The Colorado End of Life Options Act/Medical Aid in Dying, enacted in 2017 allows an eligible terminally ill person with a prognosis of six months or less to live, to request and self-administer medial aid-in-dying medication in order to voluntarily end his or her life. And, it authorizes a physician to prescribe the medication to the terminally ill person.
On June 5, Gov. Jared Polis signed an amendment that significantly expands access to this law for Colorado residents. This amendment, effective Aug. 7, reduces the barriers some patients experience in navigating this important law. Now it is more accessible and efficient to use for mentally competent people who are suffering from terminal illness, intractable pain and chronic or progressive disabilities.
Some of the changes:
- To include advanced nurse practitioners as evaluators and prescribers to broaden the pool of qualified medical professionals who can assist patients in end-of-life decisions, especially in rural areas experiencing medical personnel shortages. Some people feel this is inappropriate, as not enough doctors, let alone nurse practitioners, are trained in end-of-life care. (acamaid.org)
- To reduce the mandatory waiting period between oral requests from 15 days to seven days, which significantly shortens time terminally ill patients must wait before they can access the medication.
- To authorize providers to waive the waiting period entirely if the critically ill patient is unlikely to survive more than 48 hours and meets all other qualifications.
In 2023 (latest data), 389 patients were given prescriptions for the medicine here in Colorado. This is a 22% increase compared with 2022. Two-hundred and ninety four of these people received the medicine, and it is unknown how many of them actually used it to end their life, or died from their underlying illness or condition or other causes.
Little by little we are improving this law. More accessibility, easier to use, and more doctors entering the pool of practitioners who are willing to help people who are suffering. (Here in Durango, dignitycarecolorado.com.) Many politicians and advocacy groups have fought for these achievements, and we thank them for their relentless work.
The next step is to address the huge elephant in the room, dementia. (See DurangoDementiaCoalition.org.) We need to create a pathway for people with dementia/Alzheimer’s and other neurological diseases to be able to choose how and when to end their lives. In certain instances, ALS and Parkinson’s patients may qualify. A Better Exit, in California is working on this very issue. They are committed to achieving a more compassionate law and will stay the course for as long as it takes.
In Canada, you must have a “grievous and irremediable condition” in order to obtain the medication. This can be having a serious illness disease or disability, (and even a mental disorder, legally starting in 2027); be in an advanced state of decline that can’t be reversed; and/or be experiencing unbearable physical or mental suffering from an illness, disease or state of decline that “cannot be relieved under conditions that the person considers acceptable.” Right on, Canada!
So you can see, we here in the States have much work to do. Why should a person who has early onset dementia, have to go through unbearable distress and loss of autonomy and have to be cared for, for perhaps many years after the dementia and/or Alzheimer’s decline? Basic human compassion says we should all have the choice to end our lives if they feel completed and we judge our quality of life to be unacceptable.
Any competent person unbearably suffering an intractable medical condition should have an effortless and uncomplicated option to die legally and peacefully. There is a difference between committing suicide and an elder choosing to end their life to avoid continued suffering from an illness.
Martha McClellan has lived in Durango since 1993 and has been an educator, consultant and writer. Reach her at mmm@bresnan.net.
