DBQ-End of Life Policy

Second Regular Session Seventieth General Assembly STATE OF COLORADO

INTRODUCED

LLS NO. 16-0867.01 Christy Chase x2008 SENATE BILL 16-025

Senate Committees House Committees State, Veterans, & Military Affairs

A BILL FOR AN ACT CONCERNING END-OF-LIFE OPTIONS FOR INDIVIDUALS WITH A101

TERMINAL ILLNESS.102

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.)

The bill enacts the "Colorado End-of-life Options Act" (act), which authorizes an individual with a terminal illness to request, and the individual's attending physician to prescribe to the individual, medication to hasten the individual's death. To be qualified to request aid-in-dying medication, an individual must be a capable adult resident of Colorado who has a terminal illness and has voluntarily expressed the wish to

SENATE SPONSORSHIP Merrifield,

HOUSE SPONSORSHIP Court and Ginal,

Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment. Capital letters indicate new material to be added to existing statute. Dashes through the words indicate deletions from existing statute.

receive a prescription for aid-in-dying medication by making 2 oral requests and a written request to his or her attending physician. An individual who requests aid-in-dying medication may rescind the request at any time, regardless of his or her mental state.

The act outlines the responsibilities of the attending physician, including:

! Determining whether the requesting individual has a terminal illness, is capable of making an informed decision, and is making the request for aid-in-dying medication voluntarily;

! Requesting the individual to demonstrate proof of Colorado residency;

! Referring the individual to a consulting physician to confirm that the individual is qualified to request aid-in-dying medication;

! Providing full disclosures to ensure that the individual is making an informed decision; and

! Informing the individual of the right to rescind the request at any time.

An attending physician cannot write a prescription for aid-in-dying medication unless at least 2 health care providers determine that the individual is capable of making an informed decision. The attending or consulting physician is to refer the individual to a licensed mental health professional if he or she believes the individual's ability to make an informed decision is compromised. The attending physician cannot write a prescription unless the mental health professional communicates, in writing, that the individual is capable.

The bill grants immunity from civil and criminal liability and from professional discipline to a person who participates in good faith under the act. The bill also specifies that actions taken in accordance with the act do not constitute suicide, assisted suicide, mercy killing, homicide, or elder abuse.

A health care provider is not obligated to prescribe aid-in-dying medication, 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.

A person commits a class 2 felony if the person purposely or knowingly:

! Alters or forges an aid-in-dying medication request without the terminally ill individual's authorization;

! Conceals or destroys a rescission of a request for aid-in-dying medication; or

! Coerces or exerts undue influence to get a terminally ill individual to request, or to destroy a rescission of a request for, aid-in-dying medication.

