The Ministry of Health is responsible for implementing the End of Life Choice Act 2019 (the Act). This includes making any regulations, developing policy, and providing guidance to the health sector.
The Act creates three statutory roles within the health system to oversee assisted dying and make sure the processes outlined in the Act are followed.
The three roles are:
- the Support and Consultation for End of Life in New Zealand (SCENZ) Group
- the End of Life Review Committee
- the Registrar (assisted dying).
The Support and Consultation for End of Life in New Zealand (SCENZ) Group
A Support and Consultation for End of Life in New Zealand (SCENZ) Group will be established with a range of responsibilities relating to doctors, nurse practitioners, psychiatrists and pharmacies involved in delivering assisted dying.
The Director-General of Health will appoint SCENZ members with the collective knowledge and understanding to:
- make and maintain a list of doctors who are willing to act as replacement and/or independent doctors
- provide contact details for replacement and independent doctors when required in a way that ensures the person’s attending doctor does not choose the replacement or independent doctor
- make and maintain a list of psychiatrists who are willing to be involved with assisted dying
- provide contact details for psychiatrists when required in a way that ensures the other doctors do not choose the psychiatrist
- make and maintain a list of pharmacists who are willing to dispense medication under the Act; and provide contact details when required
The SCENZ group will also, in relation to the administration of medication:
- prepare standards of care
- advise on the required medical and legal procedures
- provide practical assistance if requested.
Appointments to SCENZ
Applications for SCENZ Group members were invited in April and selection processes are now underway. The Group is expected to be established formally around July.
Together, SCENZ members must represent the range of professions involved in the Act – medical practitioners, nurse practitioners, psychiatrists, and pharmacists. The Group is expected to bring knowledge and understanding of a Tikanga Māori, legal, ethical, and patient/whānau perspective.
The End of Life Review Committee
The End of Life Review Committee will be appointed by the Minister of Health. The Committee will include a medical ethicist, a doctor specialising in end-of-life care, and one other health practitioner.
The role of the Committee will be to:
- consider reports provided by the doctor or nurse practitioner about the assisted death of a person under the Act
- report to the Registrar whether it considers that the information contained in assisted death reports shows satisfactory compliance with the requirements of the Act
- direct the Registrar to follow up on any information contained in an assisted death report if it considers the report does not show satisfactory compliance with the Act.
Appointments to the End of Life Review Committee
Applications for the End of Life Review Committee were invited in April and selection processes are now underway.
The Registrar (assisted dying)
The Registrar (assisted dying) will be an employee of the Ministry of Health who is appointed by the Director-General of Health.
The Registrar's role will be to:
- check that the processes required by the Act have been complied with to ensure people who wish to receive assisted dying are eligible
- notify the doctor if they are satisfied that the processes have been complied with before the administration of assisted dying medication.
The Registrar must also establish and maintain a register of:
- approved forms held by the Registrar
- reports from the End of Life Review Committee
- the Registrar's reports to the responsible Minister.
The Registrar must also receive complaints and refer complaints under the Act to the appropriate authority, such as the Health and Disability Commissioner or the New Zealand Police.
The Registrar must report annually to the responsible Minister. The responsible Minister must then provide a copy of the report to the House of Representatives. Expressions of interest for this role will be invited later this year.
The role of the Ministry
The Ministry of Health is responsible for the End of Life Choice Act and has developed a work programme to implement it. This includes developing policy and preparing guidance for health providers prior to the commencement date of 7 November 2021.
In addition, once the Act comes into force, the Ministry is required by the Act to review it within 3 years, and every 5 years after that.
The implementation is overseen by a governance group which has the following membership:
- Deputy Director-General – Health System Improvement and Innovation – Co-Chair
- Deputy Director-General – Māori Health – Co-Chair
- Deputy Director-General – System Strategy and Policy
- Chief Nursing Officer – Ministry of Health
- Chief Medical Officer – Ministry of Health
- DHB Chief Executive
- Member of the Council of Medical Colleges
- Member of Te Apārangi: Māori Partnership Alliance