Notice to Patients: Colorado’s End of Life Options Act
Colorado’s recently adopted End-of-Life Options Act (EOLOA) permits adults who are terminally ill to request medication from their health care provider for the purpose of ending their own life. The act allows both patients and health care providers to choose whether to opt in or opt out of participation in the end-of-life activities described in EOLOA.
At this time, Denver Health and Hospital Authority has opted out of participation in these activities pending further evaluation.
Two out of three voters in Colorado voted in favor of EOLOA. We understand that we may have patients at Denver Health who seek this service, and we are supportive of our patients’ rights to do so.
We are diligently evaluating how to lawfully and responsibly offer EOLOA to our patients and hope to be prepared to do so by July 1, 2017.
In the meantime, our employed and contracted physicians, mental health professionals and all other staff are not authorized to prescribe or dispense aid-in-dying medication to Denver Health patients, cannot serve as witnesses to a written request for aid-in-dying medication, and cannot evaluate a patient’s mental capacity for purposes of requesting aid-in-dying medication under EOLOA.
Until Denver Health is able to opt in to EOLOA, our opt-out applies at all Denver Health facilities, and to all Denver Health employees and contractors. Self-administration of aid-in-dying medication is prohibited at all Denver Health facilities.
Upon patient request, Denver Health will provide referral assistance and transfer relevant records to another health care provider for the patient to participate in the activities permitted under EOLOA.
View this end of life options notice in Spanish.
Frequently Asked Questions
Why has Denver Health decided not to offer the medical aid-in-dying services allowed under the EOLOA at this time?
As the safety net hospital for the City and County of Denver, Denver Health is reliant on state and federal funding to carry out our mission to provide care to all who need us. Since federal law specifically prohibits use of any federal funds to pay for medical aid-in-dying services, Denver Health is actively exploring ways to provide these services to our patients without jeopardizing our federal funding, which would negatively impact our ability to carry out our mission.
In addition, Denver Health will need to put in place appropriate policies and protocols for our clinical staff to be able to offer this support responsibly to our patients.
What should a Denver Health patient do if they want medical aid-in-dying services before Denver Health has made those services available?
Our Palliative Care department is working to create a list of providers we can refer our patients to while Denver Health is opted out of providing medical aid-in-dying services. We have also found the website, Compassion and Choices, to be a good source of information for patients.
Do other options exist for terminally ill patients?
Denver Health’s Palliative Care team provides specialized medical care for patients with serious or life-threatening illnesses through a multi-disciplinary team to improve symptoms, provide patient and family support, aid access to helpful services, and assist in end-of-life decision-making. There are a number of options that can be offered to terminally ill patients that provide support and comfort. Visit our webpage for more information.
GENERAL INFORMATION ABOUT THE COLORADO END-OF-LIFE OPTIONS ACT (EOLOA)
Who may receive medical aid-in-dying medication?
An adult resident of Colorado may request medical aid-in-dying medication if the following conditions are met:
- The patient’s attending physician has diagnosed him or her with a terminal illness with a prognosis of six months or less
- The patient’s attending physician has determined he or she has mental capacity to make the decision
- The patient has voluntarily expressed their wish to receive a prescription for aid-in-dying medication
Are health care providers, nurses and pharmacists required to participate?
No, an individual health care provider may choose whether or not to participate in providing medical aid-in-dying services to a patient. Denver Health has opted out of participation in providing these services at this time but may offer the services at a later date.
Does an individual have to be a current Denver Health patient to make the request?
The individual must be a patient of the attending physician to make the request. If the patient’s attending physician has chosen to opt-out of participation in medical aid-in-dying services, the attending physician can refer that patient’s care to another physician.
Denver Health has opted out of participation in medical aid-in-dying services at this time, but will provide referral assistance to patients upon request.
What kind of prescription will the patient receive?
The attending physician determines and prescribes the aid-in-dying medication. Oral barbiturate medications are the most commonly prescribed medications in other states participating in medical aid- in-dying.
Where and when does an individual self-administer the aid-in-dying medication?
The patient can choose when and where to administer the aid-in-dying medication, but it must be in a private location and not a public space. Most patients choose to take the medication at their home or another private residence.
Does a physician have to be present when the medication is taken?
EOLOA does not require the presence of a physician when a patient takes the medical aid-in-dying medication. A physician may be present at the request of the patient; however, the patient must administer the medication themselves.
What is an informed decision?
An informed decision means a decision that is:
- Made by a qualified individual to obtain medical aid-in-dying medication that the individual may decide to self-administer to end his or her life in a peaceful manner
- Based on the understanding and acknowledgement of relevant facts
- Made after the attending physician fully informs the individual of the following:
- His or her medical diagnosis and prognosis of six months or less
- The potential risks association with taking the medical aid-in-dying medication to be prescribed
- The probable result of taking the medical aid-in-dying medication
- The choices available to an individual that demonstrates his or her self-determination and intent to end his or her life in a peaceful manner
- All feasible alternatives or additional treatment opportunities, including comfort care, palliative care, hospice care and pain control have been explored
How does a patient demonstrate residency?
The patient demonstrates residency by providing any of the following to their attending physician:
- A Colorado driver’s license or identification card
- A Colorado voter registration card or other documentation showing the individual is registered to vote in Colorado
- Evidence that the individual owns or leases property in Colorado
- A Colorado income tax return for the most recent tax year
Can a non-resident move to Colorado in order to receive medical aid-in-dying services?
There is nothing in the law that prevents an individual from moving to Colorado. However, that individual must be able to demonstrate residency in Colorado and meet the requirements as outlined in EOLOA before receiving medical aid-in-dying services.
If a patient’s primary care physician is located in another state, can that physician write a prescription for a patient?
No. EOLOA stipulates that only M.D.s or D.O.s licensed to practice medicine by the Board of Medical Examiners for the State of Colorado can write a valid prescription for medical aid-in-dying medication.
Will this be covered by insurance?
EOLOA does not specify who must pay for services. Individual insurers determine whether the medication is covered under their policies.
How much will participation cost?
The costs associated with participation in EOLOA include the cost of the physician services and the prescribed medication. There are no other specific fees for participating in EOLOA.