Waerea Study Resources

Legal Framework

End of Life Choice Act (EoLC)

Assisted dying became legal in New Zealand through the End of Life Choice Act 2019, which came into effect in November 2021.

Assisted dying is a free service. It is usually provided at someone’s home. Currently, only Totara hospice has a special room whānau can use for this purpose. You will need to ask your local hospice, hospital or a residential care facility if they accommodate assisted dying on their premises.

Who Can Access Assisted Dying?

Under the End of Life Choice Act 2019, a person must meet all of the following criteria:

To be eligible to request assisted dying you must meet the following criteria:

  • Aged 18 years or older.
  • A New Zealand citizen or permanent resident.
  • Suffering from a terminal illness that is likely to end your life within 6 months.
  • Experiencing a serious decline in physical capability that cannot be reversed.
  • Experiencing unbearable suffering that cannot be relieved in a way you can tolerate.
  • Competent to make an informed decision about assisted dying.


You must meet all of these conditions. You are not eligible just because you are very old or because you have dementia, a mental illness or a disability.

  • You must raise the topic of assisted dying yourself with your healthcare provider.
  • Healthcare providers cannot suggest it as an option.
  • Your healthcare provider may conscientiously object and refer you to the Assisted Dying Service.
  • Two specially trained doctors must assess your eligibility (process takes 4-8 weeks).
  • No one else can make this decision on your behalf.
  • You can change your mind at any point, even moments before receiving medication.
  • There is no cost for the service.

The End of Life Choice Act 2019 sets out a formal step-by-step process that must be followed in order:

  1. Application: You raise assisted dying with your doctor and sign a formal request form. Your doctor will discuss your other end-of-life care options and confirm you are not being pressured.
  2. First Assessment: Your attending doctor assesses whether you meet all eligibility criteria and that your decision is your own.
  3. Independent Assessment: A second, independent doctor carries out their own assessment to confirm eligibility.
  4. Competency Assessment (if required):  If either doctor has concerns about your ability to make an informed decision, a psychiatrist will carry out an additional assessment.
  5. Decision on Eligibility: Your attending doctor will inform you of the outcome. If you are eligible, planning for your assisted death can begin.


Assisted dying is not an acute or emergency service. The process typically takes around 16 days for approval, though timeframes can vary. Applying early leads to better outcomes, so if you are concerned about time, contact the Assisted Dying Service directly to ask about your timeframe.

You can change your mind and stop the process at any point, right up until the medication is administered.

Source: Health New Zealand Te Whatu Ora, Assisted Dying Service General Information Sheet (2021) and Easy Read Guide (2025). Timeframe information sourced from clinical feedback.

Code of Health and Disability Consumers’ Rights

Your rights throughout this process are protected by the Code of Health and Disability Consumers’ Rights

Your Rights with Assisted Dying

If you choose to receive assisted dying, you are protected by the Code of Health and Disability Consumers’ Rights:

  • Right 1 – The right to be treated with respect | Mana.
  • Right 2 – The right to fair treatment | Manaakitanga.
  • Right 3 – The right to dignity and independence | Tū rangatira Motuhake.
  • Right 4 – The right to appropriate standards | Tautikanga.
  • Right 5 – The right to effective communication | Whakawhitiwhitinga whakairo.
  • Right 6 – The right to be informed | Whakamōhio.
  • Right 7 – The right to choice and consent | Whakaritenga mōu ake.
  • Right 8 – The right to support | Tautoko.
  • Right 9 – Rights during teaching and research | Ako me te Rangahau.
  • Right 10 – The right for your complaint to be taken seriously | Amuamu.

How the Code Works with the End of Life Choice Act

The Code of Health and Disability Consumers’ Rights work together with the End of Life Choice Act 2019.

This means:

  • Healthcare providers must follow the legal requirements of the End of Life Choice Act.
  • If a healthcare provider breaks these rules, it may be considered a failure to meet proper care standards.
  • Your healthcare provider cannot bring up assisted dying with you—you must start the conversation yourself.
  • There are special rules about how your ability to make this decision is assessed.
  • Healthcare providers must follow all their responsibilities under the End of Life Choice Act.

