Dr. Laura Chapman:

I thank the Deputy. That is a great question. There are two key features I would draw to attention that New Zealand does. The first is we have clear criteria for eligibility that are not disease based but are about the patient. You have to be over 18 years of age, you have to be a Kiwi citizen or resident, and then you have to have a disease that is going to cause you to die, likely within the next six months. You have to have unbearable suffering and physical decline in capacity. I have mixed feelings about physical decline but the fact you must be dying anyway and have death within six months and you must be suffering, and suffering is not necessarily physical but physical, mental, social or spiritual, and you have to have a capacity - those clear definitions - are important. We could have tightened up some of the wording. The word "illness" is not defined in the literature or law, but the fact that they are clear is helpful.

Then we have multiple checks in our process. We have a first assessment doctor and a second assessment doctor. Then there is a regulatory review to see if the application is compliant with the regulation and then you go through with it.

If you look at our applications, people are turned down at step one by the first doctor, they are turned down at step two by the second doctor and they are occasionally turned down at step three by the regulatory review process, so that is a very safety-focused process. Some people would say it was overly bureaucratic but I definitely think it has enabled us to have a safe process.

Obviously, the other unique feature about it in New Zealand is that we had a national referendum on this issue and we know that the country supported this in a vote. We are implementing this on behalf of the country and we need to implement it as safely as possible.

It is also important that provision is voluntary, so it is not mandated. It is not provided by our hospitals. It is voluntary and outside of the rest of our national health system. That means patients who have mixed feelings about it or who think it is a terrible to plan to have an assisted dying service know that the doctor in front of them, either the GP or at the hospital, does not have to provide and would not push it upon them. There is both psychological safety and clinical safety.