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“How do you determine whether an elderly patient is being coerced”? asks columnist Bill Ralston in The NZ Listener (July 14 – 20) and referring to doctors considering a request for assistance to die.

Doctors will be determining it the same way as they do now.  They observe the patient’s behaviour when alone, then when in the presence of family members, they observe the behaviour of the family members towards the patient, consult with other medical practitioners who interact with the same patient and draw their conclusions.

We forget that doctors are accustomed to receiving requests from patients that will culminate in death if agreed to.  These could be requests to switch off life support or requests to discontinue life-saving treatment.

Coercion assessment is standard practice for some doctors, especially those in intensive care and in hospital/hospice/rest home settings towards the end of life. 

The College of General Practitioners is neutral towards the End of Life Choice bill but has made recommendations.  One of these it that assessing doctors should have experience in acute and/or end-of-life settings.  This is very sensible.  Such doctors will already have plenty of experience in assessing lack of coercion. 

Ditto mental competence.  Ditto eligibility.   


Ann David is a retired human resources professional living in Waikanae on the Kapiti Coast. She has been a campaigner for the right to die with dignity for the past 15 years, initially in Australia and since 2009, in New Zealand. She is a member of the End of Life Choice Society and of the NZARH. 


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