Colorado Proposition 106, Physician-Assisted Death Initiative (2016)

Colorado Proposition 106
Election date November 8, 2016
Topic Assisted death
Status a Approved
Type State statute	Origin Citizens

2016 measures
November 8
Amendment T d
Amendment U d
Amendment 69 d
Amendment 70 a
Amendment 71 a
Amendment 72 d
Proposition 106 a
Proposition 107 a
Proposition 108 a
Polls
Voter guides
Campaign finance
Signature costs

The Colorado Physician-Assisted Death Initiative also known as Proposition 106, was on the November 8, 2016, ballot in Colorado as an initiated state statute. It was approved.

A "yes" vote supported making assisted death legal among patients with a terminal illness who receive a prognosis of death within six months.

A "no" vote opposed this proposal, keeping the prohibition of assisted death in Colorado.

Aftermath

Proposition 106 was designed to allow physicians, nurses, and pharmacists to refuse to offer medical aid in dying and allow health systems to refuse to perform medical aid in dying on their properties. As of January 2017, around one-third of hospitals in Colorado decided to opt out of offering medical aid in dying. Centura Health, the state's largest health system, decided not to offer medical aid in dying. Other health systems that chose to opt out included SCL Health and HealthONE. UCHealth and Kaiser Permanente Colorado planned to offer medical aid in dying.

Election results

Proposition 106
Result		Votes	Percentage
a Yes		1,765,786	64.87%
No		956,263	35.13%

Election results from Colorado Secretary of State

Overview

Status of assisted death in Colorado

At the time of this measure, aiding another person in ending his or her life was a crime of felony manslaughter in Colorado. As of 2016, assisted death was legal in five states: California, Montana, Oregon, Vermont, and Washington. Oregon became the first state to authorize assisted death when voters approved Measure 16 in 1994. Colorado Proposition 106 was modeled on Oregon Measure 16.

Initiative design

Proposition 106 permitted terminally ill patients with under six months to live, as determined by two physicians, to self-administer aid-in-dying drugs to voluntarily die. To be eligible, the patient must be at least 18 years old, determined mentally capable by two physicians, and able to communicate an informed decision. Receiving aid-in-dying drugs requires one written request, witnessed by at least two other persons, and two oral requests. The measure also allowed a physician to prescribe the lethal drug to a terminally ill patient under certain conditions. Health providers and facilities are not required to prescribe or dispense aid-in-dying medication. In addition, Proposition 106 criminalized coercing a patient with a terminal illness to request the drug.

State of the ballot measure campaigns

Yes on Colorado End of Life Options, Death with Dignity Political Fund , Compassion and Choices Action Network Colorado, and Coloradans for Liberty at Life's End registered to support the measure. The committees raised $11.69 million.

No Assisted Suicide Colorado , Coloradans Against Assisted Suicide, National Right to Life Committee for Medical Ethics, and Colorado Right to Life, registered to oppose the measure. The committees raised $2.79 million.

Text of measure

Ballot title

The ballot title was as follows:

“

Shall there be a change to the Colorado revised statutes to permit any mentally capable adult Colorado resident who has a medical prognosis of death by terminal illness within six months to receive a prescription from a willing licensed physician for medication that can be self-administered to bring about death; and in connection therewith, requiring two licensed physicians to confirm the medical prognosis, that the terminally-ill patient has received information about other care and treatment options, and that the patient is making a voluntary and informed decision in requesting the medication; requiring evaluation by a licensed mental health professional if either physician believes the patient may not be mentally capable; granting immunity from civil and criminal liability and professional discipline to any person who in good faith assists in providing access to or is present when a patient self-administers the medication; and establishing criminal penalties for persons who knowingly violate statutes relating to the request for the medication?

