The first figures released this week give us a clue.
When the referendum on the End of Life Choice Act was passed by a majority of New Zealanders in 2020, most of us got on with the job of living.
For the Ministry of Health, the task was to create a whole new unit – the Assisted Dying Service – and this has just released its first formal report covering the period from 7 November 2021, when assisted dying became available in New Zealand, to 31 March 2022.
The data gives us the first real glimpse into how the new Service is working and whether or not it is helping dying New Zealanders whose suffering is unbearable.
In the nearly five months covered, 66 people have had assisted deaths in New Zealand, 73% of those at the person’s home or another private residence.
A further 59 people were still in the process of assessment or preparation for assisted dying at 3lst March, while another 81 had applied but did not continue the process (due to being ineligible, withdrawing or dying of their condition).
Long-time Hawke’s Bay-based Assisted Dying Advocate and former Medical Director of Cranford Hospice, Dr Libby Smales says the report is “encouraging”.
“It is very thorough and it’s such a relief to know the service is up and running in New Zealand.”
The data shows that 130 medical practitioners including doctors, psychiatrists, pharmacists and nurses across the country have been trained and appointed for a two-year term to work in a variety of roles with the Assisted Dying Service. Of these, 25 are currently based in the region encompassing Hawke’s Bay, Whanganui, Wairarapa, Hutt Valley and Capital and Coast.
“What is particularly reassuring,” says Libby, “is that there are enough medical practitioners (and clinical nurse practitioners) who have come forward to make the service possible and I have been told that the training provided by the Ministry is very good.
“Comments from the practitioners providing this service echo those from overseas talking about what a humbling experience it is; what a profound privilege it is to be able to provide this service for suffering dying patients and their families; how peaceful such deaths are. “
Assisted Dying Services data is broken down in a number of ways.
Of the 206 applications for assisted dying to 3lst March, 78.6%, or 162 people were NZ European/Pākehā, 5.8 % (12) were Māori, and 2.4% (5) Asian. There were zero Pacific people who applied in the time period, and 13.1%, or 27 people came from “other ethnic groups”.
Seventy-four per cent of applicants were aged 65 years or older, while 4.4% were aged 18-44 years and 21.4% (44 people) were between 45 and 64 years old.
More women than men applied for the Service with 114 female (55.3%) applying compared with 92 (44.7 %) male.
A cancer diagnosis was the reason given for 65% (133) New Zealanders applying, while some 21 people, 10.2% had a neurological condition.
“This is what we expected, “says Dr Smales. “I think our relatively restrictive legislation disadvantages people suffering with chronic neurological degenerative diseases. “
Dr Smales is also pleased to see that 80% of applicants were receiving palliative care at the time of application. “This is an encouraging statistic. Assisted dying is not just about ending a life, it is about ending unbearable suffering.”
Only 4% of the 66 people who had an assisted death in New Zealand to March 3lst were in a hospice, 17% died in aged care facilities, 6% in district health board facilities, while the majority died at the person’s home or another private residence.
There are strict eligibility criteria for an assisted death. As at 31 March, 40 people had been assessed as ineligible for assisted dying for reasons such as they were not over 18, not a NZ citizen, not experiencing “unbearable suffering”.
“Overall I think this is a very good start,” says Libby. “I think over time, we, like other countries, will want to adjust our legislation to keep it strict and safe and make it more accessible to those who desperately need it and are currently excluded.”
For the full report on the Assisted Dying Services first quarter see: www.health.govt.nz/our-work/life-stages/assisted-dying-service/assisted-dying-service-data-and-reporting
From this point on, there will be quarterly reports, with the next one due at the end of July.