'Right-to-die' bills pass Maryland House, Senate They would allow patients to refuse medical care

April 01, 1993|By Michael Hill | Michael Hill,Staff Writer

Both houses of the state legislature passed "right-to-die" legislation yesterday, virtually guaranteeing that Marylanders will have more say in how far their doctors go to keep them alive if they are battling a fatal illness.

The legislation would allow people to refuse medical care as well as intravenous food and water -- not only when near death, but also when in a vegetative state or incapacitated by such diseases as Alzheimer's or AIDS. It is similar to laws already on the books in many states.

"This legislation basically brings Maryland up to date," said Sandra Sweeney, manager of special projects for the American Association of Retired Persons, which backed the measure.

The House and Senate passed nearly identical bills by lopsided margins, and Gov. William Donald Schaefer's signature is expected.

But in the Senate, passage came only after a lengthy debate in which opponents claimed that the legislation would open the door to abuse of the elderly.

They were backed by lobbyists for the Roman Catholic Church, who decried the measure as a step toward euthanasia, even though such mercy killing is specifically prohibited in the legislation.

Maryland law already allows residents to draft a "living will" in which they state, on paper, what sort of life-sustaining procedures should be used if their death seems imminent. The bills passed yesterday would expand that right in two key ways.

First, people could designate another person to make health-care decisions for them should they become incompetent. Maryland is one of the few states not to have such a provision on the books, though the practice has been allowed under an attorney general's opinion.

More important, the bills would allow people to decide how much medical care they want not only if they are about to die, but also if they are in a coma or in the advanced stages of a progressive, fatal disease.

Under any of those conditions, a person could refuse "life-sustaining procedures, including the artificial administration of nutrition and hydration," the legislation says.

In the event that someone has not prepared a living will or designated another person to make his decisions, the legislation specifies who should be consulted about the individual's medical care.

Those would include -- in this order -- a court-appointed guardian, a spouse, an adult child, a parent, an adult sibling and, finally, a friend or relative who is close to the patient.

Ms. Sweeney, of the Association of Retired Persons, said that the action Maryland's legislature took yesterday is part of a national trend toward giving people more control over their fate.

"Ever since the Supreme Court . . . in 1990 said that the states could state standards in this area, there has been a tremendous flurry of activity in state legislatures," she said.

But Richard Dowling, of the Maryland Catholic Conference, said that the bills were part of "a gathering momentum across the country on behalf of an ethic of euthanasia."

"Our efforts have been to limit that momentum as much as we could in Maryland," he said. "We were successful to a degree, but not as much as we would have liked."

Mr. Dowling's success came in the form of amendments to the bill that were accepted by its Senate sponsor, Paula C. Hollinger, a Baltimore County Democrat, and the bill's Senate floor leader, John A. Pica Jr., a Baltimore Democrat.

The Catholic Conference amendments generally tightened definitions, such as changing terms like "medical probability" to "medical certainty."

Nevertheless, the Senate bill was subjected to a lengthy floor fight led by Republican Sen. John A. Cade of Anne Arundel County.

He tried, but failed, with two important amendments. One would have eliminated the provision that will allow people to refuse care when they are in the advanced stages of a degenerative illness. The other would have stipulated that decisions about medical care are valid only if put in writing.

The Senate passed its bill 31 to 14. The House approved its version 110 to 14. The differences are considered minor and should be easily resolved in a conference committee.

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