The End-of-Life Option Act Black Hole – Is it time to shed more light?

Do you ever wonder what happened since the Colorado End of Life Options Act passed – Colorado’s version of physician-assisted suicide? The ballot initiative was heralded as providing a safe, compassionate option for those faced with suffering from a terminal disease. The promoters of the initiative claimed that there would be safety and transparency in its execution. It would be the impetus to make great strides in improving end-of-life care for everyone. It would not “normalize” suicide for vulnerable youth with severe emotional pain. Given the findings from the 2018 End-of-Life Options Act report (published by the Colorado Department of Health and Environment), the reality may be quite different.

Between 2017 and 2018 there was a 74% increase in patients who chose assisted suicide. What is driving the increase? We will never know since patients are never asked why they resorted to assisted suicide as part of the requirements of the bill. Is it because they had uncontrolled pain – physical or emotional? Is there subtle financial coercion because of inadequate health care coverage or the inability to utilize family/medical leave? Is it because they feel a burden to their family? Do family members influence their decision? Is it because of their fear of disability? Is it because they are anxious or depressed about dying? If we had answers to these questions, we could devise solutions to reduce the demand for assisted suicide. We could explore new palliative options to address uncontrolled symptoms that the patients identified. We could pursue legislation to improve health care coverage and family/medical leave policies. We could enhance in-home hospice support services. We could make mental health services more readily available near the end of life. Even supporters of assisted suicide need to acknowledge that choosing suicide is a failure of end-of-life care at some level. Without insight into the system failures, we don’t have the knowledge or the motivation to make these improvements.

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