Maryland committees hear emotional and technical debate over End of Life Option Act

Delegate Terri Hill, sponsor of House Bill 13-28, opened a joint hearing of the House Health and Government Operations and Judiciary Committees by summarizing the bill as a narrowly-defined medical option for some terminally ill adults and stressing its safeguards. “I highly value life, and I highly value life with dignity and the dignity of death,” Hill said as she read provisions from the bill describing how a qualified patient would request and receive medication.

The bill, titled the End of Life Option Act and referenced in the hearing as the Elijah E. Cummings and Shaney Pendergrass Act, would allow a physician to prescribe medication that a qualified individual may self-administer to bring about death. Under the version read into the record, a patient would make an initial oral request, then a second oral request at least 15 days later; a written request signed and dated by the individual must be witnessed by two people (no more than one may be a relative), and at least one of the oral requests must occur when the patient is alone with the physician. The attending physician would confirm capacity and diagnosis, a consulting physician would confirm the prognosis, and either physician must refer for a licensed mental health assessment if they have concerns about impaired judgment. The bill states an individual “is not considered qualified if that qualification is solely due to their age, disability, or specific illness.”

Why it matters: supporters and many witnesses said the law would give mentally capable adults facing imminent death an additional option to avoid what they called prolonged, intolerable suffering. Opponents — including psychiatrists, hospice clinicians, disability advocates and clergy — said the measure creates legal and ethical risks for vulnerable people, institutional patients and health professionals and raised practical questions about pharmacies, reporting, involuntary-commitment law intersections and insurance incentives.

Supporters' testimony emphasized autonomy and real-life examples. Witnesses who said they were living with terminal disease described why they want the choice: “I don’t want my disease to choose when I die,” said Lynn Cave, who described metastatic eye cancer and told the committee that the option would provide “comfort” even when the medication is never used. Laura Schrank described a friend with ALS who traveled out of state to obtain a medically assisted death and asked lawmakers to give Maryland residents the same choice. Dan Diaz described his late wife’s experience in a jurisdiction where aid in dying was available and said the safeguards felt protective.

Medical and ethical supporters included retired and practicing physicians who said strict steps in the bill — dual physician confirmation of diagnosis, a waiting period and witness rules — reduce the risk of coercion. “The attending and consulting physicians both got it right,” said Dr. Elizabeth Morrison, a Maryland psychiatrist who cited studies where attending and consulting physicians’ assessments of capacity aligned with specialist reviewers. Several physicians and advocates also argued that hospice and palliative care do not resolve unbearable suffering for every patient and that aid in dying can coexist with those services.

Opponents raised several categories of concern. Dr. Annette Hanson, a forensic psychiatrist, said the bill could “create confusion regarding our involuntary mental health treatment laws,” including practical questions about emergency petitions and whether a civil-commitment process could intersect with a legally obtained prescription. Hospice and nursing witnesses warned of operational and ethical difficulties: an experienced hospice nurse cited surveys and said many hospices in states with aid-in-dying laws restrict staff presence when a patient self-administers medication; another nurse argued that untreated depression can drive requests and that mental-health safeguards in practice are insufficient.

Pharmacy and practical logistics also drew scrutiny. Pharmacist Christine Seibert told the committees the prescribed mixture used in other jurisdictions is complex and typically requires compounding, raising questions about where families would obtain and store large quantities of powdered drugs and how pharmacists and hospice staff should advise on handling, ingestion risks and disposal.

Disability advocates and some clergy argued the law would transmit a harmful message about the value of lives of people with disabilities and older adults. Representatives of several disability and religious organizations told the committees that even carefully framed laws can produce pressure on vulnerable people and cited the need for strong supports and robust palliative care instead. Rabbi Ariel Satter and other faith witnesses urged rejection on moral and communal grounds.

Lawmakers on both panels pressed the sponsor on specific protections. Delegates asked about safeguards against coercion, whether the consulting physicians should be prohibited from being in the same practice as the attending physician, reporting requirements to the Department of Health and clarifications about pharmacists’ conscience protections. Delegate Kaufman and others requested follow-up conversations on disability concerns; Hill said she was open to amendments, including possible language about consulting physicians not being in the same practice and more detailed reporting criteria.

No final vote or formal action was taken during the hearing. Committees heard multiple panels of favorable and unfavorable witnesses and flagged technical and policy questions — including how the measure would operate in state hospitals and prisons, how mental-health evaluations would be triggered and what reporting and disposal requirements should look like. Testimony and written material submitted at the hearing were entered into the record for future consideration.

The hearing illustrated the central tension driving the debate: supporters describe the bill as a narrowly tailored choice for mentally capable adults facing imminent death; opponents contend that the safeguards are inadequate in practice and that the law would place clinicians, institutions and vulnerable people at risk. The committees may consider amendments before deciding whether to advance the bill for a floor vote.