When someone is facing only months to live due to terminal illness, they may consider a physician’s assistance to ease the pain of dying and have more control over what their final moments may look like. But in Maryland, a physician is currently prohibited from participating in so-called “medical aid-in-dying.”
Maryland lawmakers have tried year after year, but so far, no bill to legalize medical aid in dying has passed.
But supporters of the legislation think that 2024 might be the year it passes, due to a changing political climate and overall voter support for the measure. The General Assembly is set to convene Jan. 10.
Del. Joseline Peña-Melnyk, chair of the House Health and Government Operations Committee, said that another round of medical aid in dying legislation will be introduced in the upcoming 2024 session.
“We have been working on it during the interim,” Peña-Melnyk (D-Anne Arundel and Prince George’s) said in a written statement. “I am hoping that this is the year the bill is successful. It has been carefully drafted and thoughtful. I hope the bill is allowed to come to the Senate floor.”
She said that she has asked Del. Terri Hill (D-Howard) to sponsor the House bill next year. Hill could not be reached for comment.
Peña-Melnyk led the previous attempt last year, with House Bill 933, called the “The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act.” The bill would have provided certain medical patients the ability to self-administer medication that would result in their own death.
The 2023 legislation restricted such requests to people with a terminal illness and the mental capacity to make their medical decisions. An individual would initially request aid in dying to a physician and then submit a written request that says they were “of sound mind” and suffering from an illness that “will, more likely than not, result in death within 6 months.”
While medical aid in dying legislation has never quite made it over the finish line in Maryland, 10 other states and Washington, D.C. have passed similar legislation.
Members of the House of Delegates who support the legislation believe that 2024 will be the year it passes. The question remains on whether Maryland’s senators will support the bill.
“Our question has always been on the Senate side,” said Del. Bonnie Cullison (D-Montgomery).
In 2019, the aid in dying legislation came to an end on the Senate floor when one Senator chose not to vote at all, leading to a 23-23 tie vote and the bill’s demise.
In October, Senate President Bill Ferguson (D-Baltimore City) said that he thinks aid-in-dying legislation will be a “a very real conversation this year,” Maryland Matters previously reported.
“I would say it’s probably going to be one of the headline issues to be addressed this year,” he had said at the time. The Senate president’s office did not respond to follow-up questions.
Cullison said she thinks public opinion is more strongly in favor of medical aid-in-dying procedures.
“This is just another way that folks are able to have personal autonomy over their own health care, and so I think that is how the public is perceiving it,” she said.
A Gonzales Research & Media Services‘ poll that was sponsored by the end-of-life care advocacy group Compassion & Choices surveyed 807 Maryland voters in December of 2021 on their attitudes towards aid-in-dying, and found that 69% believe that “a mentally sound adult with an incurable, terminal illness, who only has six months or less to live, should have the legal option of medical aid in dying.”
Those percentages went up to 73% among Democrats and down to 65% among Republicans. Unaffiliated voters supported the measure at 63%.
And Gov. Wes Moore (D) has previously voiced support for aid-in-dying legislation during an interview with The Daily Record when he was governor-elect.
Donna Smith, the D.C. campaign director for Compassion and Choices, an advocacy group that has pushed aid-in-dying legislation across the nation, said that she thinks that we’re in a different climate than in previous years to take serious consideration on aid-in-dying bills.
For one, she said the conversation about aid-in-dying goes hand in hand with discussions of ‘bodily autonomy’ especially after the overturning of Roe v. Wade.
“I think this is a timely discussion, especially as we look at the abortion rights issue, because that’s one of self-autonomy, right?” she said. “That pregnant women should have autonomy over their body. And I think that applies to death and dying as well. Because why would we not give dying people options at the end of life, when the options are so few?”
“I think what it did was it pointed out the concept of personal autonomy and choices,” Cullison said. “There is a natural progression from that discussion to the discussion we’re having about end of life options.”
Smith with Compassion and Choices also said that the COVID pandemic may have led people consider the challenging discussion, as it “put death and dying in the conversation in a way that had not happened before.”
“It has people thinking about what they want their end of life to look like,” Smith said.
“The experience of going through that, we had to talk about death and dying, what that looks like, in a way that we didn’t have to do that before. The conversation was very taboo to even have. Now, it’s less taboo,” she added.
But there are many who oppose the measure all together.
Various religious groups like the Maryland Catholic Conference oppose aid-in-dying legislation because it “seeks to legalize the intentional taking of human life,” according to its website.
According to a Gallup poll from 2018, while 72% of people surveyed said that a physician should be able to medically end a terminally ill patient’s life at the request of the patient, favorability drops among regular church goers.
Of those who attended church weekly, only 37% agreed with medical aid-in-dying. That went up to 69% among those who would attend church nearly weekly or monthly. Of those who never or seldom attended church, 86% supported medical aid in dying.
There are also concerns from some members of the disability community, who worry that aid-in-dying procedures will endanger people with disabilities. The disability group called Not Dead Yet has opposed the Maryland legislation in the past, and say that efforts should be made to improve quality of care for disabled people.
But supporters of the legislation insist the bill will not target individuals with disabilities and has guardrails to ensure that a patient is not being coerced into making a life-ending decision that they do not want to make.
“A small percent of people opt to go through the process,” Smith said. “And an even smaller percentage of people actually get through the process. Understand that we are talking about terminally ill people. And having a disability does not automatically qualify you for the law.”
By Danielle J. Brown