Assisted Dying

Assisted Dying is a New and Strange Way of Dying

Death is a tapu time. Many of us have sat beside someone who is ill and dying or spent time with them after they have passed. As Māori, we have always had our own tikanga — customs and ways of doing things — guided by our tūpuna, iwi, hapū and whānau. Tikanga and kawa (ceremonies) shape how we care for someone at the end of life and how we farewell them.

Assisted dying is new for many whānau. It can feel unfamiliar, and sometimes unsettling. It is a different type of death — not only in a physiological and emotional sense, but also from a wairua perspective. If you have not been part of an assisted death before, everything may feel new and strange. Emotions can feel heightened. Questions may arise. This is completely understandable.

Whānau supporting someone who is considering or choosing assisted dying often find it helpful to have clear, practical information. Knowing what the assessment process involves, what happens on the day they have the procedure, and what to expect can reduce uncertainty.

Some whānau may wish to see what the medications look like or understand how they are administered. Others may want to know what will happen after the medication is given, and how long it might take for the person to die or what they might look like. Having access to information — and the opportunity to ask questions — can help whānau and friends feel more prepared and less anxious. It is important for whānau to have an opportunity to support their loved one at the assisted dying assessments as the attending medical practitioners are experts in this area.

One of the most important ways to support someone choosing assisted dying is to ensure their wishes are upheld in the way they would like. Whānau have told us that upholding our whanaunga’s mana motuhake at the end of their life is vitally important. We should first understand the legal requirements under the End of Life Choice Act 2019, and become familiar with the eligibility criteria, safeguards, and assessment process. Being well informed allows whānau to walk alongside their loved one with confidence and clarity.

It is also especially important that whānau have space to talk together. Often, whānau place the wishes of their terminally ill loved one first — even if they personally feel uncertain or uncomfortable about assisted dying. Open discussion can help whānau navigate this pathway together, rather than carrying concerns alone. These conversations can strengthen understanding and maintain relationships during a sensitive time. Grieving can become extremely complicated when whānau bottle everything up and have no avenue to express their feelings.

Thinking about who will be included on the journey is also important. Some people may want to be present at every stage. Others may only feel comfortable offering support before the assisted dying procedure takes place. Both responses are valid. On this website, we offer Te Oro Ngākau Nui – A Mind Level Tool to help whānau reflect on where they stand — whether they feel comfortable, unsure, or uncomfortable — and to guide respectful conversations. The aim is to keep everyone safe.

Creating a peaceful and culturally safe space on the day of the assisted death matters deeply. This may include arranging the environment according to the person’s wishes, inviting the right people to be present, and ensuring preferred cultural or spiritual practices are honoured. The goal is that the person feels calm, supported, and ready to leave their body in a way that aligns with their values and beliefs.

Death is tapu. It is okay if the person choosing assisted dying wants only certain people to know or to be present before, during, or after their death. It is their decision who is included. Privacy may be particularly important to them.

At the same time, it can be helpful to think about how other whānau and friends might be supported if they later find out. If someone learns that a loved one had an assisted death without understanding the background, they may feel shocked or distressed. They may not know about the assessment process or the careful considerations involved. They may not realise that, for the person who chose it, assisted dying was seen as a continuation of good palliative care and a way to maintain dignity and reduce suffering.

Providing gentle information and support — when appropriate — can help prevent misunderstandings and protect relationships within the wider whānau. This journey is about aroha, respect, and care. Every whānau will walk this path differently. What matters most is that the person at the centre feels heard, supported, and surrounded by love.

Whānau, we interviewed in the Waerea study told us it is all about caring for the mana of the person who is dying – upholding their mana motuhake to relieve pain and suffering and have a dignified death is what is most important. But it is also about caring for whanau and ensuring they are well informed and supported as they walk their beloved home.

The End of Life Choice Act came into effect on 7 November 2019. Assisted dying is available for a person who has a terminal diagnosis with less than six months to live. There are safeguards in the EoLC Act and strict eligibility criteria. Not everyone with a terminal illness will be eligible. For example, people cannot have an assisted death based on disability, advanced age or mental illness, unless they also have a terminal illness. The assisted dying criteria are:

  • Aged 18 years or over.
  • A citizen or permanent resident of New Zealand
  • Suffering from a terminal illness that is likely to end their life within six months.
  • In an advanced state of irreversible decline in physical capability
  • Experiencing unbearable suffering unable to be relieved in a tolerable manner.
  • Competent to make an informed decision about assisted dying.

Assisted dying is a way of dying that involves an attending medical practitioner supporting the person with a terminal illness to end their life at a time the person chooses providing they meet the EoLC Act (2019) assisted dying criteria. They can choose to administer the medication themselves or, the assisted dying practitioner can administer the medication.

Applying for an assisted death involves being assessed by two different doctors to ensure the person meets the eligibility criteria for an assisted death. They also have a role in ensuring the legal requirements for an assisted death are being upheld. So, for example, they will check the person is not being coerced or pressured by someone to apply for an assisted death.

Assisted dying upholds a person’s mana motuhake (independence, autonomy) over their preferences for not only how they die but also when they die. People who meet the assisted dying eligibility criteria are able to choose their dying day date and they have a choice about who will administer the medication to end their life (they can self-administer the medication or request an assisted dying clinician to administer it).

People who want to have an assisted death are also entitled to receive palliative care. Palliative care continues for the remainder of a person’s life. When an illness cannot be cured everything is done by whānau and health professionals to increase comfort and reduce pain and other symptoms.

Palliative care includes the care whānau provide during those last months, weeks, and days of life and it also includes the care health professionals provide to reduce pain and other symptoms of the tinana – body, hinengaro – emotions and wairua – spirit. Palliative care also supports whānau who provide support to someone who has a serious illness at the end of their life and their whānau pani (grieving family).

How to access the Assisted Dying Service

The Pou Kāpura website has been designed to share information about Māori experiences of assisted dying to support Māori individuals who have a terminal illness and their whānau to make informed decisions about palliative care including the option of assisted dying.

This website does not provide direct access to Assisted Dying Services, nor is it a place to make enquiries about applying for an Assisted Dying assessment. To access the clinical pathway for the Assisted Dying Service, contact Te Whatu Ora – Health NZ to access an assisted dying clinical advisor.

Phone: 0800 223 852 Email: AssistedDying@health.govt.nz

Whānau experiences of assisted dying

Tess Moeke-Maxwell

Assisted dying

Tess Moeke-Maxwell & Jackie Robinson

Assisted dying

Te Hurinui Karaka-Clarke and Annabel Ahuriri-Driscoll