Assisted dying

For assisted dying to be allowed, the person must meet specific criteria under the End of Life Choice Act 2019. It is done by or in the presence of a doctor or nurse practitioner (a specialised nurse).

End of Life Choice Act 2019 — New Zealand Legislationexternal link

The criteria for assisted dying

Choosing not to receive a specific medical treatment is every person's right. You can also decline to have treatment ahead of time with advance care planning.

Advance care plans

Some people make a choice that if their heart stopped beating or they stopped breathing they would not want cardiopulmonary resuscitation (CPR). This is called a 'do not resuscitate' (DNR) order. Anyone can decide to have this and have it documented — it is very different from assisted dying.

These things can help focus your care on things that are important to you. It allows a natural death to happen when the time comes.

You cannot request assisted dying in an advance care plan. This is because an advance care plan only comes into effect when you are no longer able to speak for yourself, for example, if you are unconscious or confused.

You are required by law to be fully competent right up to the point when assisted dying happens.

No one else can make a decision to receive assisted dying on your behalf. This even applies to someone who holds an enduring power of attorney for you or who is a welfare guardian.

Health New Zealand has a lot of useful information about assisted dying.

Assisted dying information for the public — Health New Zealandexternal link

You can also talk to your own healthcare provider about it. Doctors and other healthcare providers are not allowed to suggest assisted dying as an option if you have a terminal illness. You must raise the topic yourself. No one else can raise it with your healthcare provider either, it must come from you.

Your healthcare provider is allowed to conscientiously object to assisted dying, so they might not be able to provide this service. If they do object, they must tell you and they must advise you how to access the Assisted Dying Service. You can contact the Assisted Dying Service by:

• email AssistedDying@tewhatuora.govt.nz
• phone 0800 223 852.

Your healthcare provider can help you contact the service.

Health New Zealandalso has a list of healthcare providers who provide assisted dying services. They are members of the Support and Consultation for End of Life in New Zealand (SCENZ) Group.

Practitioners who provide assisted dying services — Health New Zealandexternal link

After you have made a request for assisted dying, the doctor must give you certain information. This includes information about your illness and other end-of-life options that may be available to you. They will encourage you to speak to your whānau and friends, or a counsellor. But they must also let you know that you do not have to do this.

To be eligible to request assisted dying you must be:

• aged 18 years or older
• a New Zealand citizen or permanent resident
• suffering from a terminal illness that is likely to end your life within 6 months
• experiencing a serious decline in physical capability that cannot be reversed
• experiencing unbearable suffering that cannot be relieved in a way you can tolerate
• competent to make an informed decision about assisted dying.

You must meet all of these conditions. You are not eligible just because you are very old or because you have dementia, a mental illness or a disability.

Two specially trained doctors need to decide that you meet the criteria for assisted dying. If either doctor is not sure you are competent to decide to end your life, they will ask for a psychiatric assessment.

Your request will only be moved forward if the psychiatrist decides you are competent to make an informed decision.

The doctors and, if necessary, a psychiatrist need to be sure you really understand the decision you are making. They will do this by asking you questions to see if you:

• are able to understand the information about what assisted dying means
• are able to remember and consider that information in the decision-making process
• can communicate that decision in some way.

Your doctors also need to be sure that you are not under pressure from anyone else to make this decision. This may involve them talking to other healthcare providers who are in regular contact with you. It may also involve them talking to members of your whānau, with your permission.

The next steps if you are eligible for assisted dying

The doctor will talk to you about when your assisted death can take place. There are forms to fill out and the Ministry of Health has to check that everything complies with the law.

You are free to change your mind at any point in the process right up to when you are about to be given the medication. You can choose to delay the time of assisted dying for up to 6 months or cancel the request altogether.

Doctors and nurse practitioners are the only health professionals able to administer the medication, or help you if you want to do this yourself. You can choose the method, date and time.

There are 4 methods for taking the medication. Some of these options may not be suitable for you.

• You can take the medication yourself by swallowing it.
• You can give it to yourself intravenously after the doctor or nurse has put a tube into your vein.
• You can choose for the doctor or nurse to give the medication by injecting it into your vein.
• The doctor or nurse can give it to you through a tube inserted through your nose into your stomach.

Before you are given the medication, the doctor or nurse will ask if you still want to go ahead. If you are not sure, you can choose to wait and have the medication at another time within the next 6 months. Or you can cancel the request altogether.

If you choose to go ahead and you take the medication or it is given to you, the doctor or nurse practitioner must stay nearby until you have died. They can stay in the same room or in a nearby room or area. You will be able to have anyone you want with you at the time.

Healthcare providers are funded by the Ministry of Health to provide this service. You do not have to pay. If you have any concerns or questions around costs, talk to your healthcare provider.

The ability to claim on your life insurance is not affected by your decision to proceed with assisted dying.

If you choose to receive assisted dying, you will be protected by the Code of Health and Disability Consumers' Rights.

Code of Health and Disability Consumers' Rights — Health and Disability Commissionerexternal link

These include the right to:

• be treated fairly and with respect
• care and support that meets your needs
• make choices about your care
• discuss your care in a way that you understand
• receive good quality care.

If you feel your rights have not been upheld, you can complain.

If you cannot sort out your complaint by speaking directly with the person concerned, you have 2 options.

• You can contact the Nationwide Health and Disability Advocacy Service by phoning 0800 555 050. They provide a free and confidential service and will help you resolve the issue.
• You can contact the Health and Disability Commissioner to make a complaint.

Nationwide Health and Disability Advocacy Serviceexternal link

Making a complaint — Health and Disability Commissionerexternal link