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Colorado Voters Accept Right-To-Die Measure (npr.org)
150 points by happy-go-lucky on Nov 10, 2016 | hide | past | favorite | 65 comments



Colorado resident here. A few years back, I watched my wife die of cancer, in great pain, and with many other associated problems. She tried to find a doctor who could give her the option to end things, should she no longer be able to stand it, but none were able to help her.

I voted yes. Forcing people to live through that is beyond cruel.


The Right To Die is an often ignored but important law for the exact reasons you listed. It's something you don't think you need until you absolutely do need it.

These Frontline Documentaries are very explanatory for those who want to know more :

http://www.pbs.org/wgbh/frontline/film/suicide-plan/

https://www.pbs.org/wgbh/pages/frontline/suicidetourist/

http://www.pbs.org/wgbh/pages/frontline/facing-death/

http://www.pbs.org/wgbh/frontline/film/being-mortal/


Jesus, that's a horrible story. I'm very sorry you had to go through that ... holy hell.


I am so sorry for your loss. Thank you for voting yes.


Fellow Colorado voter - really happy I voted on this, for your wife and for death with dignity.


> The measure requires that people "make two oral requests, separated by at least fifteen days, and a valid written request to his or her attending physician." It also requires that people be capable of taking the medication unassisted

Why the last requirement? Seems to me like a lot of terminally ill patients wanting to die might not be self-sufficient


My dad is in the early stages of dementia and has repeatedly said he'd prefer to die than live on as a husk of a human.

Interestingly, he's got one of the weird dementias, called "primary progressive aphasia", which is slowly robbing him of the ability to speak. There are cognitive deficits as well, but the main issue is that he has trouble formulating sentences. So if we lived in Colorado, when he actually wanted to die, he would be unable to fulfill these requirements.

Also interestingly, part of his motivation is explicitly monetary: he wants his life savings to go to his family, not a nursing home.

This experience has reaffirmed my position in favor of right-to-die, but it really is a complex issue. If gran-gran doesn't want to go to the gas chamber, there should be stringent protections in place to keep her family from sending her there.


>"Also interestingly, part of his motivation is explicitly monetary: he wants his life savings to go to his family, not a nursing home."

That sentiment may seem strange to most people but I think it's more than just a logical conclusion, it's an emotional one as well.

We recently lost one of our family's matriarch's (grandmother-in-law) after her long battle with a failing cardiovascular system. After one particularly difficult evening, she realized her time was about to come and asked her husband to stay by her side while she passed in their home. Unfortunately, her end did not come easily and a relative convinced my grandfather-in-law to call an ambulance when she went into respiratory arrest as it was shockingly painful to watch. She was taken to the hospital and placed in the ICU where she was stabilized but only at the footstep of death's door. The miracles of modern medicine managed to keep her borderline comatose body alive for almost a month in the ICU before the family could come to agreement on sending her to hospice.

That month in the ICU cost almost everything they had worked their entire lives for and was intended to be passed down to their children and grandchildren. Two lifetime's worth of hard work and thoughtful planning went to cover the cost of just one last month of "life".

My point in sharing that story is that the true cost of that month isn't measured in dollars and cents, it's measured in the loss of the legacy they had worked so hard to build. Neither of them viewed their estate as something as simple as "money". Instead they saw it as things like "college tuition for the grandchildren", "a wedding gift to help the grandkids start their married life", "land my ancestors have lived on for generations", and "one last vacation for the whole family". That's what I mean when I saw they lost their legacy and why it's as much or more of an emotional decision than a cold calculation of financial realities.


While I am absolutely in favor of "right to die" laws, there are already tools in place to cover situations like those of your grandmother-in-law. If someone does not want to be kept alive artificially, they should obtain a Do Not Resuscitate order[1]. This serves as an expression of the patient's wishes, and would supersede the relative who wanted the ambulance called.

[1] https://en.wikipedia.org/wiki/Do_not_resuscitate


When you consider situations like this, it makes total sense why hospitals would have every incentive to fight for "the right to life" and "foster a culture of life" and oppose right-to-die / assisted suicide.


