C.R.S. § 25-48-101 Short title
25-48-101. Short title. The short title of this article is the "Colorado End-of-life Options Act".
End-of-life Options
C.R.S. tit. 25, art. 48
in effectC.R.S. § 25-48-102 Definitions
25-48-102. Definitions. As used in this article 48, unless the context otherwise requires:
(1) "Adult" means an individual who is eighteen years of age or older.
(1.5) "Advanced practice registered nurse" has the same meaning as set forth in section 12-255-104 (1).
(2) "Attending provider" means a physician or advanced practice registered nurse who has primary responsibility for the care of a terminally ill individual and the treatment of the individual's terminal illness.
(3) "Consulting provider" means a physician or advanced practice registered nurse who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding a terminally ill individual's illness.
(4) "Health-care provider" or "provider" means a person who is licensed, certified, registered, or otherwise authorized or permitted by law to administer health care or dispense medication in the ordinary course of business or practice of a profession.
(5) "Informed decision" means a decision by a mentally capable individual to request and obtain a prescription for medication pursuant to this article 48, that the qualified individual may self-administer to bring about death, after being fully informed by the attending provider and the consulting provider of:
(a) The individual's diagnosis and prognosis;
(b) The potential risks associated with taking the medication to be prescribed;
(c) The probable result of taking the medication to be prescribed;
(d) The feasible end-of-life care and treatment options for the individual's terminal disease, including comfort care, palliative care, hospice care, and pain control, and the risks and benefits of each of these options; and
(e) The individual's right to withdraw a request pursuant to this article 48 or withdraw consent for any other treatment at any time.
(6) "Licensed mental health professional" means a psychiatrist licensed under article 240 of title 12 or a psychologist licensed under part 3 of article 245 of title 12.
(7) "Medical aid-in-dying" means the practice of evaluating a request, the determining of qualification, the performing of the duties in sections 25-48-106 and 25-48-107, and the providing of a prescription to a qualified individual pursuant to this article 48.
(8) Repealed.
(9) "Medically confirmed" means a consulting provider has examined the terminally ill individual and the individual's relevant medical records and has confirmed the medical opinion of the attending provider.
(10) "Mental capacity" or "mentally capable" means that in the opinion of an individual's attending provider, consulting provider, psychiatrist, or psychologist, the individual has the ability to make and communicate an informed decision to health-care providers.
(11) "Physician" means a doctor of medicine or osteopathy licensed to practice medicine by the Colorado medical board.
(12) "Prognosis of six months or less" means a terminal illness will, within reasonable medical judgment, result in death within six months.
(13) (a) "Qualified individual" means a resident of the state who is a capable adult and who has satisfied the requirements of this article 48 in order to obtain a prescription for medication to bring about a death.
(b) An individual is not a "qualified individual" based solely on the individual's age or disability.
(14) "Resident" means an individual who is able to demonstrate residency in Colorado by providing any of the following documentation to his or her attending physician:
(a) A Colorado driver's license or identification card issued pursuant to article 2 of title 42, C.R.S.;
(b) A Colorado voter registration card or other documentation showing the individual is registered to vote in Colorado;
(c) Evidence that the individual owns or leases property in Colorado; or
ency in Colorado by providing any of the following documentation to his or her attending physician:
(a) A Colorado driver's license or identification card issued pursuant to article 2 of title 42, C.R.S.;
(b) A Colorado voter registration card or other documentation showing the individual is registered to vote in Colorado;
(c) Evidence that the individual owns or leases property in Colorado; or
(d) A Colorado income tax return for the most recent tax year.
(15) (a) "Self-administer" means when a qualified individual performs an affirmative, conscious, voluntary act to ingest medication prescribed pursuant to this article 48 to bring about the individual's death.
(b) "Self-administer" does not include administration by parenteral injection or infusion.
(16) "Terminal illness" means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death within six months.
C.R.S. § 25-48-103 Right to request medical aid-in-dying medication
25-48-103. Right to request medical aid-in-dying medication. (1) An adult resident of Colorado may make a request, in accordance with sections 25-48-104 and 25-48-112, to receive a prescription for medical aid-in-dying medication if:
(a) The individual's attending provider has diagnosed the individual with a terminal illness with a prognosis of six months or less;
(b) The individual's attending provider has determined the individual has mental capacity; and
(c) The individual has voluntarily expressed the wish to receive a prescription for medical aid-in-dying medication.
(2) The right to request medical aid-in-dying medication does not exist because of age or disability.