”

Ballot summary

The ballot summary was as follows:

Proposition 106 creates the "Colorado End-of-Life Options Act," which allows individuals with a terminal illness to request from their physician and self-administer medical aid-in-dying medication (medication). To be eligible to request medication, the individual must: be a Colorado resident aged 18 or older; be able to make and communicate an informed decision to health care providers; have a terminal illness with a prognosis of six months or less to live (terminally ill) that has been confirmed by two physicians, including the individual's primary physician and a second, consulting physician; be determined mentally capable by two physicians, who have concluded that the individual understands the consequences of his or her decision; and voluntarily express his or her wish to receive the medication. Request process. To receive the medication, the individual must make two oral requests, at least 15 days apart, and one written request in a specific form to his or her primary physician. The written request must be witnessed by at least two other persons who attest that the requesting individual is mentally capable, acting voluntarily, and not being coerced into signing the request. One witness may not be a relative of the individual; an heir; or an owner, operator, or employee of a health care facility where the individual is receiving medical treatment or is a resident. Neither the primary physician nor the individual's qualified power of attorney or durable medical power of attorney, may be a witness to a written request. Physician requirements. The primary physician is required to document that an individual requesting the medication is terminally ill and meets all other eligibility criteria. The primary physician must provide full and specific information to the individual about his or her diagnosis and prognosis; alternatives or additional treatment opportunities, such as hospice or palliative care; and the potential risks and probable results associated with taking the medication. The primary physician must also inform the individual that he or she may obtain, but choose not to use the medication and may withdraw his or her request at any time. The primary physician must confirm, in private with the individual, that his or her request to receive medication was not coerced or influenced by any other person and is required to refer the individual to a consulting physician to confirm that the individual meets all eligibility criteria. If either a primary or consulting physician believes the individual is not mentally capable of making an informed decision about receiving the medication, that physician must refer the individual to a licensed psychiatrist or a licensed psychologist before the request process may proceed. This mental health professional must communicate his or her findings in writing to the referring physician. If a person is found to be mentally incompetent, he or she is no longer eligible for medical aid-in-dying. Dispensing of medical aid-in-dying medication. Medication may be dispensed when two physicians agree on the individual's prognosis. Immediately prior to writing a prescription for the medication, the primary physician must verify that the individual is making an informed decision and that the process has been completed properly. Health care providers, including physicians and pharmacists, who dispense medication are required to file a copy of the dispensing record with the state. Unused medication must be returned to the primary physician or to any other state or federally approved medication take-back program. Death certificates. The death certificate of an individual who uses the medication must be signed by the primary physician or hospice medical director and must list the underlying terminal illness as the cause of death. Deaths resulting from medical aid-in-dying are not subject to automatic investigation by the county coroner. Voluntary participation by health care providers. Physicians and pharmacists are not obligated to prescribe or dispense the medication. If a health care provider is unable or unwilling to carry out an eligible individual's request for the medication and the individual transfers to a new provider, the initial provider is required to coordinate the transfer of medical records to the new provider. A health care facility may prohibit a physician employed or under contract with the facility from prescribing medication to an individual who intends to use the medication on the facility's premises. The facility must provide advance written notice of its policy to the physician and its patients. A health care facility may not discipline a physician, nurse, pharmacist, or other person for actions taken in good faith or for refusing to participate in any way. Civil and criminal penalties. The measure creates a class 2 felony for tampering with a request for medication or knowingly coercing a terminally ill person to request the medication. Persons are immune from civil or criminal liability or professional disciplinary action unless they act with negligence, recklessness, or intentional misconduct. Insurance, wills, contracts, and claims. Requesting or self-administering the medication does not affect a life, health, or accident insurance policy or an annuity, and nothing in the measure affects advance medical directives. Insurers may not issue policies with conditions about whether or not individuals may request medication.

Text of measure

The full text of Proposition 106 can be read here.

Fiscal impact statement

The fiscal impact statement was as follows:

“

State revenue and spending. Beginning in FY 2016-17, Proposition 106 may increase state revenue from criminal fines by a minimal amount. The measure increases state spending by about $45,000 annually for the Department of Public Health and Environment to collect information about health care provider compliance and prepare an annual report. To the extent that persons are tried and convicted of crimes created by the measure, workload and costs will also increase. Local government impact. This measure may affect local governments as a result of prosecuting new criminal offenses under the measure. These impacts are anticipated to be minimal.

”

Support

Yes on Colorado End-of-Life Options, also known as Yes on 106, led the campaign in support of Proposition 106.

