The Ministry of Health is responsible for implementing the End of Life Choice Act 2019 (the Act) and making any regulations, and is developing policy and guidance for health providers.
The Act also 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 are now open. Together, SCENZ members must represent the range of professions involved in the Act – medical practitioners, nurse practitioners, psychiatrists, and pharmacists. Applications will also be sought from those with a knowledge and understanding of a Tikanga Māori, legal, ethical, and patient/whānau perspective.
Applications close on April 20 2021.
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 are now open. Applications close on April 20 2021.
For more information, and to apply for the End of Life Review Committee, please please see the Ministry of Health Careers website. Any questions about the process can be directed to [email protected].
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.
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
End of Life Choice Act Implementation Key milestones
|Jan to Mar 2021||
|April to Jun 2021||
|July to Sept 2021||
|Oct to Nov 2021||
Further detail and timing of the steps for implementation will be made available on this webpage as they become available.
Any queries about the implementation of the Act can be sent to [email protected].
In early February, the Ministry of Health issued a survey to health practitioners about the implementation of the End of Life Choice Act.
The purpose of the survey was to gain an early understanding of workforce knowledge, understanding and attitudes of practitioners about the Act.
Learning about the number of practitioners who may choose to have a role in the assisted dying service, the settings they currently work in and any specific concerns they may have in relation to the Act will help inform the design, planning, and implementation of the system.
Health practitioners have a right to conscientiously object to providing assisted dying services. A response to this survey was not a confirmation of a health professional’s choice to either participate in, or opt out of, the service.
The survey was completely optional.
The survey ran from 1 February to 28 February 2021 and a total of 1,980 responses were received.
Below is a high-level overview of some of the key findings of the survey. These figures represent the views of the health practitioners that opted into completing the survey.
Respondents and participation in principle
- 47 percent of those who responded supported assisted dying in principle
- 53 percent of those who responded opposed assisted dying in principle
- Close to 30 percent of respondents indicated that they would possibly or definitely be willing to provide assisted dying services.
Respondents and their areas of interest
The survey asked respondents what areas of the Act, and the implementation, they would like more information on as implementation planning progresses. The top areas identified by respondents were
- how the process will work end to end
- training and guidance
- support available for clinicians
- funding arrangements.
Responses to the summary are being analysed, including the open-ended answer sections of the survey, and a summary of themes will be shared soon.