SB16-025-2-

Be it enacted by the General Assembly of the State of Colorado:1

SECTION 1. In Colorado Revised Statutes, add article 48 to title2

25 as follows:3

ARTICLE 484

End-of-life Options5

25-48-101. Short title. THE SHORT TITLE OF THIS ARTICLE IS THE6

"COLORADO END-OF-LIFE OPTIONS ACT".7

25-48-102. Definitions. AS USED IN THIS ARTICLE, UNLESS THE8

CONTEXT OTHERWISE REQUIRES:9

(1) "ADULT" MEANS AN INDIVIDUAL WHO IS EIGHTEEN YEARS OF10

AGE OR OLDER.11

(2) "AID IN DYING" MEANS THE MEDICAL PRACTICE OF A PHYSICIAN12

PRESCRIBING MEDICATION TO A QUALIFIED INDIVIDUAL THAT THE13

QUALIFIED INDIVIDUAL MAY CHOOSE TO SELF-ADMINISTER TO BRING14

ABOUT HIS OR HER DEATH.15

(3) "AID-IN-DYING MEDICATION" MEANS MEDICATION PRESCRIBED16

BY A PHYSICIAN PURSUANT TO THIS ARTICLE TO PROVIDE AID IN DYING TO17

A QUALIFIED INDIVIDUAL.18

(4) "ATTENDING PHYSICIAN" MEANS A COLORADO-LICENSED19

PHYSICIAN WHO HAS PRIMARY RESPONSIBILITY FOR THE CARE OF A20

TERMINALLY ILL INDIVIDUAL AND THE TREATMENT OF THE INDIVIDUAL'S21

TERMINAL ILLNESS.22

(5) "CAPABLE" MEANS THAT, IN THE OPINION OF A TERMINALLY ILL23

INDIVIDUAL'S ATTENDING PHYSICIAN, CONSULTING PHYSICIAN,24

PSYCHIATRIST, OR LICENSED MENTAL HEALTH PROFESSIONAL, A25

TERMINALLY ILL INDIVIDUAL HAS THE ABILITY TO MAKE AND26

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COMMUNICATE AN INFORMED DECISION TO HEALTH CARE PROVIDERS,1

INCLUDING COMMUNICATION THROUGH A PERSON FAMILIAR WITH THE2

INDIVIDUAL'S MANNER OF COMMUNICATING IF THAT PERSON IS AVAILABLE.3

(6) "CONSULTING PHYSICIAN" MEANS A COLORADO-LICENSED4

PHYSICIAN WHO IS QUALIFIED BY SPECIALTY OR EXPERIENCE TO MAKE A5

PROFESSIONAL DIAGNOSIS AND PROGNOSIS REGARDING A TERMINALLY ILL6

INDIVIDUAL'S ILLNESS.7

(7) "HEALTH CARE PROVIDER" OR "PROVIDER" MEANS A PERSON8

WHO IS LICENSED, CERTIFIED, REGISTERED, OR OTHERWISE AUTHORIZED OR9

PERMITTED BY LAW TO ADMINISTER HEALTH CARE OR DISPENSE10

MEDICATION IN THE ORDINARY COURSE OF BUSINESS OR PRACTICE OF A11

PROFESSION. THE TERM INCLUDES A HEALTH CARE FACILITY, INCLUDING12

A LONG-TERM CARE FACILITY AS DEFINED IN SECTION 25-3-103.7 (1) (f.3).13

(8) "INFORMED DECISION" MEANS A DECISION THAT IS:14

(a) MADE BY A QUALIFIED INDIVIDUAL TO REQUEST AND OBTAIN15

A PRESCRIPTION FOR MEDICATION THAT THE QUALIFIED INDIVIDUAL MAY16

SELF-ADMINISTER TO END HIS OR HER LIFE IN A PEACEFUL MANNER;17

(b) BASED ON AN UNDERSTANDING AND ACKNOWLEDGMENT OF18

THE RELEVANT FACTS; AND19

(c) MADE AFTER THE ATTENDING PHYSICIAN FULLY INFORMS THE20

QUALIFIED INDIVIDUAL OF:21

(I) HIS OR HER MEDICAL DIAGNOSIS AND PROGNOSIS;22

(II) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE23

MEDICATION TO BE PRESCRIBED;24

(III) THE PROBABLE RESULT OF TAKING THE MEDICATION TO BE25

PRESCRIBED;26

(IV) THE CHOICES AVAILABLE TO AN INDIVIDUAL THAT27

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DEMONSTRATE HIS OR HER SELF-DETERMINATION AND INTENT TO END HIS1

OR HER LIFE IN A PEACEFUL MANNER, INCLUDING THE ABILITY TO CHOOSE2

WHETHER TO:3

(A) REQUEST AID IN DYING;4

(B) OBTAIN A PRESCRIPTION FOR MEDICATION TO END HIS OR HER5

LIFE;6

(C) FILL AND POSSESS A PRESCRIPTION FOR MEDICATION TO END7

HIS OR HER LIFE; AND8

(D) ULTIMATELY SELF-ADMINISTER THE MEDICATION TO BRING9

ABOUT A PEACEFUL DEATH; AND10

(V) FEASIBLE ALTERNATIVES OR ADDITIONAL TREATMENT11

OPPORTUNITIES, INCLUDING COMFORT CARE, PALLIATIVE CARE, HOSPICE12

CARE, AND PAIN CONTROL.13

(9) "LICENSED MENTAL HEALTH PROFESSIONAL" MEANS A14

PSYCHIATRIST LICENSED UNDER ARTICLE 36 OF TITLE 12, C.R.S., OR A15

PERSON LICENSED UNDER ARTICLE 43 OF TITLE 12, C.R.S., TO PRACTICE A16