Supporters

Officials

• Gov. John Hickenlooper (D)
• Sen. Lucia Guzman (D-32)
• Sen. Michael Merrifield (D-11)
• Rep. Lois Court (D-6)
• Rep. Joann Ginal (D-52)

Former officials

• Attorney General J.D. MacFarlane (D)
• State Treasurer Cary Kennedy (D)
• Sen. Greg Brophy (R-1)
• Sen. Donna Johnson (D-32)
• Sen. Bob Bacon (D-14)

Organizations

• ACLU of Colorado
• Art of the Land
• Axiom Action
• Boulder Medical Society
• The Colorado Community Health Network
• Denver Medical Society
• JohnstonWells Public Relations
• Libertarian Party of Colorado
• MIND Science Spiritual Center
• NARAL Pro-Choice Colorado
• New Era Colorado
• Peoples Legal Alternative Network
• ProgressNow Colorado
• Pueblo County Medical Association
• Pueblo Medical Society
• Putnam Transportation Solutions
• Selig & Associates
• The Safe Center

Individuals

• Dan Diaz, husband of Brittany Maynard

Arguments

Rep. Lois Court (D-6) and former Sen. Greg Brophy (R-1) argued:

“

The Colorado End-of-Life Options Act will take government out of medical decisions best left to patients, their doctors, their families and their faith. We believe there is no role for government – or anyone else – in the very personal and difficult decisions made at the end of a person’s life. Furthermore, passing the measure doesn’t affect those who don’t consider using the option of aid in dying. Modeled after Oregon’s Death with Dignity Act of 1997, we know from the statistics that the thorough protections built into the Act will prevent misuse or abuse.

”

Andrea Maikovich-Fong, a board-certified clinical health psychologist who works with cancer patients, said the measure "supports the basic human right to dignity and self-control." She stated:

“

Unfortunately, there is sometimes a point at which the human body no longer has the capability to successfully heal, and it is inevitable that death will come soon. At this point, suffering is no longer a sacrifice bravely made toward the end goal of ultimate survival, but for some it becomes simply a painful state that precedes an inevitable, close death. ... Another uncomfortable truth is that there simply are more and less peaceful deaths. One of the factors that differentiates between these is the degree to which a person maintains a sense of dignity and a sense of control at the end of life. I believe that when there is suffering without any hope of recovery, and when that suffering becomes intolerable, offering the choice of aid in dying may be the ultimate way to care for each other and honor each other’s dignity and humanity. ...

”

Other arguments in support of the measure included:

• Julie Selsberg, a Coloradan whose father died from ALS, said, "We should respect the choice for those who want to end their suffering and be with family in their final days."

Official arguments

The official arguments in favor of Proposition 106 as listed in the voter guide were as follows:

“ 1) Proposition 106 expands the options and supports available to a terminally ill person in the last stage of life. Under the measure, a terminally ill individual may consult with a physician and benefit from medical guidance in deciding whether and how to end his or her life. The measure allows a mentally competent individual to peacefully end his or her life in the time, place, and environment of his or her choosing after voluntarily requesting and self-administering the medication. Proposition 106 also provides protections from criminal penalties for physicians and family members who choose to support a terminally ill individual through the dying process. 2) Proposition 106 seeks to balance the choice of a terminally ill person to voluntarily end his or her life with the state's interest in promoting public safety. It establishes safeguards by creating criminal penalties and ensuring that an individual's physician, family members, and heirs are not the only witnesses to requests for medication. The measure protects the individual by prohibiting any other person, including a physician, from making the decision to request medical aid-in-dying or from administering the medication. Further, by requiring that at least two physicians examine the individual and document his or her prognosis and mental capabilities, the measure establishes a process to ensure that an individual is capable of making an informed decision to end his or her life. 3) Access to medical aid-in-dying may provide a sense of comfort to a terminally ill person by authorizing medication as insurance against suffering and the potential loss of dignity and autonomy. Proposition 106 is similar to options available in Oregon, Washington, Vermont, Montana, and California, that respect the end-of-life concerns of terminally ill people. Oregon's experience shows that the majority of persons requesting medication cited concerns about losing autonomy and dignity at the end of their lives. Once the medication is requested, it is up to the individual to decide when and if to take it. In Oregon, for example, of the 1,545 people who requested the medication since 1997, approximately one-third chose not to use it. ”

Campaign advertisements

The following campaign advertisements were produced by Yes on Colorado End-of-Life Options:

Brittany Maynard from Colorado End-of-Life Options.

