Proposition 106 in Colorado: What you need to know about medical aid in dying

There are currently five states where doctors can legally help someone end their life. Proposition 106 would make Colorado the sixth.
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There are currently five states where doctors can legally help someone end their life. Proposition 106 would make Colorado the sixth. This proposition touches on one of the most personal aspects of life: how we die.

Proponents say it offers a humane option for people experiencing a lot of pain as they near the end. Opposition comes from people whose faith teaches that suicide is wrong in all circumstances but also from some disability rights activists who fear those with severe disabilities might be pressured by those who are supposed to care for them.

Here's the language you'll see on your ballot:

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; and in connection therewith, requiring two licensed physicians to confirm the medical prognosis, that the terminally-ill patient has received information about other care and treatment options, and that the patient is making a voluntary and informed decision in requesting the medication; requiring evaluation by a licensed mental health professional if either physician believes the patient may not be mentally capable; granting immunity from civil and criminal liability and professional discipline to any person who in good faith assists in providing access to or is present when a patient self-administers the medication; and establishing criminal penalties for persons who knowingly violate statutes relating to the request for the medication?

Colorado ballot guide: Learn about the rest of this year's ballot measures.
What does that mean?

Helping someone take their own life is currently considered manslaughter under Colorado law. Proposition 2016 would enact a Colorado End-of-Life Options Act that allows people who are terminally ill to ask for and self-administer drugs to end their life and allows doctors to fulfill those requests.

To use this option, a person would need to be a Colorado resident aged 18 or older, be able to make an informed health care decision and communicate it to providers and have a terminal illness with a prognosis of six months to live or less.

The drugs would be a strong dose of barbiturates, and the person would have to be able to administer the drugs themselves.

The person would have to voluntarily express their wish to receive medication to end their life -- first as two separate oral requests at least 15 days apart and then again in written form. The written request must be witnessed by two people, and at least one of them may not be a family member or heir or an employee or operator of a facility where the person resigns. That is, it must be someone who would not have any potential interest in encouraging the person to end their life prematurely. The person's primary care physician or the person who has power of attorney cannot be one of the witnesses either.

The person would also have to be deemed mentally capable by two physicians.

The death certificate for people who use medication to end their life under this program would list the underlying illness as the cause of death, and their deaths would not automatically be investigated by the coroner's office.

The measure makes it a felony to tamper with someone's decision or coerce them in any way. The measure also explicitly allows doctors to opt out of participating.

Who supports this measure?

Many of the people who support it have watched loved ones die protracted, painful deaths in which they could not get adequate pain relief. They want others to avoid that fate and have some control over how and when they die. In this Colorado Public Radio debate, Denver attorney Julie Selsberg describes her father's death from ALS. In the Colorado Independent, the friends of Sheryl Randall, who suffered from a mitochondrial disease that attacked her organs, wish she had access to drugs instead of hanging herself.

"We have five hundred volunteers who went to collect signatures and nearly every one of them has a story of a loved one who had suffered a painful death and that palliative care and pain management did not work," Selsberg said. "I am not saying this is a replacement for any of those things but there are a certain small percentage of people for whom those things do not work and this is just one more option."

Supporters believe the measure includes sufficient protections against abuse and offers valuable peace of mind to those with terminal illness.

Who opposes this measure?

The Catholic Archdiocese of Denver, the evangelical Christian group Focus on the Family, Colorado Right to Life and many disability rights activists oppose it. In that same CPR debate, attorney and activist Carrie Ann Lucas argues that the law does not include enough safeguards. Many people with chronic conditions would die within six months if they discontinued their treatment, which would technically make them eligible for life-ending medication, she said. And the estimated one in 10 older people who are victims of elder abuse would be particularly vulnerable to coercion. Lucas said it would be better to focus on providing better pain relief and palliative care than to help people die.

"I think the biggest concern is is what happens if I were to become depressed," Lucas said. "Just like any other middle aged woman, I could experience depression. And I would hope that my doctor would send me for treatment and not offer me a lethal prescription if I asked because my doctor knows me well. But nothing in this measure would prevent me from doctor shopping."

You can watch Lucas and Compassion and Choices President Barbara Coombs Lee debate the proposition here, with Colorado Independent Editor Susan Greene as moderator.

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