While I can't speak for "hospitals". I can tell you that doctors are very much in favor of "do not resuscitate" directives, which would have prevented the scenario described above.


> So if we lived in Colorado, when he actually wanted to die, he would be unable to fulfill these requirements.

Colorado's law is fairly specific to those that are imminently terminal (6 months or less), so most forms of dementia do not qualify.

I'm terribly sorry for what your father, your family, and you are going through. I wish I had some words of comfort, but really there is nothing good about where dementia will take him or your family.

I went through a fairly similar experience with my father who had PSP (Progressive Supranuclear Palsy - http://www.psp.org/). Early on in the disease he was aware of his mental decline and expressed a desire to end his own life. Everyone was concerned and the doctors ended up putting him on antidepressants. If only we had known how bad things would get...

There are many forms of dementia, and nearly all of them involve a horrible quality of life at the end.

My brothers and I joke about taking up skydiving in our retirement and packing our own parachutes. If our mental acuity declines to the point where we pack the chute wrong, then at least it would be a quick end.


interesting. makes me wonder if he were to write it out on paper would that still be ok? since i'd say the spirit of that requirement is the person is still able to express their desire unambiguously


My concern there - what if he changes his mind and is unable to communicate it? I happen to know the guy pretty well, and this is a decades-old position that I seriously doubt will change, but "take my word for it" isn't a really compelling burden of proof.


I don't think people change their mind on this kind of decision. For example, I could list in the document (written when healthy) that if I am unable to clearly communicate my wishes either verbally, by blinking, or whatever, maybe for more than X days, then I prefer to err on the side of dying.

A big advantage of having this written (and binding!) is that it takes the burden off of family to make the decision. Many people cannot make this kind of decision for others when they are incapacitated.


I understand that the dying process is unfamiliar territory and none of us know how we're going to go or what the path will be like.

My father died a couple years ago after a long decline. He would have passed the verbal request criteria, but he had a long history of saying unambiguously that he did not want extraordinary measures to prolong his life, and he consistently refused medications and medical care in the last 10 years of his life.

However, hearing him say things like "If I knew how to end this, I would" was one of the hardest things I've ever heard, because he was not the type to give up.

In the end, he declined rapidly in the course of a couple weeks and passed away on his own. There's some peace to knowing that even though it was a really hard road, he went out basically the way he wanted - without being plugged into a bunch of machines, without medications, in his own time and his own bed.

I'm glad we didn't indulge his last minute desires for the easy way out. I really hope Coloradoans will make good decisions, but I know that sometimes they won't.


Presumably it's to stop people "helping" their elderly relatives who, perhaps, have a nice big house or millions of pounds.


I've spent way too much time in assisted living homes the last 5 years. There aren't that many of the rich elderly people. More likely their families want to avoid paying thousands of dollars a month in care costs.


> More likely their families want to avoid paying thousands of dollars a month in care costs.

Is killing the elderly in order to save a lot of money much more moral than killing them in order to inherit a lot of money?


Normally debts don't get inherited without consent.

This, is more about shifting this debt to the kids or kicking them out of the facility. Further, they are not going to get 'better' the facility's are focused on keeping patents alive to extract as much money from the family as possible not because the elderly actually want to suffer as long as possible or necessarily benefit from the care.

PS: Funeral homes are also setup to prey on people suffering a loss. It's a sick business.


Is it moral that they're just humans that got sick, and they are burdened to pay the ridiculous cost of care that they don't want?


Based on how often that happens, as opposed to people in pain who want to die but aren't able to take their own medication, I'm willing to risk that happening. Being forced to stay alive in pain is every bit as bad as being forced to die.


Murder is still considered worse than torture by most people, so it's appropriate that our laws reflect that.


Given that the choice is between "torture leading to death" and "death", our laws are wrong.


If the first 2 requirements have been met, clarifying the intent of the person wanting to die, then surely the physical assistance at this point shouldn't be an issue in that situation?


Coercion isn't unknown. Although the two oral requests would probably help to avoid that a little bit.


so are those requests being done while limiting who can be on hand to witness? I would expect a member of the hospital, state representative, and their doctor, would be sufficient. Having a family member on hand might be detrimental unless they ask for them separately


Maybe it is to protect the people who might be administering the medication from criminal and/or civil litigation?


