The End of Life Choice Act 2019 comes into law in New Zealand on 7 November 2021. From that date, those over 18 who experience unbearable suffering from a terminal illness will be able to legally ask for medical assistance to end their lives.
Who will be eligible to receive assisted dying?
The legislation sets tight controls on who can avail themselves of the option. Those wishing to end their lives under the law must be:
- terminally ill and likely to die within the next six months.
- in an advanced state of irreversible decline and must be undergoing “unbearable” suffering.
- and must be mentally able enough to make an informed decision.
This, therefore, excludes people living with degenerative illnesses such as Huntington’s disease and dementia or Alzheimer’s, or those struggling with long-term mental health issues for example.
Health professionals involved in the implementation of the Act have estimated that a very small number of people will be eligible to receive assisted dying when it becomes legally available – approximately 350 people a year.
How does the process begin?
The decision to receive assisted dying is entirely up to the eligible person. It is against the law to be pressured in any way around this decision (if health professionals have been found to have raised the issue with someone first, they can be prosecuted). This is a big decision though so it’s advisable to talk to those closest such as a friend, family member or trusted health care professional.
After the person has decided that this is the right option for them, they must first raise the subject with their doctor as they are not permitted to raise it with their patient. Health practitioners do not have to help a person with assisted dying if they have an objection to doing so. If they are unwilling to assist in this journey, the person has the right to choose another one who will help work through the process.
A number of assessments are undertaken to ensure that the person applying meets the criteria. This includes:
- two medical practitioners agreeing that the person is eligible under the strict criteria
- a psychiatrist assessment if there is any uncertainty about their capacity or competency.
What choices will the eligible person have?
The eligible person will have some decisions to make about their assisted death. This includes choosing the date and time (which can be delayed), the location (such as hospital or home), whether they’d like loved one’s present, and how the medication will be administered.
Some options may not be appropriate or possible depending on a person’s condition. In those cases, a person’s health practitioner will be able to provide advice about options.
Asking for assisted dying cannot be set out in an advanced directive or will.
What safeguards have been put in place?
It is important to know that if a person has chosen assisted dying, they can change their mind at any time. Anecdotal evidence from other countries that have made assisted dying legal suggests that after people raise the issue with a health professional, they will often change their mind once they receive palliative care.
A committee has also been set up that who will review reports of those undergoing assisted dying: the committee consists of Dr Dana Wensley, a medical ethicist, Brenda Close, a health practitioner, and Dr Jane Greville, a medical practitioner practising end-of-life-care.
The Support and Consultation for End of Life in New Zealand group (SCENZ) will maintain a list of health practitioners providing assisted-dying services and will help develop and oversee standards of care.
Detailed information about End of Life Choice Act can be found on the Ministry of Health website.