The purpose of the Act is to give people with a terminal illness the option of legally asking for medical assistance to end their lives. They must meet the eligibility criteria to have the option.
Parliament passed the End of Life Choice Act, but it has not come into force. The Act will only come into force if more than 50% of voters in the referendum vote 'Yes'. 'Coming into force' means that the Act will start operating as law in New Zealand.
The Act uses words and language you might not be familiar with. The information below may help to explain the Act and what you can vote on in the referendum.
In the Act, 'assisted dying' means:
In the Act, 'medication' means a lethal dose of medicine used for assisted dying.
The Act is built on 4 elements.
1. Defining those who are eligible for assisted dying.
2. That the person requesting assisted dying is able to understand the nature and consequences of their decision.
3. There is free choice, without pressure, to take part in the process.
4. That a range of roles exist to oversee how the Act is working.
To be eligible for assisted dying, a person must meet ALL of the following criteria. They must:
Under the Act, a person is competent to make an informed decision about assisted dying if they can do ALL of the following things:
A person would not be eligible for assisted dying if the only reason they give is that they:
A health practitioner is not allowed to suggest that a person consider assisted dying while providing a health service to that person.
An advance directive cannot be used to request assisted dying. An advance directive is a statement signed by a person setting out ahead of time what treatment they want or do not want to receive in the future.
Welfare guardians do not have any power to make decisions or take actions under the Act.
The assisted dying process begins with a request from the person to their doctor.
The doctor must do their best to make sure that a person's choice to receive assisted dying is made of their own free will. The doctor must carry out ALL the following checks:
1. The doctor must give the person the following information:
2. The doctor must regularly talk with the person about their wish for assisted dying.
3. The doctor must make sure the person understands their other options for end-of-life care.
4. The doctor must make sure the person knows they can change their mind at any time.
5. The doctor must encourage the person to discuss their wish for assisted dying with family, friends and counsellors, and must ensure the person has the opportunity to do so. However, a person who chooses to receive assisted dying does not have to discuss their wish with anyone if they don't want to.
6. The doctor must talk with other health practitioners who are in regular contact with the person.
7. The doctor must, with the person's permission, talk with members of the person's family.
If at any time the doctor or nurse practitioner suspects a person is being pressured about their decision, they must stop the process.
The person's request is recorded in an approved form given to them by the doctor. The doctor must record the actions they have taken to comply with the checks above in this form.
The person making the request must sign and date the form. If the person is unable to write, they may ask someone else to sign and date the form on their behalf. However, the person who signs on their behalf must meet ALL of the following criteria:
The doctor must be present when the form is signed. The form is shared with the Registrar (a Ministry of Health official who oversees the assisted dying process).
If the doctor decides that the person requesting assisted dying is eligible, they must seek a second opinion from an independent doctor. The independent doctor must also agree that the person meets all the criteria, which includes being competent to make an informed decision about assisted dying.
If either doctor is unsure of the person's ability to make an informed decision, a third opinion from a psychiatrist is required. The psychiatrist must complete a form outlining their opinion and provide it to the Registrar.
If a person is not eligible, they cannot receive assisted dying. The doctors, and the psychiatrist if appropriate, must explain the reasons for their opinion to the person requesting assisted dying.
If the person is eligible for assisted dying, the doctor must do all of the following things:
The person can also choose to delay the date they receive assisted dying by up to 6 months. They may also choose to withdraw their request to receive assisted dying at any time.
Before the date chosen by the person to receive the medication, the doctor must ask the person to choose 1 of these 4 methods.
1. Ingestion, triggered by the person.
2. Intravenous delivery, triggered by the person.
3. Ingestion through a tube, triggered by the doctor or a nurse practitioner.
4. Injection, administered by the doctor or a nurse practitioner.
At least 48 hours before the chosen time, the doctor or nurse practitioner must write the prescription for the person who chooses to receive assisted dying. The doctor or nurse practitioner must advise the Registrar of the method and date chosen.
If the Registrar is satisfied that the process has been complied with, the Registrar must notify the doctor.
At the chosen time for receiving the medication, the doctor or nurse practitioner must ask the person if they choose to:
If the person wants to stop their request to receive assisted dying or does not want to take the medication at that time, it must be taken away immediately. The Registrar must be advised.
If the person wishes to receive the medication at a time no more than 6 months later, the Registrar must be advised.
If the person chooses to receive the medication, the doctor or nurse practitioner gives it to the person. The doctor or nurse practitioner must be available to the person until they die, either in the same room as the person or nearby.
A report must be sent to the Registrar, which includes information about the person who received assisted dying and the medical staff who attended to the person.
No person may make public:
Health practitioners who have complied with the requirements of the Act are immune from criminal and civil liability.
Conscientious objection is when a person refuses to carry out a procedure based on their personal beliefs. No health practitioner has to help a person with assisted dying if they have a conscientious objection.
If the doctor has a conscientious objection they must tell the person who has requested assisted dying, and that they have a right to ask for the name and contact details of a replacement doctor.
1. Support and Consultation for End of Life in New Zealand (SCENZ) Group.
SCENZ would be established by the Director-General of Health and have the following responsibilities:
In relation to the administration of the medication, SCENZ would be responsible for:
2. The End-of-Life Review Committee
The Review Committee would be appointed by the Minister of Health. The Committee would be made up of a medical ethicist, a doctor specialising in end-of-life care, and 1 other health practitioner.
The Committee would:
3. Registrar (assisted dying)
The Registrar would be a person within the Ministry of Health, appointed by the Director-General of Health.
The Registrar's role would be to:
If the Act comes into force, it will be reviewed within 3 years, with further reviews every 5 years after that. Reviews of the Act should take no longer than 6 months.
Nothing in the Act affects a person's right to refuse nutrition, hydration or life-sustaining medical treatment.
Nothing in the Act affects a doctor's duty to alleviate suffering according to standard medical practice.
For the purpose of any life insurance or other contracts, a person who receives assisted dying is taken to have died from the terminal illness from which they suffered, as if assisted dying had not been provided.
The End of Life Choice referendum will give you the opportunity to vote on whether the Act should come into force. 'Coming into force' means that the Act will start operating as law in New Zealand.
The referendum question is:
Do you support the End of Life Choice Act 2019 coming into force?
You can choose 1 of these 2 answers:
If more than 50% of people vote 'Yes' in the referendum, the Act will come into force 12 months after the final result is announced.
If more than 50% of people vote 'No' in the referendum, the Act will not come into force. It will not start operating as law in New Zealand.
You can download and read the Act in full.
At this year's General Election, you'll also be given the opportunity to vote in a referendum on the recreational use of cannabis.