Te Tiriti o Waitangi and assisted dying implementation

This section aims to provide information about how Te Tiriti o Waitangi has been considered and incorporated as part of the implementation of the End of Life Choice Act 2019.

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Te Tiriti o Waitangi and assisted dying service implementation

Te Tiriti o Waitangi is considered and incorporated as part of the implementation of the new Assisted Dying Service.

Assisted dying services will be part of the health and disability system, and the Ministry is committed to supporting a Māori worldview of health and ensuring quality (culturally and clinically safe), equitable, and effective services for Māori as part of the new assisted dying services. This includes:

  • giving effect to the Ministry’s obligations under Te Tiriti o Waitangi by ensuring the Assisted Dying Service considers and is inclusive of the interests, views and needs of Māori
  • equitable access so that Māori can access the service in ways that meet their particular needs
  • providing services that are effective and have robust accountability and safety measures.

The sector’s Tiriti framework is embedded in Whakamaua: Māori Health Action Plan 2020–2025. This framework draws on the findings of the Hauora Report on the Health Services and Outcomes Kaupapa Inquiry (Wai 2575) and adopts an approach based on both the principles and articles of Te Tiriti. The principles and articles of Te Tiriti, as understood by the Ministry in Whakamaua: Māori Health Action Plan, were considered and incorporated as part of the implementation planning and deliverables.

This included:

  • focused and ongoing engagement with Māori health and disability organisations and Kaupapa Māori health and disability service providers as part of the establishment of assisted dying (for more about this see the engagement section)
  • ensuring the Te Tiriti o Waitangi commitments are incorporated in the service design and reflected in the guidelines, standards of care, care pathway, clinical guidelines, Section 88 notice (funding mechanism); training for the sector, and information about the service. The new service aims to ensure:
    • the services are provided in a culturally appropriate way that recognises and supports the expression of hauora Māori models of care
    • the services provide for Māori self- determination and mana motuhake. Services are person-centred and whānau centred
  • formal partnerships and governance that provide ongoing guidance and direction alongside the Ministry of Health. See the Governance information for more details.

Design principles

The following principles have been considered in the design of the Assisted Dying Service and these principles will continue to guide the delivery of assisted dying services:

  • giving effect to our obligations under Te Tiriti o Waitangi, including considering the interests and needs of Māori
  • ensuring equity (inclusiveness for all communities and equity of access to services)
  • providing services that are effective and have robust accountability and safety measures
  • providing good value for health and disability system resources
  • ensuring consistency with health and disability system strategies.

Governance

Formal partnerships and representation in governance provide ongoing guidance and direction alongside the Ministry of Health as part of the implementation and establishment of assisted dying services.

The partnerships and governance include:

Te Apārangi: Māori Partnership Alliance

Te Apārangi: Māori Partnership Alliance provides guidance, direction and recommendations as part of the implementation of the new assisted dying services. Te Apārangi members include health and disability service providers, researchers and sector experts.

Te Apārangi currently provides oversight and guidance on the implementation of the updated Health and Disability Services Standard (the Standard) to the Ministry.

Te Apārangi: Māori Partnership Alliance was established to work in partnership with HealthCERT as part of the Standards review. Their Terms of Reference can be found at Te Apārangi: Māori Partnership Alliance.

Te Apārangi’s terms of reference were extended to provide advice and guide the implementation of the 2021 Standard using Te Tiriti o Waitangi as the framework to provide guidance, direction and recommendations.

For more about the governance and statutory roles related to the End of Life Choice Act implementation visit Statutory bodies and governance.

Engagement

Engagement has been undertaken and will continue to be undertaken with Māori health and disability organisations and Kaupapa Māori health and disability service providers as part of the design and implementation of the assisted dying service. This includes regular meetings with Māori led primary health organisations and Māori health providers with general practitioner practices. 

Engagement as part of the implementation aims to recognise Māori, and support Māori in their aspirations, whatever they are, by recognising mana motuhake – self-determination.

The purpose of the engagement has been to inform the sector about the Act, and the implementation of the Act, an invite the sector to inform the design of the new service, including at key stages. 

Engagement is ongoing and includes meetings and discussions with Māori led primary health organisations, Māori primary health care providers, and regular updates with the National Māori Health Organisations as part of the implementation of assisted dying.

Māori health organisation feedback is included in the development of the care pathway, the health professional training and guidance, the Standard of Care and Clinical Guideline, and the Section 88 Notice that, once final, will support the funding for practitioners delivering the services.

There will be continued work to develop information that will support care planning specific to Māori who may request assisted dying. For example, it is important the person and their whānau can explain preferences as part of the assisted dying service, particularly from a social, cultural and spiritual perspective.

Assisted dying is a sensitive topic and may be difficult for some people. If reading this information has raised some distressing feelings for you, please know there is support available. You can call or text 1737 for free to speak to a trained counsellor at any time.

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