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The bill explained

David Seymour’s End of Life Choice Bill was drawn from the members’ bills ballot on 8 June 2017. The First Reading vote passed the bill to Select Committee stage on 13 December 2017. 

End of Life Choice Bill 2017

This bill gives people with a terminal illness or a grievous and irremediable medical condition the option of requesting assisted dying.

In-depth information is available here or you can read an overview below.

Purpose

The aim of the Bill is to legalise voluntary euthanasia in certain circumstances. The explanatory note states that the Bill gives “people with a terminal illness or a grievous and irremediable medical condition the option of requesting assisted dying.” [1]

Background

The explanatory note to the Bill states: “evidence and analysis considered in the case of Seales v Attorney-General [2015] NZHC 1239 demonstrated that, without a change in the law, some people in New Zealand are suffering unbearably at the end of the lives and are taking their lives earlier than they would if assisted dying were legally available to them. There was broad consensus that palliative care cannot alleviate all suffering, including suffering that is unbearable for a person.” [2]

The Explanatory note to the Bill also states: “Under this Bill, it remains a criminal offence to assist a person to die except by an action undertaken by a medical practitioner in the very limited circumstances prescribed. This Bill will provide the option of relief to a small but significant number of people who suffer unendurably during the terminal days or weeks of a difficult illness, despite the best that palliative care can offer, or to those who suffer unendurably as a result of a grievous and irremediable medical condition, despite the best available medical care.” [3]

Main Provisions

Assisted death

The Bill provides that if a person chooses “assisted dying” (i.e. “the administration by a medical practitioner of a lethal dose of medication to a person to relieve his or her suffering by hastening death”), subject to the process described in this Bills Digest, the “attending medical practitioner” (the person’s medical practitioner) must administer the medication which will cause the death to the person (and which has been chosen by that person) by-

  • “ingestion, triggered by the person”,
  • “intravenous delivery, triggered by the person”; or
  • ‘ingestion through a tube”,
  • “injection”

The attending medical practitioner must “be available to the person until the person dies” or “arrange for another medical practitioner to be available to the person until the person dies”. The medical practitioner is “available to the person” if they are “in the same room as the person” or “not in the same room as the person but in close proximity to the person.”

The Bill provides that “a person who dies as a result of the provision of assisted dying is taken for all purposes to have died as if assisted dying had not been provided” and “a person is immune from liability in civil or criminal proceedings for acts or omissions in good faith and without negligence in providing or intending to provide assisted dying.”

The Bill also provides that it does not affect a person’s right to refuse to received nutrition, refuse to receive life-sustaining hydration, and refuse to receive life-sustaining medical treatment. The Bill also states that the Bill does not affect a medical practitioner’s duty to alleviate suffering in accordance with standard medical practice (Part 2, Clause 15 (“Medication chosen”), Clause 16 (“Medication administered”), subclauses (4)-(6); Part 4, Causes 24, 25 and 26 (“Other rights and duties not affected”, “Effect of death under this Act” and “Immunity in civil or criminal proceedings”); Part 1, Clause 3, definitions of “assisted dying” and “attending medical practitioner”).

Request made for assisted dying

The Bill provides that a person who wishes to have the option of assisted dying must tell the attending medical practitioner. The medical practitioner must:

  • give the person the following information -
    • the prognosis for the terminal illness or grievous and irremediable medical condition; and
    • the irreversible nature of assisted dying; and
    • the anticipated impacts of assisted dying; and
  • talk with the person about his or her wish at intervals determined by the progress of his or her terminal illness or medical condition; and
  • ensure that the person understands his or her other options for end of life care; and
  • ensure that the person knows that he or she can change his or her mind at any time; and
  • encourage the person to talk about his or her wish with others such as family, friends, and counsellors; and
  • ensure that the person knows that he or she is not obliged to talk to anyone; and
  • ensure that the person has had the opportunity to talk about his or her wish with those whom he or she chooses; and
  • do his or her best to ensure that the person expresses his or her wish free from pressure from any other person by talking with other health practitioners who are in regular contact with the person and talking with members of the person’s family approved by the person; and
  • complete the first part of the prescribed form requesting the option of assisted dying by recording the actions he or she took to comply with the above requirements (Part 2, Clause 8).
Request for assisted dying confirmed

The Bill provides that if the person wishes to proceed, the attending medical practitioner must give the person who desires assisted dying the prescribed form requesting the option of assisted dying. The person requesting assisted dying must sign and date the “second part of the form” or it may be signed by another person if the person to whom the form relates requests that other person to sign and date it. The attending medical practitioner must then collect the form and send it to the Registrar (i.e. the Registrar (assisted dying)) (Part 2, Clause 9; Part 2, Clause 21 (“Registrar (assisted dying)”).

Comment

The forms are to be prescribed by regulations and so do not exist in the Bill. The words “second part of the form” should therefore be replaced (Part 4, Clause 23).

