Senior Hospital Clinician Speaks Out on Assisted Dying: “I Just Don’t Understand How We Got Here”

Assisted dying — legal in New Zealand since November 2021 — remains one of the most ethically complex developments in modern healthcare. More than 1,200 New Zealanders have died under the legislation since it came into force, in hospitals, aged care facilities, private homes and at least one hospice.

Before the law was enacted, a number of doctors and healthcare practitioners voiced concern. The strongest opposition came from those working most closely with the dying: palliative care clinicians who traditionally focus on comfort, dignity and holistic support at the end of life.

Now, for the first time, a senior clinician from one of New Zealand’s leading tertiary hospitals has publicly shared his experience of how assisted dying is affecting frontline medical teams.

His account paints a picture of moral distress, workplace tension, and unresolved ethical questions.

“I Got Into This to Save Lives”

“I got into this to save lives,” the clinician says. “To try and cure, and at the same time to ease suffering.”

He describes a profession centred on perseverance — helping patients face life-altering diagnoses, gruelling treatments and emotional exhaustion. “The people that I see want to live. That’s their first priority. If possible, they want more time. More time to do the things they want to do. More time with their families.”

Treatments are often physically, psychologically and financially draining. “Part of my job is cheering them on — saying, ‘You can do this. There is a light at the end of the tunnel.’ We’re focused on life, preserving life, saving life.”

The introduction of assisted dying has created what he describes as a profound contradiction inside the hospital system.

“Suddenly, we start to kill people. I’m kind of shocked, to be honest.”

He compares the experience to a fundamental contradiction within hospital practice — describing the tension of providing complex, expensive, life-preserving interventions in one room while, nearby, another patient is being prepared to die by medical administration.

“We're doing these really expensive, really complicated investigations, interventions, going the extra mile thinking what can we do? And then right on the same ward, we're surrendering them up to get killed.”

External Providers and Workplace Strain

In all cases, doctors who administer assisted dying on his ward have been brought in from outside. While the clinician says he cannot speak to their motives, he has observed what he describes as an urgency.

“They seem very enthusiastic to get the thing in quickly — sometimes even faster than the process should actually go,” he says. “There’s not much room given to try and slow the process down a bit and maybe think again. They just seem to be in such a hurry. You just wonder, what’s the enthusiasm?”

Within his service, three assisted dying cases have caused what he describes as “major issues” and “major dramas,” largely centred around communication breakdowns and inadequate consideration for staff who conscientiously object.

Efforts to separate patients pursuing aggressive treatment from those proceeding with assisted dying were declined by hospital authorities. Promised communication protocols designed to protect objecting staff were inconsistently followed. On two occasions, an objecting clinician was left involved in the care process because no one else was available.

“It’s like if you believe something evil is happening and you’re forced to stand around and witness it,” he says. “The system you trust to deliver healthcare is preparing someone for getting killed. It’s horrible.”

That colleague required sick leave following such an incident. “That puts stress on the rest of the team. It was terrible.”

Policies exist, he acknowledges, but implementation is another matter. “You’ve got all the policy documents in the world — unless someone actually does it, things don’t occur as they should. This is a very sensitive issue. There needed to be much more precision.”

Financial Pressure and a Troubling Case

One case remains particularly troubling for him.

The patient, an older man with progressive illness, had been living independently with good quality of life. A sudden loss of mobility left him unable to return home. Though he was not in significant pain, he had lost independence.

“Immediately he talked about euthanasia,” the clinician recalls.

He believes the decision came during a period of acute adjustment. “It was too soon. It takes months to adjust to major changes in your life. I’ve seen people rethink what really matters and still live meaningful, fulfilling lives.”

When he asked whether the decision would change if adequate home care were available, the patient and his wife reportedly said it would. “If we had enough money,” they said. The wife wept, explaining they could not afford the care required to bring him home.

“That just made me so angry,” he says. “There were financial pressures. He wanted to make sure his wife would be okay when he was gone. One of the biggest drivers for this person was actually just to deal with care, getting adequate care. And that's purely a resource and financial issue.”

The clinician declined to participate in the assisted dying process, citing moral and professional objections.

“We should be looking after you properly instead of you feeling like you need to speed up the process because we’re not able to provide the proper care.”

He worries that assisted dying risks becoming what he calls “an easy solution that shortcuts the hard thinking work — the advocacy, the fight to get the right resources for people. It’s too easy to surrender and pull the plug.”

Coercion and Context

Perhaps the most serious concern raised is the issue of coercion — subtle, indirect, and often impossible to formally prove.

“Coercion is so hard to measure. You just have this feeling that something’s not right. You’re uncomfortable. But you can’t prove it.”

But those who spend extended time with patients and families, he argues, see far more than a brief assessor might.

Frontline clinicians observe family dynamics. They overhear conversations. They see exhaustion in spouses. They witness anxiety about finances, inheritance, or the burden of care.

“You just have this feeling that something’s not right,” he says. “You’re uncomfortable. And you always wonder afterward.”

The challenge, he explains, is that coercion rarely appears overt. It may not involve explicit pressure or verbal instruction. Instead, it can emerge in tone, context, circumstance — in what is implied rather than said.

“There’s always uncertainty. You wonder afterward.”

He also questions whether psychological conditions such as depression are being sufficiently addressed. “One of the major symptoms we look out for is suicidal ideation. Ordinarily, I would come alongside someone and say, ‘Why are you thinking like that?’ What am I supposed to do now?”

Now, he questions whether expressing a wish to die is being properly distinguished from treatable psychological distress.

Moral Distress and Professional Identity

The clinician says the moral burden has been significant.

“I was really thinking about quitting. I didn’t feel like going into work. It was a real blow.”

He describes end-of-life care as more than clinical intervention. “It’s all-of-person care. You’re lifting up their spirits. If their spirit is right, they can get through this.”

He fears that if the sense of moral distress disappears, something essential within the profession may be lost. “To have moral distress in this situation is actually normal. If that dies in me, something bad has gone wrong.”

He remains concerned about the long-term impact on the medical workforce. “I may end up leaving the profession. It won’t be just me. But if we all leave, there’s no resistance.”

His closing reflection is stark: “I just don’t understand how we got here — how we got to the point where doctors are killing their patients. What happened to us?”

Health Care Practitioners are not Alone

“We want those in healthcare that are feeling the same way as this brave clinician to know they are not alone,” Voice For Life national president Lydia Posthuma says.

“Conscientious objection must be protected and we need to stand with those in healthcare who are feeling pressure. Healthcare providers, especially our hospitals, need to respect their employees’ choices in this regard or we will lose some of the most skilled practitioners in an already stretched environment.”