Matt and Kelly Larson from Colorado End-of-Life Options.

Opposition

No on Prop 106 led the campaign in opposition to Proposition 106.

Coloradans Against Assisted Suicide also registered as opposing the initiative.

Opponents

Officials

• Gov. John "Pete" Ricketts (R) of Nebraska
• Sen. Larry Crowder (R-35)
• Former U.S. Rep. Bob Beauprez (R-7)

Organizations

• Not Dead Yet Colorado
• Coloradans Against Assisted Suicide
• Focus on the Family
• Colorado Christian University
• The Church of Jesus Christ of Latter-Day Saints Office of the First Presidency

Individuals

• John Stonestreet, President of the Chuck Colson Center for Christian Worldview

Religious communities

• Colorado Catholic Conference
• Archdiocese of Denver
• Roman Catholic Diocese of Colorado Springs
• Archdiocese of Kansas City in Kansas

Arguments

No on Prop 106 made four arguments against Proposition 106's "fatal flaws" on their website. The following were excerpts from their arguments:

“

Medical errors National Public Radio’s Morning Edition recently reported on a Johns Hopkins University study that found medical errors are the third-leading cause of death in the US, right after cancer and heart disease. The NPR report later states, “…the study estimates that more than 250,000 Americans die each year from medical errors.” Yet Prop 106 would give two doctors, any two doctors, the license to say that someone has only six months to live and can commit suicide. Doctors make mistakes. We all know this. Should we really vote for a policy that could lead to more forever-fatal mistakes? ... No mental health exam? Prop 106 says that to qualify for assisted suicide, one must be of sound mind to make that decision. Yet, curiously, there is no requirement that any trained psychiatrist or licensed psychologist be in the loop. Instead, just any doctor gets to decide. Ask yourself, should someone who mainly treats bunions or earaches be allowed to assess the mental health of a seriously ill patient? ... Consult a specialist? If you were facing a life-threatening disease, you’d want to consult the finest doctor you could see, almost assuredly a specialist. But Proposal 106 does JUST THE OPPOSITE. If you face a potentially life-ending disease, it allows you to choose suicide on the basis of the opinion of any old doctor, even one that has no experience with your disease or illness. ...

”

Carrie Ann Lucas, "disabled woman, a mother, an attorney and a business owner" and Executive Director of Disabled Parents Rights, criticized the measure, saying that Proposition 106 threatens the lives of disabled persons. She argued:

“

I am expensive to keep alive. I have had to fight to ensure that I have access to attendant care to live in the community, and have faced Medicare denials that refused to pay for my ventilator and other equipment necessary to live. I have had to fight efforts to place a do-not-resuscitate order in my medical file. In a profit-driven health care system, people will die needlessly when insurance companies refuse to pay for necessary medications and equipment, and instead offer to pay for a much cheaper lethal prescription. We’ve already seen that happen in Oregon, where this is legal. We know that suicide is cheaper than treatment.

”

Other arguments against the measure included:

• Dr. Alan Rastrelli, medical director for Divine Mercy Supportive Care, said, "With Proposition 106, an overdose of medication is ingested with the intention of ending one’s life — by definition: suicide — an action we desperately try to prevent among those feeling hopeless."

Official arguments

The official arguments against Proposition 106 as listed in the voter guide were as follows:

