Compassion & Choices featured in Denver magazine
Nov 5, 2018 Colorado End of Life Options Act medical aid in dying
The Denver lifestyle magazine 5280 set out this month to further the conversation about dying in Colorado. While the authors cover a lot of ground, from death doulas to estate planning 101, they dive into the step-by-step details about how to access Colorado’s End-of-Life Options Act.
Step No. 1: Determine Eligibility
For a person to be eligible to receive care under the law, he or she must be 18 years or older; a resident of Colorado; terminally ill with six months or less to live; acting voluntarily; mentally capable of making medical decisions; and physically able to self-administer and ingest the lethal medications. All of these requirements must be documented by the patient and confirmed by the patient’s physician, who must agree to prescribe the medication.
In addition, the piece covers barriers to accessing the law - a key component that Compassion & Choices’ Colorado Access Campaign tackles. The Access Campaign works to educate doctors and facilities about medical aid in dying so that Coloradans who want this option to peacefully end their suffering from a terminal illness can find a supportive medical team.
Step No. 2: Present Oral And Written Requests
An individual must ask his or her physician for access to a medical-aid-in-dying prescription a total of three times. Two of the requests must be oral, in person, and separated by 15 days. The third must be written and comply with the conditions set in the law (signed and dated by the patient; signed by two witnesses who attest that the patient is mentally capable of making medical decisions, acting voluntarily, and not being coerced by anyone).
Coloradans living in rural communities can face hardship finding doctors who will participate in the law. In response to this challenge, our Access Campaign is continually reaching out to hospice and medical facilities all across the state to advise them that the End-of-Life Options Act does not allow facilities to “opt-out” of participating in the law; only physicians themselves are permitted to refuse to prescribe.
Step No. 3: Get A Referral To A Consulting Physician
The law requires that once a patient’s attending physician has received the appropriate requests and determined the patient has a terminal illness with a prognosis of less than six months to live, the doctor must refer the patient to another physician, who must agree with the diagnosis and prognosis as well as confirm that the patient is mentally capable, acting voluntarily, and not being coerced.
Compassion & Choices knows that finding a medical team that is supportive of your end-of-life care decisions can be difficult in the “ramping-up” phase of a policy. That is why our Access Campaign is so important to educate physicians.
Step No. 4: Fill The Prescription At A Pharmacy
Colorado’s medical-aid-in-dying law doesn’t stipulate which drug a physician must prescribe. There are multiple options, which your doctor should discuss with you. Depending on your insurance coverage (Medicare, Medicaid, and many insurance companies do not cover the drugs), as well as which hospital system your doctor works in, getting the medication can be as simple as filling a script for anything else.
It is important to discuss with your medical team which medication will be best if medical aid in dying is the end-of-life care option that fits best with your values. A pharmacist can help prepare the medication and walk your medical and personal support team through the process of how to ingest the medication.
Step No. 5: Self-Administer The Medications
Although the time and place are mostly up to the patient, if he or she does decide to take the life-ending drugs, he or she must be physically able to do so independent of anyone else. Physical capability is something patients must consider, especially if their conditions are progressing quickly and could ultimately render them incapable of, for example, swallowing the medications.
The Access Campaign is important to terminally ill Coloradans to ensure they are able to obtain medical aid in dying well before they absolutely need to take it. A death that aligns with your own values should not be a race against the clock.
In addition to highlighting the process of medical aid in dying in Colorado, 5280 recognized us as “Colorado’s best aid-in-dying” resource:
An Oregon nonprofit is Colorado’s best aid-in-dying resource.
Although Oregon’s Compassion & Choices is best known here as the organization that helped push Proposition 106 onto Colorado’s November 2016 ballot, the nation’s oldest end-of-life-options nonprofit didn’t abandon the Centennial State after the initiative passed. ‘First, we help states enact the laws,’ says Compassion & Choices’ Kat West, ‘then we stick around to help with implementation and make sure it’s successful.’
“In Colorado, the rollout has been fairly fluid. Perfect? Certainly not. Fortunately, Compassion & Choices has been trying to smooth some of the wrinkles in the system. The biggest help so far might be its website. The nonprofit keeps its online content updated with everything a Coloradan needs to know about the state’s End-of-Life Options Act. Of particular note: the Find Care tool, which lists clinics and health systems that have adopted supportive policies, since finding participating physicians, hospitals, and pharmacies is still challenging. ‘Patients don’t have the time or energy to figure this out on their own,’ West says. ‘We do it for them.’
