Assisted dying

You can contact the Assisted Dying Service by:

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

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.

For assisted dying to be available, 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.

You can talk to your healthcare provider about assisted dying. 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 that you can contact the Assisted Dying Service.

Contact the assisted dying service

Your healthcare provider can help you contact the service.

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.

Two specially trained doctors need to decide that you meet the criteria for assisted dying. The process can take 4 to 8 weeks and there are legal requirements that need to be met. The doctors will contact you to set up appointments. They will come to you – there is no cost to you for this. If either doctor is not sure you are competent to decide to end your life, they will ask for a psychiatric assessment.

First assessment

A first doctor will assess you to make sure you meet eligibility criteria. This doctor could be your general practitioner if they provide assisted dying services. They will consider your individual circumstances including:

• the severity of your illness
• the likely progression of your illness.

They will discuss your other options, including palliative care. They will likely ask you some questions to make 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.

Second assessment

If your healthcare provider considers you to be eligible, a second independent doctor (known as the independent medical practitioner) will then assess you. This doctor is assigned by the service.

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

If one or both of these doctors thinks that you might not be competent to make a decision, a psychiatrist may carry out a third assessment. A psychiatrist is a doctor who specialises in mental health.

The independent medical practitioner and psychiatrist, if required, will be from the practitioner lists held by the SCENZ Group. The SCENZ group is responsible for making and maintaining lists of health professionals who are willing to deliver assisted dying services.

SCENZ Groupexternal link

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.

Your assisted death will be entered on your death certificate.

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

To give feedback on the service

• complete the feedback form published by Manatū Hauora: Give feedback or make a complaint | Ministry of Healthexternal link
• phone: 0800 223 852
• email: AssistedDying@TeWhatuOra.govt.nz
• post:

Health New Zealand | Te Whatu Ora
Assisted Dying Services
PO Box 793
Wellington 6140