Coloradans overwhelmingly back compassionate end of life option for medical aid-in-dying

Joins Oregon, Washington, Vermont, California and Montana

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One of the most encouraging results was to see the movement for compassionate choices at the end of life work inward from the coast zones, as now two High Plains states, Montana and Colorado, have joined the Pacific “blue” bloc (Washington, Oregon, and California) and Vermont (the Atlantic Oregon) in permitting physicians offer terminally ill patients the option of a fatal dose of drugs as an alternative to continued medical treatment or suffering.

Coloradans voted yes with a vengeance, with 13 out of every 20 Coloradans voting in favor.


 Coloradans Overwhelmingly Vote in Favor of End-of-Life Options — 65% Support

November 9, 2016

Champions of Prop 106, medical aid in dying react to election results

COLORADO — Colorado today voted to become the sixth state to allow terminally ill adults with six months or fewer to live and suffering unbearably the option to request, obtain, and if they so choose, self-administer a prescription medication to bring about their peaceful death.

According to the latest polling numbers, the Colorado End-of-Life Options Act was just voted into law. The win comes just seven months after Compassion & Choices and the Compassion & Choices Action Network made the strategic decisions to support a ballot initiative in Colorado. Compassion & Choices lent its policy know-how and deep understanding of aid-in-dying laws to work with petitioners to draft the proposed statute, while the Compassion & Choices Action Network provided important financial resources to foster an effective on-the-ground advocacy effort. Bolstered by funds provided by Compassion & Choices Action Network – Colorado (CCAN-CO), the Yes on Colorado End of Life Options committee organized the citizen-led campaign for Proposition 106 after two failed attempts by the Colorado legislature to pass the legislation, in spite of multiple public polls showing overwhelming support for the measure.

In celebrating The End of Life Options Act passage, Compassion & Choices and Compassion & Choices Action Network President Barbara Coombs Lee issued the following statement:

“This is a historic day for all Coloradans, and an especially tremendous victory for terminally ill adults who worry about  horrific suffering in their final days. It brings great joy knowing Coloradans can make these deeply personal end-of-life decisions, together with their families, doctors and spiritual advisors.

“We are delighted the significant investment paid off and are proud to have lent the expertise and resources to empower the voters of Colorado. We congratulate Colorado for becoming the sixth state where more people have peace of mind at the end of life and fewer suffer unnecessarily.”

Modeled closely on Oregon’s Measure 16, the Colorado bill is likely to have the same smooth implementation that Oregon has experienced. The ballot title summary makes clear how much the proponents looked to Oregon’s experience.

Proposition 106 creates the “Colorado End-of-Life Options Act,” which allows individuals with a terminal illness to request from their physician and self-administer medical aid-in-dying medication (medication). To be eligible to request medication, the individual must:

  • be a Colorado resident aged 18 or older;
  • be able to make and communicate an informed decision to health care providers;
  • have a terminal illness with a prognosis of six months or less to live (terminally ill) that has been confirmed by two physicians, including the individual’s primary physician and a second, consulting physician;
  • be determined mentally capable by two physicians, who have concluded that the individual understands the consequences of his or her decision; and
  • voluntarily express his or her wish to receive the medication.

Request process. To receive the medication, the individual must make two oral requests, at least 15 days apart, and one written request in a specific form to his or her primary physician. The written request must be witnessed by at least two other persons who attest that the requesting individual is mentally capable, acting voluntarily, and not being coerced into signing the request. One witness may not be a relative of the individual; an heir; or an owner, operator, or employee of a health care facility where the individual is receiving medical treatment or is a resident. Neither the primary physician nor the individual’s qualified power of attorney or durable medical power of attorney, may be a witness to a written request.

Physician requirements. The primary physician is required to document that an individual requesting the medication is terminally ill and meets all other eligibility criteria. The primary physician must provide full and specific information to the individual about his or her diagnosis and prognosis; alternatives or additional treatment opportunities, such as hospice or palliative care; and the potential risks and probable results associated with taking the medication. The primary physician must also inform the individual that he or she may obtain, but choose not to use the medication and may withdraw his or her request at any time. The primary physician must confirm, in private with the individual, that his or her request to receive medication was not coerced or influenced by any other person and is required to refer the individual to a consulting physician to confirm that the individual meets all eligibility criteria.

If either a primary or consulting physician believes the individual is not mentally capable of making an informed decision about receiving the medication, that physician must refer the individual to a licensed psychiatrist or a licensed psychologist before the request process may proceed. This mental health professional must communicate his or her findings in writing to the referring physician. If a person is found to be mentally incompetent, he or she is no longer eligible for medical aid-in-dying.

Dispensing of medical aid-in-dying medication. Medication may be dispensed when two physicians agree on the individual’s prognosis. Immediately prior to writing a prescription for the medication, the primary physician must verify that the individual is making an informed decision and that the process has been completed properly. Health care providers, including physicians and pharmacists, who dispense medication are required to file a copy of the dispensing record with the state. Unused medication must be returned to the primary physician or to any other state or federally approved medication take-back program.

Death certificates. The death certificate of an individual who uses the medication must be signed by the primary physician or hospice medical director and must list the underlying terminal illness as the cause of death. Deaths resulting from medical aid-in-dying are not subject to automatic investigation by the county coroner.

Voluntary participation by health care providers.
Physicians and pharmacists are not obligated to prescribe or dispense the medication. If a health care provider is unable or unwilling to carry out an eligible individual’s request for the medication and the individual transfers to a new provider, the initial provider is required to coordinate the transfer of medical records to the new provider. A health care facility may prohibit a physician employed or under contract with the facility from prescribing medication to an individual who intends to use the medication on the facility’s premises. The facility must provide advance written notice of its policy to the physician and its patients. A health care facility may not discipline a physician, nurse, pharmacist, or other person for actions taken in good faith or for refusing to participate in any way.

Civil and criminal penalties. The measure creates a class 2 felony for tampering with a request for medication or knowingly coercing a terminally ill person to request the medication. Persons are immune from civil or criminal liability or professional disciplinary action unless they act with negligence, recklessness, or intentional misconduct.

Insurance, wills, contracts, and claims. Requesting or self-administering the medication does not affect a life, health, or accident insurance policy or an annuity, and nothing in the measure affects advance medical directives. Insurers may not issue policies with conditions about whether or not individuals may request medication.