C.R.S. § 25-48-104 Request process - witness requirements
25-48-104. Request process - witness requirements. (1) (a) Except as provided in subsection (1)(b) of this section, in order to receive a prescription for medical aid-in-dying medication pursuant to this article 48, an individual who satisfies the requirements in section 25-48-103 must make two oral requests, separated by at least seven days, and a valid written request to the individual's attending provider.
(b) If an individual's attending provider has determined that the individual will, within reasonable medical judgment, die within forty-eight hours after making the initial oral request under this section, the individual may satisfy the requirements of this section by reiterating the oral request to the attending provider at any time after making the initial oral request.
(2) (a) To be valid, a written request for medical aid-in-dying medication must be:
(I) Substantially in the same form as set forth in section 25-48-112;
(II) Signed and dated by the individual seeking the medical aid-in-dying medication; and
(III) Witnessed by at least two individuals who, in the presence of the individual, attest to the best of their knowledge and belief that the individual is:
(A) Mentally capable;
(B) Acting voluntarily; and
(C) Not being coerced to sign the request.
(b) Of the two witnesses to the written request, at least one must not be:
(I) Related to the individual by blood, marriage, civil union, or adoption;
(II) An individual who, at the time the request is signed, is entitled, under a will or by operation of law, to any portion of the individual's estate upon his or her death; or
(III) An owner, operator, or employee of a health-care facility where the individual is receiving medical treatment or is a resident.
(c) The individual's attending or consulting provider or a person authorized as the individual's qualified power of attorney or durable medical power of attorney shall not serve as a witness to the written request.
C.R.S. § 25-48-105 Right to rescind request - requirement to offer opportunity to rescind
25-48-105. Right to rescind request - requirement to offer opportunity to rescind. (1) At any time, an individual may rescind his or her request for medical aid-in-dying medication without regard to the individual's mental state.
(2) An attending provider shall not write a prescription for medical aid-in-dying medication under this article 48 unless the attending provider offers the qualified individual an opportunity to rescind the request for the medical aid-in-dying medication.
C.R.S. § 25-48-106 Attending provider responsibilities
25-48-106. Attending provider responsibilities. (1) The attending provider shall:
(a) Make the initial determination of whether an individual requesting medical aid-in- dying medication has a terminal illness, has a prognosis of six months or less, is mentally capable, is making an informed decision, and has made the request voluntarily;
(b) Request that the individual demonstrate Colorado residency by providing documentation as described in section 25-48-102 (14);
(c) Provide care that conforms to established medical standards and accepted medical guidelines;
(d) Refer the individual to a consulting provider for medical confirmation of the diagnosis and prognosis and for a determination of whether the individual is mentally capable, making an informed decision, and acting voluntarily;
(e) Provide full, individual-centered disclosures to ensure that the individual is making an informed decision by discussing with the individual:
(I) His or her medical diagnosis and prognosis of six months or less;
(II) The feasible alternatives or additional treatment opportunities, including comfort care, palliative care, hospice care, and pain control;
(III) The potential risks associated with taking the medical aid-in-dying medication to be prescribed;
(IV) The probable result of taking the medical aid-in-dying medication to be prescribed; and
(V) The possibility that the individual can obtain the medical aid-in-dying medication but choose not to use it;
(f) Refer the individual to a licensed mental health professional pursuant to section 25-48-108 if the attending provider observes signs that the individual may not be capable of making an informed decision;
(g) Confirm that the individual's request does not arise from coercion or undue influence by another person by discussing with the individual, outside the presence of other persons, whether the individual is feeling coerced or unduly influenced by another person;
(h) Educate the individual about the importance of:
(I) Having another person present when the individual self-administers the medical aid-in-dying medication prescribed pursuant to this article;
(II) Not taking the medical aid-in-dying medication in a public place;
(III) Safe-keeping and proper disposal of unused medical aid-in-dying medication in accordance with section 25-48-120; and
(IV) Notifying the individual's next of kin or any person who plays a significant role in the individual's life, which may include a person not legally related to the individual, of the request for medical aid-in-dying medication;
(i) Inform the individual that the individual may rescind the request for medical aid-in-dying medication at any time pursuant to this article 48;
(j) Verify, immediately prior to writing the prescription for medical aid-in-dying medication, that the individual is making an informed decision;
(k) Ensure that all appropriate steps are carried out in accordance with this article before writing a prescription for medical aid-in-dying medication; and
(l) Either:
(I) Dispense medical aid-in-dying medications directly to the qualified individual, including ancillary medications intended to minimize the individual's discomfort, if the attending provider has a current drug enforcement administration certificate and complies with any applicable administrative rule; or
(II) Deliver the written prescription personally, by mail, or through authorized electronic transmission in the manner permitted under article 280 of title 12, to a licensed pharmacist, who shall dispense the medical aid-in-dying medication to the qualified individual, the attending provider, or an individual expressly designated by the qualified individual.
