While the bill’s opponents say it flies in the face of medical ethics and could be used to exploit vulnerable Marylanders, its supporters say the bill has evolved to include stronger protections against abuse and more explicit directions for how the medicine must be prescribed and taken.

Under this year’s legislation, patients would need to first verbally request the end-of-life medication, and then submit a written request signed by themselves and two witnesses. They would be required to wait 15 days after their verbal request and two days after submitting their written request before making a second verbal request, which they would have to make with no witnesses present to ensure that they are not being coerced.

Patients would only be eligible if two doctors determined that their illness was terminal, meaning that it was expected to result in their death within six months. Either of the doctors could refer the patient to a mental health provider, if they are unsure whether the patient meets the mental competency criteria. Physicians would be protected from civil and criminal prosecution for prescribing the life-ending medication. They would not be required to participate in the process.

Sen. Jeff Waldstreicher, a Democrat representing Montgomery County and the bill’s Senate sponsor, said he’s always supported the idea behind the legislation, but opposed a previous version because he thought its language was too loose and could be abused.

“I have a disabled sister,” he said Wednesday. “I’d never vote for a bill that unintentionally could be used against people with disabilities or people who are not mentally competent.”

Opponents of the bill, however, worry what its passage would mean for vulnerable state residents. They include people who oppose the legislation based on faith, as well as disability rights advocates and elder abuse attorneys.

Dr. Joseph Marine, a cardiologist at Johns Hopkins Medicine and member of Maryland Against Physician Assisted Suicide, became involved in opposing such bills in the state in 2016. Since then, his resolve has only deepened that the legislation is misguided and dangerous.

Aid-in-dying is explicitly forbidden in the original text of the Hippocratic Oath, Marine said. He also described end-of-life medications as experimental, unregulated and untested, and noted that doctors do not have the power to accurately predict a person’s prognosis 100% of the time.

“What we should be supporting is access to excellent palliative pain management and hospice care programs,” he said. “We have some of the best health care in the world right here in Maryland. We should use it and not undermine our health care system with this dangerous bill.”

Kraus told her son about her breast cancer diagnosis when she was driving him home after his first semester of college in Pennsylvania’s Lehigh Valley.

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