Terminally ill people should have the right to choose when they die | COMMENTARY

Maryland could have all the pieces in place this year to finally pass legislation to allow the terminally ill the choice of how and when they die.

While there is universal agreement among members of a free society that everyone deserves a dignified life, the right to a dignified death is not yet guaranteed for every Maryland citizen. That might be about to change — as it should.

The central dilemma for dying people is that, in spite of the loftiest intentions, the most sophisticated medical treatments, and a range of strategies to mitigate suffering (namely, advanced directives, palliative care and hospice), science is still powerless in the face of intractable pain. For some patients there is no respite from the agony except death itself. For other terminal patients, the psychic pain of loss is equally devastating and untreatable.


In Maryland, the End-of-Life Options Act addresses the basic human right to self-determination when death is imminent. The issue has gained traction since its first introduction in 2015 as more citizens and legislators become educated about the issue. Last year, in a nail-biter, it passed for the first time in the House and fell just one vote short in the Senate.

So what is different this year? What has changed in the intervening years and why should five times be the charm?


In 2014, only a handful of West Coast states had taken up the challenge, most notably Oregon, whose first-in-the-nation aid-in-dying bill celebrated its 25th anniversary just last month. Standing the test of time, it has become a model for the rest of the country.

In that year, the very public death of Brittany Maynard, the courageous young woman with an insidious brain cancer who moved from California to Oregon so she could die with dignity, galvanized the debate and captivated the nation. Her decision catapulted many fledgling state campaigns that were laying groundwork for the following year into immediate action, even though they were not entirely prepared to launch a full-court political press.

Although Maryland wasn’t quite ready, it was ripe. After all, the state was already known as a leader for choice: The groundbreaking Freedom of Choice Act, passed in 1991, protects a woman’s right to choose at the beginning of life, and the historic Marriage Equality Act of 2013 protects the right to choose whom to love in the middle of life. So it was only a natural progression to recognize the right to have choice at the end of life.

Encouraged by that year’s Goucher Poll (a respected statewide survey that even then showed 60% support for aid-in-dying) and a passionate group of grassroots volunteers, two national organizations stepped into the breach that year to launch the campaign. Together, Compassion & Choices and Death With Dignity helped build political coalitions and nurture a bottom-up movement for medical aid-in-dying in Maryland.

Much has changed since then. In addition to the continuing support of these national partners, in 2017 a new homegrown group emerged to advocate for the bill’s passage. Marylanders for End-of-Life Options is a physician-led non-profit whose members have been in the trenches since the very beginning of this effort.

On the national and world stage, nine states and the District of Columbia have now legalized aid-in-dying. In Canada, our neighbor to the north whose society is most similar to ours in values and morés, medical aid-in-dying is the law of the land.

The Maryland General Assembly has also changed. With the recent passing of the baton in both chambers, new leadership and new faces provide new opportunities to win support and finally put this bill over the top.

The language of the bill has been refined over the years to embody all of the best practices learned over the last quarter century. What hasn’t changed is the basic directive to authorize a lethal dose of medication for adults with a terminal prognosis of less than six months, who are cognitively intact and able to self-administer.


Another thing that hasn’t changed is public opinion. The 2019 Goucher Poll re-affirmed that 62% of Marylanders support the End-of-Life Options Act.

Martin Luther King Jr. once said, “The arc of the moral universe is long, and it bends towards justice.” In Maryland, the arc of progress bends towards choice and we are balanced on its cusp, ready to make human rights history once again.

Ruth Goldstein ( is an essayist and retired nurse writing from Baltimore, Maryland.