“ 1) Encouraging the use of lethal medication by terminally ill people may send the message that some lives are not worth living to their natural conclusion. People who are in the final stages of life are often in fear of the dying process. The availability of medical aid-in-dying may encourage people to make drastic decisions based on concerns about the potential loss of autonomy and dignity, not realizing that modern palliative and hospice care may effectively address these concerns. Services such as pain and symptom management, in-home services, and counseling can help individuals navigate the end of their lives while minimizing suffering. Promoting medical aid-in-dying may lead to a reduced emphasis on treatment and development of new options for end-of-life care. 2) Proposition 106 creates opportunities for abuse and fraud. The protections in the measure do not go far enough to shield vulnerable people from family members and others who may benefit from their premature death. Proposition 106 allows a family member or heir to be one of the witnesses to a request for the medication, potentially subjecting the individual to coercion. The measure does not require that a physician have any specific training in order to make an assessment of the individual or require independent verification that the medication was taken voluntarily or under medical supervision. Proposition 106 fails to ensure that the lethal medication will be stored in a safe location, potentially placing others at risk or leading to its misuse. 3) Proposition 106 may force physicians to choose between medical ethics and a request to die from a person for whom they feel compassion. The measure compromises a physician's judgment by asking him or her to verify that an individual has a prognosis of six months or less to live, yet fails to recognize that diagnoses can be wrong and prognoses are estimates, not guarantees. The measure also requires that the physician or hospice director list the terminal illness or condition on the death certificate, which requires these professionals to misrepresent the cause of death. ”

Campaign finance

See also: Campaign finance requirements for Colorado ballot measures

The campaign finance information on this page reflects the most recent scheduled reports that Ballotpedia has processed, which covered through December 31, 2016.

Yes on Colorado End of Life Options, Death with Dignity Political Fund , Compassion and Choices Action Network Colorado, and Coloradans for Liberty at Life's End registered to support the measure. The committees raised $11.69 million.

No Assisted Suicide Colorado , Coloradans Against Assisted Suicide, National Right to Life Committee for Medical Ethics, and Colorado Right to Life, registered to oppose the measure. The committees raised $2.79 million.

	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
Support	$11,409,752.79	$275,901.67	$11,685,654.46	$10,624,152.62	$10,900,054.29
Oppose	$2,795,666.00	$0.00	$2,795,666.00	$2,782,863.81	$2,782,863.81
Total	$14,205,418.79	$275,901.67	$14,481,320.46	$13,407,016.43	$13,682,918.10

Support

The following table includes contribution and expenditure totals for the committee(s) supporting the measure.

Committees in support of Proposition 106
Committee	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
Compassion and Choices Action Network Colorado	$5,865,834.50	$8,969.58	$5,874,804.08	$5,091,739.83	$5,100,709.41
Yes on Colorado End of Life Options	$5,492,736.79	$266,932.09	$5,759,668.88	$5,481,247.79	$5,748,179.88
Death with Dignity Political Fund	$51,000.00	$0.00	$51,000.00	$51,000.00	$51,000.00
Coloradans for Liberty at Life's End	$181.50	$0.00	$181.50	$165.00	$165.00
Total	$11,409,752.79	$275,901.67	$11,685,654.46	$10,624,152.62	$10,900,054.29

Donors

The following were the top donors to the support committee(s).

Donor	Cash Contributions	In-Kind Contributions	Total Contributions
Compassion and Choices	$5,189,038.52	$8,969.58	$5,198,008.10
Compassion and Choices	$4,539,442.92	$107,613.58	$4,647,056.50
Adam Lewis	$50,000.00	$0.00	$50,000.00
Cathy May	$25,000.00	$0.00	$25,000.00
Charles Hamlin	$25,000.00	$0.00	$25,000.00

Opposition

The following table includes contribution and expenditure totals for the committee(s) in opposition to the initiative.

Committees in opposition to Proposition 106
Committee	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
No Assisted Suicide Colorado	$2,635,456.00	$0.00	$2,635,456.00	$2,623,213.11	$2,623,213.11
Coloradans Against Assisted Suicide	$140,020.00	$0.00	$140,020.00	$140,020.00	$140,020.00
National Right to Life Committee for Medical Ethics	$20,000.00	$0.00	$20,000.00	$19,630.70	$19,630.70
Colorado Right to Life	$190.00	$0.00	$190.00	$0.00	$0.00
Total	$2,795,666.00	$0.00	$2,795,666.00	$2,782,863.81	$2,782,863.81

Donors

The top donors to the opposition committee(s) were as follows:

Donor	Cash Contributions	In-Kind Contributions	Total Contributions
Archdiocese of Denver	$1,605,499.00	$0.00	$1,605,499.00
Roman Catholic Diocese of Colorado Springs	$500,000.00	$0.00	$500,000.00
Diocese of Pueblo Colorado	$135,000.00	$0.00	$135,000.00
Patient Rights Action Fund	$125,000.00	$0.00	$125,000.00
Catholic Association	$50,000.00	$0.00	$50,000.00
Colorado Christian University	$50,000.00	$0.00	$50,000.00

Methodology

To read Ballotpedia's methodology for covering ballot measure campaign finance information, click here.