C.R.S. § 25-48-107 Consulting provider responsibilities
25-48-107. Consulting provider responsibilities. (1) Before an individual who is requesting medical aid-in-dying medication may receive a prescription for the medical aid-in-dying medication, a consulting provider must:
(a) Examine the individual and the individual's relevant medical records; and
(b) Confirm, in writing, to the attending provider that the individual:
(I) Has a terminal illness;
(II) Has a prognosis of six months or less;
(III) Is making an informed decision;
(IV) Is mentally capable, or provide documentation that the consulting provider has referred the individual for further evaluation in accordance with section 25-48-108; and
(V) Has requested a prescription for medical aid-in-dying medication.
C.R.S. § 25-48-108 Confirmation that individual is mentally capable - referral to mental health professional
25-48-108. Confirmation that individual is mentally capable - referral to mental health professional. (1) If either the attending provider or the consulting provider has doubts as to whether an individual is mentally capable, the provider shall refer the individual to a licensed mental health provider for determination regarding mental capability.
(2) The licensed mental health provider to whom the individual is referred pursuant to subsection (1) of this section shall submit to the requesting attending provider or the consulting provider who referred the individual a written determination of whether the individual is mentally capable.
(3) If the licensed mental health provider determines that the individual is not mentally capable, the individual is not a qualified individual and the attending provider shall not prescribe medication to the individual under this article 48.
C.R.S. § 25-48-109 Death certificate
25-48-109. Death certificate. (1) Unless otherwise prohibited by law, the attending provider or the hospice medical director shall sign the death certificate of a qualified individual who obtained and self-administered medical aid-in-dying medication.
(2) When a death has occurred in accordance with this article, the cause of death shall be listed as the underlying terminal illness and the death does not constitute grounds for post-mortem inquiry under section 30-10-606 (1), C.R.S.
C.R.S. § 25-48-110 Informed decision required
25-48-110. Informed decision required. (1) An individual with a terminal illness is not a qualified individual and may not receive a prescription for medical aid-in-dying medication unless he or she has made an informed decision.
(2) Immediately before writing a prescription for medical aid-in-dying medication under this article 48, the attending provider shall verify that the individual with a terminal illness is making an informed decision.
C.R.S. § 25-48-111 Medical record documentation requirements - reporting requirements - department compliance reviews - rules
25-48-111. Medical record documentation requirements - reporting requirements - department compliance reviews - rules. (1) The attending provider shall document in the individual's medical record the following information:
(a) Dates of all oral requests;
(b) A valid written request;
(c) The attending provider's diagnosis and prognosis, determination of mental capacity, and that the individual is making a voluntary request and an informed decision;
(d) The consulting provider's confirmation of diagnosis and prognosis, mental capacity, and that the individual is making an informed decision;
(e) If applicable, written confirmation of mental capacity from a licensed mental health professional;
(f) A notation of notification of the right to rescind a request made pursuant to this article; and
(g) A notation by the attending provider that all requirements under this article 48 have been satisfied and indicating steps taken to carry out the request, including a notation of the medical aid-in-dying medications prescribed and when.
(2) (a) The department of public health and environment shall annually review a sample of records maintained pursuant to this article to ensure compliance. The department shall adopt rules to facilitate the collection of information defined in subsection (1) of this section. Except as otherwise required by law, the information collected by the department is not a public record and is not available for public inspection. However, the department shall generate and make available to the public an annual statistical report of information collected under this subsection (2).
(b) The department shall require any health-care provider, upon dispensing a medical aid-in-dying medication pursuant to this article, to file a copy of a dispensing record with the department. The dispensing record is not a public record and is not available for public inspection.
C.R.S. § 25-48-112 Form of written request
25-48-112. Form of written request. (1) A request for medical aid-in-dying medication authorized by this article 48 must be in substantially the following form:
Request for medication to end my life
in a peaceful manner
I, am an adult of sound mind. I am suffering from , which my attending provider has determined is a terminal illness and which has been medically confirmed. I have been fully informed of my diagnosis and prognosis of six months or less, the nature of the medical aid-in-dying medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives or additional treatment opportunities, including comfort care, palliative care, hospice care, and pain control.
I request that my attending provider prescribe medical aid-in-dying medication that will end my life in a peaceful manner if I choose to take it, and I authorize my attending provider to contact any pharmacist about my request.
I understand that I have the right to rescind this request at any time.
