End of Life Care
Medical Aid in Dying Documents
The End of Life Options Clinic at BCH welcomes any interested patients to inquire about their end of life options. This clinic was started for patients to inquire, discuss, and obtain Medical Aid in Dying (MAID), which was legalized in Colorado with Proposition 106 in 2016. In addition, some patients with chronic debilitating conditions may need a safe place to discuss their own end of life options if they don't qualify for MAID.
Patients may self refer to our End of Life Options Clinic at BCH by calling 303-415-4244. No formal referral is required for a consult.
What is Medical Aid In Dying (MAID)?
Medical aid in dying, sometimes referred to as ‘MAID’ or ‘death with dignity’ is a legal process in which a competent, terminally ill adult with a prognosis of less than 6 months to live can request a medication they can choose to take to bring about a peaceful death.
Who is eligible for MAID?
To be eligible for medical aid in dying you must be:
- An adult 18 years of age or older
- Terminally ill with six months or less to live
- Mentally capable of making your own healthcare decisions
- A resident of Colorado
- Acting voluntarily
- Able to take the medication on your own
What steps do I need to take?
- Speak with your primary provider about your wishes. If your provider does not want to participate (that is their right by law), they will refer you to someone who will. A physician or nurse practitioner can be a prescriber for medical aid in dying. Unfortunately a physician assistant or “PA” cannot.
- At least two appointments with the prescribing provider are needed, at least 7 days apart. These are considered the required “verbal requests.” They can be in person or by telemedicine.
- Speak with a consulting provider who will confirm that you are eligible to receive the medication. Our team can help you coordinate a consultant if you do not already have a supportive clinical team.
- Make a written request to the prescribing provider using the required state form that has been signed by 2 witnesses; once completed, this form can be given to the medical team at any time during the process, including submitted electronically.
- Once you have completed all the required steps, your attending provider needs to order the medication for you and send notification to the state.
Do you have to be a current Boulder Community Health Patient?
No, you do not have to be an established BCH patient to request an appointment or consult. We will make you a chart when your first visit is scheduled.
What are my other end-of life options?
- Palliative Care: Pain and symptom management, often called palliative care, can be provided in medical settings, assisted livings, nursing homes, and in the home. It involves the use of medications, spiritual care, social work and other therapies to bring comfort.
- Hospice: For people with a prognosis of six months or less, hospice care focuses on quality of life rather than the length of life, with the goal of comfort. A team of health care professionals works with the patient and their family to help you manage your symptoms and provide spiritual support. This can be done wherever a person lives
- Voluntarily stopping of eating and drinking (VSED): Some people choose to stop eating and drinking to shorten the dying process. Pain and symptom management should be done to lessen any discomfort and can be handled by the hospice team.
- Declining or stopping life-sustaining treatment: Treatments aimed at prolonging life (e.g., feeding tube, ventilator, antibiotics, etc.) can be refused at any time. Pain and symptom management should be done to lessen discomfort.
- Switzerland: One option for folks seeking to end their lives in a medically sanctioned way, but who don't qualify for MAID is to travel to a country where it is legal to determine your death- Dignitas or Pegasus are agencies that can help you get a medically facilitated chosen death, and they do not require a 6 month prognosis. However, they are expensive (10-20k) and you must have capacity to travel and choose your own path.
Final Exit Network is a national group that advocates for a Chosen Death, and can counsel patients who may not live in a state where MAID is an option, or who don't have a terminal prognosis of 6 months or less. With FEN, you must have capacity, and physical capability, but they can inform you on your rights and laws. They are volunteer based and do not charge for their services. You can call 866-654-9156 or their website https://finalexitnetwork.org/
Help us to expand access to our community
Boulder Community Health is actively developing our End of Life Options program to expand access to our community. If you are financially fortunate and able to assist your community, consider making a contribution to this program by clicking https://www.bch.org/foundation/donate-now/geriatric-program/. Donors can put in the comments “End of Life Options." You can learn more about the Boulder Community Health Foundation at bch.org/gratefulpatient.