Colorado Democrats want to open medically assisted suicide to out of state residents, cut down waiting time

A proposal from two Democratic legislators seeks to allow residents of other states to obtain medically assisted death in Colorado, as well as cut down the waiting time to make the request.  

Medically assisted death is legal in Colorado and nine other states. According to data from Forbes and Statista, more than 13,000 Americans died by physician-assisted death in 2021. In Colorado, the state health agency reported more than 240 deaths in 2022, the highest on record. 

The proposed legislation, sponsored by Sen. Joann Ginal, D- Fort Collins, and Rep. Kyle Brown, D-Louisville, removes several restrictions from Colorado's existing "medical aid-in-dying" law.

Originally passed in 2016, the law allows a physician to prescribe medication to an individual, who can choose to self-administer the drug in order to "bring about a peaceful death." The law limits application to those who are terminally ill adults — who must be residents of the state — with a prognosis of six or fewer months.

This year's proposal makes numerous changes to existing law.

Notably, it erases the state residency requirements, opening up the procedure to individuals from other states.    

Currently, residents must make two oral requests, separated by 15 days, plus a written request to their attending physician.

The proposal cuts down the oral requests' wait time to between 48 hours.

However, Brown and Ginal plan to amend the bill to change that time period to seven days. 

"It's just to make sure," Ginal said. "It's one of the stop-gaps that would protect that patient if they change their mind. Because I've heard that for some people that are suffering, 15 days may be too long, so seven days seems like a good timeframe for those people who are waiting." 

In addition to reducing the wait time, the bill extends the ability to prescribe the medication to advanced practice registered nurses. This was done for two reasons, the bills sponsors said. It would increase access to rural communities with limited medical professionals, the sponsors said, adding that nurse practitioners also often have the closest relationships with patients. 

"Many peoples' primary care practitioner is a physician's assistant or a nurse practitioner, so expanding it to the people you trust most in your life to provide you with the care just makes sense," Brown said.

"It just gives a patient more access to people they may know and trust better," added Ginal. 

In addition, the bill prohibits insurers from denying or altering available benefits to an individual based on the availability of end of life options. It also prevents them from coercing patients to request the medication. 

Among the medically assisted deaths reported by the state health department, cancer was the most common illness faced by individuals. Other illnesses included progressive neurological or neurodegenerative disorders and major cardiovascular diseases.

In 2022, a total of 316 patients received prescriptions for life-ending medication, a 44% increase compared to the year before. Of the number, 246 obtained the medication, and the health department recorded 243 death certificates.

The median age of individuals prescribed the drugs was 74, though some were were in their early 30s and others were in the late 90s. 

In Oregon, a settlement two years ago in a federal lawsuit extended physician-assisted death to out of state residents. 

The following year, Vermont removed its residency requirement for medically assisted death following a lawsuit.

Currently, no other states allow individuals traveling from other states to obtain the medication. 

The sponsors also insisted that the term "assisted suicide" is "medically and legally" inaccurate, arguing that when a patient dies by using this medication, the coroner does not classify the death as "suicide" and instead attributes it to the underlying illness.

"This is an option for a person to be able to have a choice in how they leave this world," said Ginal. "This is not suicide. We've worked very hard to make sure that this is an option for people who are terminally ill and want to go out on their terms in their way. If they want that choice, it should be there." 

The Colorado Catholic Conference, which opposes the measure, said the bill promotes a "culture of death."

The group representing Catholic bishops said the proposal makes a "bad" law, referring to existing physician-assisted suicide statutes, "even worse with expansions that are both unconstitutional and unethical."

"Physician assisted suicide targets the most vulnerable in our society, corrupts the medical practice, and distorts the patient-doctor relationship by violating a doctor’s commitment to the health of his patients," the group said.

"Furthermore, physician assisted suicide distorts obligations to our elderly, disabled, or ill members of our community by viewing them as a burden," the group said, adding that the proposed expansion of the assisted suicide law "continues to violate human dignity and equality. "

The Colorado bill is scheduled for a hearing in the Health and Human Services Committee on Feb. 29.