The End of Life Choice Act
Starting 7 November 2021, terminally ill New Zealanders will have the right to ask a doctor to end their life. This will make New Zealand one of just 10 countries in the world that offer some form of assisted dying.
Assisted dying is a highly controversial issue socially, and the legislation comes with a broad range of requirements and safeguards to ensure ethical use. However, it raises practical questions as well. To answer these, the End of Life Choice (EOLC) Act includes provisions regarding who can choose assisted dying, and under what circumstances – as well as spelling out its financial implications.
Who is covered by the EOLC Act?
In order to have access to assisted dying, the patient needs to:
- be aged 18 years or over
- be a citizen or permanent resident of New Zealand
- suffer from a terminal illness that is likely to end their life within 6 months
- be in an advanced state of irreversible decline in physical capability
- experience unbearable suffering that cannot be relieved in a manner that the person considers tolerable
- be able to make an informed decision about assisted dying.
This limits eligibility significantly, excluding people suffering from disabilities, grievous but non-terminal illnesses, or cognitive decline. This is, in part, due to financial considerations. Life insurance is not affected by assisted dying, so limiting EOLC to terminally ill patients is an essential way to prevent insurance from being seen as an incentive to use it.
Assisted dying can’t be chosen ahead of time, or by anyone else
It’s common to use Advance Directives (also known as a Living Will) to indicate what kind of medical treatment you do or don’t want to receive in the event of your incapacitation. This might include a wish not to be resuscitated, or that your right to refuse treatment and medication is respected.
While an Advance Directive is not a legally binding document, it does provide guidance to your family and health care providers of your wishes and instructions . This can be a gift to your loved ones when faced with making life changing decisions at a such a difficult time.
Similarly, it’s common to grant one or more Enduring Powers of Attorney (EPAs) to loved ones with the help of a trustee company or lawyer, who can then make medical and financial decisions on your behalf.
Personal Care and Welfare Attorney’s appointed via an EPA or welfare guardians (Court appointed guardians), cannot choose assisted dying on your behalf. Advance Directives also can’t be used, for example in the early stages of cognitive decline, to make an assisted dying decision for the future. In order to use the EOLC, the patient needs to personally request it at the time that they are eligible for it.
This limits the use of both EPAs and Advance Directives, preferring to err on the side of caution to protect human lives and prevent potential abuse. The EOLC Act isn’t designed to allow anyone to plan for assisted dying. Rather, it’s meant to be a last resort, only to be brought up by the patient in question.
Life can be unpredictable. It’s important to have these conversations with your family and loved ones while you are still mentally and physically able.
The End of Life Choice is different from other kinds of healthcare decisions, which can and should be made ahead of time. In the event of your unexpected death or incapacitation, your loved ones may be faced with a wide range of potential challenges that can be avoided with sufficient preparation.
In the event that you should become temporarily or permanently incapacitated, the proper paperwork can make all the difference. That means appointing EPAs to look after your best interests, making your wishes known via an Advance Directive and creating your Will to ensure your loved ones are taken care of and that your estate is managed in the way you wish.
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