PARTICULAR MENTAL HEALTH PROFESSION.17

(10) "MEDICALLY CONFIRMED" MEANS THAT A CONSULTING18

PHYSICIAN WHO HAS EXAMINED THE TERMINALLY ILL INDIVIDUAL AND THE19

INDIVIDUAL'S RELEVANT MEDICAL RECORDS HAS CONFIRMED THE MEDICAL20

OPINION OF THE ATTENDING PHYSICIAN.21

(11) "QUALIFIED INDIVIDUAL" MEANS A TERMINALLY ILL ADULT22

WHO IS CAPABLE, IS A RESIDENT, AND HAS SATISFIED THE REQUIREMENTS23

OF THIS ARTICLE IN ORDER TO OBTAIN A PRESCRIPTION FOR AID-IN-DYING24

MEDICATION TO END HIS OR HER LIFE.25

(12) "RESIDENT" MEANS AN INDIVIDUAL WHO IS ABLE TO26

DEMONSTRATE RESIDENCY IN COLORADO BY PROVIDING ANY OF THE27

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FOLLOWING DOCUMENTATION TO HIS OR HER ATTENDING PHYSICIAN:1

(a) A COLORADO DRIVER'S LICENSE OR IDENTIFICATION CARD2

ISSUED PURSUANT TO ARTICLE 2 OF TITLE 42, C.R.S.;3

(b) A COLORADO VOTER REGISTRATION CARD OR OTHER4

DOCUMENTATION SHOWING THE INDIVIDUAL IS REGISTERED TO VOTE IN5

COLORADO;6

(c) EVIDENCE THAT THE INDIVIDUAL OWNS OR LEASES PROPERTY7

IN COLORADO; OR8

(d) A COLORADO INCOME TAX RETURN FOR THE MOST RECENT TAX9

YEAR.10

(13) "SELF-ADMINISTRATION" MEANS, IF A QUALIFIED INDIVIDUAL,11

TO ENGAGE IN AN AFFIRMATIVE AND VOLUNTARY ACT TO USE PRESCRIBED12

MEDICATION TO BRING ABOUT HIS OR HER OWN PEACEFUL AND HUMANE13

DEATH.14

(14) "TERMINAL ILLNESS" MEANS AN INCURABLE AND15

IRREVERSIBLE ILLNESS THAT HAS BEEN MEDICALLY CONFIRMED AND WILL,16

WITHIN REASONABLE MEDICAL JUDGMENT, RESULT IN DEATH WITHIN SIX17

MONTHS.18

25-48-103. Right to request aid-in-dying medication. (1) A19

CAPABLE, ADULT RESIDENT OF COLORADO MAY MAKE A REQUEST, IN20

ACCORDANCE WITH SECTIONS 25-48-104 AND 25-48-111, TO RECEIVE A21

PRESCRIPTION FOR AID-IN-DYING MEDICATION IF:22

(a) THE INDIVIDUAL'S ATTENDING PHYSICIAN HAS DIAGNOSED THE23

INDIVIDUAL WITH A TERMINAL ILLNESS; AND24

(b) THE INDIVIDUAL HAS VOLUNTARILY EXPRESSED THE WISH TO25

RECEIVE A PRESCRIPTION FOR AID-IN-DYING MEDICATION.26

(2) A PERSON DOES NOT QUALIFY TO RECEIVE A PRESCRIPTION FOR27

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AID-IN-DYING MEDICATION SOLELY BECAUSE OF AGE OR DISABILITY.1

25-48-104. Request process - witness requirements. (1) IN2

ORDER TO RECEIVE A PRESCRIPTION FOR AID-IN-DYING MEDICATION3

PURSUANT TO THIS ARTICLE, AN INDIVIDUAL WHO SATISFIES THE4

REQUIREMENTS IN SECTION 25-48-103 MUST MAKE TWO ORAL REQUESTS,5

SEPARATED BY AT LEAST FIFTEEN DAYS, AND A VALID WRITTEN REQUEST6

TO HIS OR HER ATTENDING PHYSICIAN.7

(2) (a) TO BE VALID, A WRITTEN REQUEST FOR AID-IN-DYING8

MEDICATION MUST BE:9

(I) SUBSTANTIALLY IN THE SAME FORM AS SET FORTH IN SECTION10

25-48-111;11

(II) SIGNED AND DATED BY THE INDIVIDUAL SEEKING THE12

MEDICATION; AND13

(III) WITNESSED BY AT LEAST TWO INDIVIDUALS WHO, IN THE14

PRESENCE OF THE INDIVIDUAL, ATTEST TO THE BEST OF THEIR KNOWLEDGE15

AND BELIEF THAT THE INDIVIDUAL IS:16

(A) CAPABLE;17

(B) ACTING VOLUNTARILY; AND18

(C) NOT BEING COERCED TO SIGN THE REQUEST.19

(b) OF THE TWO WITNESSES TO THE WRITTEN REQUEST, AT LEAST20

ONE MUST NOT BE:21

(I) RELATED TO THE INDIVIDUAL BY BLOOD, MARRIAGE, CIVIL22

UNION, OR ADOPTION;23

(II) AN INDIVIDUAL WHO, AT THE TIME THE REQUEST IS SIGNED, IS24

ENTITLED, UNDER A WILL OR BY OPERATION OF LAW, TO ANY PORTION OF25

THE INDIVIDUAL'S ESTATE UPON HIS OR HER DEATH; OR26

(III) AN OWNER, OPERATOR, OR EMPLOYEE OF A HEALTH CARE27

SB16-025-7-

FACILITY WHERE THE INDIVIDUAL IS RECEIVING MEDICAL TREATMENT OR1

IS A RESIDENT.2

(c) THE INDIVIDUAL'S ATTENDING PHYSICIAN SHALL NOT SERVE AS3

A WITNESS TO THE WRITTEN REQUEST.4

25-48-105. Right to rescind request - requirement to offer5

