Bill to expand access to medical aid in dying starting its journey at the Colorado capitol

Colorado's state House on the last day of the legislative session. May 8, 2023.
Kevin J. Beaty/Denverite
Colorado’s state House on the last day of the legislative session. May 8, 2023.

An effort to expand access for terminally ill patients to medicine that can end their lives gets its first hearing at the statehouse today, and the bill’s sponsor is already planning changes that could limit the scope of the proposal.

Colorado voters overwhelmingly approved medical aid in dying for terminal patients in 2016. The law, which only applies to people who have a prognosis of less than six months to live, has been in effect since 2018. Data from the state shows the majority of users so far have been terminal cancer patients. 

The original law came with safeguards written in, to ensure that there wouldn't be any abuse in the system. Patients must be residents of Colorado, mentally competent, and able to self administer the medication. To obtain the lethal prescription, two different doctors must sign off on the request, with at least 15 days between visits.

As introduced, Senate Bill 68 sought to increase accessibility by expanding which medical professionals can approve the process, dramatically reducing the wait time between visits and allowing out-of-state residents to participate.

But Democratic sponsor Joann Ginal plans to offer amendments Thursday to strip some of those provisions. 

“I take cautious steps. And I think that what I'm trying to do right now with this bill is to make it more available to patients, but make it safe and make sure those patients are actually the patients that are wanting to take the medication, and not being coerced,” Ginal told CPR News.

Ginal’s original bill reduced the wait time between doctor recommendations to 48 hours, but her amendment will change that to seven days. Ginal said she had her own concerns and listened to others too, who felt that a two-day window might risk people acting on impulse.

“What if you're in a lot of pain and you're just in a mood and you say, ‘I want to do this,’” said Ginal. “I am very protective of this bill. I'm very protective of patients.”

The proposal would still allow for a shorter timeline at a provider’s discretion, if they believe the patient will not otherwise survive another seven days.

Disability rights activists have long been skeptical of medical aid in dying, concerned it could be misused by the medical system or others to push people with disabilities into ending their lives. Julie Reiskin, the Co-Executive Director of the Colorado Cross-Disability Coalition, said a 48-hour window would have been far too short.

“Someone might just say, like, ‘Oh, this isn't worth it,’ but then two days later they feel better," said Reiskin. But "people are saying the 15 days is too long., so I think seven days is a fair compromise.”

Some families with loved ones who have used medical aid in dying lamented some of the changes to the bill, though.

Centennial resident Jacob Shannon, who plans to testify at the hearing, said he regrets it will no longer allow people to come to Colorado to access medical aid in dying.

His mother, a Connecticut resident with terminal ovarian cancer, went to court to challenge the law in neighboring Vermont so she could use medical aid in dying there. Her activism led Vermont to become the first state to allow non-residents to participate. Shannon’s mother died in Vermont in January.

Shannon noted that his mother had the resources and desire to push for that change, which is out of reach for many patients. He doesn’t believe access to medical aid in dying should be limited by geography. 

“I have a home here, my girls are here, my mom's granddaughters. If she could have come here, she could have been in one of her family's homes. Why didn't I have that option?” said Shannon.

However, in spite of the amendments, he still strongly backs the bill. 

“If we can slowly move this towards being more accessible to more people, then we're on the right journey. We're going in the right direction.”

One key provision will remain in the bill as introduced: an expansion of the types of healthcare providers who can approve the process. Right now it's limited to physicians. The bill would allow advanced practice nurses to also sign off and prescribe the medication.