DENVER – Voters are being asked to approve so-called “aid-in-dying” medication.
The statutory Proposition 106 asks, “Shall there be a change to the Colorado Revised Statutes to permit any mentally capable adult Colorado resident who has a medical prognosis of death by terminal illness within six months to receive a prescription from a willing licensed physician for medication that can be self-administered to bring about death ...”
The topic is an emotional one, and measures failed in two previous legislative attempts in the past two years.
The measure – known as the Colorado End-of-Life Options Act – would allow terminally ill patients with six months or less to live to request and self-administer medication that would end their life. To qualify, the individual would need to:
Be a Colorado resident aged 18 or older;Be able to communicate an informed decision;Have a terminal illness with a prognosis of six months or less to live;Have that prognosis confirmed by two physicians;Be determined mentally capable by two physicians andVoluntarily express his or her wishes.Patients would need to make two oral requests, at least 15 days apart, and one written request, to a physician. The written request would need to be witnessed by at least two others, and those witnesses would need to attest that the patient is mentally capable and acting voluntarily.
Even more specific, one witness would be prohibited from being a relative, an heir or someone who works at or owns a health care facility where the individual is receiving care. The primary physician or someone who has power of attorney would also be prohibited from being a witness to the written request.
Physicians would be required to provide information to the individual about their diagnosis and prognosis, as well as alternative treatments. Physicians would also be required to refer patients to therapy if they feel the individual is not mentally capable.
Patients would be allowed to withdraw their request at any time.
Those who dispense the life-ending medication, including pharmacists, would be required to file a copy of the record with the state. Unused medication would need to be returned to the physician or to an approved take-back program.
Just as the program would be voluntary for patients, participation also would be voluntary for doctors and providers.
In an effort to combat abuse, the initiative would create a felony charge for tampering with a request for medication or coercing someone into taking the medication.
The measure also would prohibit use of the medication from affecting insurance policies. Insurers would be prohibited from issuing policies with conditions around life-ending medication.
A “yes” vote for the measure would create the Colorado End-of-Life Options program.
A “no” vote would continue to make it illegal to assist someone in ending their life for medical reasons in Colorado.
Those in favor of the initiative – pushed largely by Compassion and Choices Action Network – say the proposal would expand options for terminally ill patients, offering them a peaceful passing at a painful time.
Supporters point out that similar programs have been successfully administered in five other states. In Oregon, of the 1,545 people who requested life-ending medication since 1997, approximately one-third chose not to use it.
Opponents, however, have latched onto a belief that all life is precious, which is often based in religious convictions. Critics fear that people who are in the final stages of life are scared, and therefore might make drastic decisions, when they could be better served in hospice or other care.
Opponents also worry about abuse, despite the protections built into the initiative. They worry about coercion from family members and heirs who might benefit from an individual’s premature death.
Additionally, concerns have been raised about storage of the life-ending medication.
In the medical community, some have expressed concerns that the initiative would force doctors to choose between ethics and an emotional request from a dying patient. They point out that a prognosis is often an estimate, which creates problems with the six-months-to-live requirement.
There are legal concerns as well, including how to file the death certificate. Some doctors wonder whether they should list the terminal illness on the certificate, worrying that doing so would be a misrepresentation of the individual’s death.
pmarcus@durangoherald.com