Md.’s End-of-Life Option Act gives terminally ill a choice to ‘stop dying’

A year ago, Wendel Thompson’s wife, Carolyn, was dying. She was 86, in pain from lumbar stenosis and not taking any food or drink.

“The morphine put her to sleep. Her last days were silent,” Thompson, who lives in Baltimore County, said in testimony last week in support of legislation that would give competent, terminally ill adults the option of medical aid in dying.

“Carolyn could have been awake and present to us under this law. We could have had the immediate family there,” he said. “I think she would have wanted that.”

I am proud to be the sponsor of that legislation, the End-of-Life Option Act, also known as the Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act (House Bill 403/Senate Bill 443).

The legislation asks what input the state, any institution or uninvited individuals can have in the final decisions when death is imminent, and it answers “none.” It acknowledges the intimacy of the final journey and offers those who find it unbearable the legal option to receive medication to end their life on their own terms.

I value all life. As a doctor, daughter and caregiver, I have stood with friends and family members as they’ve fought to live, and as they’ve died. The bill respects a patient’s right, given adequate capacity, to be fully informed and empowered to make personal health care decisions. Marylanders overwhelmingly support its passage. Unsure as to whether they would exercise this option when their own time comes, most are sure they want to have it.

HB403/SB443 provides compassion and autonomy to residents facing imminent death. It facilitates honest discussion between the patient and their loved ones about respective fears, hopes, wishes and regrets, while decisions about treatment, care, support and transitioning are being made — discussions that carry a different tone and urgency when death is tangible, rather than abstract. Enacted, it could ease the guilt or shame sometimes felt by dying patients and their loved ones over perceived “failures” for not fighting hard enough or being unable to relieve the suffering, or for being either too willing or too unwilling to say goodbye.

It allows terminally ill Marylanders qualified under strict criteria to request and receive prescribed medication for self-administration if, and when, they choose to end their dying process. They must request to participate multiple times, days apart, and give informed consent after being told of the implications, process, rights, and alternative resources and supports. At least two physicians would evaluate them, and a third if a psychiatric evaluation is indicated. Only the patient could request the prescription. They would have no obligation to take it and could withdraw their request at any time. Unused medication would need to be safely disposed of in the manner required by law.

This legislation does not compel. It is rooted in personal autonomy, choice, and agency. No patient, family member, or health provider is required to participate.

Medical aid in dying is not suicide — people attempting suicide are looking to stop living; people opting for medical aid in dying are looking to stop dying. Proper medical intervention may prevent suicide. Medical intervention will not prevent death for terminally ill patients, who typically exhaust available treatments as they fight to live. Their disease is killing them, and prescribed medication affords the assurance and comfort of having some control in ending their dying process should the process prove too painful or unbearable.

The End-of-Life Option Act, modeled after medical aid-in-dying laws in Washington, D.C., and 10 states, applies only to mentally competent, terminally ill persons with a prognosis of less than 6 months. It explicitly DOES NOT authorize a person to end another person’s life. It is not the same as euthanasia laws seen in some other nations. Ninety percent of medical-aid-in dying patients are in hospice when they first make their request. One-third of patients receive but choose not to take the medication. Over the 25 years since Oregon became the first U.S. state to authorize medical aid in dying, the number of deaths attributed to the medication represent less than 1% of annual deaths in the 11 authorized jurisdictions.

A 2024 Gonzales Media Research poll found that 70% of Maryland voters support this option regardless of geography, party, race, religion or disability status. Marylanders trust the protections and want the autonomy to make end-of-life decisions that this bill provides.