Early experiences of the End of Life Choice Act 2019 amongst assisted dying practitioners in Aotearoa New Zealand.

Abstract

Background: The global trend of legalising assisted dying (AD) has reshaped end-of-life care practices, and Aotearoa New Zealand's adoption of the End of Life Choice Act (the Act) in 2019 represents a significant shift. Limited empirical research on AD in New Zealand after the enactment of the Act underscores the need for investigation. Conducting research in the early stages of AD implementation is crucial to building a strong knowledge base and laying the foundation for future research. This would ensure equitable and suitable service provision for the service users.

Aim: This research captured the experiences of health practitioners directly involved in providing AD under New Zealand's End of Life Choice Act 2019.

Design: Using the "memorable case" approach, 22 participants reflected on the process of assessing, treating, and delivering AD services in the first 12 months of implementing the new AD law.

Results: Thematic analysis identified four major themes underlying the experiences of assisted dying practitioners/providers (ADPs). The themes focused on three aspects of ADPs' experience: KNOWING: prior personal experience (personal beliefs, clinical background, and AD training) and reflective experiences of DOING assessments, service delivery, and patient/family experiences and BEING an ADP (personal, professional, emotional, and social impacts). Additionally, the themes highlighted the overarching influence of health system infrastructure, challenges, and resources that shaped ADPs' overall experience.

Conclusion: These findings contribute to new knowledge by uncovering gaps in understanding, competency, service implementation, and the emotional impact on ADPs. The findings could inform the development of an educational, supportive, and culturally safe program, including resources for workforce development.