Roles in the Assisted Dying Service

A medical practitioner means a doctor who is registered with the Medical Council of New Zealand, and who holds a practising certificate. 

A nurse practitioner has advanced education, clinical training and the demonstrated competence and legal authority to practise beyond the level of a registered nurse.

The Act specifies roles for medical and nurse practitioners related to the provision of assisted dying. It is acknowledged that the scope of practice for nurse practitioners is restricted under the Act. 

The Act requires assessments to determine eligibility for assisted dying to be undertaken by two medical practitioners; and a psychiatrist if there is uncertainty about whether someone is competent to request assisted dying. Determining a person’s eligibility for an assisted death can only be done by a medical practitioner.

The administration of assisted dying medication can only be done by a medical practitioner, or a nurse practitioner (under the instruction of a medical practitioner).

Nurse practitioners can be involved in the planning of assisted dying with the person and their whānau and can be with the person to administer medicines or supervise self-administration if that is what the person chooses.

• The medical and nurse practitioner information sheet is on the Delivering assisted dying services page

The wider health workforce, including nurses, allied health professionals and non-registered health professionals, provide ongoing care of people at critical times in their lives, and it is anticipated that these professionals would continue to provide support and wider care for a person who may choose to seek assisted dying.

Training is available for all health professionals on the Act, the assisted dying care pathway and responding when a person raises assisted dying. 

Public hospitals are required to be a facility of last resort for assisted dying under the Crown Funding Agreement. Hospitals are not expected to provide appropriately qualified staff to directly provide the assisted dying service.

Appropriately qualified hospital staff can potentially provide the assisted dying service if they wish to and as agreed as part of their hospitals role. In these situations, the practitioner and the hospital do not receive any additional funding. Practitioners employed by hospitals could also provide the service as part of their private practice (outside their hospital role). In these situations, practitioners could access funding under section 88.

• Policy guidance for DHBs are on the Information for health service providers page
• Assisted Dying Service provision and payment

Pharmacists in general won’t be required to be involved in the dispensing or supply the medications as part of this service. Pharmacies do have important roles in the community, and it will be important for pharmacists and pharmacy staff to have a general understanding of the law, and where to find information if needed should they be asked about the assisted dying service.

A centralised pharmacy distribution approach through two district health board pharmacies will enable medications kits to be provided on prescription directly to practitioners delivering the services across the country.