69 end-of-life prescriptions written in Colorado's first year of program

50 received medicine of 69 scripts written

DENVER – Sixty-nine Coloradans were prescribed medication to end their lives, and 50 had their prescriptions filled, during 2017—the first year of Colorado’s medical aid in dying program.

The Colorado Department of Public Health and Environment (CDPHE) released the first annual study of the program Tuesday. Voters approved rights to end-of-life options in the state in 2016, when they passed Proposition 106 with 65 percent of the vote. The measure became the “Colorado End-of-Life Options Act” once it was written into statute.

The new law allows any “mentally-capable” adult aged 18+ with a diagnosed terminal illness that leaves them six months or less to live to receive a prescription from a licensed physician that can be taken voluntarily to end their life.

The person’s primary physician and a secondary physician both have to confirm the person has less than six months to live, and also have to deem the person mentally capable to make the decision to end their own life.

However, the CDPHE is not allowed to follow up with doctors or families about how or if the medication was used, and the law requires the person’s death certificate to list their underlying terminal condition as the cause of death. As such, there is no way of knowing whether or not the person ended their own life with the medication or if they died due to their illness.

The CDPHE says 69 people received aid-in-dying prescriptions during 2017. Among those prescribed, 50 people filled the prescriptions.

And CDPHE says that it has so far received death certificates of 56 patients who were among the 69 who received prescriptions.

People who received prescriptions had an array of conditions, including cancers, heart diseases, chronic respiratory diseases and Lou Gehrig’s disease.

Cancer patients represented the largest group who received prescriptions, at 63.8 percent. Ten percent of people prescribed had Lou Gehrig’s disease; another 10 percent had heart disease; 8.7 percent had chronic lower respiratory disease; and the other 7 percent had conditions listed as “other.”

Of the people who died (56), 30 were men and 26 were women. Eleven people were aged 85+; 17 people were aged 75-84; 16 were aged 65-74; 9 were aged 55-64; and 3 were aged 35-54. CDPHE says the youngest patient was in their early 40s and the oldest was in their mid-90s. The median age of patients prescribed was 75.

Ninety-six percent of the patients who died after receiving medication were white. Only two of the patients were not.

A majority of patients came from the Denver metro area (62.5 percent), while 25 percent came from other Front Range communities in El Paso, Larimer, Pueblo or Weld Counties.

Three-quarters of the patients died at home; nine died at a nursing home or long-term care facility; and three died somewhere else that was not specified. Ninety-three percent were under hospice care when they died.

The report says that the median time between when a prescription was written and the date of a patient's death was 13 days. The minimum amount of time between the prescription and death was zero days, while the longest was nearly three months.

The prescriptions were written by 37 different Colorado physicians, and medications were dispensed by 19 different pharmacists. Some health providers opted out of the law last year.

Three different drugs were dispensed for the patients’ end-of-life options in 2017: 21 people received Secobarbitol; 28 people received a combination drug of diazepam, digoxin, morphine sulfate and propranolol; and one person received morphine sulfate either by itself or combined with other drugs.

The report also noted that some documentation submitted by doctors or prescribers was incomplete, however, it said that “all requirements of the Colorado End-of-Life Options Act have been met, and that required documentation is complete and contained in patients’ records.”

“Efforts continue to educate physicians and other health care providers about reporting requirements,” the report says. More on the program can be found here.

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