More than 30 South Island doctors have expressed an interest in providing assisted dying services.
Assisted dying becomes legally available in New Zealand from Monday, but few further details are available on how the service will function in the South.
The Ministry of Health has spent the past year finalising the system approved by voters in a referendum at the last election, one designed with a range of checks and balances to ensure it is not misused.
Each patient who seeks to use the service is to be assigned an attending medical practitioner as their primary carer. By last week, 96 doctors nationwide had expressed interest.
Of those, a third are based in the South Island.
Nationwide, eight nurse practitioners and 93 clinicians are willing to do second assessments, and 13 psychiatrists will also assess patients if requested.
That list of clinicians is compiled and maintained by Support and Consultation for End of Life in New Zealand (SCENZ) for the ministry, but specific questions about how many clinicians had agreed to take part in Otago and Southland were not answered.
"Whilst there is a good spread of practitioners across the country, not every location may have a practitioner available to provide assisted dying services," ministry chief clinical adviser Kristin Good said.
"Therefore, practitioners who need to travel to provide assisted dying services to people will be funded to do so . . . we expect this service to be provided mainly by general practitioners and primary care in Otago."
The ministry had earlier canvassed all clinicians for expressions of interest in taking part in the system, and 129 people had accessed full training and more than 6000 had completed a training module available for all health professionals, Dr Good said.
Primary health organisation WellSouth’s medical director, Carol Atmore, said the PHO was not getting involved in the assisted dying system, but would post information on its internal health pathways site for clinicians to access.
"The list of available practitioners will be available through SCENZ, but to be honest I’m not actually sure what level of engagement from practitioners there has been from clinicians in Otago and Southland."
As the subject was one which by law clinicians were not able to raise with patients, it was likely some GPs would not review the effect of the law change until it became an issue for them, Dr Atmore said.
"It’s new territory and as time goes by it will embed and we will see how it goes ... but it also highlights that the alternative pathway, good-quality palliative care, also needs to be on the Government’s radar," Dr Atmore said.
One thing which is clear is the stance of the region’s main palliative care service, the Otago Community Hospice. It opposed the End of the Life Choice Act and will not provide an assisted dying service.
"A fundamental principle of hospice and palliative care is to neither hasten nor postpone the natural progression of death," the organisation said.
"As such we will not add euthanasia to our services ... however, we will absolutely respect a patient’s choice to take this path and it will not stop us caring for them in every other way."
Assisted dying
Who: Patients must be 18 or over, a citizen or permanent resident of New Zealand, suffer from a terminal illness likely to end their lives within six months, be in an "advanced state of irreversible decline", suffering in a way they consider intolerable, and competent to make an informed decision. Being disabled, mentally ill or old cannot be given as the sole reason to apply for assisted dying.
The paperwork: The patient must ask their medical practitioner for assistance to die; the practitioner must stop the process if they believe pressure is being put on the patient.
The practitioner has to give the patient a prognosis and ensure they understand all their options before they start the process.
An independent medical practitioner must evaluate the patient’s file, examine them, and agree with the first practitioner. If there are any doubts of the patient’s competence, a psychiatrist must examine the patient.
How? The patient decides from four methods, and picks the time when they will be assisted to die.
