On this page

Responding when a person raises assisted dying: conversation guide and handbook

It is important that healthcare staff are prepared to respond with respect and compassion if assisted dying is raised by a person, regardless of their personal views.

The conversation guide and accompanying handbook, aim to support registered healthcare staff to respond appropriately and respectfully if a person raises assisted dying with them. It contains an overview of the assisted dying conversation guide and strategies for common scenarios.

These resources are designed to support healthcare staff, when responding to an initial request. They are not a guide to assessing a person's eligibility.

We recommend that you read the handbook "Responding when a person raises assisted dying" first, before using the conversation guide.

An e-learning module is available to support understanding and use of the conversation guide. Healthcare staff can access the e-learning module in Ko Awatea LEARN or healthLearn.

Ko Awatea LEARN (external link)

healthLearn (external link)

Assisted dying care pathways 

Although not all health practitioners will provide assisted dying services, a person is entitled to raise assisted dying with any health practitioner. It is important to ensure the person’s request is met with respect and compassion. There are also legal obligations for medical practitioners when assisted dying is raised.

There are three care pathways for assisted dying services:

  1. For medical practitioners who do not provide assisted dying services for reasons of conscientious objection or as they do not have the appropriate skills or experience (reasons of competency).
  2. For health practitioners (not including medical practitioners) who cannot provide assisted dying services.
  3. For medical and nurse practitioners who will provide assisted dying services.

Objectives of the care pathways

The three care pathways aim to ensure that assisted dying services are provided in a person- and whānau-centred way that focuses on what matters from the perspectives of the person and their whānau at each step of the process.

A person- and whānau-centred approach means that a person and their whānau are heard, information is provided in a way that is understood by a person and their whānau, and the person is informed and empowered to make decisions affecting them. Choosing assisted dying is the person’s choice.

Health practitioners are encouraged to consider any additional support a person may need throughout these care pathways based on individual circumstances, such as for a person with a disability, or other social need.

The objectives of the care pathways include ensuring there is: 

  • robust accountability and safety measures 
  • timely access to appropriate information (verbal, written, accessible formats, translations)
  • equitable access and service delivery
  • continuity of care throughout the care pathway
  • consistency with health and disability system legislation and strategies, including standards of care, codes of conduct, evidenced best practice and Te Tiriti o Waitangi.

The assisted dying care pathways for health practitioners supporting information guide provides an overview of the process followed when a person raises the topic or chooses to access assisted dying or chooses to access the assisted dying services.

The three care pathway diagrams can also be downloaded and used as reference documents 

Further information is also available in the Ko Awatea LEARN or healthLearn module: Assisted dying care pathway: Overview.

This e-learning module explains the process for accessing assisted dying, including the roles of different health practitioners.

Ko Awatea LEARN (external link)

healthLearn (external link)

Standard of care

Ministry of Health | Manatū Hauora has published the Standard of care, titled 'Standard of Care: Administering assisted dying medication in New Zealand Aotearoa"

The standard of care outlines best practice for administering assisted dying medication to ensure safe service delivery for people and whānau. 

Standard of Care: Administering assisted dying medication in New Zealand Aotearoa | Ministry of Health NZ (external link)

Medications

The medications used for assisted dying are safe and effective medicines. Use of these medications for assisted dying is what’s is referred to as an ‘off-label’ use. That means a medicine, prescribed for purpose not included in the product information. Prescribing off label is very common.

A centralised pharmacy distribution approach enables medication kits to be provided on prescription directly to delivering the services.

Medical and nurse practitioners providing the assisted dying service will be provided with the Assisted Dying Clinical Guideline covering considerations and requirements related to medications and the administration. 

The guideline is not publicly accessible due to public safety considerations.

Assisted dying is a sensitive topic and may be difficult for some people. If you need support, please consider talking to your employer or accessing the Employee Assistance Programme (EAP) available in your workplace.

You can also talk to a trained counsellor by calling or texting 1737 — a free, confidential service available 24/7.