Assisted suicide in Maryland is stirring through this electoral season and will certainly be in the 2027 Maryland General Assembly. Regardless of how the issue is framed by proponents of physician-assisted suicide, the outcome is still death. They have given death a new wardrobe. They've dressed a lethal prescription in the language of compassion. But do not be deceived. Make no mistake: physician-assisted suicide is still suicide. The goal is still death. The poison is still poison. And the people who will be most exposed to it—the people who will feel its weight most brutally—are the same people who have always been asked to carry the heaviest burdens in this state: Black Marylanders and our brothers and sisters living with disabilities.
I have testified before this legislature. I have stood before committees and spoken the truth plainly. I have made the legal case. I have made the medical case. And today, I am making the moral case, because there is a reckoning that must be named.
A Firewall Is Falling
For years—for years—the Black legislative caucus of Maryland stood as a firewall. At approximately 30 percent of the legislature, the African American delegation was more than a constituency. It was a conscience. They knew what their communities knew. They had heard the sermons. They understood, instinctively and historically, that when the government starts making death affordable and convenient, it is the poor and the brown and the disabled who get offered the off-ramp first. They voted no, no to Medical aid in dying (MAID) because they understood the stakes.
The members of the legislature representing the most Black-populated jurisdictions in this state consistently voted against the bill in 2019 with a simple, almost pastoral, reasoning: they feared medical centers, including nursing homes, would coerce vulnerable people into a decision they hadn't truly made for themselves. That is a lived reality for communities where medical trust has been seared in the furnace of Tuskegee and forced sterilizations.
Now, whispers inside the statehouse and on the campaign trail suggest the firewall is crumbling. Some who once stood firm are reconsidering. Some are being told this bill is different this time—that the safeguards are real, that the community's fears are overblown. Some, it appears, are being persuaded by lobbyists, by campaign coffers, and by the social currency of national progressive credentialing. But you are being sold a lie, and in accepting it, you are selling your people downriver.
What "Safeguards" Cannot Safeguard
The proponents of physician-assisted suicide love their so-called "safeguards." But they are an imposter’s gesture of responsibility with no actual protection. The bill requires that a patient be evaluated for mental health impairment, but only if the attending physician thinks they might have impaired judgment. In any other context where a person expresses a desire to end their life, society mobilizes. Dial 988. Crisis counselors. Full intervention.
But under this bill, because the desire to die has been legally gambled away into "medical treatment," the system does not intervene. It complies. It prescribes. It sends them home—alone, often without witness, without medical supervision—with a lethal dose and a death certificate that lies and says "natural causes."
And what of coercion? The bill's answer to coercion is to ask the patient if they're being coerced. Think about that. Undue influence, by definition, operates by overcoming a person's free will without their immediate awareness. If they knew they were being coerced, it would not be coercion. “Safeguard,” therefore, is a legal fiction designed to check a compliance box while a vulnerable human being is ushered toward their death.
A Community in the Crosshairs
Communities of color in Maryland face documented, persistent disparities in healthcare access. Black patients are more likely to receive inadequate pain management. They are more likely to be categorized as terminal without exhaustive exploration of alternatives. They face greater financial barriers to life-saving treatment. They navigate a healthcare system that has, in living memory, exploited their bodies for research, sterilized them without consent, and delivered inferior care as a matter of policy.
Now, into this same broken landscape, we are being asked to introduce legal suicide as a medical option. And when the penniless state and strained insurers are facing budget shortfalls, when the cost of keeping a terminally ill patient alive is weighed against the cost of a lethal prescription, do we honestly believe that the patient in the underserved community will receive the same calculus as the patient in an affluent area of the state? At this point, this is more than a slippery slope. This is digging the pit, and our most vulnerable neighbors are standing at the edge.
The disability community has been sounding this alarm for decades. They have argued that assisted suicide laws endanger them. When society tells certain communities, directly or indirectly, that death is cheaper than treatment, then choice becomes expectation, and expectation becomes pressure. All this is packaged in a sinister opaque bill that in the past would almost guarantee a no vote from black legislators. Now we are not so certain we can count on them to do the right thing for our community.
The Spiritual Weight of This Moment
I am a man of faith. I am so grateful for the life that Jesus created in me and the color of the skin he put in. And I believe with everything in me that life is not an accident—it is a declaration. It is God's consistent proclamation that a person matters, that they carry the very image of their Creator. Jeremiah 29:11 tells us that God's plans for each of us are plans to prosper and not to harm, to give hope and a future. You do not get to legislate that away. No committee substitute, no floor amendment, no lobbying dinner can repeal the sovereignty of God over a human soul.
I do not say this to shame anyone. I say this because the Black church—the institution that has been the backbone, the sanctuary, the war room of this community through slavery and Jim Crow and every assault that came after—has been nearly unanimous in its opposition. The Maryland Baptists have spoken. The faith leaders of Prince George's County have spoken. But when elected officials begin to drift away from the communities they represent and toward the interests of those who fund their campaigns, we have a word for that. It is called betrayal.
A Charge to Those Who Would Reconsider
To any Black Maryland legislator who is wavering—who has been lobbied, who has been charmed, who has been offered some calculus of political benefit in exchange for this vote—I want to humbly appeal to you now.
The people who are pushing this bill have money. They have infrastructure. They attempted to wave poll numbers in your face. But they are not your misdiagnosed grandmother, your neighbor who cannot afford a life-saving specialist, your disabled cousin fighting to be seen as fully human. A vote to legalize physician-assisted suicide targets those who look into your eyes every day. It places a state-sanctioned death option before our people who, in many ways, have never had equal access to life-affirming care.
The Maryland We Still Choose
Maryland's Black legislators were right the first time. They were right in 2019. They were right in 2024. And if they hold that line—if they choose their people over political expediency—they will be right again. History will vindicate them. Our communities will thank them. And in a generation where so many surrendered, they will be counted among the few who stood firm on solid ground for life when death was hoping to meet our people down river.
Jonathan M. Alexandre is an attorney and Legislative Counsel for the Maryland Family Institute.