Bills being considered in both Maryland’s House of Delegates and its State Senate that would legalize physician-assisted suicide in the state have been criticized as racist, dangerous to vulnerable populations and lacking in safeguards against abuse.

The measures – SB845 introduced in the Maryland Senate and HB933 introduced in the Maryland House – would allow licensed physicians to legally prescribe medication at the request of a patient who has been deemed “capable of making a medical decision” and has a terminal illness that, within a reasonable medical judgment, involves a prognosis that likely will result in the individual's death within six months.

Both chambers held hearings this week on the proposals. The Senate’s Judicial Proceedings Committee heard testimony March 7 and the House’s Health and Government Operations and Judiciary Committees heard testimony March 10.

The Maryland Catholic Conference (MCC) said it opposes legalizing physician-assisted suicide because it “violates the most basic tenet of our belief in the sacredness of life, but also because of the many dangers this legislation poses to vulnerable populations.”

In written testimony to state senators, the MCC said, “At the heart of the Catholic Church’s ministry to the sick, the disabled, the elderly and those without access to adequate medical care is the recognition of the Gospel’s call to embrace the lives of those most in need of our love, care, and compassion.”

“While some may view this legislation as a response to the understandable fears about pain and loss of ‘dignity’ that someone diagnosed with a terminal illness might face, we insist firmly that the answer to those fears should be a demand for medical treatment that provides adequate pain management and excellent palliative or hospice care,” the MCC said in its statement.

The MCC has joined with Maryland Against Physician Assisted Suicide (MAPAS), a nonpartisan coalition of health care professionals, disability rights advocates, mental health professionals, advocates for seniors, and members of faith communities that was organized in opposition to the push to legalize physician-assisted suicide in Maryland.

Frequently called “medical aid in dying” or “death with dignity,” similar death with dignity bills have been introduced in Maryland in 2015, 2017, 2019 and 2020. “The proposal is the same dangerous, misguided policy that has failed repeatedly in Maryland,” MAPAS said in a statement, “(and) remains unethical, discriminatory and a danger to so many people in Maryland.”

Only 10 states – California, Montana, Maine, Vermont, Colorado, New Jersey, Washington, New Mexico, Hawaii and Oregon – and the District of Columbia have legalized physician assisted suicide. Maryland is one of 10 states whose lawmakers are currently considering physician assisted suicide measures.

The MCC noted that with physician-assisted suicide, a doctor prescribes a lethal drug cocktail of up to 100 pills that a person picks up at the local pharmacy, grinds up into half a cup of water, and drinks in less than two minutes. “Sometimes, the person can take hours or days to die,” the MCC said. “Plus, there are no requirements for a witness or notification of family. Assisted suicide isn’t dignified, it’s deadly.”

Christine Sybert, a clinical pharmacist at St. Agnes Hospital in Baltimore, said the measures’ “lack of oversight from clinicians is appalling.”

“No medical provider is required to be in attendance at the ingestion (of the deadly drug cocktail). The side effects being reported – horrible taste, painful burning, nausea, vomiting, prolonged deaths, sometimes days – are not benign,” she said in a statement to the House Health and Government Operations and Judiciary Committees. “It is not always a peaceful passing, and some patients even survive the overdoses. And, this is limited data because no healthcare provider or witness is required to be there.”

Ann Dowling, a resident of Davidsonville, Maryland who is a disability advocate, told lawmakers that her opposition to the proposals stemmed from her own experience caring for her mother who had a series of mini-strokes, suffered from vascular dementia as well as a brain tumor.

She said she has “no confidence when this bill assures us that a person requesting ‘aid in dying’ must possess the ‘capacity to make medical decisions’ and not be ‘suffering from impaired judgment.’”

“Time and time again, I watched my mom transform into a different person at her doctors’ appointments. Indeed, the wit and sarcastic humor she displayed for her primary care physician convinced him that even though she had dementia, she could manage quite well,” Dowling said. “Somehow, in his 10-minute visits with her a few times a year, he was able to determine that she was certainly capable of making her own healthcare decisions.  What he didn’t see in those visits is what I routinely saw because I lived with my mom.”

