Dr. Laura Chapman:

I am happy to cover that first. I am not absolutely certain why New Zealand chose six months. Our Act was written by politicians and legislators. One of the complexities is that I do not believe there was enough clinical input into how to enact that. The clinical governance structures that I would have liked to see were not built in. However, our Act was written to be a slow, thoughtful and well regulated process. The outline is that it would take six to eight weeks. There is potential for patients to go through the process faster than that but if they only had a three-month prognosis, that would be a rush, which would lead to poor decision-making. I would not. therefore. want there to be a three-month prognosis as a barrier. I believe a six-month period is a reasonable point. Our legislation states that the patient has to be likely to die within six months, which has been defined as 51% or more. It is not a certainty. The six-month window gives us time to have considered decision-making, get to know somebody and ensure that no point of the process is rushed. That is really important.

In regard to the input of psychiatry, our Act states that if either of the two assessing doctors feels that capacity should be assessed by a psychiatrist, that is a compulsory step but it is not a compulsory step for other patients. It is a compulsory step if capacity is questioned.