End-of-Life Option Act (The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act)
SB 926 would create Maryland’s “End-of-Life Option Act,” authorizing certain terminally ill adults to request and receive medication that they may self-administer to bring about death. The bill sets out a detailed process for making an initial oral request, a written request, and a second oral request; requires the patient to be an adult with decision-making capacity and a terminal illness expected to result in death within six months; and requires confirmation by both an attending physician and a consulting physician. It also requires disclosure of diagnosis, prognosis, risks, alternatives, and palliative care or hospice options, and it includes safeguards such as witness requirements, the ability to rescind the request at any time, and referral for a mental health assessment when capacity is in doubt.
The bill also establishes rules for how medication may be prescribed and dispensed, including limits on who may receive it and when a pharmacist may dispense it. It provides that a death under the act is treated as death from natural causes for legal and insurance purposes, and it prohibits contracts or insurance provisions from penalizing a person for making or rescinding a request for aid in dying. The measure further clarifies that participation by health care providers is voluntary, allows health care facilities to adopt policies restricting participation on their premises, and creates criminal penalties for forging, altering, concealing, or coercing requests or rescissions.
In terms of state law, SB 926 would amend the Criminal Law Article to state that licensed health care professionals do not violate Maryland’s assisted-suicide prohibition when acting in accordance with the new subtitle. It would add a new subtitle to the Health-General Article governing aid in dying and add a corresponding insurance provision to the Insurance Article. The bill would also authorize the Maryland Insurance Commissioner to enforce certain provisions and require the Department of Health to collect data and publish annual statistical reports.
Because no committee transcripts or recorded votes were provided, the bill’s sentiment cannot be measured from hearings or floor action. Based on the text alone, the bill appears designed to balance patient autonomy with procedural safeguards, provider conscience protections, and anti-coercion measures. The main points of contention likely concern the moral and legal status of physician-assisted dying, the adequacy of safeguards against coercion or misuse, and the extent to which hospitals and other facilities may restrict participation by their staff.
SB 926 would significantly change Maryland law by creating a new legal framework for physician-assisted dying for terminally ill adults, while carving out an explicit exception to the state’s assisted-suicide prohibition for conduct that complies with the act. It would also alter insurance law so that aid-in-dying decisions cannot be used to deny, limit, or alter coverage or contractual rights, and it would require state-level reporting and regulatory implementation. The bill affects terminally ill patients, physicians, pharmacists, mental health professionals, health care facilities, insurers, and family members involved in end-of-life care.
No committee discussion or vote history was provided, so there is no recorded legislative sentiment to summarize from hearings or roll calls. From the bill’s structure, the measure is framed as a carefully regulated end-of-life option with multiple safeguards, suggesting supporters would emphasize patient autonomy, dignity, and access to hospice/palliative counseling, while opponents would likely focus on ethical objections and concerns about abuse or pressure on vulnerable patients.
The likely points of contention are whether Maryland should authorize aid in dying at all, whether the bill’s safeguards are sufficient to prevent coercion, and how much discretion health care facilities should have to prohibit participation on their premises. Other likely disputes include the role of pharmacists, the adequacy of mental health screening, the treatment of the act as a natural death for insurance and legal purposes, and the criminal penalties for tampering with requests or coercing patients. The bill also draws a line between voluntary participation by providers and the ability of institutions to restrict participation, which may be contested by both patient-rights advocates and religious or institutional health systems.