MD HB1323

Requires all Maryland hospitals to establish surrogate committees to make health care decisions for "unrepresented patients" — those who lack decision-making capacity, have no advance directive, and have no identifiable family member or friend available to serve as surrogate

Surrogate committees must include seven categories of members: a physician, nurse, social worker or clergy member, patient care advisory committee member, an external patient advocate, a current or former patient/caretaker, and a disability or aging advocacy representative

Committee members must complete mandatory training developed by the Office of Health Care Quality covering bioethics, informed consent, capacity assessment, patient rights, conflicts of interest, and implicit bias related to race, disability, socioeconomic status, and other factors

Hospitals must submit annual reports to the Office of Health Care Quality by January 31 detailing each case, including patient demographics, treatment decisions considered, the committee's decision and rationale, and whether guardianship was required

Surrogate committees may authorize treatment decisions including withholding or withdrawing care, but may not authorize patient discharge, sterilization, or mental disorder treatment; the bill takes effect October 1, 2026