT AN 1
INDIVIDUAL HAS A TER MINAL ILLNESS AND IN FORMING THE INDIVIDU AL OF THE 2
MEDICAL PROGNOSIS ; 3
2. PROVIDING INFORMATION ABOUT THIS SUBTITLE TO 4
AN INDIVIDUAL ON THE REQUEST OF TH E INDIVIDUAL; OR 5
3. PROVIDING AN INDIVIDU AL, ON REQUEST OF THE 6
INDIVIDUAL, WITH A REFERRAL TO A NOTHER PHYSICIAN . 7
(B) (1) A HEALTH CARE FACILITY MAY PROHIBIT A HEALT H CARE 8
PROVIDER FROM PARTIC IPATING IN AID IN DY ING UNDER THIS SUBTITLE ON THE 9
PREMISES OF THE PROH IBITING HEALTH CARE FACILITY IF THE PROH IBITING 10
HEALTH CARE FACILITY HAS NOTIFIED ALL HEA LTH CARE PROVIDERS W ITH 11
PRIVILEGES TO PRACTI CE ON THE PREMISES O F THE PROHIBITING HE ALTH CARE 12
FACILITY’S POLICY REGARDING P ARTICIPATING IN AID IN DYING. 13
(2) THIS SUBSECTION DOES NOT PROHIBIT A HEALT H CARE 14
PROVIDER FROM PROVID ING HEALTH CARE SERV ICES THAT DO NOT CON STITUTE 15
PARTICIPATING IN AID IN DYING UNDER THIS SUBTITLE TO AN INDIV IDUAL. 16
(C) A HEALTH CARE FACILITY MAY SUBJECT A HEALTH CARE PROVIDER TO 17
THE FOLLOWING SANCTI ONS IF THE SANCTIONI NG HEALTH CARE FACIL ITY HAS 18
NOTIFIED THE SANCTIO NED HEALTH CARE PROV IDER, BEFORE THE SANCTIONE D 19
HEALTH CARE PROVIDER PARTICIPATES IN AID IN DYING, THAT THE SANCTIONING 20
HEALTH CARE FACILITY PROHIBITS PARTICIPATION IN AID IN DYING: 21
(1) LOSS OF PRIVILEGES , LOSS OF MEMBERSHIP , OR OTHER 22
SANCTIONS PROVIDED U NDER THE MEDICAL STA FF BYLAWS, POLICIES, AND 23
PROCEDURES OF THE SA NCTIONING HEALTH CAR E FACILITY IF THE SA NCTIONED 24
HEALTH CARE PROVIDER IS A MEMBER OF THE SANCTION ING HEALTH CARE 25
FACILITY’S MEDICAL STAFF AND PARTICIPATES IN AID IN DYING WHILE ON TH E 26
PREMISES OF THE SANC TIONING HEALTH CARE FACILITY; 27
(2) TERMINATION OF A LEAS E OR ANY OTHER PROPE RTY CONTRACT 28
OR OTHER NONMONETARY REMEDIES PROVIDED BY A LEASE OR OTHER PROPERTY 29
CONTRACT, NOT INCLUDING LOSS O R RESTRICTION OF MED ICAL STAFF PRIVILEGE S 30
OR EXCLUSION FROM A PROVIDER PANEL , IF THE SANCTIONED HE ALTH CARE 31
PROVIDER PARTICIPATE S IN AID IN DYING WH ILE ON THE PREMISES OF THE 32
SANCTIONING HEALTH C ARE FACILITY OR ON PR OPERTY THAT IS OWNED BY OR 33
UNDER THE DIRECT CON TROL OF THE SANCTION ING HEALTH CARE FACI LITY; OR 34
(3) TERMINATION OF A CONT RACT OR OTHER NONMON ETARY 35 SENATE BILL 443 19
REMEDIES PROVIDED BY A CONTRACT IF THE SA NCTIONED HEALTH CARE PROVIDER 1
PARTICIPATES IN AID IN DYING WHILE A CTING IN THE COURSE AND SCOPE OF THE 2
SANCTIONED HEALTH CA RE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR 3
INDEPENDENT CONTRACT OR OF THE SANCTIONIN G HEALTH CARE FACILI TY. 4
(D) SUBSECTION (B) OF THIS SECTION DOES NOT PROHIBIT: 5
(1) A HEALTH C ARE PROVIDER FROM PA RTICIPATING IN AID I N 6
DYING: 7
