Sixty-six percent of Colorado voters approved the End of Life Options Act last November.

This is the law that allows physicians to prescribe life-ending medication to terminally ill and suffering patients of sound mind who have been given fewer than six months to live. This is how it works:

The patient must request the medication three times – once in writing and twice verbally. Two different doctors must verify in writing that the patient is terminal and decisional and not being coerced, and the prescribing physician must first educate the patient about alternatives, including counseling, hospice or other treatments. Finally, the patient must be able to administer the medication himself or herself by mouth – not by injection.

No physician is required by this bill to prescribe life-ending medication, and no patient similarly is required to ingest it. It is a choice.

Seven months after the election, I was interested to know how it is working, especially here in Southwest Colorado. This is what I found:

Dr. John Boyd, medical director at Mercy Regional Medical Center, told me that the Catholic Ethical and Religious Directives for Catholic Health Care Services do not condone any action that “by intention causes death in order to alleviate suffering.” Therefore, no employee or person representing Mercy may prescribe, dispense or help any patient to qualify for medication that will be used to end the patient’s life.

However, Mercy will not abandon a patient at the end of life – even if the patient chooses to avail himself or herself of a medical aid in dying prescription from a physician who is not employed by Mercy.

This is tricky because Mercy operates a hospice organization. Patients will be told they cannot take the medication in the hospital or in the inpatient hospice now under construction on the Mercy campus. If they can acquire it, they can ingest the medication at home, which most people prefer when choosing this option.

The challenging part is obtaining the prescription. Independent doctors, including those who have Mercy privileges but are not employees, can prescribe outside the Mercy setting, so several of the primary care physicians locally may choose to do so.

I have found that many doctors do not agree with the ethical aspects of the law, and are not willing to prescribe. No one has received the medication in the Durango area yet. Some patients have received it on the Front Range. However, they are running into difficulties because two-thirds of the hospitals in Colorado are under a religious umbrella that does not authorize end-of-life options, and many physicians work as their employees.

Compassion & Choices, the national group working to get this law passed in all states, said it is launching a campaign in Colorado to get the Catholic hospitals on board. The group has overcome this opposition in all the other states that have legalized the act – Oregon, Washington, Montana, Vermont and California – and is confident it will succeed here. Compassion & Choices hopes to change the process so that it is easier for a patient to obtain the medication, without stigma, and without unnecessary challenges.

Jennifer Ballentine, of the Iris Project in Denver, advocates, educates and consults on end-of-life issues. She said the biggest problem is that many practitioners feel uncomfortable with prescribing. This law requires an adjustment for the medical profession. To help people end their untreatable suffering is a shift from prolonging life just for life’s sake. Doctors may not want others to know they will prescribe, and they may not want that to be known publicly.

Ballentine added that hospice and palliative care programs are already in place and working well. Physicians do not want their patients to suffer, so those remain viable options at this time. Proponents of medical aid in dying feel that suffering encompasses more than just physical pain; it also entails dignity, self-care and respect, and feeling a burden to loved ones. Mercy is addressing these issues in their hospice and palliative care units, and will continue to do so for patients who have obtained medical aid in dying prescriptions from non-Mercy physicians.

There are doctors in the Durango area who are actively pursuing this option for their patients. And, there are patients here with terminal diseases who are requesting the medication as a choice in their anticipation of suffering.

Pagosa Springs Medical Center voted not to participate in the implementation for 2017, but plans to revisit the issue early in 2018. Southwest Health System in Cortez opted-out as well to allow for further study and planning, though caregivers will still provide patients and families all other requested end-of-life and palliative care services.

A surgical hospital, Animas Surgical Hospital doesn’t address end-of-life issues. Heather Holcomb, quality specialist at ASH, said she thought the general medical culture is a litigious environment and physicians are scared. So far, there have been no lawsuits in any of the states that have passed end-of-life options legislation.

We won’t know how many prescriptions for the life-ending medication have been written in Colorado until the end of 2017, as physicians must report to the state when this is done. Compassion & Choices says that 10 prescriptions have been written so far on the Front Range. Regardless of the number, doctors need to become more educated about this subject without fear of lawsuits or recrimination, and we all need to be asking our practitioners about our wishes at the end of life.

The law is on the books; let’s start allowing qualified people the right to use it.

Martha McClellan writes the Herald’s “Authentic Aging” column that appears the first weekend of each month. The first in a series of columns she is writing about Verlena Collentine also appears in this section. Future columns will appear in “Authentic Aging” through October. Reach McClellan at mmm@bresnan.net