Pou Kāpura

He rā ki tua. There is a day beyond this one.

Karakia mō te Pae Tukutuku o te Mate Whakaahuru

Tau mai rā ko te kōrero o tuaukiuki hei arahi
Tau mai rā ko te manaakitanga o ngā mātua tūpuna hei tiaki
Tau mai rā ko te aroha o te wāhi ngaro hei whakamāmā
i tā mātou haerenga i tēnei ara tapu o te Mate Whakaahuru.

Kia ū tonu mātou ki te tika
Kia ū tonu mātou ki te pono
Kia ū tonu mātou ki te aroha
Mō te hunga e takatū ana
Mō te hunga e manawa kiore haere ana
Mō ngā whānau e tangi ana,
Mō ngā ringa atawhai e tautoko ana.

Tukua mai te āio o Ranginui e tū iho nei
Tukua mai te aroha o Papatūānuku e takoto nei
Tukua mai te hau maiangi o Tāwhirimātea
Tukua mai te whakapapapounamu o te moana o Tangaroa
Tukua mai te pono o Ngākau
hei ārahi i ā mātou mahi katoa.

Haumi ē, hui ē,
tāiki ē!

May the ancient words of wisdom guide us
May the tenderness of our ancestors protect us
May the love of the unseen realm care for us
and lighten our steps on this sacred path of Assisted Dying.

We remain steadfast in what is right,
We remain committed to what is true
We remain anchored in love
for those preparing to journey beyond the veil
for the grieving whānau who remain behind
and for the caring hands that provide support.

Bestow upon us the tranquillity of Ranginui
Bestow upon us the love of Papatūānuku
Bestow upon us the gentle breezes of Tāwhirimātea,
Bestow upon us the glistening of the seas of Tangaroa
Bestow upon us a sincerity of heart
to guide all that we do.

Let it be bound, let it be joined,
It is so!

Written by Te Hurinui Karaka-Clarke

Nau mai, haere mai – Welcome

Pou Kāpura is a term that means ‘beacon of light.’ The Pou Kāpura website has been named by the Te Ārai Kāhui (Te Ārai Palliative Care and End of Life Research Group, School of Nursing, University of Auckland). The website was created to enable whānau to access, understand and discuss the end of life options available to people who have a terminal illness including assisted dying (euthanasia).

Having access to information about palliative care and assisted dying can help people with a terminal illness and their whānau prepare for what lies ahead. Whānau who feel confident talking about assisted dying, and exploring any questions or concerns they may have, will be in a stronger position to care for each other before, during and following an assisted death. Together, whānau will be in a much better place to support the person with a terminal illness to have the best quality of life available to them, including an assisted death, if that is their preference.

Findings from the Waerea study revealed that the assisted dying end of life pathway requires much more than whānau aroha, manaakitanga and practical support. Whānau have the responsibility to provide guardianship and protection towards the seriously ill and dying person because assisted dying is new and it brings its own challenges. The Kaitiakitanga Pathway has three phases. Each phase is tied to a specific timeframe on the pathway that whānau must navigate. We draw on the phases of the moon to understand and prepare for the assisted dying journey as it gently transitions through its natural cycle. Hinauri (Phase 1) symbolises the waning moon and is activated when someone in the whānau chooses the path of assisted dying. Whānau provide manaakitanga, advocacy and support following a life limiting diagnosis and as kaitiaki (guardians) they protect the person by keeping their decision private before the assisted death. Hina-te-pō (Phase 2) symbolises the dark moon and is activated at the time of the assisted dying procedure. Whānau kaitiaki continue to provide aroha, support, and protection of privacy until the completion of the assisted dying procedure.
Hina-te-ao (Phase 3) symbolises the waxing moon returning to the night sky. This phase marks the time following death and includes Māori post-death customs including tangihanga and whānau bereavement.

The information and resources on this website have been informed by the Waerea research study on Māori whānau experiences of assisted dying. We are grateful to the many whānau and support workers who took part in a confidential interview. This project would not have been possible without their experiences. The Waerea research team is also grateful to the Health Research Council, New Zealand for providing funding support (Rangahau Hauora Project Grant, 2023-2026).

Accessing the Assisted Dying Service

If you require information about assisted dying or you wish to access an assisted dying clinical advisor please contact Te Whatu Ora – Health NZ’s Assisted Dying Services, Phone: 0800 223 852 or Email: AssistedDying@health.govt.nz

This informational website does not provide direct access to Assisted Dying Services, nor is it a place to make enquiries about applying for an assisted death.