(I) WHILE ACTING OUTSIDE THE COURSE AND SCOPE OF THE 8
HEALTH CARE PROVIDER ’S CAPACITY AS AN EMP LOYEE OR INDEPENDENT 9
CONTRACTOR OF THE SA NCTIONING HEALTH CAR E FACILITY; OR 10
(II) OFF THE PREMISES OF T HE SANCTIONING HEALTH C ARE 11
FACILITY OR OFF ANY PROPERTY THAT IS OWN ED BY OR UNDER THE D IRECT 12
CONTROL OF THE SANCT IONING HEALTH CARE F ACILITY; OR 13
(2) AN INDIVIDUAL FROM CO NTRACTING WITH THE I NDIVIDUAL’S 14
ATTENDING PHYSICIAN OR CONSULTING PHYSIC IAN TO ACT OUT SIDE THE COURSE 15
AND SCOPE OF THE ATT ENDING PHYSICIAN ’S OR CONSULTING PHYS ICIAN’S 16
CAPACITY AS AN EMPLO YEE OR INDEPENDENT C ONTRACTOR OF THE SAN CTIONING 17
HEALTH CARE FACILITY . 18
5–6A–15. 19
(A) (1) PARTICIPATION BY A HE ALTH CARE PROVIDER I N AID IN DYING 20
UNDER THIS SUBTITLE IS VOLUN TARY. 21
(2) A HEALTH CARE FACILITY MAY NOT REQUIRE THE PHYSICIANS ON 22
THE MEDICAL STAFF OF THE HEALTH CARE FACI LITY TO PARTICIPATE IN AID IN 23
DYING. 24
(B) IF AN INDIVIDUAL REQU ESTS OR INDICATES AN INTEREST IN AID IN 25
DYING, AND THE ATTEND ING PHYSICIAN OF THE INDIVIDUAL DOES NOT WISH TO 26
PARTICIPATE IN AID I N DYING, THE ATTENDING PHYSIC IAN SHALL INFORM THE 27
INDIVIDUAL THAT THE ATTENDING PHYSICIAN DOES NOT WISH TO PAR TICIPATE. 28
(C) ON REQUEST , AN ATTENDING PHYSICI AN EXPEDITIOUSLY SHA LL 29
TRANSFER A COPY OF AN INDI VIDUAL’S RELEVANT MEDICAL R ECORDS TO ANOTHER 30
ATTENDING PHYSICIAN IF: 31
(1) THE INDIVIDUAL REQUES TS OR INDICATES AN I NTEREST IN AID IN 32
DYING; 33 20 SENATE BILL 443
(2) THE ORIGINAL ATTENDIN G PHYSICIAN IS UNABL E OR UNWILLING 1
TO PARTICIPATE IN AI D IN DYING FOR THE INDIVIDUAL ; AND 2
(3) THE INDIVIDUAL TRANSF ERS THE INDIVIDUAL ’S CARE TO 3
ANOTHER ATTENDING PH YSICIAN. 4
(D) A HEALTH CARE FACILITY MAY ADOPT WRITTEN PO LICIES PROHIBITING 5
A LICENSED PHYSICIAN ASSOCIATED WITH THE HEALTH CARE FACILITY FROM 6
PARTICIPATING IN AID IN DYING , IN ACCORDANCE WITH § 5–6A–14 OF THIS 7
SUBTITLE. 8
5–6A–16. 9
(A) AN INDIVIDUAL WHO WIL LFULLY ALTERS OR FOR GES A WRITTEN 10
REQUEST MADE UNDER §§ 5–6A–02 AND 5–6A–03 OF THIS SUBTITLE OR CONCEALS 11
OR DESTROYS A RESCIS SION OF AN INDIVIDUA L’S WRITTEN REQUEST WITHOUT THE 12
AUTHORIZATION OF THE INDIVIDUAL AND WITH THE INTENT OR EFFECT OF CAUSING 13
THE INDIVIDUAL ’S DEATH IS GUILTY OF A FELONY AND ON CONV ICTION IS SUBJECT 14
TO IMPRISONMENT NOT EXCEEDING 10 YEARS OR A FINE NOT EXCEEDING $10,000 15
OR BOTH. 16
(B) AN INDIVIDUAL WHO COE RCES OR EXERTS UNDUE INFLUENCE ON AN 17
INDIVIDUAL TO MAKE A WRITTEN REQUEST UNDE R §§ 5–6A–02 AND 5–6A–03 OF 18
THIS SUBTITLE FOR TH E PURPOSE OF ENDING THE INDIVIDUAL ’S LIFE OR TO 19
DESTROY A RESCISSION OF A WRITTEN REQUEST IS GUILTY OF A FE LONY AND ON 20