Media editorials

Support

• Aurora Sentinel said: "Proposition 106 is long overdue. It’s time to bring these changes to Colorado so we can talk about them, put them in place, and understand them for those who want or need them. Anything else is inhumane."
• Colorado Springs Independent said: "Opponents seem to be more focused on scare tactics regarding how this could be abused, but that hasn't been the case in Oregon, where it's been legal since 1997."
• The Durango Herald said: "Given all that has gone into shaping legislation in the five other states, and the detailed and emotional legislative debates in Colorado, Proposition 106 is well-crafted. It contains a multitude of provisions to answer many what-ifs that have arisen elsewhere or could arise in Colorado."
• Grand Junction Daily Sentinel said: "There’s no evidence of abuse or coercion in Oregon. Furthermore the term “assisted suicide,” we think, is a misnomer intended to muddy the waters. A person who is suicidal wants to die. A person in the process of dying wants to live, but won’t. This measure gives the dying the peace of mind that they won’t suffer needlessly."
• The Pueblo Chieftain said: "But frankly, we don’t think it’s fair for those who feel that way to deny that opportunity to those who do not feel guilt, who do not feel compelled to die as people always have, who do not feel they will be loved less by God if they use modern medicine to end their fatal suffering."
• The Tribune said: "Still, this measure is statutory, not a constitutional change. That means if problems do emerge, the Legislature can — and must — act to correct them. On balance, we think this measure will offer a number of Coloradans some much-needed compassion."
• Steamboat Today said: "We sincerely believe it’s time for Colorado to take this poignant and compassionate step forward in the matter of life and death."

Opposition

• Colorado Springs Gazette‎ said: "In a state saddened and confounded by rising teen and adult suicide rates, it seems reckless to pass a law that legalizes self-inflicted death. Imagine another Colorado teenager facing what seem like insurmountable problems. The teen contemplates suicide and calculates the fact grandma ended her life with pills prescribed by a doctor. The law, a doctor and a beloved mentor have inadvertently told this child how suicide is a good way out."
• The Denver Post said: "The Denver Post editorial board has in the past supported proposed legislation that would have allowed doctors to prescribe life-ending drugs to patients with six months or less to live. We came down on the side of personal liberty before the bill failed in 2015. But we worry the present measure fails to include reporting requirements in place in an Oregon law that Colorado’s initiative draws from, and that Proposition 106 would entice insurers to drop expensive treatments for terminal patients even when medical advances might add months or years more to a life that a patient may wish to take."
• Longmont Times-Call said: "However, this is one of those issues that is best left to lawmakers to ensure that if this right were to exist, it would be under an extremely narrow set of circumstances. That does not appear to be the case now. A "no" vote is recommended."
• Loveland Reporter-Herald said: “However, this is one of those issues that is best left to lawmakers to ensure that if this right were to exist, it would be under an extremely narrow set of circumstances. That does not appear to be the case now. A "no" vote is recommended.”

Polls

See also: 2016 ballot measure polls

• Colorado Mesa University, Rocky Mountain PBS, and Franklin & Marshal College surveyed 540 registered voters in September 2016 on Proposition 106. The poll found 70 percent of respondents favoring and 22 percent opposing the measure.

Colorado Proposition 106 (2016)
Poll	Support	Oppose	Undecided	Margin of error	Sample size
Colorado Mesa University, Rocky Mountain PBS, and Franklin & Marshal College 9/14/2016 - 9/18/2016	70.0%	22.0%	8.0%	+/-5.1	540
Note: The polls above may not reflect all polls that have been conducted in this race. Those displayed are a random sampling chosen by Ballotpedia staff. If you would like to nominate another poll for inclusion in the table, send an email to editor@ballotpedia.org.

