Euthanasia and assisted dying
Overview
What is assisted dying?
End of Life Choice Act 2019, s 4
Assisted dying is when a person with a terminal illness (and who meets the eligibility criteria) requests medication to relieve their suffering and end their life. The medication will be given to them by their doctor or nurse, or the person could take the medication themselves. Assisted dying is often referred to as “euthanasia”.
Assisted dying is not a replacement for hospice care or other health care services.
Who is eligible for assisted dying?
End of Life Choice Act 2019, ss 5, 6
To request assisted dying you need to:
- be 18 years or over, and
- be a New Zealand citizen or permanent resident, and
- have an illness that’s likely to end your life within six months, and
- be in “an advanced state of irreversible decline in physical capability” which means your health has gotten worse over a period a time, and
- have unbearable suffering that can’t be relieved in a way you find tolerable, and
- be able to make an informed decision about assisted dying, which means:
- you can understand and remember relevant information,
- you can use that information to help you make a decision, and
- you can communicate that decision to others.
You can’t choose assisted dying in advance and no one can choose assisted dying for you. This includes anyone who holds your enduring power of attorney. Your doctor is responsible for making sure that you meet these criteria.
How do I request assisted dying?
End of Life Choice Act 2019, ss 10, 11
If you want information about assisted dying or want to request it, you have to ask your doctor. Your doctor should never bring it up without you asking them to. You could say “I would like to talk about my options around assisted dying” or “I would like to request assisted dying under the End of Life Choice Act”.
Can my doctor refuse?
End of Life Choice Act 2019, ss 8, 9
Yes. Your doctor can refuse your request if they disagree for ethical reasons (called a “conscientious objection”). If they do refuse, they need to put you in touch with the Support and Consultation for End of Life in New Zealand (SCENZ) group.
This group has a list of doctors who are willing to carry out assisted dying.
What happens after I have requested assisted dying?
End of Life Choice Act 2019, ss 11-18
Your doctor must talk to you about their opinion of the likely course of your illness (their “prognosis”). They will discuss the process of assisted dying with you and make sure that you understand your other options for end-of-life care.
Your doctor should also encourage you to discuss your wish with others such as whānau, friends, and counsellors.
Your doctor must get a second opinion. The second doctor will check that you’re making an informed decision, read your medical file and examine you. If one or both doctors have concerns about your ability to make an informed decision, a psychiatrist will be brought in to assess you and make the decision on that.
If at any time the health practitioner suspects that you are being pressured about your decision to receive assisted dying, they must immediately stop the process. They should be discussing the risk of pressure with other health practitioners that you regularly see, plus anyone from your family that you’ve approved.
The process of requesting and getting approval will take some time. Throughout, your doctor is required to personally check in with you about your decision to make sure everyone is on the same page. This can be by phone, in writing or in person.
What happens next if I get approved?
If you have been approved, you will need to fill out some forms. The Registrar, appointed by the Director-General of Health, will check that this paperwork has been done.
You will be able to choose the date and time you receive the medication. Before you’re given the medication, you’ll be asked if you still want to go ahead. If not, you can choose to have the medication on another day or not take it at all.
If you choose not to take the medication, your doctor needs to destroy the medication and fill out a form recording your decision and send it to the Registrar.
What if I’m denied assisted dying?
If your doctor and an independent second doctor decide you are not eligible to receive assisted dying, you’ll be notified and told why your application was denied.
If you disagree with the decision (for example, if the doctor says you don’t meet the threshold for “unbearable suffering that can’t be relieved,” but you disagree), you should get in touch with SCENZ for support with reapplying. They may be able to help you gather more information to show you meet the criteria,
Can I change my mind and not go through with assisted dying?
Yes, you can change your mind at any time.