United Nations Universal Declaration of Human Rights (1948)

The Declaration establishes the fundamental rights and freedoms to which all people are entitled, without discrimination of any kind. In the context of palliative and end-of-life care, the following articles are particularly relevant:

  • Article 1 – The right to dignity and equality.
  • Article 3 – The right to life, liberty and security of person.
  • Article 5 – The right to freedom from cruel, inhuman or degrading treatment.
  • Article 7 – The right to equal protection under the law without discrimination.
  • Article 12 – The right to privacy and protection of family.
  • Article 18 – The right to freedom of thought, conscience and religion.
  • Article 25 – The right to an adequate standard of living, including medical care.
  • Article 27 – The right to participate in cultural life and have cultural interests protected.

For more information about your rights:

Visit the Code of Health and Disability Services Consumer Rights website:


Visit the United Nations website:

If you feel your rights have not been upheld:

  • Phone: The Nationwide Health and Disability Advocacy Service: 0800 555 050 (free and confidential)
  • Contact the Health and Disability Commissioner to make a formal complaint

Ministry of Health Assisted Dying Service
Phone: 0800 223 852
Email: AssistedDying@tewhatuora.govt.nz
Website: End of Life Choice Act 2019

Ministry of Health Assisted Dying Webpage

For detailed information on:

  • Declining to have treatment is not assisted dying
  • You must be competent when assisted dying happens
  • Making a request for assisted dying
  • Deciding if you meet criteria
  • Changing your mind about assisted dying
  • How you will be assisted to die
  • Cost of assisted dying
  • Life insurance and assisted dying
  • Give feedback on the assisted dying service
  • Accessible resources on assisted dying


Visit: https://info.health.nz/health-topics/conditions-treatments/end-of-life-care/assisted-dying

Cultural Considerations

What is Cultural Safety?

Cultural safety focuses on delivering quality care to all patients in palliative and end-of-life care. Cultural safety requires professionals to acknowledge and be aware of the power structures in healthcare services and reflect on their own culture and cultural systems. This reflection is directly linked to achieving health equity, ensuring that a person and their family feel spiritually, psychologically, and physically safe as they navigate the end of life, particularly for Indigenous and ethnically minoritised communities.

Cultural safety goes beyond cultural competency, which is focused on the healthcare practitioner and their capacity to increase care and health status by integrating cultural behaviour into clinical context. cultural competency assumes a health professional can master a set level of knowledge and understanding of a patient’s culture to offer culturally responsive care, which limits healthcare practitioners’ learning to becoming “competent” in others’ cultures.

In assisted dying, palliative care and end of life care whānau are entitled to culturally safe, culturally competent and culturally responsive services to provide health equity and best care for Māori.

Mauri Mate is a Māori Palliative Care Framework for Hospices commissioned by Totara Hospice (South Auckland) jointly with Mary Potter Hospice (Wellington).

This Framework responds to issues that Māori have raised with service providers and researchers. The aim is to develop guidelines for hospices, so adult Māori receive access to good palliative care which includes:

  • Good (quality) care in the lead-up to the end-of-life.
  • Good comfort (compassionate) care at the end-of-life.
  • Helpful whānau support during and after the end-of-life (including spiritual care and grief support).


What is in the Mauri Mate Palliative Care Framework Report:

  • Context: purpose, Te Tiriti o Waitangi, equity, and palliative care services.
  • Contemporary social overlay: Māori population, social complexity, diverse whānau experiences, intergenerational trauma, and communication preferences.
  • Clinical services: cultural safety, clinical communication, care, spirituality, grief and loss.
  • Clinical workforce: Māori and clinical workforce development.
  • Appendices: palliative care definitions, ethical issues, and a Māori palliative care framework for hospice.

Te Ohu Rata o Aotearoa Māori Medical Practitioners. (2019). Mauri Mate a Māori palliative care framework for hospices.

Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition.
Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S., & Reid, P. (2019). International Journal for Equity in Health, 18(1), 174. Read here

Becoming a culturally competent health practitioner in the delivery of culturally safe care: A process oriented approach.
Duke, J., Connor, M., & Mceldowney, R. (2009).
Journal of Cultural Diversity, 16(2), 40–49. Read here

“Cultural Competence and Medical Practice in New Zealand”,
Durie, Professor Mason, (2001).
Paper delivered to the Australian and New Zealand Boards and Councils Conference (p2).

Cultural Safety in Nursing: the New Zealand Experience.
Papps, E., & Ramsden, I. (1996).
International Journal for Quality in Health Care, 8(5), 491–497. Read here

Expressions of cultural safety in public health nursing practice.
Richardson, A., Yarwood, J., & Richardson, S. (2016).
Nursing Inquiry, 24(1). Read here