Aspen Valley Hospital to decide whether to opt in or out as end-of-life facility at special meeting Monday, Dec. 19
Eligibility requirements under Prop 106
Under Proposition 106, called the “Colorado End-of-Life Options Act,” terminally ill Colorado residents can request medication from their physician. The patients must self-administer the medication.
Eligibility requirements include:
• Must be a Colorado resident aged 18 or older;
• be able to make and communicate an informed decision to health care providers;
• have a terminal illness with a prognosis of six months or less to live (terminally ill) that has been confirmed by two physicians, including the individual’s primary physician and a second, consulting physician;
• be determined mentally capable by two physicians, who have concluded that the individual understands the consequences of his or her decision; and
• voluntarily express his or her wish to receive the medication.
Aspen Valley Hospital’s board of directors will decide at a special meeting Monday, Dec. 19, whether to opt in or out of the state’s End of Life Options law that voters approved in November and Gov. John Hickenlooper signed into law Friday.
The law took effect immediately with Hickenlooper’s signature, meaning the Aspen hospital board must determine whether it will be a venue for self-medicated deaths by terminally ill Coloradans who have no more than six months to live.
Aspen Valley Hospital CEO David Ressler said Friday he will recommend to the board, whose meeting is scheduled for 5 p.m. at the facility’s conference room, to opt out as a venue for adults wanting to end their lives.
He said he respects the will of the voters — by a 2-1 margin, more than 1.7 Coloradans voted in favor of Proposition 106, while in Pitkin County, 8,565 voters, or 85.5 percent of the ballots cast, supported the measure. Even so, Ressler said he is more inclined for the hospital to take a wait-and-see approach by initially opting out, but possibly opting in at a later date.
“We’re not ready,” he said. “And we don’t want to opt in until such a time that we are going to be able to provide the appropriate experience for the patient and their family.”
Ressler said he has had discussions about the issue with both hospital physicians and Hospice of the Valley in Glenwood Springs.
The Aspen hospital’s medical staff stands on the side of honoring the community’s vote. However, individual physicians are not required to prescribe the medications or sign a death certificate if it goes against their cultural values or religious beliefs, Ressler told the board at its regular monthly meeting Dec. 12.
Under the law, patients are required to verbally request the mediations from two different doctors at least 15 days a part. Also, patients, not doctors, would have to administer the barbiturate-based medication, the most common form of end-of-life drug.
Historically speaking, hospitals also aren’t known as venues for terminally ill patients to end their lives in states that allow them to. Colorado is among five states — California, Oregon, Washington and Vermont, as well as Washington, D.C. — that have laws on the books allowing the procedure.
Oregon individuals typically exercise the law, called “Death With Dignity,” at home, according to the Death With Dignity website.
“Most people, about 90 percent, choose to take the medications at home; those who reside in assisted-living or nursing home facilities tend to take them there,” it says.
Ressler noted that since the law was enacted in Oregon on Oct. 27, 1997, just one individual used a hospital to end the person’s life.
“Looking at the states that have implemented similar statues … indicates the patients opting to have an end of-life-option in a hospital is extraordinarily rare,” he told the board last week.
Markey Butler, the executive director of Hospice in the Valley, said most terminally patients suffer from Lou Gehrig’s Disease, lung cancer and chronic obstructive pulmonary disease, which makes breathing difficult.
Butler said she has spoken to area hospital officials and doctors about Proposition 106.
“Some physicians told me they don’t want to sign the death certificate, that they don’t want to be near this, and we have to honor that,” she said.
The hospice could serve as a venue for end-of-life procedures if a hospital or the Shaw Regional Cancer Center in Vail would recommend that patients go there to die. However, Hospice in the Valley has yet to create its own policy on Proposition 106. Markey said she is planning to hold a meeting with area health-care providers within the next few weeks, and noted that most patients who don’t wish to die at home would consider hospice over a hospital.
“We will encounter those individuals seeking assisted aid in death, and most of those will be at hospice,” she said.
“If the hospice decided that they’re not getting to the point that they are comfortable with this process, then that would be a significant issue for us,” Ressler said. “For us, we would not have a partner to work with.”