Accessing assisted dying
The person must raise assisted dying themselves
The person wanting to access assisted dying must start the process by raising assisted dying with someone in their health care team. The person must be the one to raise assisted dying. A health professional cannot suggest it as an option.
The person can raise assisted dying with anyone in their health care team, but it is best to talk to a doctor about assisted dying, as only doctors can start the assessment process as set out in the law.
The person should be clear that they are raising assisted dying with their health professional and seeking information about it. The health professional will likely ask the person some questions to check what the person is asking about, and why they are raising assisted dying.
Whānau can support the person through the process
Whānau and carers can play an important role in supporting a person through the process, if the person wants them to.
Whānau may mean different things for different people. Whānau may be the person’s close family and may also include the person’s extended family and whānau, their partners, friends, or other representatives chosen by the person. The involved whānau could be one person or many people.
Whānau may support a person by:
- helping the person understand and consider their end-of-life options
- attending medical appointments with the person (the involved doctors may want to speak to the person on their own at some points in the process)
- providing personal care, such as bathing and feeding
- supporting planning for the assisted death
- providing comfort and pastoral care
- offering care and support when the medication is administered.
The person who chooses to receive assisted dying does not have to discuss it with their whānau if they don’t want to. However, the person is encouraged to talk to their whānau or other support people who are important to them, and there must be opportunity for the person to do so. Whānau should not raise assisted dying with a health professional on someone’s behalf.
The person will have a doctor to provide care throughout the process
The person will have a doctor who will support them throughout the assisted dying process. This doctor is known as the attending medical practitioner. The person’s attending medical practitioner will lead the assessment process, and if the person is eligible can they help the person and their whānau with planning for the assisted death, and can also administer the medication.
Sometimes the person’s attending medical practitioner will be their current doctor, such as their general practitioner or specialist. Not all doctors will provide assisted dying services. This may be due to personal beliefs (conscientious objection), or because they do not have the appropriate skills or experience.
If a person raises assisted dying with their doctor, and their doctor does not provide assisted dying services due to a conscientious objection, by law the doctor must:
- inform the person of their objection
- tell the person they have the right to ask the SCENZ Group for the name and contact details of a medical practitioner who is willing to provide assisted dying services.
The person can contact the SCENZ Group on 0800 223 852 for help to find a medical practitioner who provides assisted dying services. The Ministry of Health secretariat will work with the SCENZ Group to help connect the person with an appropriate attending medical practitioner. A person does not have to speak to someone in their health care team before contacting the SCENZ Group.
Other health professionals are involved in the assisted dying service
When a person requests assisted dying, they will be assessed, and supported by other health professionals as they go through the assisted dying process.
If the person is found eligible by the attending medical practitioner, they will then be assessed by a second independent doctor (known as the independent medical practitioner). If one or both of these assessments was unable to determine that the person is competent to make a decision, a third assessment may then be undertaken by a psychiatrist. A psychiatrist is a doctor that specialises in mental health.
The independent medical practitioner who completes the second assessment, and the psychiatrist, if required, will both be provided from the practitioner lists held by the SCENZ Group.
The person may also have a nurse practitioner (known as an attending nurse practitioner) involved in their care. An attending nurse practitioner will work with the person’s attending medical practitioner and can help the person and their whānau with planning related to the assisted death and can administer the medication instead of the attending medical practitioner should the person choose this.
The person’s existing health care team may also provide support at different stages, such as providing the person with information or helping the person and their whānau plan arrangements. However, this is not considered part of the formal process for assisted dying.
The person does not have to pay to access the assisted dying service
A person does not have to pay for appointments or medications that are part of the assisted dying service. These are publicly funded.
The person may still have to pay for other costs that are part of their wider health care. This includes:
- the cost of the appointment where the person firsts talk to their general practitioner (or someone else in their health care team) about assisted dying (even if the general practitioner then becomes the person’s attending medical practitioner)
- the cost of other general practitioner appointments that are not specifically related to the assisted dying service (even if the general practitioner is the person’s attending medical practitioner)
- the cost of prescriptions that are needed for the person’s wider health care, such as pain relief.
The person should continue to speak to their general practitioner or others in their health care team about any other health care they might need while they are accessing the assisted dying service. If other supports or services related to their wider health are needed, such as at-home care or counselling, these will be provided through existing channels.