The bill also adds registered nurses to the list of who can prescribe the drugs.
The Colorado legislature is poised to pass a bill that halves the waiting period for the terminally ill to request and receive drugs to speed their death, and adds advanced-practice registered nurses (APRNs) to physicians on the list of who can prescribe the drugs.
The bill passed the state senate 24–11 last month, emerging with several amendments agreed to by opponents, and now heads to the Democrat-dominated house of representatives.
The house Health & Human Services committee on Tuesday referred the bill, ‘Medical Aid in Dying,’ to the whole house on a party-line 9–4 vote. Three amendments, one requiring depression screening of all potential suicides, failed prior to the committee’s final vote.
“The governor’s office has been monitoring SB24-068 as it moves through the legislative process and will evaluate the final version if it reaches the governor’s desk,” Governor Jared Polis’s press secretary said in a statement.
While Polis remains publicly noncommittal, the bill is all but guaranteed to become law. And while opponents secured some safeguards, Colorado will likely join other progressive states in moving incrementally toward state-sanctioned suicide on demand
Gateway Laws
State senator Joann Ginal co-sponsored the bill with fellow Democrat Representative Kyle Brown. Dr. Ginal has been a general-assembly force for physician-assisted suicide since 2015 and 2016, when she introduced bills in the house to expand the practice, both of which failed.
Proponents instead pushed Proposition 106 statewide in 2016; it won with 65 percent of the vote.
Current law, established by 106, lets doctors prescribe drugs that kill, after written and verbal requests, to Colorado residents, provided they’re not suffering from dementia and have fewer than six months to live. There’s a 15-day waiting period.
The new bill cuts the waiting time to seven days — proponents originally sought just 48 hours — and lets APRNs prescribe the drugs. Life-insurance benefits can’t be denied; patients also get information on hospice care and pain control.
An attempt to rescind the residency requirement was removed. Patients self-administer drugs, typically one of two types of four-drug mash-ups.
Ginal sought changes to “expand the number of practitioners who can help the patient” as “there aren’t that many docs who actually do this.” A shorter wait-time went in because “people were dying between requests.”
Brown couldn’t be reached, nor could house minority whip Richard Holtorf.
Whose Compassion
Dr. Tom Perille, president of the Colorado chapter of Democrats for Life of America, agreed “compassion for suffering people was the motivation” for Proposition 106 and the current bill, but said it’s badly deployed.
“I understand the sentiment — wanting to direct things when you have very little sense of control,” the retired M.D. told National Review. Physician-assisted suicide “gives some sense of control, but ignores community, solidarity, interdependence; these are fundamental to a thriving state.”
Julie Reiskin, co-executive director, with Hillary Jorgensen, of the Colorado Cross-Disability Coalition, which is neutral on the bill, said it fought the two-day waiting period — “you can’t get a driver’s license that fast.”
She wants more focus on the psychological and physical pain that can contribute to a desire to die.
“When I learned I had [multiple sclerosis] I was horrified,” she said. “I thought being disabled was worse than death. It turned out not to be.”
The bill “continues to erode the relationships between patients and providers,” said Brittany Vessely, executive director of Colorado Catholic Conference.
CCC “secured conscience protections for practitioners and hospitals” and helped change the original bill’s two-day waiting period to seven.
“It’s still a bad bill,” she said. “A die-quicker bill.”
Good Fences
What these groups want now are expanded safeguards.
Perille wants a stronger mental-health component, requiring screening for anyone who requests the drugs, as with now-routine checks for depression and anxiety in general-practitioner settings.
“It’s preposterous to think people are able to make this kind of decision,” so quickly.
He also wants more surveying of patients and random review of cases for compliance with the law.
Reiskin, of the disability group, wants pain treated more fully before people decide to kill themselves.
“They’re committing suicide for pain, not disease,” she said. “Let’s make sure people get their pain treated.”
Vessely has begun work with a coalition of groups aiming at deeper changes.
“A broader cultural movement has to happen,” she said. “The only thing that will win Colorado back is a wider campaign.”
“We put up guardrails,” Senator Ginal said. “It’s been working.”
But the guardrails of today are the burdens of tomorrow: In California, progressives have introduced legislation to do away with a requirement in existing law that patients be diagnosed as terminally ill before becoming eligible for physician-assisted suicide.
Canada, too, has seen steady erosion from an idea pitched as a solution to the most dire cases of terminal illness to a catch-all response to myriad ailments including, for instance, depression.
Already, major players in the physician-assisted suicide movement, such as the group Compassion & Choices, are saying current Colorado law, which it helped enact via Prop. 106, includes “unnecessary regulatory requirements.”
Compassion & Choices declined an interview request.
Talking Tuesday
SB24-068 is expected to be passed in a final house vote in the coming week and signed into law shortly thereafter.
“This will go through,” Colorado Catholic’s Vessely said.
Democrats hold a two-thirds super-majority in the house and are one vote from the same in the senate. And Colorado is likely to see another bill — the return of two-day waits and no residency requirements — in a few years.
“It seems so long ago, but it wasn’t,” Senator Ginal said of the 2016 proposition that started everything. “I think it’s great to do gradual changes . . . as medicine changes, as we as a society change. I think in the future we’ll have more things to add.”