New Zealand law strikes a good balance between an individual's choice and the interests of the community.
THE PRESENT LAW
- Anyone in New Zealand can choose to refuse any form of medical treatment, or ask to have existing medical treatment or interventions discontinued. The New Zealand Bill of Rights Act 1990 (Section 11) specifically grants everyone the right to refuse to undergo any medical treatment.
- Withdrawing futile medical assistance from a patient, even when this action will result in a person’s death, is considered to be legal and ethical in New Zealand.
- Anyone in New Zealand can choose and reasonably expect to receive medication to relieve pain and suffering. The provision of such pain relief under the care of a doctor is both legal and ethical, even if there is a risk that the treatment may result in an earlier death.
- While suicide is devastating in its consequences for those left behind, choosing to commit suicide is technically not illegal in New Zealand. It is choosing to assist someone else to take their own life, or to administer a lethal medication directly to another person, that remains illegal.
OTHER CHOICES AND POSSIBILITIEs
- Anyone of any age in New Zealand with a life-limiting condition can choose to access palliative care services. It has been Government policy since 2001 to provide such services in a coordinated and culturally appropriate way, and this commitment to improving end of life care is ongoing.
- The quality of palliative care in New Zealand ranks third highest in the world, meaning that no one need suffer extreme pain during the dying stages of life. Medication can always be used on compassionate grounds to relieve pain and suffering, and this is perfectly legal as long as it is not intended to directly end the life of the patient.
- Everyone in New Zealand is protected by a code of rights published by the Commissioner under the Health and Disability Commissioner Act 1994. For example:
- The right to have services provided in a manner that respects the dignity and independence of the individual.
- The right to have services provided in a manner that minimises the potential harm to, and optimises the quality of life of, the individual.
- The right to make an informed choice and give informed consent.
- The right to refuse services and to withdraw consent to services.
- The right to use an advance directive in accordance with the common law.
- Te Ara Whakapiri: Principles and guidance for the last days of life, published by the Ministry of Health, outlines the essential components and considerations required to promote quality care at the end of life.
There are countless stories which can be told, even here in New Zealand, about people who have found a preciousness and poignancy in allowing others to care for them at the end of life. This involves an element of choice, but once the choice is made we can be surprised by the possibilities that it brings.