From 7 November 2021, if you have a terminal illness and meet specific criteria, you can ask for help to end your life.
Key points about assisted dying
- Assisted dying involves a person taking or being given medication to end their life.
- There are clear guidelines around who will be able to ask for and receive assisted dying.
- Only the person themselves can make the decision about ending their life. They can talk to whānau about it, but nobody else can make that decision for them.
- Even if a person starts the process to request assisted dying, they can stop it at any time right up to the time it is about to be administered.
|This is a sensitive topic. If you are upset by reading this information and would like somebody to talk to about it, you can call or text 1737 to speak to a trained counsellor for free.|
What is assisted dying?
Assisted dying is when a person who meets specific criteria under the End of Life Choice Act 2019 is helped to end their own life by taking or being given certain medication. This is done by, or in the presence of, a doctor or a Nurse Practitioner (a specialised nurse).
Assisted dying is different from when people choose beforehand not to receive treatment, eg, when someone chooses not to be resuscitated if something like a heart attack occurs. Choosing to not receive medical treatment ahead of time is covered by an advance directive. You cannot choose to receive assisted dying in an advance directive and nor can anyone who holds an enduring power of attorney for you or who is a welfare guardian make this decision for you.
How do I get started if I want to make a request for assisted dying?
The first step is to talk to your own doctor about it. Doctors are not allowed to suggest assisted dying as an option for somebody who is terminally ill, so you have to raise the topic yourself. Nobody else can raise it with your doctor either, it must come from you.
If your doctor objects to assisting people to die (they are lawfully allowed to object and not provide this service to you), they must tell you this and advise you how to contact a doctor who will help. A list of health practitioners who are willing to provide assisted dying services has been set up. This is called the Support and Consultation for End of Life in New Zealand (SCENZ) Group and your doctor will tell you how to contact them.
If, after you have made a request, your doctor is prepared to talk to you about assisted dying or you have been provided with an alternative doctor from the SCENZ Group who will provide the service, then there is certain information the doctor must give you. This includes information about your illness and other end-of-life options that may be available to you. They need to encourage you to speak to your family and friends, or a counsellor, but they must also let you know that you don’t have to do this.
How do I know if I meet the criteria for assisted dying?
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.
All of these conditions must be met. You are not eligible just because you are very old, or because you have dementia, a mental illness or a disability.
Who would decide that I meet the criteria for assisted dying?
The decision about whether or not you would meet the criteria for assisted dying must be made by 2 medical practitioners (doctors). If either or both of the doctors are unsure about whether you are competent to make a decision to end your life (the last bullet point above), a psychiatrist must be asked for their opinion on whether you are competent to make the decision. The request will only be moved forward if the psychiatrist decides that you are competent to make an informed decision about assisted dying.
How will they be able to decide if I am competent or not?
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.
I've been found eligible to receive assisted dying. What will happen next?
Your doctor will talk to you about the progress of your illness and the likely timing to receive the medication. There are forms to fill out and the Ministry of Health has to check that everything under the law has been complied with.
Can somebody else make the decision for me?
No, it has to be your decision and nobody else’s. Your doctor cannot make the decision for you and neither can a member of your whānau – even if they have power of attorney. You don't even have to talk to your family/whānau about it if you don’t want to, although you will be encouraged to.
Your doctor also needs to be sure that you are not under pressure from anyone else to make this decision. This may involve the doctor talking to other health professionals who are in regular contact with you. It may also involve the doctor talking to members of your family/whānau who you agree beforehand the doctor can talk to.
What if I change my mind about assisted dying?
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.
Can I set the process up now in case I can’t decide for myself in the future?
No. This is because you need to be competent to make the decision about being assisted to die right up to the point where you are given the medication.
How would I be assisted to die?
Doctors and nurse practitioners are the only health professionals able to administer the medication to you or to help you if you want to do this yourself. You would be able to choose the method, date and time.
There are 4 options for how to take the medication. You can take the medication yourself (by swallowing, or intravenously after the doctor or nurse has put a tube into a vein) or you can choose for the medication to be administered by the doctor or nurse (by giving it to you through a tube inserted through your nose into your stomach, or by injection). Some of these options may not be suitable for everyone.
Before you're given the medication, you will be asked if you still want to go ahead. If you're not sure, you can choose to wait and have the medication at another time, within the next 6 months, or cancel the request altogether.
If you choose to go ahead and the medication is taken by you or given to you, the doctor or nurse practitioner must stay nearby until you have died, eg, in the same or in a nearby room or area. You would be able to have any family/whānau or whoever you wanted with you at the time.
Will this service cost me anything?
Health practitioners providing this service in primary care (eg, in a GP practice) or within a DHB are able to be funded by the Ministry of Health to provide this service. A funded provider cannot ask for a co-payment which means they can't ask you to pay for the service. If you have any concerns or questions around costs, you should check this with your healthcare provider.
Does a decision to use assisted dying affect my life insurance?
Your life insurance is not affected by your decision to proceed with assisted dying.
How are my rights in relation to assisted dying being protected?
If you choose to receive assisted dying you will be protected by the Code of Health and Disability Consumers' Rights. These include the right to be treated fairly and with respect, to care and support that meets your needs, to make choices about your care, to discuss your care in a way that you understand and to receive good quality care.
If you feel your rights have not been upheld, then you can complain. If you can't sort out your complaint by speaking directly with the person concerned, you have two options. You can contact the Nationwide Health and Disability Advocacy Service (0800 555 050) who provide a free and confidential service and will help you resolve the issue. Otherwise you can contact the Health and Disability Commission to make a complaint.
The following links provide further information about assisted dying. Be sure to only obtain information from New Zealand websites as the laws are different in other countries.
About the end of life choice act 2019 Ministry of Health, NZ
Assisted dying – what you need to know about the new law Consumer NZ
Assisted dying – people's rights under the code Health & Disability Commissioner, NZ
Note: This page will be regularly updated as more resources about assisted dying in Aotearoa New Zealand are developed.
|Melanie Naulls is passionate about consumer-focussed healthcare and helping healthcare professionals in practice. She splits her time between being a lawyer for Hutt Valley DHB and running her own health law practice, Ora Health Law (www.orahealthlaw.co.nz).