In La Plata County, 74 percent voted yes; in far more conservative Montezuma County, 59 percent favored it. Clearly, many Colorado voters want the option to manage the end of their own lives.
Since then, health-care organizations — including Centura Health, which operates Mercy Medical Center in Durango and its clinics, and Southwest Health System in Cortez, which operates Southwest Memorial Hospital and associated clinics — have opted not to provide aid-in-dying services.
The measure allows physicians, nurses and pharmacists to opt out of participation. Health-care organizations can prohibit the practice on their premises, a major issue in communities where one system owns most physician practices. Although the law specifically states that health systems can’t prohibit physician employees from writing prescriptions for life-ending medications to be taken off-site, that provision is being challenged by religiously affiliated hospitals.
Providers cite various reasons for not wanting to participate. Some (including Centura, which is jointly operated by Catholic Health Initiatives and Adventist Health System) oppose assisted suicide as inconsistent with their religious and moral values. Others are concerned with fraud, coercion and the potential to be embroiled in lawsuits. Some just want more time to figure out how the provision of aid-in-dying counseling and prescriptions might work before they decide whether to offer such services.
Openly acting to cause death is a change for professionals and organizations whose mission has been to heal, although there are many steps along the continuum between prolonging life and hastening death. A Colorado Medical Society survey of its membership earlier this year found that 56 percent of doctors were in favor of medical aid in dying, while 35 percent were opposed or strongly opposed, the Denver Post reported.
Many Coloradans can envision a time when they might want this service; many medical professionals are reluctant to provide it. So what will give?
One possibility is that an industry will arise similar to the one created by the medical marijuana law: physicians who have no previous relationship with these patients will rubber-stamp requests and provide prescriptions for a hefty price. That’s far from optimal, but it would provide patients with access to aid in dying.
Two scenarios are more attractive, both with structures more in line with what the creators of the law envisioned. One is that organizations will be created specifically for this purpose; the other is that hospices and similar providers will offer such assistance. Neither is as helpful as an ongoing, long-term relationship with a physician whom a patient trusts to provide truthful information and honest guidance about end-of-life choices. Either would be far better than nothing for terminally ill individuals who experience agonizing pain and no hope for improvement.
Right now, proponents are developing websites and hotlines to provide information and support to physicians and pharmacists, and to connect patients with providers who will provide aid-in-dying services. That may be the best that can be done while Colorado works through the issues involved in openly aiding those who want to end their lives.
This impasse won’t last forever — the market will equalize — but until then, Coloradans have uneven access to services they thought they were voting to make available, and that’s the last thing some of them need.
