Colorado Euthanasia Law: Who Qualifies, Requests, and Providers

Colorado’s euthanasia law is often misunderstood because Colorado does not actually permit euthanasia. Euthanasia, where a physician directly administers a lethal drug to a patient, remains illegal. What state law allows is medical aid in dying: a terminally ill adult can request a prescription for medication and take it themselves. The rules come from the Colorado End-of-Life Options Act, passed by voters as Proposition 106 in 2016 and updated by Senate Bill 24-068 in 2024.¹

The word that carries the whole distinction is “self-administer.” The patient must voluntarily swallow or otherwise ingest the medication. If another person administers the drug, that act falls outside the law and can be prosecuted as a homicide.

Who Qualifies

A patient has to meet all four requirements before any Colorado provider will write a prescription.

Age and Colorado Residency

The patient must be at least 18 and a Colorado resident. The residency requirement has survived legislative efforts to remove it, so people cannot travel to Colorado solely to use the law. Residency can be shown with a Colorado driver’s license or state ID, voter registration, property ownership or a lease in the state, or a Colorado income tax return for the most recent year.²

A Terminal Diagnosis of Six Months or Less

The patient must have a terminal illness with a prognosis of six months or less to live, and two providers, an attending and a consulting provider, must independently confirm that prognosis. The statute does not list qualifying diseases. In practice, advanced cancer, ALS, and end-stage organ failure commonly qualify. Serious but non-terminal conditions, such as well-managed diabetes or early-stage dementia, do not.³

Mental Capacity to Decide

The patient must be mentally capable of making an informed decision, meaning they understand the diagnosis, prognosis, alternatives such as palliative care and hospice, and the risks and expected outcome of taking the medication. The attending provider makes that call first. If either the attending or consulting provider suspects impaired judgment, they must refer the patient to a licensed mental health professional, and the prescription cannot be written until that professional confirms in writing that the patient is capable.²

A mental health diagnosis alone does not disqualify anyone. The question is whether the person can reason through the decision at the time they make it.

How the Request Works

The process is deliberately layered. The patient must make two separate oral requests to the attending provider. Under the 2024 amendments, those requests must be at least seven days apart, down from the original 15 days. If the attending provider determines the patient is unlikely to survive more than 48 hours, and all other requirements are met, that waiting period can be waived.⁴

After the second oral request, the patient submits a written request using a form that substantially follows the template in Colorado Revised Statutes Section 25-48-112. The form confirms the patient has been informed of the diagnosis, prognosis, and alternatives, and acknowledges that most deaths occur within three hours but the process can take longer.⁵

Two witnesses must sign the written request, attesting that the patient appears capable, is acting voluntarily, and is not being coerced. At least one witness must be unrelated to the patient by blood, marriage, civil union, or adoption; must not stand to inherit from the estate; and must not work for the healthcare facility treating the patient. The attending and consulting providers cannot serve as witnesses, and neither can anyone holding the patient’s power of attorney.⁶

A patient can withdraw the request at any point, regardless of mental state at that moment. The attending provider must remind the patient of this right before writing the prescription.

Which Providers Can Participate

Since the 2024 amendments, advanced practice registered nurses can serve in roles previously limited to physicians.⁴

The attending provider has primary responsibility for the patient’s care. They confirm the terminal diagnosis, evaluate capacity, discuss alternatives, verify residency, and write the prescription. The consulting provider independently confirms the diagnosis and prognosis and documents that assessment, but does not prescribe. The pharmacist dispenses the medication after verifying documentation and files a form with the Colorado Department of Public Health and Environment within ten calendar days.³

Both the attending and consulting providers must be licensed in Colorado.

Opt-Outs by Providers and Facilities

No provider is required to participate. A physician or APRN who objects on personal, moral, or religious grounds can decline, though they should tell the patient so the patient can seek another provider. Hospitals, nursing homes, and other healthcare facilities may adopt policies prohibiting their staff from participating on the premises, and several Colorado hospitals have publicly opted out. A facility that opts out cannot prevent a patient from pursuing the process through other providers elsewhere.¹

Cost and Insurance

The statute does not specify which drug must be prescribed. Options have ranged from secobarbital, a barbiturate sedative that can exceed $4,000 for a lethal dose, to multi-drug compound formulations closer to $500. The pharmacy and the specific formulation drive the price.

Federal law bars Medicare and Medicaid funds from covering any service provided to cause or assist in causing a patient’s death, which includes the medication itself and the dispensing costs.⁷

The 2024 amendments added protections on the private side. Health and life insurance carriers in Colorado cannot deny or alter a covered person’s benefits based on the availability of medical aid in dying, and they cannot steer a terminally ill patient toward requesting it as an alternative to covering treatment.⁴

Life insurance generally pays out. Colorado law provides that after the first policy year, suicide is not a defense to a life insurance claim regardless of whether the death was voluntary. And because medical aid in dying is not classified as suicide under the End-of-Life Options Act in the first place, claims should not be affected. Policies covering accidental death specifically are excluded from that protection.⁸

How the Death Is Recorded

When a patient dies after taking medication under the law, the death certificate lists the underlying terminal illness as the cause of death, not the medication. The death does not legally constitute suicide or homicide. That classification carries through to life insurance, estate matters, and public health data.³

Criminal Exposure for Going Outside the Law

Providers who follow the law’s requirements in good faith are shielded from criminal prosecution, civil liability, and professional discipline. Stepping outside the framework is another matter.¹

Causing someone’s death by forging or altering a request for medical aid-in-dying medication without the patient’s authorization is a class 2 felony, carrying a presumptive sentence of 8 to 24 years in prison.⁹¹⁰

Physically helping a patient take the medication, rather than letting them self-administer, can lead to manslaughter charges. Intentionally causing or aiding another person to commit suicide is a class 4 felony under Colorado’s manslaughter statute.¹¹

The risk is not theoretical. In January 2026, a Boulder County grand jury indicted two family members on manslaughter charges for their roles in an assisted death that did not follow the End-of-Life Options Act. One had purchased equipment used in the death, and both were present without the safeguards the law requires. Family members and caregivers who help outside the law’s framework face real criminal exposure, even when the person who died had wanted to die.

1
Justia Law. Colorado Code Title 25 Health Care Article 48 – End-of-Life Options
2
Colorado General Assembly. HB16-1054 End-of-Life Options for Terminally Ill Individuals
3
Colorado Department of Public Health and Environment. Medical Aid in Dying
4
Colorado General Assembly. SB24-068 Medical Aid-in-Dying
5
Justia Law. Colorado Code Title 25 Section 25-48-112 – Request for Medical Aid-in-Dying Medication
6
Justia Law. Colorado Code Title 25 Section 25-48-104 – Request Process – Witness Requirements
7
Office of the Law Revision Counsel. 42 US Code 14402 – Restriction on Use of Federal Funds Under Health Care Programs
8
Justia Law. Colorado Code Title 10 Section 10-7-109 – Suicide No Defense for Nonpayment
9
Colorado.Public Law. Colorado Revised Statutes 25-48-119 – Liabilities
10
FindLaw. Colorado Revised Statutes Title 18 Section 18-1.3-401 – Felonies Classified
11
Justia Law. Colorado Code Title 18 Section 18-3-104 – Manslaughter