Access to care that prioritises individual needs, preferences, goals, and values is a fundamental human right. Aotearoa’s commitment to te Tiriti o Waitangi and the United Nations Convention on the Rights of Persons with Disabilities drive aspirations to achieve health equity. Given the evidence of conscious and unconscious bias within healthcare and its impact on structurally disadvantaged groups, as well as concerns about vulnerable populations, researching equity of access to assisted dying (AD) is imperative. Yet, the equity of access to AD is currently unknown.
Our talk reports on a national study of AD in Aotearoa. We used semi-structured online interviews and face-to-face hui (meetings). We interviewed 96 adults from the following groups: eligible/ineligible service users; eligible/ineligible service users with impairments; families of service users; AD providers; non-providers (providers who objected to AD and others who, although not opposed in principle, were not directly involved in providing AD); health service leaders; and Māori community members.
We used iterative reflexive thematic analysis to analyse the data, focusing on equity and inequity. We identified facilitators, including a publicly well-funded and person and family/whānau-centred service. Barriers included low health and internet literacy, plus delays in access due to communication processes. Barriers were unevenly distributed across certain groups.
We propose a working model of facilitators and barriers to equitable access to Aotearoa’s AD service. We examine how this model can be applied to AD law and practice. Improvements are needed regarding equity-driven data collection, palliative care funding, and health and death literacy.