Statutory body established for New Zealand’s assisted dying service

Implementation of the End of Life Choice Act 2019 (the Act) is well under way, in preparation for when assisted dying becomes legally available in New Zealand from 7 November this year.

The statutory body for the assisted dying service, the Support and Consultation for End of Life in New Zealand (SCENZ) group, has now been formed, with appointments made by the Director-General of Health, Dr Ashley Bloomfield.

“Eleven people have been appointed for a term of two years to SCENZ. The calibre of candidates was extremely high, and the members together bring significant clinical and health and disability sector experience,” Dr Bloomfield said.

“The SCENZ group brings collective experience in the awareness of Te Ao Māori and an understanding of Tikanga Māori; clinical expertise, expertise in ethics and law, and the disability sector; and includes representation of the views of patients, whānau and the community. Membership includes health professionals, among them a psychiatrist, a pharmacist, and a nurse practitioner, all of them currently practising.”

The SCENZ group is required to be established under the Act. As part of the role, SCENZ will work closely with the secretariat of the assisted dying service.

Responsibilities include maintaining the list of health practitioners and psychiatrists involved in providing assisted dying services; and providing contact details for replacement, or independent medical practitioners as part of the service, and the contact details for when psychiatrists may be required.

The SCENZ group will also support the development of the standards of care for medicines as part of the implementation being led by the Ministry of Health, and SCENZ will then go on to have oversight of the standards.

The other statutory body, the End of Life Review Committee, which will report on compliance with the Act to the Registrar (assisted dying), is expected to be appointed by the Minister of Health around October in preparation for when assisted dying services becomes lawful in November.

Assisted dying remains illegal in New Zealand until 7 November 2021.

The Support and Consultation for End of Life in New Zealand (SCENZ) group

The SCENZ group is a statutory body for the assisted dying service It is required to be established under the Act and was formally established on 1 August 2021

Responsibilities of the group include maintaining the list of medical practitioners and psychiatrists involved in providing assisted dying services; providing contact details for replacement, or independent medical practitioners as part of the service; and providing the contact details for when psychiatrists may be required.

The SCENZ group will support the development of the standards of care for medicines as part of the implementation of the Act being led by the Ministry of health. The SCENZ group will have oversight of the standards and will work closely with the secretariat of the assisted dying service at the Ministry of Health once the assisted dying service becomes legally available from 7 November 2021.

The SCENZ group brings collective experience in the awareness of Te Ao Māori and an understanding of Tikanga Māori; expertise in ethics and law, and the disability sector; and includes representation of the views of patients, whānau and the community.

The eleven members are appointed by the Director-General of Health for a term of two years. Membership includes practising medical practitioners, a practising psychiatrist, a practising pharmacist, and a practising nurse practitioner.

The SCENZ group members are:

Dr Caroline Ansley, New Zealand Pakeha, is a general practitioner based in Christchurch. She is a fellow of the Royal New Zealand College of General Practitioners. In addition to her clinical expertise, Dr Ansley is a senior clinical editor for Community Healthpathways, and through this role, is able to facilitate communication about the implementation of the act to general practice teams, and to feedback concerns from general practice about its practical implementation to the SCENZ Group. Dr Ansley believes she can contribute to the SCENZ Group by utilising her experience in working with diverse groups of stakeholders to provide streamlined consistent delivery of care.

Dr Michael Austen, New Zealand European, is a specialist physician in Occupational and Environmental Medicine and in Urgent Care and is based in Wellington. Dr Austen is a Fellow of both the Royal Australasian College of Physicians and the Royal New Zealand College of Urgent Care. He is also an enrolled barrister and solicitor of the High Court of New Zealand. Dr Austen works in clinical practice in Urgent Care and as a clinical advice manager for ACC. In his ACC role, he provides oversight of the clinical advice that specialist clinical staff provide within ACC’s legislative framework. Dr Austen will contribute to the SCENZ Group in preparing standards of care and advising on the required medical and legal procedures.

Dr Kynan Bazley, New Zealand European, is currently a general practitioner based in Nelson. He has recently returned from remote family medicine general practice in Canada where he was a physician lead for the Medical Assistance in Dying (MAiD) program in a rural region. He has assessed and provided MAiD services to patients. Dr Bazley has also worked in palliative care delivery. Dr Bazley is a member of the Ministry’s informal sector advisory network that has been established as part of the End of Life Choice Act implementation programme.

Heather Browning, New Zealand European, is a director and owner of a company providing service audits and projects, largely in the disability sector. She’s a member of the consumer reference group of Te Aho o Te Kahu, Cancer Control Agency and is an elected member of MidCentral DHB. Ms Browning has held a number of governance and board roles, including ministerial appointed roles. In addition to her work and volunteer experience in the disability sector, Ms Browning has recent personal experience of family members in end of life care and believes her insights will assist with the work of the SCENZ Group.