I further understand that although most deaths occur within three hours, my death may take longer, and my attending provider has counseled me about this possibility. I make this request voluntarily, without reservation, and without being coerced, and I accept full responsibility for my actions.
Signed:
Dated:
Declaration of witnesses
We declare that the individual signing this request:
Is personally known to us or has provided proof of identity;
Signed this request in our presence;
Appears to be of sound mind and not under duress, coercion, or undue influence; and
I am not the attending provider for the individual.
witness 1/date
witness 2/date
Note: Of the two witnesses to the written request, at least one must not:
Be a relative (by blood, marriage, civil union, or adoption) of the individual signing this request; be entitled to any portion of the individual's estate upon death; or own, operate, or be employed at a health-care facility where the individual is a patient or resident.
And neither the individual's attending or consulting provider nor a person authorized as the individual's qualified power of attorney or durable medical power of attorney shall serve as a witness to the written request.
C.R.S. § 25-48-113 Standard of care
25-48-113. Standard of care. (1) Physicians and health-care providers shall provide medical services under this act that meet or exceed the standard of care for end-of-life medical care.
(2) If a health-care provider is unable or unwilling to carry out an eligible individual's request and the individual transfers care to a new health-care provider, the health-care provider shall coordinate transfer of the individual's medical records to a new health-care provider.
C.R.S. § 25-48-114 Effect on wills, contracts, and statutes
25-48-114. Effect on wills, contracts, and statutes. (1) A provision in a contract, will, or other agreement, whether written or oral, that would affect whether an individual may make or rescind a request for medical aid in dying pursuant to this article is invalid.
(2) An obligation owing under any currently existing contract must not be conditioned upon, or affected by, an individual's act of making or rescinding a request for medical aid-in-dying medication pursuant to this article.
C.R.S. § 25-48-115 Insurance or annuity policies
25-48-115. Insurance or annuity policies. (1) The sale, procurement, or issuance of, or the rate charged for, any life, health, or accident insurance or annuity policy must not be conditioned upon, or affected by, an individual's act of making or rescinding a request for medical aid-in-dying medication in accordance with this article.
(2) A qualified individual's act of self-administering medical aid-in-dying medication pursuant to this article does not affect a life, health, or accident insurance or annuity policy.
(3) An insurer shall not deny or otherwise alter health-care benefits available under a policy of sickness and accident insurance to an individual with a terminal illness who is covered under the policy, based on whether or not the individual makes a request pursuant to this article.
(4) An individual with a terminal illness who is a member of medical assistance under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5, shall not be denied benefits under the medical assistance program or have the member's benefits under the program otherwise altered based on whether or not the member makes a request pursuant to this article 48.
C.R.S. § 25-48-116 Immunity for actions in good faith - prohibition against reprisals
25-48-116. Immunity for actions in good faith - prohibition against reprisals. (1) A person is not subject to civil or criminal liability or professional disciplinary action for acting in good faith under this article, which includes being present when a qualified individual self-administers the prescribed medical aid-in-dying medication.
(2) Except as provided for in section 25-48-118, a health-care provider or professional organization or association shall not subject an individual to any of the following for participating or refusing to participate in good-faith compliance under this article:
(a) Censure;
(b) Discipline;
(c) Suspension;
(d) Loss of license, privileges, or membership; or
(e) Any other penalty.
(3) A request by an individual for, or the provision by an attending provider of, medical aid-in-dying medication in good faith compliance with this article 48 does not:
(a) Constitute neglect or elder abuse for any purpose of law; or
(b) Provide the basis for the appointment of a guardian or conservator.
(4) This section does not limit civil or criminal liability for negligence, recklessness, or intentional misconduct.
C.R.S. § 25-48-117 No duty to prescribe or dispense
25-48-117. No duty to prescribe or dispense. (1) A health-care provider may choose whether to participate in providing medical aid-in-dying medication to an individual in accordance with this article.
(2) If a health-care provider is unable or unwilling to carry out an individual's request for medical aid-in-dying medication made in accordance with this article 48, the provider shall inform the individual of the provider's inability or unwillingness.
(3) If the individual transfers the individual's care to a new health-care provider, the prior health-care provider shall transfer, upon request, a copy of the individual's relevant medical records to the new health-care provider.
