'Death with Dignity' to resurface with new name

Elisha Sauers
Contact Reporteresauers@capgaznews.com
Maryland 'death with dignity' could include data collection rules and a coercion safeguard.

When advocates push for a Maryland "death with dignity" policy in 2016, the bill will return with a new name mimicking a law passed in California this year.

The End of Life Option Act will likely undergo several other alterations discussed in a work group that met for the last time in Annapolis Tuesday.

Lead House sponsor Del. Shane Pendergrass, D-Howard, said the legislation could include changes to prevent patient coercion, spell out the cause of death and make requirements for government data collection.

"That's not to say there may not be other changes," said Pendergrass, who has not filed a draft of the new bill yet.

In Maryland, the 2015 session was the first time the legislature considered whether terminally ill patients should have a state right to access a drug to die. The bill was named after Roger "Pip" Moyer and Richard "Dick" Israel, two former Annapolis leaders, both of whom died in 2015 after long struggles with Parkinson's disease. Lawmakers pulled back the bill after it became clear the issue would lead to a heated floor debate.

The legislation would have made it legal for patients with a six-month prognosis to get a lethal prescription drug from a physician. Only patients could make the decision, and they would have to be able to take the medication without assistance.

Advocates believe it's a humane option for suffering, dying patients who could have some control over their own circumstances. Opponents argued the bill would sanction death for those who relied on others for care, putting the state's most vulnerable at risk.

Legislators formed the work group this summer to address concerns and refine the policy before it returned in January. At its third and final meeting Tuesday, Pendergrass said a lot of her revisions are modeled on the California legislation.

Sponsors are considering changing the witness form to two separate documents, one for each of the witnesses, to make the directions less complicated. The rules would also require that one of the two witnesses not be a relative or beneficiary.

Other possible changes would be to require documenting the cause of death as "Pharmacologically Accelerated Imminent Natural Death" — or P.A.I.N.D. — on the patients' death certificates. That consistent term could help health officials track data on patients who opt for the life-ending drug.

As an additional measure to ensure relatives or caregivers aren't coercing a patient, sponsors want to include a mandatory private consultation between the doctor and patient as a safeguard.

Some members of the work group said they had been inundated with constituent emails on the issue. Del. Chris West, R-Baltimore County, said he received hundreds over the weekend, mostly from outside of his district and containing boilerplate messages from the Maryland Catholic Conference.

Sen. Ronald Young, D-Frederick and Washington, said he's received mixed feedback, particularly from faith groups. But the reality, he said, is many patients and their families are making life-ending choices informally already.

"I know many, many cases, including, again, one in my own family, where the doctor said, 'I think what I should do is give enough morphine to keep them out of pain and let it take its course,'" said Young, who sponsored the death-with-dignity bill in 2015. "And that's how my mother went. And my mother would have loved to have this option."

Not every member of the work group is on board with the bill for 2016, and many continued to raise concerns that speak to the heart of people's religious and philosophical differences on the subject. While some shared technical reservations about the proposal, others had big-picture problems. Sen. Wayne Norman, R-Cecil and Harford counties, opposed the original bill.

"I'm 60 years old. I've always understood that suicide is wrong," Norman said. "Taking poison to kill yourself is wrong."

Three other states — Oregon, Washington and Vermont — have right-to-die laws. Six years ago, Montana's Supreme Court ruled nothing legally prevented a physician from giving a terminally ill, mentally competent patient a lethal medication upon request. Several Montana lawmakers have introduced bills attempting to ban the practice, according to advocacy group Death with Dignity National Center, none of which have passed.

In an interview with The Capital this week, House Speaker Michael E. Busch, D-Annapolis, said under the right circumstances, he believes residents should have the opportunity to decide for themselves.

"To summarily say that you're not allowed to do that just is not something that the general public, I think in this day and age, supports," he said. "That's one that people are going to have to get there on their own, as far as their conscience is concerned."

Other additions lawmakers have proposed are immunity to protect medical practitioners from legal action, privacy requirements for the records, disposal rules for any unused drugs and penalties for violators of the law.

Del. Terri Hill, D-Baltimore and Howard counties, said she plans to introduce a related bill requiring state health officials to develop a booklet and website to provide a comprehensive list of options for terminally ill residents, including information on hospice and palliative care.

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