Colorado Right to Die Law: Steps, Qualifications, and 2024 Changes

Colorado’s right-to-die law, formally the End-of-Life Options Act, allows a terminally ill adult resident with a prognosis of six months or less to request and self-administer a prescription that ends their life.¹ Voters approved it in 2016 as Proposition 106, and the legislature updated it in 2024. The medication has to be taken by the patient personally. No one else, including a doctor, is allowed to administer it.

Who Qualifies

Five conditions must all be met before any provider can write a prescription under the Act.

You are at least 18. Minors are not eligible, with or without parental consent.
You are a Colorado resident. A state-issued ID, voter registration, or a lease or property record can serve as proof. The law sets no minimum length of residency, and providers decide whether your documentation is sufficient.¹
You have a terminal illness with a prognosis of six months or less, confirmed by two providers. Advanced cancer, ALS, and end-stage organ failure commonly qualify.
You are mentally capable of making and communicating an informed healthcare decision. If either provider has doubts, you are referred for a mental health evaluation before anything else happens.²
You are physically able to ingest the medication on your own, by swallowing or through a feeding tube. This is a hard line. If your condition takes that ability away, you are no longer eligible.

Dementia alone does not qualify, and neither does a mental illness. The law is written around a terminal physical prognosis combined with intact decision-making capacity at the time of the request.

The Steps to Get a Prescription

The process has deliberate pauses built into it. You cannot complete it in a single appointment.

Two Oral Requests, Seven Days Apart

You make two separate verbal requests to your attending provider, with at least seven days between them. If your attending provider determines you are unlikely to survive another 48 hours, and you meet every other qualification, the waiting period can be waived.³

A Written Request With Two Witnesses

You also submit a written request on a form that follows the format in the statute, signed and dated in front of two witnesses. The witnesses attest that you appear mentally capable, are acting voluntarily, and are not being coerced.⁴

At least one of the two witnesses cannot be a relative by blood, marriage, civil union, or adoption; cannot be someone who would inherit from your estate; and cannot be an owner, operator, or employee of the healthcare facility treating you.⁴

One Last Check Before the Prescription

Immediately before writing the prescription, your attending provider has to offer you the chance to rescind and verify that you are still making an informed decision.⁵ If you have lost the ability to communicate or to self-administer the medication by that point, the request is void.

What Changed in 2024

SB24-068 took effect August 7, 2024, and made two changes worth knowing about if you or a family member read older material on the law. The waiting period between the two oral requests dropped from 15 days to 7. And advanced practice registered nurses can now serve as the attending or consulting provider, roles previously limited to physicians.³ That second change matters for access, particularly in parts of the state where finding a participating physician is difficult.

The Two Providers Involved

Your attending provider has primary responsibility for your care. They confirm your diagnosis and prognosis, determine that you are mentally capable and acting voluntarily, and walk you through the alternatives: comfort care, palliative care, hospice, and pain management.⁵ They also explain the risks, the likely effect of the medication, and the fact that you can fill the prescription and never take it.

The attending provider will counsel you about telling your next of kin and having someone with you when you take the medication.⁵ Notification is counseling, not a requirement. Choosing not to tell your family cannot be a reason to deny your request.

A second, consulting provider then independently confirms the diagnosis, prognosis, capacity, and voluntariness.² If the consulting provider disagrees on any point, the process stops until it is resolved. If either provider thinks a mental health condition is affecting your judgment, you have to be evaluated by a mental health professional before you can go further.

Providers and Hospitals Can Refuse

No provider, nurse, or pharmacist is required to participate. If your provider declines, they must transfer a copy of your records to a new provider on request so you can continue elsewhere.⁶

Hospitals and clinics can prohibit their employed or contracted providers from writing aid-in-dying prescriptions on their premises, but only if the facility gave written notice of that policy in advance. Some Catholic and other faith-based systems in Colorado have adopted such policies, so it is worth asking early whether your hospital participates. If it does not, you may need to find a provider outside that system.

Changing Your Mind

You can withdraw your request at any time, for any reason, and in any manner. The statute allows rescission “without regard to the individual’s mental state,” so a statement that you no longer want the medication is enough to stop the process even if your capacity has slipped.⁵ No form is required. Telling your attending provider is enough. If you later decide to proceed after all, you begin the process again from the start.

Cost, Insurance, and the Death Certificate

Federal law bars Medicare and Medicaid from paying for any item or service intended to cause or assist in causing death, including this medication.⁷ For most patients that means paying out of pocket. Some private insurers cover part of the cost. One Colorado healthcare system has reported that provider visits plus medication run about $700 in total, though the drug protocol can push the price from a few hundred dollars to several thousand.

The death certificate lists the underlying terminal illness as the cause of death, not the medication, and the death does not trigger a coroner’s investigation.⁸ Because the death is not legally classified as suicide, life insurance and annuity contracts stay enforceable, and insurers cannot use a patient’s participation as grounds to deny a claim.¹

Leftover Medication

If the prescription is filled but not used, or if some remains after the patient’s death, whoever has custody of the drugs has to dispose of them legally. There are two lawful options: return the medication to the prescribing provider, or use a federally approved drug take-back program.⁹ Flushing them or throwing them in the trash is not allowed. Your attending provider is required to walk you through storage and disposal when the prescription is written.

Protections Against Coercion

Tampering with someone else’s request, coercing a terminally ill person into making a request, forging a request, or destroying one without the patient’s consent are all criminal offenses under the Act.¹ The witness rules, the two-provider requirement, the waiting period, and the repeated offers to rescind all sit on top of these criminal provisions as layered safeguards against pressure from family, heirs, or facilities.

1
Colorado Department of Public Health and Environment. Medical Aid in Dying
2
Justia Law. Colorado Revised Statutes Section 25-48-107 (2024)
3
Colorado General Assembly. SB24-068 Medical Aid-in-Dying
4
Justia Law. Colorado Revised Statutes Section 25-48-104 (2024)
5
Colorado General Assembly. Colorado End-of-Life Options Act – Initiative Text
6
Colorado General Assembly. Colorado End-of-Life Options Act – Initiative Text
7
Office of the Law Revision Counsel. 42 USC 14402 – Restriction on Use of Federal Funds Under Health Care Programs
8
Justia Law. Colorado Revised Statutes Section 25-48-109 (2023) – Death Certificate
9
Justia Law. Colorado Revised Statutes Section 25-48-120 (2023) – Safe Disposal of Unused Medical Aid-in-Dying Medications