opportunity to rescind. (1) AT ANY TIME, AN INDIVIDUAL MAY RESCIND6

HIS OR HER REQUEST FOR AID-IN-DYING MEDICATION WITHOUT REGARD TO7

THE INDIVIDUAL'S MENTAL STATE.8

(2) AN ATTENDING PHYSICIAN SHALL NOT WRITE A PRESCRIPTION9

FOR AID-IN-DYING MEDICATION UNDER THIS ARTICLE UNLESS THE10

ATTENDING PHYSICIAN OFFERS THE QUALIFIED INDIVIDUAL AN11

OPPORTUNITY TO RESCIND THE REQUEST FOR THE MEDICATION.12

25-48-106. Attending physician responsibilities. (1) THE13

ATTENDING PHYSICIAN SHALL:14

(a) MAKE THE INITIAL DETERMINATION OF WHETHER AN15

INDIVIDUAL REQUESTING AID-IN-DYING MEDICATION HAS A TERMINAL16

ILLNESS, IS CAPABLE OF MAKING AN INFORMED DECISION, AND HAS MADE17

THE REQUEST VOLUNTARILY;18

(b) REQUEST THAT THE INDIVIDUAL DEMONSTRATE COLORADO19

RESIDENCY BY PROVIDING DOCUMENTATION AS DESCRIBED IN SECTION20

25-48-102 (12);21

(c) PROVIDE A STANDARD OF CARE UNDER ACCEPTED MEDICAL22

GUIDELINES;23

(d) REFER THE INDIVIDUAL TO A CONSULTING PHYSICIAN OF THE24

INDIVIDUAL'S CHOOSING FOR MEDICAL CONFIRMATION OF THE DIAGNOSIS25

AND PROGNOSIS AND FOR A DETERMINATION OF WHETHER THE INDIVIDUAL26

IS CAPABLE AND ACTING VOLUNTARILY;27

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(e) PROVIDE FULL, INDIVIDUAL-CENTERED DISCLOSURES TO1

ENSURE THAT THE INDIVIDUAL IS MAKING AN INFORMED DECISION BY2

DISCUSSING WITH THE INDIVIDUAL:3

(I) HIS OR HER MEDICAL DIAGNOSIS AND PROGNOSIS;4

(II) THE FEASIBLE ALTERNATIVES OR ADDITIONAL TREATMENT5

OPPORTUNITIES, INCLUDING COMFORT CARE, PALLIATIVE CARE, HOSPICE6

CARE, AND PAIN CONTROL;7

(III) THE POTENTIAL RISKS ASSOCIATED WITH TAKING THE8

AID-IN-DYING MEDICATION TO BE PRESCRIBED;9

(IV) THE PROBABLE RESULT OF TAKING THE AID-IN-DYING10

MEDICATION TO BE PRESCRIBED; AND11

(V) THE POSSIBILITY THAT THE INDIVIDUAL CAN OBTAIN THE12

MEDICATION BUT CHOOSE NOT TO USE IT;13

(f) REFER THE INDIVIDUAL TO A LICENSED MENTAL HEALTH14

PROFESSIONAL PURSUANT TO SECTION 25-48-108 IF, IN THE ATTENDING15

PHYSICIAN'S OPINION, THE INDIVIDUAL'S ABILITY TO MAKE AN INFORMED16

DECISION IS COMPROMISED FOR ANY REASON;17

(g) CONFIRM THAT THE INDIVIDUAL'S REQUEST DOES NOT ARISE18

FROM COERCION OR UNDUE INFLUENCE BY ANOTHER PERSON BY19

DISCUSSING WITH THE INDIVIDUAL, WITHOUT THE PRESENCE OF OTHER20

PERSONS, WHETHER THE INDIVIDUAL IS FEELING COERCED OR UNDULY21

INFLUENCED BY ANOTHER PERSON;22

(h) COUNSEL THE INDIVIDUAL ABOUT THE IMPORTANCE OF:23

(I) HAVING ANOTHER PERSON PRESENT WHEN THE INDIVIDUAL24

SELF-ADMINISTERS THE AID-IN-DYING MEDICATION PRESCRIBED PURSUANT25

TO THIS ARTICLE;26

(II) NOT TAKING THE AID-IN-DYING MEDICATION IN A PUBLIC27

SB16-025-9-

PLACE;1

(III) SAFE-KEEPING AND PROPER DISPOSAL OF UNUSED2

MEDICATION IN ACCORDANCE WITH SECTION 25-48-119; AND3

(IV) NOTIFYING HIS OR HER NEXT OF KIN OF THE REQUEST FOR4

AID-IN-DYING MEDICATION;5

(i) INFORM THE INDIVIDUAL THAT HE OR SHE MAY RESCIND THE6

REQUEST FOR AID-IN-DYING MEDICATION AT ANY TIME AND IN ANY7

MANNER;8

(j) VERIFY, IMMEDIATELY PRIOR TO WRITING THE PRESCRIPTION9

FOR AID-IN-DYING MEDICATION, THAT THE INDIVIDUAL IS MAKING AN10

INFORMED DECISION;11

(k) ENSURE THAT ALL APPROPRIATE STEPS ARE CARRIED OUT IN12

ACCORDANCE WITH THIS ARTICLE BEFORE WRITING A PRESCRIPTION FOR13

AID-IN-DYING MEDICATION; AND14

(l) (I) DISPENSE AID-IN-DYING MEDICATIONS DIRECTLY TO THE15

QUALIFIED INDIVIDUAL, INCLUDING ANCILLARY MEDICATIONS INTENDED16

TO MINIMIZE THE INDIVIDUAL'S DISCOMFORT, IF THE ATTENDING17

PHYSICIAN HAS A CURRENT DRUG ENFORCEMENT ADMINISTRATION18

CERTIFICATE AND COMPLIES WITH ANY APPLICABLE ADMINISTRATIVE19

RULE; OR20

(II) WITH THE QUALIFIED INDIVIDUAL'S WRITTEN CONSENT:21

