Colorado's End-of-Life Options Act

A new death with dignity law allows terminally ill patients to request life-ending medication under certain conditions.

By , MSLIS · Long Island University
Updated by Jeff Burtka, Attorney · George Mason University Law School

Recently, there's been a dramatic increase in the number of states considering death with dignity laws. Sometimes called "assisted suicide" or "right to die" initiatives, these laws make it possible for terminally ill patients to use prescribed medication to end their lives peacefully rather than suffering a painful and protracted death.

The catalyst for greater national attention to this issue was 29-year-old Brittany Maynard, a woman diagnosed with terminal brain cancer who moved from California to Oregon to end her life in 2014. Maynard chose Oregon because California had not yet passed its aid-in-dying law, and Oregon is one of just a few other states to allow terminally ill patients to legally end their lives.

After the Colorado legislature failed to pass a death with dignity bill in early 2016, proponents collected enough signatures to get an aid-in-dying initiative on the Colorado ballot. In November 2016 voters passed Initiative 106, the Colorado End-of-Life Options Act, by 65 to 35 percent. The law allows terminally ill patients to request aid in dying in certain clearly defined situations.

In 2022, 316 people received prescriptions under the act (a 44% increase compared to 2021). Of those patients, 246 patients actually obtained the aid-in-dying medication. (For additional statistics, see the Colorado End-of-Life Options Act 2022 Data Summary published by the Colorado Department of Public Health and Environment.)

This article first clarifies some confusing language related to death with dignity laws and then sets out the basics of Colorado's law.

Death With Dignity, Assisted Suicide, Right to Die: What's the Difference?

"Death with dignity" is one of the most commonly accepted phrases describing the process by which a terminally ill person ingests prescribed medication to hasten death.

Many people still think of this process as "assisted suicide" or "physician assisted suicide." However, proponents of death with dignity argue that the term "suicide" doesn't apply to terminally ill people who would prefer to live but, facing certain death within months, choose a gentler way of dying. In fact, Colorado's law states that terminating one's life under the law is not suicide—and it isn't homicide or elder abuse under the law. (Colo. Rev. Stat. § 25-48-121 (2024).)

Increasingly, health organizations are turning away from the term "suicide" to describe a terminally ill patient's choice to reduce the suffering of an inevitable death. The phrase "aid in dying" is becoming a more accepted way to refer to this process.

You might also see the phrase "right to die" used in place of "death with dignity." However, "right to die" is more accurately used in the context of directing one's own medical care—that is, refusing life-sustaining treatment such as a respirator or feeding tubes when permanently unconscious or close to death. You can provide your own health care directions by completing a Colorado living will and medical durable power of attorney. (See the end of this article for more information.)

Death With Dignity Requirements in Colorado

Both doctors and patients must comply with certain legal requirements for a patient to receive a prescription for aid-in-dying medication.

Which Patients Can Obtain Aid-In-Dying Medication?

To request a prescription for life-ending medication in Colorado, a patient must be:

  • at least 18 years old
  • a Colorado resident
  • mentally capable of making and communicating health care decisions, and
  • diagnosed with a terminal disease that will result in death within six months.

(Colo. Rev. Stat. § 25-48-103 (2024).)

Additionally, the patient's request to receive aid-in-dying medication must be voluntary. The patient also must be able to ingest the medication on their own. (Colo. Rev. Stat. §§ 25-48-102; 25-48-103 (2024).)

How Can a Patient Get Aid-In-Dying Medication?

A patient who meets the requirements above will be prescribed aid-in-dying medication only if:

  • The patient makes two verbal requests to their doctor, at least 15 days apart.
  • The patient gives a written request to the doctor. (The law sets out the specific form that the patient must use.)
  • The patient signs and dates the request in front of two qualified adult witnesses. (See below for witness qualifications.)
  • The witnesses attest that the patient is mentally capable, acting voluntarily, and not being coerced.

(Colo. Rev. Stat. §§ 25-48-104; 25-48-112 (2024).)

Colorado law limits who can be the two witnesses for the patient's request for aid in dying. A witness can't be the patient's agent under a power of attorney or the patient's attending physician. Also, one of the two witnesses can't be:

  • related to the patient by blood, marriage, civil union, or adoption
  • entitled to inherit from the patient, or
  • an employee, owner, or operator of the health care facility where the patient is receiving care.

(Colo. Rev. Stat. § 25-48-104 (2024).)

What Are the Doctor's Obligations?

A doctor may prescribe aid-in-dying medication to an eligible patient only if:

  • The prescribing doctor and one other doctor confirm the patient's diagnosis and prognosis.
  • The prescribing doctor and one other doctor determine that the patient is capable of making medical decisions.
  • The patient has a psychological examination—if either doctor feels the patient's judgment is impaired.
  • The prescribing doctor confirms that the patient isn't being coerced or unduly influenced by others when making the request.
  • The prescribing doctor informs the patient of any feasible alternatives to the medication, including care to relieve pain and keep the patient comfortable.
  • The prescribing doctor asks the patient to notify their next of kin of the prescription request. (The doctor can't require the patient to notify anyone, however.)
  • The prescribing doctor offers the patient the opportunity to withdraw the request for aid-in-dying medication before granting the prescription.

(Colo. Rev. Stat. §§ 25-48-106; 25-48-107 (2024).)

A patient must take the aid-in-dying medication; another person can't administer it to them. A doctor or any other person who administers the lethal medication could face criminal charges. (Colo. Rev. Stat. §§ 25-48-102; 25-48-116; 25-48-121 (2024).)

The full text of Colorado's End-of-Life Options Act can be found at Colo. Rev. Stat. §§ 25-48-101 through 25-48-123.

Learn More

For more details about Colorado's End-of-Life Options Act, see the extensive list of End-of-Life Options Act resources on the website of the Colorado Department of Public Health & Environment.

To find out more about the history and current status of death with dignity laws in the United States, visit the website of the Death With Dignity National Center.

For information about appointing a health care agent and making known your own wishes for medical care at the end of life, see the Living Wills & Medical Powers of Attorney section of Nolo.com.

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