How Prop 106 Works
The Colorado End-of-Life Options Act
The Colorado End-of-Life Options Act (Prop 106) authorizes the medical practice of aid in dying. Medical aid in dying (also known as death with dignity) allows a terminally ill, mentally capable person who has a prognosis of six months or less to live to request, obtain and — if his or her suffering becomes unbearable — self-administer medication that brings about a peaceful death.
Medical Aid in Dying is a Safe and Trusted Medical Practice
Medical aid in dying is a safe and trusted medical practice because the eligibility requirements and safeguards ensure that only mentally capable, terminally ill adults with a prognosis of six months or less who want the choice of a peaceful death are able to request and obtain aid in dying medication. The prestigious and peer-reviewed Journal of Palliative Medicine published clinical criteria for medical aid in dying, which physicians use to ensure that the practice meets the highest standards of medical care.
The Colorado End-of-Life Options Act has the same eligibility criteria as Oregon’s Death With Dignity Act, in effect since 1997. To be eligible for aid in dying under Prop 106, the person must meet the following eligibility criteria:
- The person must be an adult
- The person must be terminally ill, with six months or less to live
- The person must be mentally capable of making their own healthcare decisions
- The person must be fully informed of all their options for care, including pain management, palliative care, hospice and comfort care
- Two physicians must determine the person has no mental condition impairing their ability to make decisions and is free from undue influence or coercion
- The person must be able to take the medication themselves
- The person must be a Colorado resident
- The physician must offer the person multiple opportunities to take back the request for aid in dying medication
- Two witnesses must sign the request form confirming that the person is mentally capable and the request is voluntary
- Wills, contracts, insurance and annuity policies are not affected by a person choosing aid in dying
The attending and consulting physician must refer the individual to a licensed psychiatrist or psychologist if either one believes the individual may not be mentally capable of making an informed decision. In this case, the attending physician may not write a prescription unless the psychiatrist or psychologist communicates, in writing, that the individual is mentally capable and making an informed request.
The ballot measure grants immunity from civil and criminal liability and from professional discipline to a person who participates in good faith under the Act. The law also specifies that actions taken in accordance with the Act do not constitute suicide, assisted suicide, euthanasia, mercy killing, homicide or elder abuse.
No one is obligated to prescribe aid-in-dying medication or to witness a death where aid-in-dying is chosen, and a health care facility may prohibit a physician from writing a prescription for a resident of the facility who intends to use aid-in-dying medication on the facility’s premises.
Safe Disposal of Unused Medication
The law requires that the person in custody of any unused aid in dying medication must dispose of it safely and in accordance with Federal take-back programs.
Medical aid in dying is currently authorized in five states, either through statute or court decision:
Oregon (1994, ballot initiative)
Washington (2008, ballot initiative)
Montana (2009, state Supreme Court decision)
Vermont (2013, legislation)
California (2015, legislation)