The man was at the end of a progressive, debilitating neurological disease, and was assessed to not be expected to survive beyond four months. Photo: 123rf.com
A man faced multiple issues while trying to access an assisted death, according to a new case study released by the Health and Disability Commission (HDC).
The issues included a hospital room being offered but under the condition it may become unavailable right up until the day of his assisted death, the study by HDC Commissioner Morag McDowell, released on Monday, stated.
The man was at the end of a progressive, debilitating neurological disease, and was assessed to not be expected to survive beyond four months when he entered a new care home in January 2022.
At his previous care home, he had had a conversation with the centre's general practitioner about an assisted death.
Once he moved, the man's daughter was told by the GP providing services at the new care home that he did not meet competence requirements for an assisted death.
However, the GP had not done a formal and complete assessment, and the Commissioner said that assumptions by the GP around the man's inability to communicate were incorrect.
Commissioner Morag McDowell also stated the GP expressed an opinion on eligibility, giving a false impression to the man and his family that access his assisted death was restricted.
After this advice, the man's daughter contacted Support and Consultation for End of Life New Zealand (SCENZ), where he was able to access an assisted death.
"Around the time that he was determined to be eligible for assisted dying (via a process assisted through SCENZ), the man's daughter was informed by the care home manager that the care home did not support assisted dying on its premises, and alternative arrangements needed to be made," the case study stated.
It said the staff appeared not to have been fully aware that the centre did not offer assisted dying services within its facilities, and they had had to seek confirmation of the position.
The HDC said that if staff had known the centre's stance they could have proactively explained the care home's position earlier, possibly before the man moved in.
It said that a residential care facility has the right to decline to provide assisted dying services on its premises, but the Commissioner's view was that this was information a prospective resident and family interested in the service were entitled to know before entering into a service agreement.
The case study notes the daughter made several attempts to arrange another venue, including a room at the local hospital.
The hospital had a room available, but would not confirm it's availability until the morning of the procedure.
In the case study, Te Whatu Ora said that final approval around the room required a significant number of conditions to be met, including the right for hospital staff to postpone or reschedule for unforeseen capacity or emergency requirements.
"The indication of a potential 'day of the procedure' postponement is not consumer or whānau centred, and is arguably a deterrent to the use of hospital facilities for assisted dying," Commissioner McDowell said.
Commissioner Morag McDowell made an extra recommendation to Te Whatu Ora's national office, saying it should review policies on access to assisted dying services in its hospital settings.
The complaint did not result in the Health and Disability Commission making a breach against any organisation or individual, but HDC says a case study is provided for its educational value.
