Health Care Decisions Act - Surrogate Decision Making - Mental Disorders

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*sb0550*

SENATE BILL 550
J1 6lr2608

By: Senator Charles
Introduced and read first time: February 4, 2026
Assigned to: Finance

A BILL ENTITLED

AN ACT concerning 1

Health Care Decisions Act – Surrogate Decision Making – Mental Disorders 2

FOR the purpose of repealing the prohibition against a surrogate authorizing treatment for 3
a mental disorder for a person who has been certified to be incapable of maki ng an 4
informed decision; and generally relating to surrogate health decision making. 5

BY repealing and reenacting, with amendments, 6
Article – Health – General 7
Section 5–605(a)(2) and (4) through (6) and (d) 8
Annotated Code of Maryland 9
(2023 Replacement Volume and 2025 Supplement) 10

BY repealing and reenacting, without amendments, 11
Article – Health – General 12
Section 5–605(a)(3) and (c)(1) and (2) 13
Annotated Code of Maryland 14
(2023 Replacement Volume and 2025 Supplement) 15

BY adding to 16
Article – Health – General 17
Section 5–605(a)(4) 18
Annotated Code of Maryland 19
(2023 Replacement Volume and 2025 Supplement) 20

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
That the Laws of Maryland read as follows: 22

Article – Health – General 23

5–605. 24

2 SENATE BILL 550

(a) (2) Subject to [paragraph] PARAGRAPHS (4) AND (5) of this subsection, 1
the following individuals or groups, in the specified order of priority, may make decisions 2
about health care for a person who has been certified to be incapable of making an informed 3
decision and who has not appointed a health care agent in accordance with this subtitle or 4
whose health care agent is unavailable[. Individuals in a particular class may be consulted 5
to make a decision only if all individuals in the next higher class are unavailable]: 6

(i) A guardian for the patient, if one has been appointed; 7

(ii) The patient’s spouse or domestic partner; 8

(iii) An adult child of the patient; 9

(iv) A parent of the patient; 10

(v) An adult brother or sister of the patient; or 11

(vi) A friend or other relative of the patient who meets the 12
requirements of paragraph (3) of this subsection. 13

(3) A friend or other relative may make decisions about health care for a 14
patient under paragraph (2) of this subsection if the person: 15

(i) Is a competent individual; and 16

(ii) Presents an affidavit to the attending physician stating: 17

1. That the person is a relative or close friend of the patient; 18
and 19

2. Specific facts and circumstances demonstrating that the 20
person has maintained regular contact with the patient sufficient to be familiar with the 21
patient’s activities, health, and personal beliefs. 22

(4) INDIVIDUALS IN A PART ICULAR CLASS MAY BE CONSULTED TO 23
MAKE A DECISION ONLY IF ALL INDIVIDUALS I N THE NEXT HIGHER CL ASS ARE 24
UNAVAILABLE. 25

[(4)] (5) An individual may not make decisions about health care for a 26
patient under paragraph (2) of this subsection if: 27

(i) The individual is the subject of an interim, temporary, or final 28
protective order and the patient is a person eligible for relief under the order; or 29

(ii) The individual is the spouse of the patient and: 30

SENATE BILL 550 3

1. The individual and patient have executed a separation 1
agreement; or 2

2. The individual or patient has filed an application for 3
divorce. 4

[(5)] (6) The attending physician shall include the affidavit present under 5
paragraph (3) of this subsection in the patient’s medical record. 6

[(6)] (7) A person who obtains new information that would prohibit an 7
individual from making health care decisions for a patient under paragraph [(4)] (5) of this 8
subsection shall provide the information to any health care provider or health care facility 9
providing services to the patient. 10

(c) (1) Any person authorized to make health care decisions for another under 11
this section shall base those decisions on the wishes of the patient and, if the wishes of the 12
patient are unknown or unclear, on the patient’s best interest. 13

(2) In determining the wishes of the patient, a surrogate shall consider the 14
patient’s: 15

(i) Current diagnosis and prognosis with and without the treatment 16
at issue; 17

(ii) Expressed preferences regarding the provision of, or the 18
withholding or withdrawal of, the specific treatment at issue or of similar treatments; 19

(iii) Relevant religious and moral beliefs and personal values; 20

(iv) Behavior, attitudes, and past conduct with respect to the 21
treatment at issue and medical treatment generally; 22

(v) Reactions to the provision of, or the withholding or withdrawal 23
of, a similar treatment for another individual; and 24

(vi) Expressed concerns about the effect on the family or intimate 25
friends of the patient if a treatment were provided, withheld, or withdrawn. 26

(d) A surrogate may not authorize[: 27

(1) Sterilization; or 28

(2) Treatment for a mental disorder] STERILIZATION. 29

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 30
October 1, 2026. 31