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. 2025 May 24;24(1):149.
doi: 10.1186/s12904-025-01747-w.

Early experiences of the End of Life Choice Act 2019 amongst assisted dying practitioners in Aotearoa New Zealand

Aida Dehkhoda  1 , Rosemary Frey  2 , Melissa Carey  2   3 , Jacqualine Robinson  2 , Frederick Sundram  2 , Nicholas Hoeh  2 , Susan Bull  2   4 , Gary Cheung  2
Affiliations

Early experiences of the End of Life Choice Act 2019 amongst assisted dying practitioners in Aotearoa New Zealand

Aida Dehkhoda et al. BMC Palliat Care. .

Abstract

Background: The global trend of legalising assisted dying (AD) has reshaped end-of-life care practices, and Aotearoa New Zealand's adoption of the End of Life Choice Act (the Act) in 2019 represents a significant shift. Limited empirical research on AD in New Zealand after the enactment of the Act underscores the need for investigation. Conducting research in the early stages of AD implementation is crucial to building a strong knowledge base and laying the foundation for future research. This would ensure equitable and suitable service provision for the service users.

Aim: This research captured the experiences of health practitioners directly involved in providing AD under New Zealand's End of Life Choice Act 2019.

Design: Using the "memorable case" approach, 22 participants reflected on the process of assessing, treating, and delivering AD services in the first 12 months of implementing the new AD law.

Results: Thematic analysis identified four major themes underlying the experiences of assisted dying practitioners/providers (ADPs). The themes focused on three aspects of ADPs' experience: KNOWING: prior personal experience (personal beliefs, clinical background, and AD training) and reflective experiences of DOING assessments, service delivery, and patient/family experiences and BEING an ADP (personal, professional, emotional, and social impacts). Additionally, the themes highlighted the overarching influence of health system infrastructure, challenges, and resources that shaped ADPs' overall experience.

Conclusion: These findings contribute to new knowledge by uncovering gaps in understanding, competency, service implementation, and the emotional impact on ADPs. The findings could inform the development of an educational, supportive, and culturally safe program, including resources for workforce development.

Keywords: Assisted dying; Early experience; New Zealand; Practitioners; The Act.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study received ethics approval from the University of Auckland Human Participants Ethics Committee (UAHPEC) (Ref. UAHPEC24335). All interviews were performed in accordance with the UAHPEC guidelines and regulations. Written informed consent for participation and use of data was obtained from all participants. Consent for publication: Not applicable as no identifying information is published in the current study. Competing interests: A.D., R.F., M.C., F.S., N.H., S.B., and G.C. declare no competing interests. J.R. is a Support and Consultation for End-of-Life New Zealand (SCENZ) group member.

Figures

Fig. 1
Fig. 1
Thematic Diagram: Assisted dying service experience. AD = assisted dying; ADP = assisted dying practitioner; MoH = Ministry of Health
See this image and copyright information in PMC

References

    1. New Zealand Legislation. End of Life Choice Act 2019. 2021; Available at: https://www.legislation.govt.nz/act/public/2019/0067/latest/whole.html. Accessed November, 2023.
    1. Te Whatu Ora. Assisted dying eligibility and access. 2023; Available at: https://www.tewhatuora.govt.nz/for-the-health-sector/assisted-dying-serv.... Accessed July, 2023.
    1. Te Whatu Ora. Delivering assisted dying services. 2023; Available at: https://www.tewhatuora.govt.nz/for-the-health-sector/assisted-dying-serv.... Accessed August, 2023.
    1. Dehkhoda A, Frey R, Carey M, Jing X, Robinson J, Sundram F, et al. Exploring the impact of e-learning modules and webinars on health professionals’ Understanding of the end of life choice act 2019: a secondary analysis of Manatū Hauora-Ministry of health workforce survey. N Z Med J. 2023;136(1582):52–63. - PubMed
    1. Patel T, Christy K, Grierson L, Shadd J, Farag A, O’Toole D, et al. Clinician responses to legal requests for hastened death: a systematic review and meta-synthesis of qualitative research. BMJ Supportive Palliat Care. 2021;11(1):59–67. - DOI - PubMed

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