First opinion on request for assisted dying

The Bill provides that the attending medical practitioner must reach the opinion that:

  • the person is a person who is eligible for assisted dying; or
  • the person is not a person who is eligible for assisted dying; or
  • the person would be a person who is eligible for assisted dying if the person’s competence were established (see below).

The attending medical practitioner must complete a prescribed form recording his or her opinion and send the completed form to the Registrar (Part 2, Clause 10).

Second opinion on request for assisted dying

The Bill provides that if the attending medical practitioner reaches the opinion that the person is a person who is eligible for assisted dying or that the person would be a person who is eligible for assisted dying if the person’s competence were established as described below, the attending medical practitioner must:

  • ask the SCENZ Group (Support and Consultation for End of Life New Zealand – established by Clause 19) for the name and contact details of an independent medical practitioner; and
  • ask the independent medical practitioner for his or her opinion on whether the person is a person who is eligible for assisted dying.

The independent medical practitioner must read the person’s files, examine the person and reach the opinion that:

  • the person is a person who is eligible for assisted dying; or
  • the person is not a person who is eligible for assisted dying; or
  • the person would be a person who is eligible for assisted dying if the person’s competence were established as described below

The Bill further provides that the independent medical practitioner must:

  • complete a prescribed form recording his or her opinion; and
  • send the completed form to the Registrar; and
  • send a copy of the completed form to the attending medical practitioner (Part 2, Clause 11; cf. Clause 12).
Specialist’ opinion on person’s competency to ask for assisted death (“third opinion”)

The Bill provides where the medical practitioners (i.e. the attending medical practitioner and the independent medical practitioner) disagree as to:

  • whether the person is a person eligible for assisted dying; or
  • that the person would be a person who is eligible for assisted dying if the persons competence was established by the specialist,

the two medical practitioners must jointly:

  • ask the SCENZ Group ((Support and Consultation for End of Life New Zealand - a group established to maintain a list of replacement medical practitioners (see “conscientious objection” described below) and independent medical practitioners, specialist and pharmacists willing to dispense the relevant medications) for the name and contact details of a “specialist” (i.e. a psychiatrist or a psychologist); and
  • ask the specialist for his or her opinion on whether the person is competent to be eligible for assisted dying (Part 2, Clause 12; Part 1, definitions of “medical practitioner”, “attending medical practitioner”, “independent medical practitioner” and “specialist”).
Communication of decision on request for assisted dying

The attending medical practitioner must explain his or her decision, if it is negative, to the person. If the decision of independent medical practitioner or the specialist, is negative, the independent medical practitioner or the specialist, as appropriate, must attend the person with the attending medical practitioner to explain the reasons for that opinion to the person who has requested assisted dying. The attending medical practitioner must complete a relevant prescribed form and send it to the Registrar (Part 2, Clause 13).

If the attending medical practitioner reaches the opinion the person requesting assisted dying is a person who is eligible for assisted dying and the independent medical practitioner agrees or a specialist reaches that opinion, the attending medical practitioner must:

  • tell the person that the person is a person who is eligible for assisted dying; and
  • discuss with the person the progress of the person’s terminal illness or grievous and irremediable medical condition; and
  • discuss with the person the likely timing of the assisted dying; and
  • make provisional arrangements to be available to administer the medication at the time indicated (Part 2, Clause 14; Part 3, Clause 19).
Reporting

The Bill makes extensive provision for the reporting of the death and the prescription and unused medication if the person who has chosen assisted death dies before the medication is not dispensed before the person dies (Part 2, Clauses 17 and 18).

Offences

The Bill provides that a person commits an offence (carrying maximum penalties (on conviction) of a maximum term of imprisonment three months or a fine not exceeding $10,000) who:

  • wilfully fails to comply with a requirement in this Bill; or
  • completes or partially completes a prescribed form for a person without the person’s consent; or
  • alters or destroys a completed or partially completed prescribed form without the consent of the person who completed or partially completed it (Part 4, Clause 27).
Conscientious objection

The Bill provides that no person is required to do anything under the Bill to which the person has a conscientious objection. Particular provision is made in this respect for an attending medical practitioner (i.e. the medical practitioner of the person requesting assisted dying) having received a request for assisted dying to assert their conscientious objection along with an obligation to tell the person that they may ask the SCENZ group for the name and contact details of a replacement medical practitioner (Part 2, Clauses 6 and 7; Clause 19 (“SCENZ Group”).

Regulations for forms

The Bill provides that the Governor-general may, by Order in Council, make regulations prescribing forms for the purposes of this Bill (Part 4, Clause 23).

Copyright: © NZ Parliamentary Service, 2017

 

You can show your support for Dignity in Dying by making a submission to the Select Committee. Here's some advice on how to make a submission. Closing date for submissions is Tuesday, 6 March 2018.

 

 

 
 
 
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