The eligibility criteria for assisted dying and how to access the service.
There are strict eligibility criteria for assisted dying. Not everyone with a terminal illness will be eligible for assisted dying. The Act states that to be eligible, the person must meet all of the criteria. The person must be:
- aged 18 years or over
- a citizen or permanent resident of New Zealand
- suffering from a terminal illness that is likely to end their life within six months
- in an advanced state of irreversible decline in physical capability
- experiencing unbearable suffering that cannot be relieved in a manner that the person considers tolerable
- competent to make an informed decision about assisted dying.
A person with a disability or mental illness can access assisted dying if they meet the above criteria. A person can’t access assisted dying solely because they have a mental disorder or mental illness, have a disability or are of advanced age.
Being competent to make an informed decision
The person must be assessed as being competent to make an informed choice about assisted dying. This means that the person is able to understand, retain, use and weigh relevant information about assisted dying, and can communicate their decision in some way.
The person must be considered competent throughout the assessment process and must also be competent at the time of the assisted death. This means if the person is found eligible for assisted dying but then loses competency, they cannot have an assisted death.
Advance directives cannot be used for assisted dying in New Zealand. An advance directive is a statement setting out what treatment the person wants, or does not want, to receive in the future.
Accessing assisted dying
Whānau and carers can play an important role in supporting a person through the process, if the person wants them to. The person does not have to discuss assisted dying with their whānau if they don't want to. However, the person is encouraged to talk to their whānau or other support people who are important to them, and there must be opportunity for them to do so.
Whānau may mean different things for different people. Whānau may be the person’s close family and may also include their extended family, partner, friends or other representatives. The involved whānau could be one person or many people.
Whānau may support a person by:
- helping them understand and consider their end of life options
- attending medical appointments with them (the involved doctors may want to speak to the person on their own at some points in the process)
- providing personal care, such as bathing and feeding
- supporting planning for the assisted death
- providing comfort and pastoral care
- offering care and support when the medication is administered.
The person must raise assisted dying themselves
The person must be the one to raise assisted dying with someone in their health care team. A health professional cannot suggest it as an option.
The person can raise assisted dying with anyone in their health care team, but it is best to talk to a doctor, as only doctors can start the assessment process set out in the Act.
The person should be clear that they are seeking information about assisted dying. The health professional will likely ask the person some questions to check what the person is asking about, and why they want to know about assisted dying.
- Related areas: Palliative care
A doctor will provide care to the person throughout the process
A doctor (known as the attending medical practitioner) will support the person throughout the assisted dying process. The attending medical practitioner will lead the assessment process, and if the person is eligible, they can help the person and their whānau with planning for the assisted death, and can also administer the medication.
Sometimes the person’s attending medical practitioner will be their current doctor, such as their general practitioner or specialist. However, not all doctors will provide assisted dying services. This may be due to personal beliefs (conscientious objection), or because they do not have the appropriate skills or experience.
If a person’s doctor does not provide assisted dying services, the doctor should:
- explain why they do not provide the service
- connect the person with a doctor who can be their attending medical practitioner, or tell the person that they can ask the SCENZ Group for the name and contact details of a medical practitioner who is willing to provide assisted dying services.
The person can contact the SCENZ Group by calling 0800 223 852 or emailing [email protected] for help to find a medical practitioner who provides assisted dying services. The Ministry of Health secretariat will work with the SCENZ Group to help connect the person with an appropriate attending medical practitioner.
A person can also choose to directly contact the SCENZ Group without speaking to their health care team first.
Other health professionals are involved in the assisted dying service
The person will be assessed and supported by other health professionals as they go through the process.
If the attending medical practitioner considers that the person is eligible, a second independent doctor (known as the independent medical practitioner) will then assess the person. If one or both of these doctors thinks that the person 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 person may also have a nurse practitioner (known as an attending nurse practitioner) involved in their care. An attending nurse practitioner will work with the person’s attending medical practitioner and can help the person and their whānau with planning related to the assisted death and can administer the medication if the person chooses this.
The person’s existing health care team may also provide support at different stages, such as providing information or helping them and their whānau plan arrangements. However, this is not considered part of the formal process for assisted dying.
The assisted dying service is free
A person does not have to pay for appointments or medications that are part of the assisted dying service. The person may still have to pay for other costs that are part of their wider health care. This includes:
- the cost of the appointment where they first talk to their general practitioner about assisted dying (even if the general practitioner then becomes the person’s attending medical practitioner)
- the cost of general practitioner appointments that are not specifically related to the assisted dying service (even if the general practitioner is the person’s attending medical practitioner)
- the cost of prescriptions that are needed for the person’s wider health care, such as pain relief.
The person should continue to speak to their general practitioner or others in their health care team about any other health care they might need during the assisted dying process, and this care will be provided as usual.
Assisted dying is a sensitive topic and may be difficult for some people. If reading this information raises distressing feelings for you, there is support available.
You can call or text 1737 for free to speak to a trained counsellor at any time.