Dr Gary Cheung, Chinese, is currently a specialist old age psychiatrist working at the University of Auckland and Auckland District Health Board. Dr Cheung holds a PhD in Psychiatry and is the Director of Academic Programme for the Northern Region Psychiatry Training Programme. He is recognised as a leader in post-graduate psychiatry training and has published extensively. Dr Cheung has particular expertise in capacity assessment training and research, suicide prevention in older adults and working with Māori, Pacific and Asian communities. Dr Cheung is a member of the Ministry’s informal sector advisory network that has been established as part of the End of Life Choice Act implementation programme.

Máté Hegedus-Gaspar, European, is currently a pharmacist and pharmacy manager based in Christchurch. He holds a Master of Laws (Hons) and is aiming to be admitted as a lawyer this year. Mr Hegedus-Gaspar has also worked as a teaching assistant at Lincoln University tutoring in commercial law. He has studied and written on pharmacy and legal aspects of assisted dying. Since 2019 he has been the Secretary of the Independent Pharmacists Association of New Zealand. Mr Hegedus-Gaspar was previously a pharmacy owner and a member of the Pharmacy Council of Hungary.

Dr Te Hurinui Karaka-Clarke, Te Arawa, Ngāi Tahu, is currently the Deputy Head of School/Senior Lecturer at the College of Education at the University of Canterbury, based in Christchurch. Dr Karaka-Clarke holds qualifications in Te Reo Māori and is able to read, write, speak, understand spoken and peer review Te Reo, and has numerous publications and conference presentations in his chosen field. He has expressed a personal interest in the process of end of life care and is willing to share his knowledge about custom and protocols that will guide and impact the work of the SCENZ Group.

Leanne Manson, Ngāti Tama Ki Te Tauihu, Te Ātiawa, is currently a Policy Analyst Māori for the New Zealand Nurses Organisation based in Wellington. She is a Registered Nurse with a Bachelor’s degree in Māori studies and a Master’s degree in Public Health and has an in-depth understanding of Te Reo and Tikanga Maōri. She is published in her chosen areas of academic interest. Ms Manson has governance experience on several iwi boards and organisations, including as an iwi representative on a District Health Board (DHB). Her Masters’ thesis was on the topic of Māori nurse’s perspective of assisted dying. Ms Manson feels she can contribute to the SCENZ Group to improve and guide cultural care in end of life care settings.

Philip Patston, New Zealand European, is a company director and owner based in Auckland. Originally a social worker, Mr Patston’s work focuses on leading change in organisations that embraces curiosity and enquiry into diversity, complexity and uncertainty. He has considerable board and governance experience. Mr Patston brings skills in governance, leadership development, change and project management.

Dr Jackie Robinson, New Zealand European, is a Senior Lecturer and Nurse Practitioner at the University of Auckland. She has worked as a lead nurse practitioner in palliative care based in Auckland working in the acute hospital and residential aged care settings. She has previously been co-chair of the Auckland DHB clinical ethics advisory group and a member of the Ministry of Health Palliative Care advisory group. Dr Robinson holds a PhD and has published extensively. Her area of research focuses on equity in palliative and end of life care, for which she has received multiple awards. Dr Robinson holds a number of governance roles and has considerable working group, committee and board experience.

Dr Jessica Young, New Zealand European, is a post-doctoral fellow at the School of Health, Victoria University of Wellington, based in Wellington. Dr Young has extensive experience researching assisted dying using a variety of methods. To continue sharing the views of the terminally ill people who Dr Young interviewed for her PhD research, she was part of a non-partisan campaign that sought to provide high-quality evidence-based information during the End of Life Choice referendum. Dr Young brings skills in research, data collection and stakeholder engagement, and an in-depth knowledge of the relevant international legislation. She is a member of the Ministry’s informal sector advisory network that has been established as part of the End of Life Choice Act implementation programme.

The End of Life Review Committee

The End of Life Review Committee will be appointed by the Minister of Health. The Committee will include a medical ethicist, a doctor specialising in end-of-life care, and one other health practitioner.

The role of the Committee will be to:

• consider reports provided by the doctor or nurse practitioner about the assisted death of a person under the Act
• report to the Registrar whether it considers that the information contained in assisted death reports shows satisfactory compliance with the requirements of the Act
• direct the Registrar to follow up on any information contained in an assisted death report if it considers the report does not show satisfactory compliance with the Act.
• Appointments to the End of Life Review Committee

Applications for the End of Life Review Committee were invited in April and selection processes are now underway. The Review Committee is expected to be established around October this year.