New Zealand report: First year of euthanasia and assisted suicide.

This article was recently published by the Australian Care Alliance.

Euthanasia and assistance to suicide became legal in New Zealand on 7 November 2021 under the End of Life Choices Act which passed the Parliament by 69 votes to 51 in December 2019 and was endorsed at a referendum in 2020 by 65.1% of voters.

Numbers

• 257 people were euthanased or assisted to suicide between 7 November 2021 and 6 November 2022.
• Deaths by euthanasia and assisted suicide accounted for approximately 0.67% of all deaths in New Zealand.
• 23% more women than men applied for euthanasia or assistance to suicide - 365 women and 296 men.

Eligibility criteria

The key eligibility criteria are that the person is an adult New Zealand citizen or permanent resident who, according to two assessing medical practitioners, “suffers from a terminal illness that is likely to end the person’s life within 6 months”.

Neither medical practitioner needs to have any specialist qualification in a field relevant to the particular terminal illness.

If either or both assessing practitioners are uncertain of the person’s competence to make an informed decision then the person must be examined by a psychiatrist to determine this matter.

Only 6 of the 636 people assessed by a first medical practitioner or the 475 people assessed by a second medical practitioner for eligibility between 7 Nov 2021 and 6 November 2022 were referred to a psychiatrist, and each of these were confirmed as eligible other than one person who died before the assessment was completed.

Health practitioner

Health practitioners are not permitted to initiate a discussion with or make a suggestion to a patient about accessing euthanasia or assistance to suicide under the Act.

A medical practitioner with a conscientious objection can refuse to participate but must advise a person who requests access of the person’s right to ask the SCENZ Group for the name and contact details of a replacement medical practitioner. The SCENZ (Support and Consultation for End of Life in New Zealand) Group maintains a register of health practitioners willing to provide access to people seeking euthanasia or assistance to suicide.

Administration

If the person chooses to self-administer the prescribed lethal poison it is only supplied to them shortly before a time specified by the person for self-administration (suicide).

Regardless of whether the lethal poison is self-administered or administered by an attending medical or nurse practitioner, the attending medical or nurse practitioner (or a substitute practitioner) must be in “close proximity to the person”, but not necessarily in the same room or area, until the person’s death.

Annual report

The only elements required by the Act to be in the annual report from the Registrar (Assisted Dying) are the total number of deaths and the number of deaths occurring through each of the four methods described in the Act and the number of complaints received about breaches of this Act and how those complaints were dealt with.

The first annual report covered the period 7 November 2021 to 31 March 2022 and reported on 66 assisted deaths.

The four methods of administration of the lethal poison set out in s19(2)(a) of the Act are, and the number of deaths by each method between 7 November 2021 and 31 March 2022 were:

• ingestion, triggered by the person - 6
• intravenous delivery, triggered by the person - 4
• ingestion through a tube, triggered by the attending medical practitioner or an attending nurse practitioner – 0, and
• injection administered by the attending medical practitioner or an attending nurse practitioner - 56

No complaints about breaches of the Act were received.