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Md. efforts aim to reduce untimely deaths and allow timely ones

From gay marriage to marijuana decriminalization, Maryland has been a national leader on social issues in the new century. This year, state legislators and new governor Larry Hogan can further burnish the state's reputation by setting a national example on heroin intervention and death-with-dignity legislation.

Let's start with Gov. Hogan's noble call to mitigate heroin addiction and overdose deaths in Maryland. The governor brings personal experience to the issue: He lost a cousin to a heroin overdose.

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Maybe the issue would not have figured so prominently on Mr. Hogan's mind if not for his family's tragedy, but so what? Governors lead best when they move low-salience or dormant issues to the forefront of the state agenda, and Mr. Hogan should be commended for doing so, whatever his reasons.

Heroin overdose deaths have been rising in the state each year since 2010 and have doubled in that period. A big part of the problem — one hardly limited to Maryland — has been the introduction of fentanyl into the heroin supply. Even for careful users with strong tolerances, fentanyl can be lethal the very first use.

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Because fentanyl is both cheaper and more potent than heroin itself, profit-minded drug dealers find it particularly attractive to cut their heroin supplies with it. They may lose a few customers along the way, but drug dealers who don't bear the personal or social costs of their menacing trade care little about the collateral damage.

The first wave of fentanyl-related heroin overdoses came in 2006, but then a second wave began two years ago. The Northeast and Midwest regions have been hardest hit.

Mr. Hogan tasked Lt. Gov. Boyd Rutherford to oversee the state's heroin response efforts. Mr. Hogan also created two state panels to investigate and remediate the problem of heroin addiction, and applied $500,000 in federal funds to increase drug treatment programs in Maryland's jails and prisons.

Let's hope Governor Hogan's prioritization of this issue reduces the state's number of tragic, untimely deaths from heroin overdose.

Timely deaths are another matter, and Maryland should cement its reputation as an early policy adopter by passing physician-assisted suicide legislation.

The right to control one's life is indelibly linked to the right to manage one's death, especially when pain and suffering for those dying and their loved ones can be relieved by suicide.

Before touting the benefits of "death with dignity" laws, I encourage people to read Atul Gawande on the subject of end-of-life medical decision-making: either his 2014 book "Being Mortal: Medicine and What Matters in the End," or his shorter but still powerful 2010 New Yorker article with the headline Letting Go. (Dr. Gawande has not staked out a clear position on physician-assisted suicide.)

People should not be forced to live in pain to satisfy other people's religious beliefs. And they darn sure shouldn't be kept alive to run up medical bills and bankrupt their survivors. As Dr. Gawande explains, people who accept their fates and embrace palliative care on average live as long if not longer than those who try vainly to defy death.

In the Maryland General Assembly, Howard County Del. Shane Pendergrass and Montgomery County Sen. Jamie Raskin are two of the leading advocates for "death with dignity" legislation. They have modeled their proposed bill on the first-in-the-nation law adopted in 1994 by Oregon. (Legal challenges prevented the law from being implemented until 1997.)

That's where 29-year-old Brittany Maynard moved so she could die with dignity last November from a brain tumor that had made her life miserable. Because hers was such an unusual case — a young woman willing to sacrifice her privacy so she could empower others with painful, terminal illnesses to have the same choice she made — Ms. Maynard became a global figure.

With a bit of luck and a lot of mercy, perhaps in the future a series of eponymous "Brittany's laws" will spread across the country much in the same way that so-called "Megan's laws" and "Amber alerts" have taken hold nationally.

Until then, Maryland should join the handful of states that permit assisted suicide.

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Thomas F. Schaller teaches political science at UMBC; his most recent book is "The Stronghold: How Republicans Captured Congress but Surrendered the White House." His column appears every other Wednesday. His email is schaller67@gmail.com. Twitter: @schaller67.

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