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October 29, 2019

Colorado End-of-Life Options Act: A Clash of Organizational and Individual Conscience

Author Affiliations
  • 1School of Medicine, Center for Bioethics and Humanities, Anschutz Medical Campus, University of Colorado, Aurora
JAMA. 2019;322(20):1953-1954. doi:10.1001/jama.2019.16438

The 2016 Colorado End-of-Life Options Act includes a provision unique among states with such laws, specifically privileging individual health care professionals, including physicians and pharmacists, to choose whether to write and fill prescriptions for life-ending medications, such as high-dose secobarbital or various combinations of morphine, diazepam, beta-blockers, and digoxin, without regard to the position their employer has taken on the law. This provision virtually guaranteed the Colorado law would eventually be challenged, which happened in August 2019.1 The current legal case directly pits the conscience rights of individual health care professionals against those of religiously affiliated corporations. Because 5 of the top 10 US hospital systems by net revenue are now religiously affiliated,2 and these systems often restrict medical care in a variety of ways,3 how the case is resolved could have far-reaching implications for US health care, extending well beyond the relatively rare use of aid-in-dying medications at the end of life.

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