Medically assisted suicide bill advances in Maryland, but with changes that frustrate advocates

A bill to allow certain terminally ill Marylanders to obtain medication to end their lives is advancing in the state Senate, but it has been changed so much that the leading advocacy group says it cannot support the bill in its current form.

Kim Callinan, CEO of Compassion & Choices, said the bill now includes so many hurdles for patients that few people will be able to avail themselves of the choice to take medication and end their lives.

“The changes that were made to this bill will result in dying patients being unable to access it,” Callinan said Friday following a vote by the Senate’s Judicial Proceedings Committee to endorse the bill.

The group, which has lobbied for bills in multiple states, is hoping for more revisions to the bill before a final vote.

“If the bill proceeds as is, and additional amendments are not made on the floor, we would not be supportive of this bill,” Callinan said.

Committee members voted 8-3 in favor of the bill. A different version of the bill was approved by the House of Delegates following an emotional debate this month.

Sen. Will Smith, the bill’s sponsor, said committee members worked hard to address concerns with the process for obtaining the medication.

“The bill sets up a very deliberate process, a number of protections for vulnerable populations,” said Smith, a Montgomery County Democrat. “Frankly, the bill does shift toward many more steps to go through … And maybe that’s a good thing, and maybe that’s not.”

Sen. Bobby Zirkin, the committee chairman, said the bill as introduced to the committee was “flawed to its core.”

Zirkin, a Baltimore County Democrat, said he didn’t want to stand in the way of terminally ill patients who are “truly, truly” at the end of their life and out of treatment options. But he said the committee added important protections.

Committee members spent more than seven hours hashing out dozens of proposed amendments to the bill during an arduous session on Thursday.

Under the bill heading to the full Senate, a terminally ill patient with a prognosis of six months or less to live could request a prescription of fatal medication from their doctor. To qualify, the patient must:

» Be at least 21 years old, a change from 18 in the original bill.

» Have their diagnosis confirmed by their attending physician and a consulting physician. Those two physicians cannot be in the same practice or have a financial relationship

» Ask for the prescription three times, including once in private with a doctor and with witnesses.

» Undergo a mental health evaluation.

The senators also set a stricter definition of who could qualify, saying they must have an “irreversible” condition that affects their quality of life and that “within a reasonable degree of medical certainty” will result in death within six months. The original bill’s standard was “reasonable medical judgment” that the individual is likely to die within six months.

Doctors also would be required to give patients written information about treatment options that are available for their condition.

The senators also stripped a requirement in the original bill that would have shielded doctors from civil lawsuits related to prescribing the fatal drugs.

Even with the changes, three committee members voted against the measure.

“To me, this crosses a very bright red line of where we should be going as a society, as a state,” said Sen. Justin Ready, a Carroll County Republican. “It sanctions health providers prescribing poison for someone to end their life on purpose … I can’t vote and say that’s OK.”

Sen. Robert Cassilly, a Harford County Republican, said he believes legalizing medically assisted suicide will shift the state and the medical community’s focus away from hospice care, which can help relieve suffering at the end of one’s life.

“This is just a huge sea shift,” he said.

A coalition called Maryland Against Physician Assisted Suicide said in a statement that even with the revisions, the bill “does not offer sufficient protection of those in our system of health care who are most vulnerable to abuse.”

The revised measure heads to the full Senate for consideration, where the vote is expected to be close. Advocates had been hoping for a final vote before the end of next week, when Smith, a Montgomery County Democrat, leaves for Afghanistan on a Navy deployment.

Del. Shane Pendergrass, who is the sponsor of the House version, said the Senate’s changes give her “great concern.” She worries that it will be too difficult for patients to go through the process to get the medication.

Pendergrass, a Howard County Democrat who has been pushing for the bill since 2015, said she’ll review the Senate version to “see if we can salvage it or not.”

Gov. Larry Hogan, a Republican, has not committed to a position on the bill. He has said that it is “one that I really wrestle with from a personal basis” and that he would give it careful consideration if it reaches his desk.

There are laws allowing medically assisted suicide in the District of Columbia and six states: California, Colorado, Hawaii, Oregon, Vermont and Washington. Montana allows the practice under a state court decision.

Legislation failed in Maryland three times before without even receiving a committee vote.

pwood@baltsun.com

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