There is no Maryland law that explicitly states that smoking around an elderly person with congestive heart failure IS abuse. Rather, Maryland, like most states, provides a rather vague definition of what constitutes abuse and then leaves it up the prosecutors, judges and juries to see what fits.
Maryland considers abuse to be the sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person.
Neglect is defined as the willful deprivation of adequate food, clothing, medical treatment or rehabilitative therapy, shelter, or supervision from a vulnerable adult.
As to a "vulnerable adult", that is defined as a person over the age of 18 who lacks the physical or mental capacity to provide for his or her daily needs.
So, the question becomes, does constant smoking by a person with knowledge of the problem constitute "cruel or inhumane treatment". As a former prosecutor, I would suggest that this would be a difficult case to pursue. While there is no EXACT list of things that would be necessary to pursue charges, I would suggest the following would help:
A certainty of the medical diagnosis
Clear proof that the abuser knew of the diagnosis
At least one person, possibly including the abused person, telling the abuser to cease the behavior
A constant and obvious disregard for the diagnosis
Please let me know if I've overlooked anything here.
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