CONVICTION IS SUBJEC T TO IMPRISONMENT NO T EXCEEDING 10 YEARS OR A FINE 21
NOT EXCEEDING $10,000 OR BOTH. 22
(C) A SENTENCE IMPOSED UND ER THIS SECTION MAY BE IMPOSED 23
SEPARATE FROM AND CO NSECUTIVE TO OR CONC URRENT WITH A SENTEN CE FOR 24
ANY CRIME BASED ON THE ACT ESTABLISH ING THE VIOLATION OF THIS SECTION. 25
(D) THIS SUBTITLE DOES NO T LIMIT ANY LIABILIT Y FOR CIVIL DAMAGES 26
RESULTING FROM ANY O THER NEGLIGENT CONDU CT OR INTENTIONAL MI SCONDUCT 27
BY ANY PERSON . 28
Article – Insurance 29
27–208.1. 30
(A) FOR ALL LEGA L RIGHTS AND OBLIGAT IONS AND OTHER PURPO SES 31
GOVERNED BY THIS ART ICLE, THE DEATH OF AN INDI VIDUAL BY REASON OF THE 32
SELF–ADMINISTRATION OF ME DICATION PRESCRIBED UNDER TITLE 5, SUBTITLE 33 SENATE BILL 443 21
6A OF THE HEALTH – GENERAL ARTICLE SHALL BE DEEM ED TO BE A DEATH FRO M 1
NATURAL CAUSES , SPECIFICALLY AS A RE SULT OF THE TERMINAL ILLNESS FROM 2
WHICH THE INDIVIDUAL SUFFERED. 3
(B) ACTIONS TAKEN IN ACCO RDANCE WITH TITLE 5, SUBTITLE 6A OF THE 4
HEALTH – GENERAL ARTICLE DO NOT , FOR ANY PURPOSE , CONSTITUTE SUICIDE , 5
ASSISTED SUICIDE , MERCY KILLING, OR HOMICIDE. 6
(C) A PROVISION IN AN INSU RANCE POLICY OR CONT RACT OR AN ANNUITY 7
CONTRACT ISSUED OR D ELIVERED ON OR AFTER OCTOBER 1, 2024, IS NOT VALID TO 8
THE EXTENT THAT THE PROVISION WOULD ATTA CH CONSEQUENCES TO O R 9
OTHERWISE RESTRICT O R INFLUENCE AN INDIVIDUAL ’S DECISION TO MAKE O R 10
RESCIND A REQUEST FO R AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE 11
HEALTH – GENERAL ARTICLE. 12
(D) AN OBLIGATION UNDER A N INSURANCE POLICY O R CONTRACT OR AN 13
ANNUITY CONTRACT EXI STING ON OCTOBER 1, 2024, MAY NOT BE CONDITIONED ON 14
OR AFFECTED BY THE M AKING OR RESCINDING OF A REQUEST FOR AID IN DYING 15
UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE. 16
(E) THE ACT BY AN INSURED OF SELF–ADMINISTERING MEDICA TION FOR 17
AID IN DYING UNDER TITLE 5, SUBTITLE 6A OF THE HEALTH – GENERAL ARTICLE 18
MAY NOT HAVE AN EFFE CT UNDER A LIFE INSU RANCE POLICY, A HEALTH INSURANCE 19
POLICY OR CONTRACT , OR AN ANNUITY CONTRA CT THAT DIFFERS FROM THE 20
EFFECT UNDER THE POL ICY OR CONTRACT OF T HE INSURED’S OR ANNUITANT ’S 21
DEATH FROM NATURAL C AUSES. 22
SECTION 2. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 23
the application thereof to any person or circumstance is held invalid for any reason in a 24
court of competent jurisdiction, the invalidity does not affect other provisions or any other 25
application of this Act that can be given effect without the invalid provision or application, 26
and for this purpose the provisions of this Act are declared severable. 27
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 28
October 1, 2024. 29