The Maryland State Senate Comes Historically Close to Passing an End-of-Life Option Act

Jordan L. Cook*

At twenty-nine-years-old Brittany Maynard was faced with a life-altering circumstance.  Brittany Maynard, My Right to Death with Dignity at 29, CNN (Nov. 2, 2014),  She was newly married and trying to start a family, but this dream was short-lived after discovering that she had brain cancer.  Id.  Brittany underwent surgery and the doctors were able to remove her cancer.  Id.  Unfortunately, the tumor came back more aggressive than before, and she was informed that she had only six months to live.  Id.  There were no treatments available to save Brittany’s life and she was left with dismal options to prolong her life: (1) receive brain radiation that would have “singed off” the hair on her scalp and left her with first-degree burns; (2) receive palliative medication at a hospice facility where she “could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind[;]” or (3) uproot her life in California so that she could  receive medical assistance in dying.  Id.  Ultimately, Brittany elected to move to Oregon; where she was able to die peacefully and with dignity in her bedroom surrounded by her family.  Id.

I.  The End-of-Life Option Act

Oregon has been a leader in the aid-in-dying movement by passing its Death with Dignity Act in October 1997.  Death with Dignity Act, Or. Health Authority, (last visited Aug. 21, 2019).  Seven other states and the District of Columbia have followed in Oregon’s footsteps to allow terminally ill patients to receive aid-in-dying, so they can die on their own terms.  Editorial Board, Maryland Comes Agonizingly Close to Passing Death-with-Dignity Legislation, Wash. Post (Mar. 28, 2019, 6:50 PM),

This year, the Maryland House of Delegates was well on its way to pass similar legislation with House Bill 399, the Richard E. Israel and Roger “Pip” Moyer End-of-Life Option Act (the Bill).  H.D. 399, 439th Gen. Assemb. (Md. 2019).  Shane Pendergrass (D-Howard), a Maryland State Delegate, sponsored the Bill along with forty-eight co-sponsors.  Maryland, Death with Dignity, (last visited Aug. 21, 2019).  This Bill would allow a Maryland resident to receive medical aid-in-dying if: (1) the individual is of “sound mind” and aware of the “associated risks [and] potential results;” (2) a doctor has determined that the individual is suffering from a prognosis in which it has been determined that the individual has six months or less to live; and (3) the individual is able to self-administer the lethal medication.  H.D. 399 §5-6A-03.  The Maryland House of Delegates passed the Bill by a 74–66 vote, and then it proceeded to the Maryland State Senate for approval.  Maryland, supra.

Senator William Smith of the Maryland State Senate sponsored Senate Bill 311, which was cross-filed with the Bill and had eighteen co-sponsors.  Id.  While in the senate, the Bill received various, substantive amendments: (1) doctors would face a risk of being sued “for helping patients die;” (2) patients would need to have a referral from a mental health professional; (3) patients would have to see multiple doctors of different practices areas; and (4) the physician would have to inform the patient of “alternative treatments” for their illness.  Ovetta Wiggins, No Aid-in-Dying in Maryland This Year: Bill Fails with Tie Vote in Senate, Wash. Post (Mar. 27, 2019, 6:41 PM),  Many senators who supported the original Bill viewed the amendments as an attempt to “sabotage” the Bill to ensure that it would never pass.  Editorial Board, supra.  On March 27, 2019, the Bill failed because of a tied 23–23 vote.  Id.  Many senators were concerned that terminally ill individuals would make aid-in-dying decisions based on economic factors, which the senators deemed as not safe or free from “coercion.”  Dominique M. Bonessi, Right-To-Die Bill Advances In Maryland House, Wamu 88.5 (Mar. 7, 2019),  Additionally, the religious views of some senators influenced their vote against the Bill.  Wiggins, No Aid-in-Dying in Maryland This Year, supra.

II.  Opposition to the Bill

Akin to the Maryland senators who rejected the Bill, many religious organizations are weary of this type of legislation becoming law.  Bonessi, supra.  Specifically, members of the Archdiocese of Baltimore, a Catholic association, expressed their disapproval of the Bill “during the March for Life in Annapolis [because] the [B]ill would ‘further undermine the dignity of human life.’”  Id.  Moreover, certain organizations believe that a bill that promotes “suicide” goes against their most sacred religious principles.  Wiggins, No Aid-in-Dying in Maryland This Year, supra.

Various medical professionals also disagree with the substance of this legislation.  See Bonessi, supra.  “Maryland Physicians Against Assisted Suicide, along with 13 other national medical organizations, have released statements in opposition to the practice of physician-assisted suicide because it ‘distorts medical ethics.’”  Id.  Medical professionals are concerned about protections to prevent vulnerable populations (e.g., seniors and disabled individuals) from being coerced into choosing aid-in-dying.  Id.  Without seeing lawmakers address these issues, many of these medical professionals will likely continue to oppose physician-assisted suicide.  Id.

III.  Support of the Bill

Many lawmakers in support of the Bill are focused on the concept of autonomy, which was evident from their heart-wrenching stories during the debates.  See Ovetta Wiggins, Maryland House Approves Aid-in-Dying Bill After Emotional Debate, Wash. Post (Mar. 7, 2019, 7:32 PM),  Senator Kelley (D-Baltimore County), whose daughter died from cancer, chose to support the Bill because she believes that “no one should be able to decide for another person what level of suffering God wants them to endure . . . [, and we] should have some autonomy[.]”  Id.  Additionally, Delegate Luedtke (D-Montgomery), who witnessed his mother with stage three cancer try to end her own life because of her humiliation and pain, eventually supported the Bill that he formerly opposed.  Id.  He stated:

Despite my personal hatred for suicide, what right do I have as a government official, even as her son, to say how her life should end? . . . This [B]ill, in my opinion, is not the government putting its finger on the scales. It’s [the] government taking its finger off the scales.

Id.  The choice to end one’s life is a very personal decision, and those who are in support of the Bill believe that they should have the option, as autonomous beings, to end their own life and die a peaceful death.  Id.


The Bill marked the fourth time since 2015 that Maryland lawmakers have considered an aid-in-dying bill.  Editorial Board, supra.  Nonetheless, the Bill presented historical progress in Maryland as Senator Smith noted—“[n]ever before has [the Bill] come out of the House and never before has it come out of the Senate committee, and . . . had 23 senators go along with it.”  Wiggins, No Aid-in-Dying in Maryland This Year, supra.  Given this close vote in legalizing aid-in-dying in Maryland, there may be a different result the next time a similar bill is presented.  See id.

*Jordan L. Cook is a second-year law student at the University of Baltimore, where she serves as a staff editor for Law Review. Jordan is also a distinguished member of the Royal Graham Shannonhouse III Honor Society. This past summer, Jordan worked as a judicial intern for the Hon. J. Mark Coulson in the U.S. District Court for the District of Maryland and the Hon. Glenn T. Harrell, Jr. in the Maryland Court of Appeals.


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