Impact on healthcare
The destructive toll of euthanasia to an industry built on care
Assisted dying is often presented as compassionate and well-regulated — but in practice it is having significant negative impacts on healthcare itself.
From unreliable eligibility criteria and gaps in mental health assessment to pressure on doctors, limited palliative care, and shifting medical ethics, these issues are undermining how care is delivered at the end of life.
Inaccurate Prognosis and Misdiagnosis
To be eligible for assisted suicide or euthanasia a person must have a life expectancy of six months or less. Posed as a clear line in the sand to define and protect... yet scientifically this boundary is farcical.
Ask any doctor about the accuracy of prognosis and you will discover how weak a measuring stick actually is. In fact, studies show that between 75% to 80% of prognoses given by doctors are incorrect. Prognostication is essentially a guess. A human being is a very complex thing, and there are all sorts of things that influence the prognosis.
Prognosis isn’t the only thing that can go wrong – every year a number of people are completely misdiagnosed. People have been diagnosed with a terminal condition they do not have.
A diagnosis can also be completely wrong. A person can be diagnosed as having a terminal condition when in fact, they do not. This might not happen regularly, but when it happens and euthanasia is now an option, the mistake can be fatal.
Killing Patients Ethics
Assisted dying represents a profound shift in healthcare ethics.
Traditionally, medicine has been grounded in a duty to preserve life, relieve suffering, and care for patients through to natural death. Introducing the option to intentionally end a patient’s life changes that foundation — reframing the role of the clinician from solely protecting and supporting life to, in certain circumstances, facilitating its end. For many, this creates a deep ethical tension, raising questions about how the principles of care, trust, and “do no harm” are understood and applied within modern medical practice.
When the End of Life Choice Act was before parliament over 1500 doctors signed the ‘Doctors Say No’ Open Letter pleading with Kiwis to vote No in the 2020 New Zealand Euthanasia referendum that asked whether the End of Life Choice Act should come into force.
Impacting the True Care of Doctors to Help Fight for Life
The introduction of assisted dying is changing the nature of end-of-life conversations between doctors and patients.
Where once statements like “I wish I could die” opened the door to deeper exploration — uncovering fear, loneliness, family tension, or unmet needs — there is now a defined pathway that can prematurely close that conversation. The ability to push back and offer a fight for a good last chapter of life is closing.
Reports from New Zealand doctors are describing a shift from walking alongside patients through the shock of diagnosis and the complexity of dying, to navigating requests that are already formed. Patients can arrive “preloaded,” with decisions made, seeking confirmation rather than guidance — limiting the opportunity for clinicians to address the root causes of suffering. And doctors are losing the ability to confront patients with probing questions, instead having to allow patients to pursue euthanasia when they mention it.
This changes the role of the doctor. Instead of helping patients process fear, build support, and find meaning even in decline, the system can redirect attention toward ending life. In doing so, it risks bypassing the relational, time-intensive care that can genuinely ease suffering — replacing it with a faster, deadly outcome that steals good life that can still be had.
The Erosion of Conscious Objection
Assisted dying is increasingly confronting and, in some cases, eroding the ability of healthcare professionals to exercise genuine conscientious objection within clinical practice.
Across New Zealand, a growing number of healthcare professionals are quietly raising concerns about how assisted dying is impacting clinical practice, ethical boundaries, and their ability to act according to conscience. While many remain reluctant to speak publicly, the unease is not isolated — it is emerging across the profession.
Proposed legislative changes risk further eroding doctors’ conscience rights by allowing clinicians to raise assisted dying as a treatment option and expanding eligibility criteria—shifting the role of doctors from responding to patient requests to actively introducing the option, and increasing pressure on those who ethically object.
Several senior New Zealand clinicians have spoken out publicly, offering a rare frontline perspective on how assisted dying is affecting medical practice and professional ethics. Drawing on firsthand experience within the healthcare system, the doctors describe growing concerns over how conscience rights are being challenged in real-world settings.
One clinician describes situations where staff who object to euthanasia are still drawn into the process due to staffing gaps or poor communication, leaving them feeling unable to step away from practices they fundamentally oppose.
In some cases, doctors report being required to remain involved in patient care even when assisted dying is taking place, despite their objections. This creates significant emotional and professional strain, with one clinician describing it as being forced to witness something they believe is wrong within a system they are meant to trust.
The result is not just ethical tension, but real impact on wellbeing — including distress, burnout, and time off work — raising serious concerns about whether doctors’ conscience rights are being fully respected in practice.
Undiagnosed Mental Illness
There is no requirement for a patient assessment to rule out mental illness in an application for assisted dying.
While applicants must be assessed for competence, there are no specific safeguards to identify or address whether mental health is influencing a person’s decision. This is significant, given evidence from overseas. In Oregon, for example, around one in six people who use assisted suicide are reported to have clinical depression.
Receiving a terminal diagnosis is one of the most devastating and shocking experiences a person can face. Alongside physical symptoms such as pain, nausea, and exhaustion, individuals often experience intense emotional distress, fear, and uncertainty — making depression common among those nearing the end of life.
The suicide of anyone experiencing mental health challenges is a tragedy. Yet the current framework does not require comprehensive mental health screening or ensure appropriate support is in place during the process.
Palliative care not guaranteed
While the End of Life Choice Act is “all about choice” – it’s ironic that there’s no choice for those who can’t get good palliative care.
You don’t have to look far to find out about major shortages in palliative care services across New Zealand.
The Ministry of Health itself says there are inequalities in access to palliative care services, particularly age, ethnicity, geographic and diagnosis groups.
As a vital service, Hospice NZ, one of our country’s biggest private palliative care groups, is only funded in part by the Government, relying on fundraising to cover the shortfall.
Other major flaws in palliative care include a lack of recognition that people who are dying can benefit from palliative care services, cultural barriers – in particular for Māori and Pasifika peoples, lack of services in rural areas, funding barriers between personal health and disability support services, poor integration and a lack of coordination of services.