>Why the last requirement?

Why the oral requests? Are signers of ASL not able to take their life under this requirement? Would a terminal patient that had their vocal cords or tongue removed not be able to make the requests?


I guess legalizing actually poisoning somebody is just a step further than legalizing selling a poison.


I agree... all these prescription drugs are a huge problem for our society.


I'm being downvoted despite what seems like a straightforward and reasonable comment, and I don't understand your response at all (is it sincere or sarcastic?). I wonder if I'm being misinterpreted somehow.

The Right to Die is a controversial and emotive topic, so legislation is likely to be a gradual process. Colorado's voted to legalize one aspect, the sale of life-ending medication. Legalizing physically administering it would require a different measure, which may or may not happen at some later point.


The downvotes (not by me, BTW) are for using emotive language that criticizes by implication without advancing an actual argument.

Consider this description of veterinary euthanasia: "I guess that legalizing poisoning pets was a natural outcome of allowing vets to buy poisons." If you used that language I think that most people would infer that you strongly object to veterinary euthanasia, but you haven't made an argument why it should be illegal to hasten the end.


Thanks for the explanation. I thought I was just speaking plainly. I am in favour of the right to die (subject to details obviously).


I misunderstood what you wrote as a reference to the last major libertarian/progressive agenda piece that Colorado legalized, which is sometimes (with weak justification) characterized as legal poison. Not my downvote, but it's possible others had the same response.


Ah, total cross purposes. Not what I meant at all.


I'm a CO resident, and I was honestly astounded that the measure passed with such a wide margin. I don't think people read or understood the measure. CO generally has a big libertarian streak (we're one of the states Gary Johnson did best in). I'm guessing the measure won on the strength of the name alone and not the merits of the actual law.

Now the usual suspects lined up against it, and that's who NPR interviewed: the Christian right out of Colorado Springs. However, I saw more opposition to this in my middle class gentrified neighborhood than I saw support or opposition for any measure, except maybe the tax measure to support the cultural district. This neighborhood is anything but conservative and this is one of the rare cases where seeing signs on the neighbors' lawns made me look deeper and actually change my vote from the reflexive "yes" to a "no".

The good news out of this election is that Prop 107 passed, which makes it harder to get constitutional amendments on the ballot. One of the things I dislike about living here is how the state is used as a political laboratory for everybody's pet poli sci project.


I voted yes on Prop 106. Can you explain your reasoning for voting no? It didn't seem like there was anything hidden inside the measure.

I think you mean Prop 71 instead of 107. I voted no on Prop 71. I like the idea in principle but didn't like the requirement to gather signatures from all districts.


Colorado resident as well and I voted yes on 107 as well, I couldn't find anything hidden but would really like to know if I had missed something about it.


My issue with it was that it squeezed the wrong end of the amendment "funnel". It makes it harder to propose amendments. I don't remember a frivolous amendment being proposed.

Instead, i would have preferred to see a bill making it harder to pass amendments, moving it to 60% or something similar. That said, a lot of the progress the state has had would have failed under either requirement. Min wage increase, end of life, recreational pot, etc.

I have never said to myself "wow, we propose and pass a lot of amendments that should never have seen the ballot in the first place". And if we did, i want to see the ideas. Keep proposing easy and make them need more voter backing to pass.


Amendment 71 also made it harder to pass amendments: the threshold is now 55%. The only exception is for amendments that repeal things from the constitution, for which the threshold is still 50%

Details: https://ballotpedia.org/Colorado_Imposition_of_Distribution_...


Yes. Prop 107 was to allow unaffiliated voters the opportunity to vote in primaries. Amendment 71 was the vote that would make it more difficult to amend the Colorado Constitution.

My understanding is that 71 won't restrict propositions or ballot initiatives. I read 71 as specifically restricting future amendments.


I'm a Coloradan and this doesn't jive with my experience. I wasn't surprised it passed. We believe in personal freedoms here, and there is perhaps no greater personal freedom than the right to choose to die with dignity.