(A) CONTACT A LICENSED PHARMACIST AND INFORM THE22

PHARMACIST OF THE PRESCRIPTION; AND23

(B) DELIVER THE WRITTEN PRESCRIPTION PERSONALLY, BY MAIL,24

OR THROUGH AUTHORIZED ELECTRONIC TRANSMISSION IN THE MANNER25

PERMITTED UNDER ARTICLE 42.5 OF TITLE 12, C.R.S., TO THE PHARMACIST,26

WHO SHALL DISPENSE THE MEDICATION TO THE QUALIFIED INDIVIDUAL,27

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THE ATTENDING PHYSICIAN, OR AN INDIVIDUAL EXPRESSLY DESIGNATED1

BY THE QUALIFIED INDIVIDUAL.2

25-48-107. Consulting physician responsibilities. (1) BEFORE3

AN INDIVIDUAL WHO IS REQUESTING AID-IN-DYING MEDICATION CAN4

RECEIVE A PRESCRIPTION FOR THE MEDICATION, A CONSULTING PHYSICIAN5

OF THE INDIVIDUAL'S CHOOSING MUST:6

(a) EXAMINE THE INDIVIDUAL AND HIS OR HER RELEVANT MEDICAL7

RECORDS;8

(b) CONFIRM, IN WRITING, TO THE ATTENDING PHYSICIAN:9

(I) THAT THE INDIVIDUAL IS SUFFERING FROM A TERMINAL10

ILLNESS;11

(II) THE INDIVIDUAL'S PROGNOSIS; AND12

(III) THAT THE INDIVIDUAL IS CAPABLE OF MAKING AN INFORMED13

DECISION, OR PROVIDE DOCUMENTATION THAT THE CONSULTING14

PHYSICIAN HAS REFERRED THE INDIVIDUAL FOR FURTHER EVALUATION IN15

ACCORDANCE WITH SECTION 25-48-108.16

25-48-108. Confirmation that individual is capable - referral17

to mental health professional. (1) AN ATTENDING PHYSICIAN SHALL NOT18

PRESCRIBE AID-IN-DYING MEDICATION UNDER THIS ARTICLE FOR AN19

INDIVIDUAL WITH A TERMINAL ILLNESS UNTIL THE INDIVIDUAL IS20

DETERMINED TO BE CAPABLE OF MAKING AN INFORMED DECISION AND21

THAT DETERMINATION IS CONFIRMED IN ACCORDANCE WITH THIS SECTION.22

(2) THE DETERMINATION OF WHETHER AN INDIVIDUAL WITH A23

TERMINAL ILLNESS WHO IS REQUESTING AID-IN-DYING MEDICATION IS24

CAPABLE OF MAKING AN INFORMED DECISION AND CONFIRMATION OF THAT25

DETERMINATION MUST BE MADE BY TWO OF THE FOLLOWING:26

(a) THE ATTENDING PHYSICIAN;27

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(b) THE CONSULTING PHYSICIAN; OR1

(c) A LICENSED MENTAL HEALTH PROFESSIONAL.2

(3) IF, IN THE OPINION OF THE ATTENDING PHYSICIAN OR THE3

CONSULTING PHYSICIAN, THE INDIVIDUAL'S ABILITY TO MAKE AN4

INFORMED DECISION IS COMPROMISED, THE ATTENDING PHYSICIAN OR5

CONSULTING PHYSICIAN SHALL REFER THE INDIVIDUAL TO A LICENSED6

MENTAL HEALTH PROFESSIONAL FOR A DETERMINATION OF WHETHER THE7

INDIVIDUAL IS CAPABLE OF MAKING AN INFORMED DECISION.8

(4) A LICENSED MENTAL HEALTH PROFESSIONAL WHO EVALUATES9

AN INDIVIDUAL UNDER THIS SECTION SHALL COMMUNICATE, IN WRITING,10

TO THE ATTENDING OR CONSULTING PHYSICIAN WHO REQUESTED THE11

EVALUATION, HIS OR HER CONCLUSIONS ABOUT WHETHER THE INDIVIDUAL12

IS CAPABLE OF MAKING AN INFORMED DECISION. IF THE LICENSED MENTAL13

HEALTH PROFESSIONAL DETERMINES THAT THE INDIVIDUAL IS NOT14

CAPABLE OF MAKING AN INFORMED DECISION, THE ATTENDING PHYSICIAN15

SHALL NOT PRESCRIBE AID-IN-DYING MEDICATION TO THE INDIVIDUAL.16

25-48-109. Death certificate. (1) UNLESS OTHERWISE17

PROHIBITED BY LAW, THE ATTENDING PHYSICIAN MAY SIGN THE DEATH18

CERTIFICATE OF A QUALIFIED INDIVIDUAL WHO OBTAINS AND19

SELF-ADMINISTERS AID-IN-DYING MEDICATION.20

(2) IF A QUALIFIED INDIVIDUAL DIES AFTER USING AID-IN-DYING21

MEDICATION, THE QUALIFIED INDIVIDUAL'S TERMINAL ILLNESS SHALL BE22

LISTED AS THE CAUSE OF DEATH ON HIS OR HER DEATH CERTIFICATE.23

WHEN AN ATTENDING PHYSICIAN CERTIFIES THAT A DEATH OCCURRED IN24

ACCORDANCE WITH THIS ARTICLE, THE DEATH IS NOT REPORTABLE AND25

DOES NOT CONSTITUTE GROUNDS FOR POSTMORTEM INQUIRY UNDER26

SECTION 30-10-606 (1), C.R.S.27

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25-48-110. Informed decision required. (1) AN INDIVIDUAL1

