HealthInfo Waitaha Canterbury

Assisted dying

 

Assisted dying is when a person is helped to end their own life by taking or being given certain medication. For this 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).

Assisted dying is different to choosing not to receive treatment as your health condition deteriorates. Choosing not to receive specific medical treatment is every person's right.

You can also decline treatment ahead of time with advance care planning. For example, people often choose not to have cardiopulmonary resuscitation (CPR) if they have a serious incurable health condition. This helps focus their care on things that are important to the person and allows a natural death 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. But you are required by law to be fully competent right up to the point when the 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.

Making a request for assisted dying

The Ministry of Health has a lot of useful information about assisted dying.

You can also talk to your own doctor about it. Doctors and other healthcare providers are not allowed to suggest assisted dying as an option for somebody who is terminally ill. You must raise the topic yourself. Nobody else can raise it with your doctor either, it must come from you.

Doctors are allowed to conscientiously object to assisted dying. So, they might not be able to provide this service. If so, 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 or by phoning 0800-223-852. Or your doctor can help you contact the service.

The Ministry of Health also has a list of health practitioners who are willing to provide assisted dying services. They are members of the Support and Consultation for End of Life in New Zealand (SCENZ) Group.

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 (family) and friends or a counsellor. But they must also let you know that you do not have to do this.

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

Deciding if you meet the criteria for assisted dying

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

Changing your 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.

How you will be assisted to die

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 administer 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.

Costs

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

Life insurance

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

My rights with assisted dying

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 and to care and support that meets your needs. They also include the right 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, 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 (0800-555-050). They 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.

  HealthInfo recommends the following pages

• Ministry of Health – Assisted dying

  Information about assisted dying, including legislation and groups involved in the service.

• Te Whatu Ora – Assisted dying accessible and translated information

  Information about the assisted dying service in audio, large print, braille and New Zealand sign language. Information sheets are available in te reo Māori, Arabic, Cook Island Māori, Hindi, Japanese, Korean, Niuean, Persian, Punjabi, Samoan, Simplified Chinese, Spanish, Tokelauan, Tongan and Traditional Chinese.

• Health and Disability Commissioner – Assisted dying: people's rights under the code

  A factsheet explaining your rights under the Code of Health and Disability Services Consumers' Rights if you choose to receive the assisted dying service. It includes how to make a complaint if you feel your rights have been breached.

Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Last reviewed October 2024.

Sources

Page reference: 1041018

Review key: HIDLT-326665