That “capable of making a medical decision” proviso was also questioned by Dr. Annette Hanson of the Maryland Psychiatric Society.

In testimony submitted to the House committees on behalf of the Joint Legislative Action Committee of the Maryland Psychiatric Society and the Washington Psychiatric Society, Hanson said “no standardized procedures exist for assessing both capacity and coercion in these specific circumstances... Given the severe consequences of an erroneous outcome, the decision-making capacity for fatal care should require a more rigorous assessment.”

“Many serious medical conditions are known to cause a variety of capacity-impairing mental disorders, such as clinical depression, cognitive impairment, and delirium. Indeed, as many as 25 percent of patients diagnosed with terminal illnesses may suffer from clinical depression,” she said.

Anita Cameron, the director of minority outreach for Not Dead Yet, a national disability rights organization opposed to medical discrimination, healthcare rationing, euthanasia and assisted suicide, highlighted the racist and discriminatory nature of physician assisted suicide.

“As a Black Latina, I didn’t see assisted suicide as part of my culture. A 2013 Pew study shows Blacks and Latinos are 65 percent opposed to assisted suicide,” she said. “Assisted suicide proponents tend to be white professional and managerial class folks.”

She said if passed, assisted suicide laws “will put sick people, seniors and disabled people, especially, at risk due to the view of doctors that disabled people have a lower quality of life, therefore leading them to devalue our lives. Now add race and racial disparities in healthcare to this. Blacks, in particular, receive inferior health care compared to whites in the areas of cardiac care, diabetes, cancer and pain management.”

Opponents of the measures also warned that the terminally ill may feel coerced or pressured into opting for assisted suicide.

Cameron said that “in states where it’s legal, if you lose access to healthcare, turning your chronic condition into a terminal one, you can request assisted suicide. It’ll be cheaper to kill you than to care for you.

Sybert, the pharmacist, noted that “a dead patient is the cheapest patient.”

“What does that mean to Maryland’s vulnerable populations? The disabled, the elderly, the socioeconomically disadvantaged, minorities? What choice will they have? None. Those in power will make the choices for them,” she warned. “This legislation will lead to an erosion of trust in the medical professions, especially in vulnerable populations.”

Dowling also warned that “the potential danger (of these laws) should be obvious.”

“Let us not be so naive to believe that undue influence over another’s actions must be overt and forceful. It can be as subtle and unintended as the exhausted face of a caregiver,” she said. “Anyone who has ever cared long-term for an ill family member knows that their loved one often feels acutely guilty for ‘being a burden.’”

She called it “a grave injustice to place any vulnerable person in the position of having to consider that it might just be better for all concerned if they simply chose to die.”

“I am concerned that patients will gradually see assisted suicide evolve from a ‘choice’ into an expectation,” MAPAS member Dr. Joseph Marine, professor of medicine at Johns Hopkins University School of Medicine, said in a statement. “There is evidence that insurance companies have declined coverage of life-extending treatments for patients in states where PAS is legal and instead approved coverage for these cheaper, experimental, non-FDA approved drug overdoses that end a patient’s life.”

The MCC said the message the proposed bills send to a terminally ill persons is that “their illness and the care they require is nothing more than a burden to their families and the rest of society…  A terminally ill patient requesting a prescription to commit suicide deserves to be surrounded by compassion, not handed lethal drugs to take their own life.”

The MCC is the public policy arm of the two Catholic archdioceses and one diocese that encompass the state – the Archdiocese of Baltimore; The Roman Catholic Archdiocese of Washington, which includes five Maryland counties surrounding the nation’s capital; and the Diocese of Wilmington, which includes counties on Maryland’s Eastern Shore.

The Catholic Advocacy Network helps parishioners learn about the issues and provides an opportunity for constituents to be heard by their legislators, and last year, Maryland Catholics sent nearly 70,000 emails to lawmakers. Parishioners can join the Catholic Advocacy Network at mdcatholic.org/joincan; or texting MDCATHOLIC to 52886.