WITH A TERMINAL ILLNESS IS NOT A QUALIFIED INDIVIDUAL AND MAY NOT2

RECEIVE A PRESCRIPTION FOR AID-IN-DYING MEDICATION UNLESS HE OR3

SHE HAS MADE AN INFORMED DECISION.4

(2) IMMEDIATELY BEFORE WRITING A PRESCRIPTION FOR5

AID-IN-DYING MEDICATION UNDER THIS ARTICLE, THE ATTENDING6

PHYSICIAN SHALL VERIFY THAT THE INDIVIDUAL WITH A TERMINAL7

ILLNESS IS A QUALIFIED INDIVIDUAL AND IS MAKING AN INFORMED8

DECISION.9

25-48-111. Form of written request. A REQUEST FOR10

AID-IN-DYING MEDICATION AUTHORIZED BY THIS ARTICLE MUST BE IN11

SUBSTANTIALLY THE FOLLOWING FORM:12

REQUEST FOR MEDICATION TO END MY LIFE 13

IN A HUMANE AND DIGNIFIED MANNER14

I, ________________, AM AN ADULT OF SOUND MIND. I AM SUFFERING15

FROM _______, WHICH MY ATTENDING PHYSICIAN HAS DETERMINED IS A16

TERMINAL ILLNESS AND WHICH HAS BEEN MEDICALLY CONFIRMED. I HAVE17

BEEN FULLY INFORMED OF MY DIAGNOSIS AND PROGNOSIS, THE NATURE OF18

THE AID-IN-DYING MEDICATION TO BE PRESCRIBED AND POTENTIAL19

ASSOCIATED RISKS, THE EXPECTED RESULT, AND THE FEASIBLE20

ALTERNATIVES OR ADDITIONAL TREATMENT OPPORTUNITIES, INCLUDING21

COMFORT CARE, PALLIATIVE CARE, HOSPICE CARE, AND PAIN CONTROL.22

I REQUEST THAT MY ATTENDING PHYSICIAN PRESCRIBE AID-IN-DYING23

MEDICATION THAT WILL END MY LIFE IN A HUMANE AND DIGNIFIED24

MANNER IF I CHOOSE TO TAKE IT, AND I AUTHORIZE MY ATTENDING25

PHYSICIAN TO CONTACT ANY PHARMACIST ABOUT MY REQUEST.26

I UNDERSTAND THAT I HAVE THE RIGHT TO RESCIND THIS REQUEST AT ANY27

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TIME.1

I UNDERSTAND THE SERIOUSNESS OF THIS REQUEST, AND I EXPECT TO DIE2

IF I TAKE THE AID-IN-DYING MEDICATION PRESCRIBED. I FURTHER3

UNDERSTAND THAT ALTHOUGH MOST DEATHS OCCUR WITHIN THREE4

HOURS, MY DEATH MAY TAKE LONGER, AND MY ATTENDING PHYSICIAN5

HAS COUNSELED ME ABOUT THIS POSSIBILITY.6

I MAKE THIS REQUEST VOLUNTARILY, WITHOUT RESERVATION, AND7

WITHOUT BEING COERCED, AND I ACCEPT FULL RESPONSIBILITY FOR MY8

ACTIONS.9

SIGNED: ___________10

DATED: ___________11

DECLARATION OF WITNESSES12

WE DECLARE THAT THE INDIVIDUAL SIGNING THIS REQUEST:13

(a) IS PERSONALLY KNOWN TO US OR HAS PROVIDED PROOF OF14

IDENTITY;15

(b) SIGNED THIS REQUEST IN OUR PRESENCE;16

(c) APPEARS TO BE OF SOUND MIND AND NOT UNDER DURESS,17

FRAUD, OR UNDUE INFLUENCE; AND18

(d) IS NOT AN INDIVIDUAL FOR WHOM EITHER OF US IS THE19

ATTENDING PHYSICIAN.20

__________ WITNESS 1/DATE21

__________ WITNESS 2/DATE22

NOTE: ONLY ONE OF THE TWO WITNESSES MAY: BE A RELATIVE (BY23

BLOOD, MARRIAGE, CIVIL UNION, OR ADOPTION) OF THE INDIVIDUAL24

SIGNING THIS REQUEST; BE ENTITLED TO ANY PORTION OF THE25

INDIVIDUAL'S ESTATE UPON DEATH; OR OWN, OPERATE, OR BE EMPLOYED26

AT A HEALTH CARE FACILITY WHERE THE INDIVIDUAL IS A PATIENT OR27

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RESIDENT.1

25-48-112. Standard of care. (1) PHYSICIANS AND HEALTH CARE2

PROVIDERS SHALL PROVIDE MEDICAL SERVICES UNDER THIS ARTICLE THAT3

MEET OR EXCEED THE STANDARD OF CARE FOR END-OF-LIFE MEDICAL4

CARE.5

(2) WHEN A HEALTH CARE PROVIDER MAKES A DIAGNOSIS THAT AN6

INDIVIDUAL HAS A TERMINAL ILLNESS, THE HEALTH CARE PROVIDER, UPON7

THE INDIVIDUAL'S REQUEST, SHALL PROVIDE THE INDIVIDUAL WITH8

COMPREHENSIVE INFORMATION AND COUNSELING, IN ACCORDANCE WITH9

THIS SECTION, REGARDING LEGAL END-OF-LIFE MEDICAL CARE OPTIONS.10

25-48-113. Effect on wills, contracts, and statutes. (1) A11

PROVISION IN A CONTRACT, WILL, OR OTHER AGREEMENT, WHETHER12

WRITTEN OR ORAL, THAT WOULD AFFECT WHETHER A QUALIFIED13