C.R.S. § 25-48-118 Health-care facility permissible prohibitions - notice to the public - sanctions if provider violates policy
25-48-118. Health-care facility permissible prohibitions - notice to the public - sanctions if provider violates policy. (1) A health-care facility may prohibit a provider employed or under contract from writing a prescription for medical aid-in-dying medication for a qualified individual who intends to use the medical aid-in-dying medication on the facility's premises. The health-care facility must notify the providers and staff at the time of hiring, contracting with, or privileging and on a yearly basis thereafter in writing of its policy with regard to prescriptions for medical aid-in-dying medication. A health-care facility that fails to provide explicit advance notice to the providers and staff shall not enforce such a policy.
(2) A health-care facility or health-care provider shall not subject a physician, nurse, pharmacist, or other person to discipline, suspension, loss of license or privileges, or any other penalty or sanction for actions taken in good-faith reliance on this article or for refusing to act under this article.
(2.5) A health-care facility shall not prohibit a provider from providing information to an individual regarding the individual's health status, including diagnosis, prognosis, recommended treatment, and treatment alternatives, including the risks and benefits of the recommended treatment and each treatment alternative.
(2.7) A health facility that is a covered entity, as defined in section 25-58-103 (1), shall comply with section 25-58-105 (3) and rules promulgated pursuant to section 25-58-105 regarding the facility's availability of end-of-life health-care services.
(3) A health-care facility must notify patients in writing of its policy with regard to medical aid-in-dying. A health-care facility that fails to provide advance notification to patients shall not be entitled to enforce such a policy.
C.R.S. § 25-48-119 Liabilities
25-48-119. Liabilities. (1) A person commits a class 2 felony and is subject to punishment in accordance with section 18-1.3-401, C.R.S. if the person, knowingly or intentionally causes an individual's death by:
(a) Forging or altering a request for medical aid-in-dying medication to end an individual's life without the individual's authorization; or
(b) Concealing or destroying a rescission of a request for medical aid-in-dying medication.
(2) A person commits a class 2 felony and is subject to punishment in accordance with section 18-1.3-401, C.R.S. if the person knowingly or intentionally coerces or exerts undue influence on an individual with a terminal illness to:
(a) Request medical aid-in-dying medication for the purpose of ending the terminally ill individual's life; or
(b) Destroy a rescission of a request for medical aid-in-dying medication.
(3) Nothing in this article limits further liability for civil damages resulting from other negligent conduct or intentional misconduct by any person.
(4) The penalties specified in this article do not preclude criminal penalties applicable under the "Colorado Criminal Code", title 18, C.R.S., for conduct that is inconsistent with this article.
C.R.S. § 25-48-120 Safe disposal of unused medical aid-in-dying medications
25-48-120. Safe disposal of unused medical aid-in-dying medications. (1) A person who has custody or control of medical aid-in-dying medication dispensed under this article 48 after a terminally ill individual's death shall dispose of the unused medical aid-in-dying medication either by:
(a) Returning the unused medical aid-in-dying medication to the attending provider who prescribed the medical aid-in-dying medication, who shall dispose of the unused medical aid-in-dying medication in the manner required by law; or
(b) Lawful means in accordance with section 25-15-328, or any other state or federally approved medication take-back program authorized under the federal "Secure and Responsible Drug Disposal Act of 2010", Pub.L. 111-273, and regulations adopted pursuant to the federal act.
C.R.S. § 25-48-121 Actions complying with article not a crime
25-48-121. Actions complying with article not a crime. Nothing in this article 48 authorizes a provider or any other person to end an individual's life by lethal injection, mercy killing, or euthanasia. Actions taken in accordance with this article 48 do not, for any purpose, constitute suicide, assisted suicide, mercy killing, homicide, or elder abuse under the "Colorado Criminal Code", as set forth in title 18.
C.R.S. § 25-48-122 Claims by government entity for costs
25-48-122. Claims by government entity for costs. A government entity that incurs costs resulting from self-administration of medication prescribed under this article 48 in a public place has a claim against the estate of the individual to recover the costs and reasonable attorney fees related to enforcing the claim.
C.R.S. § 25-48-123 No effect on advance medical directives
25-48-123. No effect on advance medical directives. Nothing in this article shall change the legal effect of:
(1) A declaration made under article 18 of title 15, C.R.S., directing that life-sustaining procedures be withheld or withdrawn;
(2) A cardiopulmonary resuscitation directive executed under article 18.6 of title 15, C.R.S.; or
(3) An advance medical directive executed under article 18.7 of title 15, C.R.S.
C.R.S. § 25-48-124 Severability
25-48-124. Severability. If any part of this article 48 is found to be in conflict with federal requirements that are a prescribed condition for receipt of federal funds, the conflicting part of this section is inoperative solely to the extent of the conflict, and the conflict does not affect the operation of the remainder of this article 48.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-25.docxFetched: 10/6/2026