The End of Life Choice Act (2019)

The End of Life Choice Act came into effect on 7 November 2019. Assisted dying is available for a person who has a terminal diagnosis with less than six months to live. There are safeguards in the EoLC Act and strict eligibility criteria. Not everyone with a terminal illness will be eligible. For example, people cannot have an assisted death based on disability, advanced age or mental illness, unless they also have a terminal illness. The assisted dying criteria are:

  • Aged 18 years or over.
  • A citizen or permanent resident of New Zealand
  • Suffering from a terminal illness that is likely to end their life within six months.
  • In an advanced state of irreversible decline in physical capability
  • Experiencing unbearable suffering unable to be relieved in a tolerable manner.
  • Competent to make an informed decision about assisted dying.

Assisted dying is a way of dying that involves a medical practitioner supporting the person with a terminal illness to end their life at a time the person chooses providing they meet the EoLC Act (2019) criteria. They can choose to administer the medication themselves or, the assisted dying practitioner can administer the medication. Applying for an assisted death involves being assessed by two different doctors to ensure the person meets the eligibility criteria for an assisted death. They also have a role in ensuring the legal requirements for an assisted death are being upheld. So, for example, they will check the person is not being coerced or pressured by someone to apply for an assisted death.

Assisted dying upholds a person’s mana motuhake (independence, autonomy) over their preferences for not only how they die but also when they die. People who meet the assisted dying eligibility criteria are able to choose their dying day date and they have a choice about who will administer the medication to end their life (they can self-administer the medication or request an assisted dying clinician to administer it).

People who want to have an assisted death are also entitled to receive palliative care. Palliative care continues for the remainder of a person’s life. When an illness cannot be cured everything is done by whānau and health professionals to increase comfort and reduce pain and other symptoms. Palliative care includes the care whānau provide during those last months, weeks, and days of life and it also includes the care health professionals provide to reduce pain and other symptoms of the tinana – body, hinengaro – emotions and wairua – spirit. Palliative care also supports whānau who provide support to someone who has a serious illness at the end of their life and their whānau pani (grieving family).

The Pou Kāpura website has been designed to share information about Māori experiences of assisted dying to support Māori individuals who have a terminal illness and their whānau to make informed decisions about palliative care including the option of assisted dying. This website does not provide direct access to Assisted Dying Services, nor is it a place to make enquiries about applying for an Assisted Dying assessment. To access the clinical pathway for Assisted Dying Services, contact te Whatu Ora – Health NZ to access an assisted dying clinical advisor. Phone: 0800 223 852 Email: AssistedDying@health.govt.nz

Mana motuhake

Mana motuhake is about individual autonomy and self-determination and it is informed by many things including whakapapa (ancestral lines), and relationships with others, especially whānau. People who are seriously unwell have the right to excellent health care and to exercise their mana motuhake over how they want to spend their last days of life and how they want to die. Whānau have the privilege of supporting someone who has a terminal illness to have the best end of life care death and post-death care possible.

Most whānau like to make important decisions after they have discussed everything with their whānau. Whānau exercise their mana motuhake by considering all the choices available to them. Reviewing their end of life care options and death preferences is an important part of this. After weighing up the choices available to them, people can choose to have a natural death (dying from their condition with or without palliative care support), or they may choose to have an assisted death (supported by a clinician who is trained to provide or administer medication to end a person’s life) with or without palliative care (person’s choice).

Mana motuhake, or agency over life and death, is not new to Māori. Whānau have always functioned as kaitiaki (guardians and protectors) when someone travels the pathway towards the ārai (veil). There are many examples in our Indigenous creation narratives highlighting individual transformation and change.

In one well known pūrākau (narrative), Hine Tītama became heartbroken after discovering her husband Tane had deceived her; she learned he was also her father. Filled with deep whakamā (shame) and mamae (pain) Hine Tītama used her self-determination to flee from the world of light to find sanctuary in the spiritual realm through transforming herself into Hine-Nui-Te-Pō. Safely in Rarohenga, Hine-Nui-Te-Pō waits to welcome her children home as they leave the world of light.

Some iwi (tribes) recall that as Hine Tītama passed through the portal between te ao mārama (the world of light) into Rarohenga (the underworld) she was companioned by her aunty Hineruakimoa, a powerful feminine kaitiaki (guardian) who witnessed Hine Tītama as she transitioned through the ārai (veil). Hineruakimoa held space for Hine Tītama’s sacred transformation into Hine-Nui-Te-Pō.

The circle of life continues when we depart te ao mārama
Life, death, life, forever flowing, transforming, evolving
The circle of life, eternal and endless
As love is unto itself.

Mate atu he tētēkura, ara mai he tētēkura.
As one fern frond dies, another rises to take its place.