Background

Voting on Assisted Death
Ballot Measures
By state
By year
Not on ballot

Assisted death in other states

Washington was the first state to vote on assisted death. Voters rejected Initiative 119 in 1991, which would have legalized assisted death in cases of medically terminal conditions. Californians defeated a similar initiative, Proposition 161, in 1992.

Other initiatives that would have legalized assisted death if voters did not reject them included Michigan Proposal B of 1998, Maine Question 1 of 2000, and Massachusetts Question 2 of 2012.

Oregon became the first state to legalize assisted death in 1994, when voters passed Measure 16. The legislature asked voters to repeal the measure via Measure 51 three years later, but voters rejected the offer. Washingtonians approved Initiative 1000 in 2008, authorizing mentally competent, terminally ill adults to request and self-administer a lethal overdose of medication.

The following table illustrates the outcome of each assisted death ballot initiative:

State	Initiative	Year	Percent “Yes”	Percent “No”
Washington	Initiative 119	1991	46.40%	53.60%
California	Proposition 161	1992	45.87%	54.13%
Oregon	Measure 16	1994	51.31%	48.69%
Michigan	Proposal B	1998	28.88%	71.12%
Maine	Question 1	2000	48.67%	51.33%
Washington	Initiative 1000	2008	57.82%	42.18%
Massachusetts	Question 2	2012	48.87%	51.13%
Average			46.83%	53.17%

In 2013, Vermont became the first state to legalize assisted death via the legislature and governor. Californian followed two years later, with Gov. Jerry Brown signing legislation in October 2015. The Montana Supreme Court upheld a lower court's ruling in Baxter v. Montana in 2009, making assisted death de facto legal in Montana as the state has neither a law protecting or forbidding assisted death.

Path to the ballot

See also: Laws governing the initiative process in Colorado

• The proposed initiative was filed with the Colorado secretary of state's office on April 8, 2016, and the petition format was approved on May 20, 2016.
• Proposition 106 proponents needed to collect 98,492 signatures by August 8, 2016, to land the measure on the ballot.
• Supporters began a signature-gathering campaign at a rally in front of the state Capitol on June 21, 2016.
• Yes on Colorado End-of-Life Options submitted over 160,000 signatures on August 4, 2016.
• The Colorado Secretary of State certified the measure on August 15, 2016.

Cost of signature collection:
Sponsors of the measure hired Grassroots Campaigns Inc. to collect signatures for the petition to qualify this measure for the ballot. A total of $689,186 was spent to collect the 98,492 valid signatures required to put this measure before voters, resulting in a total cost per required signature (CPRS) of $7.00.

State profile

Demographic data for Colorado
	Colorado	U.S.
Total population:	5,448,819	316,515,021
Land area (sq mi):	103,642	3,531,905
Race and ethnicity**
White:	84.2%	73.6%
Black/African American:	4%	12.6%
Asian:	2.9%	5.1%
Native American:	0.9%	0.8%
Pacific Islander:	0.1%	0.2%
Two or more:	3.5%	3%
Hispanic/Latino:	21.1%	17.1%
Education
High school graduation rate:	90.7%	86.7%
College graduation rate:	38.1%	29.8%
Income
Median household income:	$60,629	$53,889
Persons below poverty level:	13.5%	11.3%
Source: U.S. Census Bureau, "American Community Survey" (5-year estimates 2010-2015) Click here for more information on the 2020 census and here for more on its impact on the redistricting process in Colorado. **Note: Percentages for race and ethnicity may add up to more than 100 percent because respondents may report more than one race and the Hispanic/Latino ethnicity may be selected in conjunction with any race. Read more about race and ethnicity in the census here.

Presidential voting pattern

See also: Presidential voting trends in Colorado

Colorado voted for the Democratic candidate in five out of the seven presidential elections between 2000 and 2024.

Pivot Counties (2016)

Ballotpedia identified 206 counties that voted for Donald Trump (R) in 2016 after voting for Barack Obama (D) in 2008 and 2012. Collectively, Trump won these Pivot Counties by more than 580,000 votes. Of these 206 counties, four are located in Colorado, accounting for 1.94 percent of the total pivot counties.