INDIVIDUAL MAY MAKE OR RESCIND A REQUEST FOR AID IN DYING14

PURSUANT TO THIS ARTICLE IS INVALID.15

(2) AN OBLIGATION OWING UNDER ANY CURRENTLY EXISTING16

CONTRACT MUST NOT BE CONDITIONED UPON, OR AFFECTED BY, A17

QUALIFIED INDIVIDUAL'S ACT OF MAKING OR RESCINDING A REQUEST FOR18

AID-IN-DYING MEDICATION PURSUANT TO THIS ARTICLE.19

25-48-114. Insurance or annuity policies. (1) THE SALE,20

PROCUREMENT, OR ISSUANCE OF, OR THE RATE CHARGED FOR, ANY LIFE,21

HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY MUST NOT BE22

CONDITIONED UPON, OR AFFECTED BY, A QUALIFIED INDIVIDUAL'S ACT OF23

MAKING OR RESCINDING A REQUEST FOR AID-IN-DYING MEDICATION IN24

ACCORDANCE WITH THIS ARTICLE.25

(2) A QUALIFIED INDIVIDUAL'S ACT OF SELF-ADMINISTERING26

AID-IN-DYING MEDICATION PURSUANT TO THIS ARTICLE DOES NOT AFFECT27

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A LIFE, HEALTH, OR ACCIDENT INSURANCE OR ANNUITY POLICY, OTHER1

THAN THAT THE DEATH IS A NATURAL DEATH RESULTING FROM THE2

QUALIFIED INDIVIDUAL'S TERMINAL ILLNESS.3

25-48-115. Immunity for good-faith participation - prohibition4

against reprisals. (1) A PERSON IS NOT SUBJECT TO CIVIL OR CRIMINAL5

LIABILITY OR PROFESSIONAL DISCIPLINARY ACTION FOR PARTICIPATING IN6

GOOD FAITH UNDER THIS ARTICLE, WHICH INCLUDES BEING PRESENT WHEN7

A QUALIFIED INDIVIDUAL SELF-ADMINISTERS THE PRESCRIBED8

AID-IN-DYING MEDICATION.9

(2) A HEALTH CARE PROVIDER OR PROFESSIONAL ORGANIZATION10

OR ASSOCIATION SHALL NOT SUBJECT AN INDIVIDUAL TO ANY OF THE11

FOLLOWING FOR PARTICIPATING OR REFUSING TO PARTICIPATE IN12

GOOD-FAITH COMPLIANCE UNDER THIS ARTICLE:13

(a) CENSURE;14

(b) DISCIPLINE;15

(c) SUSPENSION;16

(d) LOSS OF LICENSE, PRIVILEGES, OR MEMBERSHIP; OR17

(e) ANY OTHER PENALTY.18

(3) A REQUEST BY A QUALIFIED INDIVIDUAL FOR, OR THE19

PROVISION BY AN ATTENDING PHYSICIAN OF, AID-IN-DYING MEDICATION20

IN GOOD-FAITH COMPLIANCE WITH THIS ARTICLE DOES NOT:21

(a) CONSTITUTE NEGLECT OR ELDER ABUSE FOR ANY PURPOSE OF22

LAW; OR23

(b) PROVIDE THE SOLE BASIS FOR THE APPOINTMENT OF A24

GUARDIAN OR CONSERVATOR.25

25-48-116. No duty to prescribe or dispense. (1) A HEALTH26

CARE PROVIDER MAY CHOOSE WHETHER TO PARTICIPATE IN PROVIDING27

SB16-025-16-

AID-IN-DYING MEDICATION TO A QUALIFIED INDIVIDUAL IN ACCORDANCE1

WITH THIS ARTICLE.2

(2) IF A HEALTH CARE PROVIDER IS UNABLE OR UNWILLING TO3

CARRY OUT A QUALIFIED INDIVIDUAL'S REQUEST FOR AID-IN-DYING4

MEDICATION MADE IN ACCORDANCE WITH THIS ARTICLE, AND THE5

QUALIFIED INDIVIDUAL TRANSFERS HIS OR HER CARE TO A NEW HEALTH6

CARE PROVIDER, THE PRIOR HEALTH CARE PROVIDER SHALL TRANSFER,7

UPON REQUEST, A COPY OF THE QUALIFIED INDIVIDUAL'S RELEVANT8

MEDICAL RECORDS TO THE NEW HEALTH CARE PROVIDER.9

25-48-117. Health care facility may prohibit participation -10

sanctions if provider violates policy. (1) A HEALTH CARE FACILITY MAY11

PROHIBIT A PHYSICIAN FROM WRITING A PRESCRIPTION FOR AID-IN-DYING12

MEDICATION FOR A QUALIFIED INDIVIDUAL WHO IS A RESIDENT IN THE13

FACILITY AND WHO INTENDS TO USE THE AID-IN-DYING MEDICATION ON14

THE FACILITY'S PREMISES. THE HEALTH CARE FACILITY MUST NOTIFY THE15

PHYSICIAN IN WRITING OF ITS POLICY WITH REGARD TO PRESCRIPTIONS FOR16

AID-IN-DYING MEDICATION.17

(2) A HEALTH CARE FACILITY OR HEALTH CARE PROVIDER SHALL18

NOT SUBJECT A PHYSICIAN, NURSE, PHARMACIST, OR OTHER PERSON TO19

DISCIPLINE, SUSPENSION, LOSS OF LICENSE OR PRIVILEGES, OR ANY OTHER20

PENALTY OR SANCTION FOR ACTIONS TAKEN IN GOOD-FAITH RELIANCE ON21

THIS ARTICLE OR FOR REFUSING TO ACT UNDER THIS ARTICLE.22

