Saturday, June 18, 2022
Jessica E Young (Victoria University of Wellington), Janine Winters (University of Otago), Jeanne Snelling (University of Otago), Ben White (Queensland University of Technology), Colin Gavaghan (University of Otago), Andrew Geddis (University of Otago), Richard Egan (University of Otago), The End of Life Choice Act: A Proposed Implementation and Research Agenda, 134 N.Z. Med. J. 145-158 (2022):
Aim: This article outlines the End of Life Choice Act 2019. It highlights some of the key implementation issues to ensure the system operates safely and equitably after the Act comes into force. It also identifies priorities for research to ensure issues are detected and provision of assisted dying (AD) is monitored.
Method: We reviewed the End of Life Choice Act, assisted dying implementation literature and governmental reports.
Results: Effective system implementation depends on infrastructure, oversight and funding. In terms of service provision, we make recommendations about training for all health practitioners and providing practitioners; the nuances of discussing the "wish to hasten death"; conscientious objection; cultural safety for Māori; and minimising the complexity of delivering assisted dying practice. Structured research is needed to understand how the assisted dying system is operating.
Conclusion: This article contributes by identifying core issues for practitioners, patients and policymakers. Implementation is an ongoing process that continues after the Act starts. Data are required to know whether access is equitable, who is choosing to make use of the law, whether providers are well informed and whether the safeguards are working as intended. The implications of how the Act is implemented are significant for patients, whānau, health professionals and society.