Pivot Counties (2020)

In 2020, Ballotpedia re-examined the 206 Pivot Counties to view their voting patterns following that year's presidential election. Ballotpedia defined those won by Trump won as Retained Pivot Counties and those won by Joe Biden (D) as Boomerang Pivot Counties. Nationwide, there were 181 Retained Pivot Counties and 25 Boomerang Pivot Counties. Colorado had three Retained Pivot Counties and one Boomerang Pivot County, accounting for 1.66 and 4.00 percent of all Retained and Boomerang Pivot Counties, respectively.

More Colorado coverage on Ballotpedia

• Elections in Colorado
• United States congressional delegations from Colorado
• Public policy in Colorado
• Endorsers in Colorado
• Colorado fact checks
• More...

Recent news

The link below is to the most recent stories in a Google news search for the terms Colorado End of Life Proposition 106 2016. These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles.

Colorado Proposition 106, Physician-Assisted Death Initiative (2016) - Google News

See also

Suggest a link

• 2016 ballot measures
• Colorado 2016 ballot measures
• Laws governing the initiative process in Colorado

External links

Basic information

• Proposition 106
• Colorado 2016 Ballot Information Book

Support

• Yes on Colorado End-of-Life Options
• Yes on Colorado End-of-Life Options Facebook
• Yes on Colorado End-of-Life Options Twitter

Opposition

• No on Prop 106
• No on Prop 106 Facebook
• No on Prop 106 Twitter
• Coloradans Against Assisted Suicide
• Coloradans Against Assisted Suicide Facebook
• Not Dead Yet Colorado
• Not Dead Yet Colorado Facebook
• Not Dead Yet Colorado Twitter

Footnotes

Ballotpedia

About

Overview • What people are saying • Support Ballotpedia • Contact • Contribute • Job opportunities

---

Executive: Leslie Graves, Founder and CEO • Gwen Beattie, Chief Operating Officer

Communications: Alison Graves, Director of Communications • Carley Allensworth • Abigail Campbell • Frank Festa • Sarah Groat • Nathaniel Harwood • Dillon Redmond • Erica Shumaker
External Relations: Geoff Pallay, Director of External Relations • Ken Carbullido, Vice President of Election Product and Technology Strategy • Ashley Fleming • Thomas Mardik • Hannah Nelson
Operations: Meghann Olshefski, Director of Operations • Amanda Herbert • Mandy Morris • Caroline Presnell • Kelly Rindfleisch
Tech: Matt Latourelle, Director of Technology Operations • Ryan Burch • Kirsten Corrao • Beth Dellea • Travis Eden • Tate Kamish • Margaret Kearney • Eric Lotto • Joseph Sanchez • Mary Susmitha

Contributors: Scott Rasmussen

---

Editorial Content

Josh Altic, Director of Content • Daniel Anderson, Associate Director of Elections & Data • Cory Eucalitto, Associate Director of Features • Ryan Byrne, Managing Editor of Ballot Measures • Mandy McConnell, Managing Editor of News • Doug Kronaizl, Managing Editor of Local Expansion • Abbey Smith, Managing Editor of Elections • Janie Valentine, Managing Editor of Law • Joel Williams. Managing Editor of Events • Andrew Bahl • Jaclyn Beran • Marielle Bricker • Joseph Brusgard • Emma Burlingame • Kelly Coyle • Jon Dunn • Thomas Ellis • Nicole Fisher • Joseph Greaney • Thomas Grobben • Brianna Hosea • Molly Kehoe • Tyler King • Glorie Martinez • Norm Leahy, Senior Editor • Nathan Maxwell • Jimmy McAllister • Brandon McCauley • Ellie Mikus • Ellen Morrissey • Mackenzie Murphy • Kaley Platek • Samantha Post • Adam Powell • Annelise Reinwald • Ethan Rice • Spencer Richardson • Victoria Rose • Briana Ryan • Myj Saintyl • Maddy Salucka • Emma Soukup • Alexis Thacker • Mina Vogel • Samuel Wonacott • Trenton Woodcox