Imagine an organisation that’s dedicated to helping people at the end of their lives and relieving their suffering. Perhaps a hospice, founded to help people live fully right up until their natural death. Or a rest home, committed to the sanctity of life and the dignity of their elderly residents. Organisations founded on clear moral convictions sustained over many decades. Now imagine those organisations being told they have to play host to a procedure that conflicts with the whole reason they exist.
Unfortunately, this isn’t just a thought experiment. The ACT party have proposed changes to the New Zealand euthanasia law that would impose on care facilities like these. Their End of Life Choice Amendment Bill isn’t on Parliament’s agenda yet, but if it ever became law it would, among other things, undermine institutional freedom of conscience.
The Bill’s most attention-grabbing proposal is to expand eligibility for assisted dying, making it available for long-term conditions and disabilities, like chronic heart conditions, frailty, diabetes, renal failure, multiple sclerosis, and motor neurone disease.
But, critically, the Bill would also have significant implications for care facilities—places like hospices, rest homes, and disability support facilities. In fact, according to their own definition, a care facility would include anywhere a temporary or permanent resident receives services like support with “bathing, showering, personal hygiene, toileting, dressing, undressing, or meals,” “assistance with mobility problems” or with “administering medicine,” or even “substantial emotional support.”
The Bill would force these facilities to allow at least some cases of euthanasia on their premises regardless of whether this is contrary to their animating beliefs.
When the current law was being debated in Parliament, there was a proposal to add in explicit conscience protection for institutions to make it clear that they did not have to allow euthanasia or assisted suicide. The law’s architect, Hon. David Seymour MP, rejected the proposal saying it was unnecessary: “nowhere in this bill is any institution required to do anything."1
When, in 2020, Hospice New Zealand went to court to get clarity about the new law before it came into force, the court noted that conscience was a “cornerstone” of the assisted dying regime.2 While also noting that the conscience rights in the End of Life Choice Act are given to individual health practitioners, it concluded that legal entities were entitled to the same rights as people “so far as is practicable”.3
In summary, the court held that an organisation with an “entrenched moral ethos ... should have the benefit of the right to freedom of conscience” to the extent that makes sense, and hospices and other facilities are entitled to exclude euthanasia and assisted suicide from the services they offer.4
As this decision recognises, there are very good reasons to respect institutional conscience. Dr Xavier Symons, an ethicist at Australian Catholic University, argues that institutions have conscience rights both to protect the individuals in the institution, and because an institution’s mission, values and integrity deserve respect just like the convictions that motivate a person.5
Institutions—what lawyers call “legal persons” rather than natural ones—aren’t conscious and therefore don’t have a conscience in the way that a person does. But Symons argues that they deserve conscience rights when they have “deeply held beliefs” that guide their actions and when violating those beliefs would be costly.6
These rights protect the “shared judgement” and “collective action” of the people who give the institution its life, and they protect the services it provides and the people it serves.7
Conscripting care facilities into the assisted dying regime regardless of their beliefs is contrary to what we were told when the current law was passed, contradicts the importance of conscience in the law, and ignores that there are good reasons to protect institutions against this.
Because euthanasia and assisted suicide are legal, some care facilities will decide to offer these procedures. But it’s ironic that a Bill that’s purportedly about end of life choice would take away freedom of choice — from those care facilities who don’t want to be involved in euthanising their residents, from the health practitioners who work there, and from the residents and patients who want the reassurance of a euthanasia-free space.
Even more ironically, if the Bill goes before Parliament, MPs will be allowed a conscience vote on it.
Readers might remember that the current law was implemented by a referendum in which 65 percent of voters agreed that it should come into force. The referendum approved a law that makes conscience a cornerstone.
Upholding freedom of conscience protects us from a government that’s too big for its boots. ACT is usually pretty big on this idea. But if their law advances, facilities that can’t square euthanasia with their mission will be backed into a corner.
Kiwis did not vote to put care providers in such an untenable position. Doing so would be unconscionable.
This article was first published in The Nathaniel Report, issue 78, April 2026.
1. Hospice New Zealand v Attorney-General [2020] NZHC 1356, [61].
2. Ibid, [117].
3. Ibid, [103].
4. Ibid, [103], [214(a)].
5. X. Symons, Why Conscience Matters: A defence of conscientious objection in healthcare (Oxon: Routledge, 2023), chapter 6.
6. Ibid,124.
7. Ibid,128-129.
