Divided Senate panel debates physician-assisted suicide bill

ANNAPOLIS – A Senate committee appeared deeply divided Thursday over legislation that would allow terminally ill patients to request and receive life-ending medication from their physicians who conclude they have at most six months to live.

Sen. William C. “Will” Smith Jr., D-Montgomery, the bill’s chief sponsor and vice chair of the Senate Judicial Proceedings Committee, said the measure would give dying people “that modicum of control toward the end of (their) life.”

But Sen. Michael J. Hough, R-Frederick and Carroll, said the proposal expressly contradicts Maryland’s prohibition on doctors and other individuals from knowingly helping someone commit suicide by providing instruments of death.

“This is not legal,” Hough said. “This is political what we are doing with this.”

The committee’s discussion of the proposed End-of-Life Option Act followed the House of Delegate’s passage of the legislation by a 74-66 vote on March 7. Similar physician-assisted suicide bills failed in or were withdrawn from the Senate Judicial Proceedings Committee in 2015, 2016 and 2017.

Sen. Robert A. “Bobby” Zirkin, D-Baltimore County and the committee’s chair, voiced opposition to a provision in the bill that would immunize the attending and consulting doctors from liability if they made their six-month prognosis and prescribed the drugs in good faith. Zirkin, a plaintiffs’ attorney, said the good-faith exemption runs counter to medical malpractice law, which imposes liability if a doctor is found to have acted negligently.

These doctors must “act under reasonable standard of care, like everybody else in the world,” Zirkin said, noting an amendment to the bill was forthcoming.

“Malpractice is malpractice,” he added. “You don’t give good-faith immunity to someone just because they are helping somebody.”

The committee planned to keep discussing the bill and to vote on amendments late into Thursday evening, Zirkin said, adding that a vote would be forthcoming soon on the amended legislation.

Under House Bill 399, an attending and a consulting physician — a doctor who specializes in the patient’s illness — would have to agree on the six-month prognosis before prescribing a fatal dose of drugs. The patients would have to request the medication and take it on their own.

The drugs could not be prescribed unless the patient makes at least three requests for the medication, including one in writing. A patient’s request for a physician’s assistance in suicide would have to be co-signed by two witnesses, neither of whom could be the attending physician or, as amended Thursday by the Senate committee, someone who would benefit financially from the patient’s death

The attending or consulting physician would have to refer the patient’s request to a mental health professional if the doctors had reason to believe the patient might lack the capacity to make the end-of-life decision. The doctors would have to await the mental health professional’s determination.

Sen. Robert Cassilly, R-Harford, likened the bill’s provisions regarding who decides if the patient has six months to live to a “pingpong game between the attending and consulting physician.”

“Who has the ball?” Cassilly asked.

Hough said that enacting the proposal would create “a slippery slope” toward allowing doctors to be more active participants in the deaths of their terminally ill patients.

Under the bill, the patient’s official cause of death would be natural causes, specifically the disease from which the person was suffering. The patient’s death by physician-assisted suicide would have no adverse effect on beneficiaries’ claims under life insurance policies, the legislation states.