After a lot of soul-searching, we are asking voters to reject Proposition 106, a measure that would give patients the legal right to end their life, because we fear the cultural, legal and medical shift that it would create in Colorado.
Those facing their final months are in a vulnerable place, a time when an individual is susceptible to pressures both subtle and overt, susceptible to self-imposed guilt over burdening family and worries about spending hard-earned savings on care. Such patients also are susceptible to depression and its dark influences on decision-making.
The Denver Post editorial board has in the past supported proposed legislation that would have allowed doctors to prescribe life-ending drugs to patients with six months or less to live. We came down on the side of personal liberty before the bill failed in 2015.
But we worry the present measure fails to include specific reporting requirements for what must be reported similar too the way in which Oregon has enacted its rules for the law that Colorado’s initiative draws from, and that Proposition 106 would entice insurers to drop expensive treatments for terminal patients even when medical advances might add months or years more to a life that a patient may wish to take.
We don’t have unfettered faith in all doctors’ ability to handle that responsibility.
There are safeguards in place to guard against overt pressures. Two doctors must confirm the terminal diagnosis, attest to the patient’s soundness of mind and hear two verbal requests and witness one written request for the fatal drugs.
In Oregon, where an aid-in-dying law has been legal for 19 years, 1,545 people have been prescribed the drugs and 991 patients have died from ingesting them. The Oregon Health Authority is required to track basic statistics about those who die, but the agency also surveys physicians who prescribed life-ending drugs about the patients after they have ingested the drug.
The Oregon studies show that historically only 22.6 percent of those who committed suicide listed “inadequate pain control or concern about it” as a primary end-of-life concern. But almost 91 percent said losing autonomy was a concern; 88 percent said being less able to engage in activities making life enjoyable; and 83 percent said a loss of dignity. Doctors were able to select multiple end-of-life concerns per patient.
We worry that the top reasons physicians give for a patient ending a life are easily influenced by those around them and by the care they receive in their final days.
Also concerning is that there is no requirement in the proposition to report or track Colorado’s program like there is in Oregon. So what little we do know about the experience in Oregon would not be known in Colorado.
As for a reporting requirement, Proposition 106 does require an annual statistical report, similar to language in Oregon’s Death with Dignity statute. The level of detailed statistics that are being collected in Oregon include demographic information about who is using the program and reasons why. Proponents note that Oregon’s reporting rules were crafted after the law’s passage by a rules-making body. Should the measure pass in Colorado, we hope the state would promulgate a robust data reporting system that goes beyond even what Oregon is accomplishing.
In the end, despite our desire to support an individual’s right to make this decision, we cannot support a law that would so easily open an irreversible door.
Editor’s note: This version has been updated to clarify information about Oregon’s reporting process.