I think you missed my point. The point is that CO is extremely libertarian, but I was seeing resistance from areas that surprised me. Liberal urban enclaves I would expect to see embracing 106 were actually fighting it.


Don't know about America, but in Australia I know it's had overwhelming public support for decades but politicians still won't go near it.


Care to share what you saw when you looked deeper?


I support the notion of right to die, but the language of this measure is pretty ambiguous with regards to the patient rescinding the request.

I think it leaves the door pretty far open for someone to claim that a person who has made the request is rescinding it when they in fact are not. The language of the measure says that the patient can (paraphrasing) "rescind by any means" their request.

I appreciate that nobody wants to put someone to death if they changed their mind, but I wish the language wasn't so wide open.


https://ballotpedia.org/Colorado_End_of_Life_Options_Act,_Pr...

As I read it, the patient must self-administer the medication.


I worry that "right to die" can devolve into "it's the right time for you to die".


It's certainly a concern, deserving of thought and safeguards, but not a reason not to do it. Any more than "the right to have an abortion" devolving into "you need to have an abortion" is a good reason to ban abortion.

(I actually see this as a very close parallel.)


Couldn't come at a sooner time.


True of every happening in this space-time continuum, no?


I think Right-to-die laws increases the pressure on the person to commit suicide, especially in the case of those who want to die to preserve or transfer their life-savings. It does not provide protection to an individual who may want to live. Right-to-die laws were primarily conceived to alleviate pain, but it is sad if it would be used for monetary reasons.


> especially in the case of those who want to die to preserve or transfer their life-savings

I don't know about you, but I think that that is a valid reason for someone to want to control when they die.


I thought that was something that one can do by putting things in a trust? If it's not your money anymore, what prevents you from passing it on?


Trusts don't protect you and your heirs from the cost of long term care and end of life treatments. I suppose you could put all your wealth in a trust and claim poverty/declare bankruptcy, but that's a very dickish thing to do with respect to society, not to mention your caretakers, and it isn't a widely practical solution.


Personally, I am not at all worried about being forced into suicide, but I am quite worried about being forced to live in tremendous pain with a terminal disease. Same for friends and family. I understand the worries, but they seem rather unlikely compared to the common reality of long, painful deaths.


That's an insightful unintended consequence that I too can unfortunately see playing out all to often. Still, the individual would have to choose suicide, right? They may have pressure on them for the choice from vultures, but it is still their choice.

Unless I'm mistaken, I don't see the need for any protection.


Technically it is their choice. But it's easy to imagine coercion. I can only imagine the state someone is in if this is an option for them - they might not be strong enough emotionally to stand up for themselves. I have a very hard time with coming to a conclusion on this one.


> Still, the individual would have to choose suicide, right?

Patient: I'm in pain, and need painkillers.

Insurance company/state health plan: We'll pay for poison pills, but not painkillers.

Patient: …

It similar to the way the United States uses highway funds to blackmail the several states into setting a uniform national drinking age.


I can't tell if you are serious but strong opioid painkillers are inexpensive to manufacture and many have been out of patent for decades. They're significantly cheaper than e.g. the pentobarbital* that Oregon physicians prescribe for assisted dying. Despite what people on my Facebook feed say, Big Pharma isn't making big money off of any of the old standbys like morphine, oxycodone, hydromorphone, etc. The prices a patient sees are unrepresentative of the actual cost of drugs to health care providers. A few years ago a friend got a shot of hydromorphone in the ER for kidney stone pain and the line item on the bill was like $200. About 1% of that would represent the cost of replenishing the consumed Dilaudid, maybe another 2% for a disposable syringe. As for where the other 97% came from, see: many lengthy tomes about American health care.

*Pentobarbital itself is also cheap/easy to manufacture in volume and has been out of patent for a very long time, but nowadays it is a niche drug so the overhead costs are higher.


Oh sure, the painkillers themselves are cheaper, but the painkillers plus hospital care plus other medicines &c. will not be cheaper than poison (or just a heavy one-time dose of painkillers).


Exactly. coercion on the part of emotionally uninvested financial stakeholders like insurance companies is a likely end- state.


One of the "usual" ways assisted dying has been done (illegally) is opiate overdose.


the lesson there is not to get insurance.




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