Assisted Dying
Policy
We comply with the End of Life Choice Act 2019 and the Code of Health and Disability Consumers' Rights when responding to requests for information about assisted dying services.
All staff understand their legal obligations under the End of Life Choice Act.
They must:
- have a basic understanding of the Act
- know how to respond appropriately if patients or whānau ask questions.
Staff must not directly, or indirectly, encourage a patient to ask about assisted dying services. The patient must initiate this conversation.
Continuity of care is to be maintained for any patient accessing assisted dying services. We:
- continue to provide end-of-life care, while needed
- work cooperatively with other clinicians involved in the patient's care
- provide
information or practical support, if askedThis could include:
- providing access to medical records, with the patient's consent
- talking to the clinician providing assisted dying services, if required
- supporting whānau or family members
- helping with practical arrangements or attending appointments, where possible.
- treat the person the same way as any other patient.
All requests for information about assisted dying, or access to services, are recorded in the patient record in Medtech.
See also End-of-life Care and Care Plans.
Conscientious objection
Anyone may conscientiously object to being involved in assisted dying services.
A conscientious objector is someone who chooses not to be involved in assisted dying services due to their personal beliefs.
Being uncomfortable discussing assisted dying, or not feeling knowledgeable enough to discuss it, does not necessarily mean someone is a conscientious objector.
Conscientious objectors must not stop a patient from getting information about assisted dying services, or discourage them from accessing a legal service.
Responding to patients who ask about assisted dying
All staff, including conscientious objectors, must have a basic understanding of the legislation and know how to respond appropriately if someone asks about assisted dying.
You must:
- respond respectfully and professionally.
- not directly or indirectly encourage someone to choose assisted dying.
- not discourage someone from asking about assisted dying, or inhibit access to lawful medical treatment.
Consider whether it is the right time and place for the conversation. Arrange another time if necessary.
Follow the procedure below for your role:
Non-clinical and unregistered staff
Non-clinical staff, including conscientious objectors, must refer the patient to an appropriate information source.
Tell the patient to:
- talk to their registered doctor.
- find information on the Ministry of Health's website, or you can provide them with printed information.
Tell the patient's GP about the inquiry, describing the kind of information requested.
Registered nurses and other health practitioners
Registered nurses who do not have a conscientious objection can provide information to a patient who asks about assisted dying. The information they provide should be appropriate for the scope of their role.
Registered nurses who are conscientious objectors must advise the patient they can contact SCENZ, (ph: 0800 223 852) but do not need to disclose their objection.
We strongly encourage the use of the Ministry of Health's Conversation Guide for Registered Health Professionals and Handbook for Registered Health Professionals.
As appropriate, tell the patient:
- about assisted dying services as well as other care options, such as end-of-life care and care plans.
- to find information about assisted dying on the Ministry of Health's website, or you can provide them with printed information.
- to speak to the patient's registered doctor.
- they can contact the SCENZ Group, (ph: 0800 223 852) for the name and contact details of a doctor who provides this service.
Advise the patient's registered doctor of the inquiry, describing the kind of information requested. The senior doctor records the information in the patient record.
Doctors and nurse practitioners
We strongly encourage the use of the Ministry of Health's Conversation Guide for Registered Health Professionals and Handbook for Registered Health Professionals.
- Doctors who are willing and able to start the assessment process for assisted dying should follow the clinical pathways on the Ministry of Health's website.
- Doctors who don't provide assisted dying services should let the patient know at the start of the conversation and are required to state the reason.
Either:
- "I have a conscientious objection … but I am able to direct you to people who can give you information."
If you are a conscientious objector, you must tell the patient this, and that they can contact the SCENZ Group (ph 0800 223 852) to get the name and contact details of a medical practitioner who can help them.
- or tell them your reason, e.g. "I don't have the skills/experience/knowledge to provide this service."
As appropriate, tell the patient:
- about assisted dying services as well as other care options, such as end-of-life care and care plans.
- to find information about assisted dying on the Ministry of Health's website, or print it and give them a copy.
- to speak to a knowledgeable clinician at the practice for more information.
- to contact the SCENZ Group (ph: 0800 223 852) for the name and contact details of a medical practitioner who can help.
- In either situation you should attempt to explore what has prompted the patient's request so additional support can be offered.
- Record details of the conversation in the patient record. Include details of any patient-related conversations with other clinicians or referrals you make.
- If you are not the patient's registered GP, you may choose to let them know the patient has asked about assisted dying.
If you are unsure how to respond to a patient, or are uncomfortable with something a patient has said, talk to a senior clinican. If necessary, contact Support and Consultation for End of Life in New Zealand (SCENZ) for advice – ph: 0800 223 852, email: AssistedDying@tewhatuora.govt.nz.
Responding to whānau or family members who ask about assisted dying
Whānau or family members cannot enquire about assisted dying on a patient's behalf, or request information about assisted dying.
If whānau or family members ask about assisted dying for a patient:
- tell them they can find general information on the Manatū Hauora | Ministry of Health's website
- advise the patient's registered doctor:
- about the kind of information requested
- if you have concerns about the patient being pressured into choosing assisted dying.
The senior doctor records the information in the patient record.
Support for staff members
Assisted dying is a sensitive topic and talking about it may be difficult for some people.
Staff members who need support should:
- access peer support networks
- check what stress and well-being support is offered at the practice
- contact their professional organisation
- access employee support services like the Employee Assistance Programme (EAP).