By Ann David, Vice-President, End-of-Life Choice Society NZ
The End-of-Life Choice Act comes into force on 7 November. Doctors and their patients can then make use of the new law that allows assisted dying under strict conditions.
The End-of-Life Choice Society fought for over 40 years to obtain this right for terminally ill New Zealanders and it remains today the only organisation that voices the needs of these patients.
Doctors have been prepared
The Ministry of Health (MoH) has worked hard to prepare the medical workforce by the deadline date. It has done exceptionally well, despite also dealing with the Covid-19 outbreak.
Training for medical practitioners willing to be involved in assisted dying is well underway. We await the publication of a dedicated 0800 phone number that patients can access for help if they are eligible, but their own doctor is a conscientious objector. This will be published on the End-of-Life Choice Society website at www.eolc.org.nz as soon as it is to hand.
Doctors are not allowed to recommend or suggest assisted dying to patients. Instead, patients must open the conversation by asking their doctor for assisted dying. Just how to do this is explained on www.eolc.org.nz. The request must be explicit: e.g. “Doctor, will you assess me for assisted dying?” (In te reo, ask for “awhina mate”).
Responsibilities of conscientious objectors
Even conscientiously objecting doctors have responsibilities under the law.
If asked for assisted dying, a doctor must tell the patient that they have a conscientious objection and tell them that they have the right to ask the SCENZ group (part of the Ministry of Health) for further information. This is where the 0800 number comes in.
Most hospices (but not all) have declared their conscientious objection to assisted dying to preserve their ethos of neither prolonging nor hastening death. Even so, under the law hospices have a requirement to establish a protocol that will deal with requests for assisted dying without frustrating patients’ access to it. Patients must be made aware when registering that the hospice is a conscientious objector.
It is a comfort to know that palliative care is available at home and in the community. The MoH expects that most assisted deaths will occur at home or in rest homes with some in DHB hospitals.
Number opting for assisted dying likely to be very small
How many people will opt for assisted dying? Due to the strictness of the eligibility criteria and the many safeguards, the Society anticipates that fewer than 1% of deaths in 2022 will be by assisted dying. New Zealand has about 35,000 deaths each year, so fewer than 350 in the first year; this may increase to 3% in subsequent years.
If you believe you may need this service, keep an eye on www.eolc.org.nz where information is constantly updated in patient-friendly language.