(3) NOTHING IN THIS SECTION OR IN SECTION 25-48-115 OR23

25-48-116 PREVENTS A HEALTH CARE PROVIDER FROM PROVIDING TO AN24

INDIVIDUAL HEALTH CARE SERVICES THAT DO NOT CONSTITUTE25

PARTICIPATION UNDER THIS ARTICLE.26

25-48-118. Liabilities. (1) A PERSON COMMITS A CLASS 2 FELONY27

SB16-025-17-

AND IS SUBJECT TO PUNISHMENT IN ACCORDANCE WITH SECTION1

18-1.3-401, C.R.S., IF THE PERSON, WITH INTENT OR THE EFFECT OF2

CAUSING AN INDIVIDUAL'S DEATH, PURPOSELY OR KNOWINGLY:3

(a) ALTERS OR FORGES A REQUEST FOR AID-IN-DYING MEDICATION4

TO END AN INDIVIDUAL'S LIFE WITHOUT THE INDIVIDUAL'S5

AUTHORIZATION; OR6

(b) CONCEALS OR DESTROYS A RESCISSION OF A REQUEST FOR7

AID-IN-DYING MEDICATION.8

(2) A PERSON COMMITS A CLASS 2 FELONY AND IS SUBJECT TO9

PUNISHMENT IN ACCORDANCE WITH SECTION 18-1.3-401, C.R.S., IF THE10

PERSON PURPOSELY OR KNOWINGLY COERCES OR EXERTS UNDUE11

INFLUENCE ON AN INDIVIDUAL WITH A TERMINAL ILLNESS TO:12

(a) REQUEST AID-IN-DYING MEDICATION FOR THE PURPOSE OF13

ENDING THE TERMINALLY ILL INDIVIDUAL'S LIFE; OR14

(b) DESTROY A RESCISSION OF A REQUEST FOR AID-IN-DYING15

MEDICATION.16

(3) NOTHING IN THIS ARTICLE LIMITS FURTHER LIABILITY FOR CIVIL17

DAMAGES RESULTING FROM OTHER NEGLIGENT CONDUCT OR INTENTIONAL18

MISCONDUCT BY ANY PERSON.19

(4) THE PENALTIES SPECIFIED IN THIS ARTICLE DO NOT PRECLUDE20

CRIMINAL PENALTIES APPLICABLE UNDER OTHER LAW FOR CONDUCT THAT21

IS INCONSISTENT WITH THIS ARTICLE.22

25-48-119. Safe disposal of unused medications. A PERSON WHO23

HAS CUSTODY OR CONTROL OF AID-IN-DYING MEDICATION DISPENSED24

UNDER THIS ARTICLE THAT THE TERMINALLY ILL INDIVIDUAL DECIDES NOT25

TO USE OR THAT REMAINS UNUSED AFTER THE TERMINALLY ILL26

INDIVIDUAL'S DEATH SHALL DISPOSE OF THE UNUSED AID-IN-DYING27

SB16-025-18-

MEDICATION BY LAWFUL MEANS IN ACCORDANCE WITH SECTION 25-15-3281

OR ANY OTHER STATE OR FEDERALLY APPROVED MEDICATION TAKE-BACK2

PROGRAM AUTHORIZED UNDER THE FEDERAL "SECURE AND RESPONSIBLE3

DRUG DISPOSAL ACT OF 2010", PUB.L. 111-273, AS AMENDED, AND4

REGULATIONS ADOPTED PURSUANT TO THE FEDERAL ACT.5

25-48-120. Actions complying with article not a crime.6

NOTHING IN THIS ARTICLE AUTHORIZES A PHYSICIAN OR ANY OTHER7

PERSON TO END AN INDIVIDUAL'S LIFE BY LETHAL INJECTION, MERCY8

KILLING, OR EUTHANASIA. ACTIONS TAKEN IN ACCORDANCE WITH THIS9

ARTICLE DO NOT, FOR ANY PURPOSE, CONSTITUTE SUICIDE, ASSISTED10

SUICIDE, MERCY KILLING, HOMICIDE, OR ELDER ABUSE UNDER THE11

"COLORADO CRIMINAL CODE", TITLE 18, C.R.S.12

25-48-121. Claims by government entity for costs. A13

GOVERNMENT ENTITY THAT INCURS COSTS RESULTING FROM AN14

INDIVIDUAL TERMINATING HIS OR HER LIFE PURSUANT TO THIS ARTICLE IN15

A PUBLIC PLACE HAS A CLAIM AGAINST THE ESTATE OF THE INDIVIDUAL TO16

RECOVER THE COSTS AND REASONABLE ATTORNEY FEES RELATED TO17

ENFORCING THE CLAIM.18

25-48-122. No effect on advance medical directives.19

(1) NOTHING IN THIS ARTICLE AFFECTS OR NEGATES:20

(a) A DECLARATION MADE UNDER ARTICLE 18 OF TITLE 15, C.R.S.,21

DIRECTING THAT LIFE-SUSTAINING PROCEDURES BE WITHHELD OR22

WITHDRAWN;23

(b) A CPR DIRECTIVE EXECUTED UNDER ARTICLE 18.6 OF TITLE 15,24

C.R.S.; OR25

(c) AN ADVANCE MEDICAL DIRECTIVE EXECUTED UNDER ARTICLE26

18.7 OF TITLE 15, C.R.S.27

SB16-025-19-

SECTION 2. Applicability. This act applies to conduct occurring1

on or after the effective date of this act.2

SECTION 3. Safety clause. The general assembly hereby finds,3

determines, and declares that this act is necessary for the immediate4

preservation of the public peace, health, and safety.5

SB16-025-20-