Voluntary Assisted Dying Bill 2017
This is a highly contentious and highly controversial bill, and at no time in my parliamentary career, short though it has been, have I been lobbied so strongly by so many on both sides of the issue.
This of course comes as no surprise, as nowhere in Australia has legislation such as this had a successful passage through Parliament, save for the Northern Territory, where it was short-lived.
I came to this debate with no strong view either way, although euthanasia in the past would have been anathema to me and palliative care the most desirable course at end of life. I have worked long and hard to form a view on this legislation and have of course spoken with many people, received many letters and emails and spoken to many representatives of many organisations. I still believe that high-quality palliative care at end of life is the most desirable of outcomes, but I also believe that there should be choice for people at end of life, and I do not believe any longer that palliative care will relieve all the pain and suffering that exists in our community at end of life.
The member for Lowan took the time today to outline the main provisions of the bill, and I do not seek to repeat much of that detail, save to stress that this bill sets out strict eligibility criteria. For me the critical issues are that the person must be 18 years of age or more; the person must have decision-making capacity in relation to voluntary assisted dying; and the person must be diagnosed with a disease, illness or medical condition that is incurable and is advanced, progressive and will cause death, and is expected to cause death within weeks or months, not exceeding 12 months, and is causing suffering to that person that cannot be relieved in a manner that that person considers tolerable.
I have read through the bill several times and have been briefed on it. While I have a few concerns about aspects of the bill, which may lead me to seek some amendments to it, in an overall sense it is acceptable to me that people who are dying of a terminal illness are able to access the voluntary assisted dying scheme that is provided for in the bill.
My life has been closely tied to the medical profession, and I have the greatest respect for their compassion and dedication to their patients. My first husband was a psychiatrist and my second husband is a paediatrician. I have friends who are GPs and specialists. They have all practised palliative care over many years. At all hours of the day and night my husband has been called out to assist in the management of dying children. He has practised an excellent standard of palliative care over his long years of practice and has done so in a very collaborative manner. I have observed the close bond that exists between him and the parents of children who have died. They have been on a journey together and have an ongoing mutually respectful connection.
I am a lawyer, not a doctor, and I consider this legislation to be momentous. As human beings we have struggled with the meaning of life and death interminably, and many great philosophers and ethicists have written at great length on these issues. I am here because I was elected by the people of my electorate to represent them. I dare say neither I nor my constituents ever contemplated that I would be required to vote on a bill such as this, and most would have had no idea how I might vote on such a matter when they elected me.
This week all members can vote according to their conscience. As with many issues requiring a difficult decision to be made, I often try to place myself in the situation of a person who may be directly affected by that decision. However, in relation to a bill which has such a broad social impact I also have to take into account what it means for our society generally. I know that I would like a choice in these circumstances.
I am of the view that a dying person should have some say in how and when they die when they are already dying. It is a major social shift to take this position, but I have lived through many other significant social shifts — for example, the availability of birth control for women and enabling them to make important decisions as to their futures, and I recall how this was railed against at the time. The Family Law Act 1975 was again a huge shift in the way we dealt with marriage breakdown, and of course over time there have been very significant changes to abortion laws. All these changes have come with positive and negative impacts, but they have given people choices about how to live their lives.
This bill provides those who are dying with some control over how and when they die. Yes, there will be impacts, but who am I to tell someone they cannot have access to this? I am an individual member of this Parliament who has been shaped by my own life experience, and I do not want to stand in the way of a person seeking access to the choices this bill allows them.
I could read you many emails about people dying in awful situations, but these individual situations are not alone the reason for my stance. I have heard from so many people in my electorate on both sides of the issue, and I have had face-to-face meetings with as many as possible. I have read emails and letters and had long conversations on the telephone with many people I know and many I had not previously met. I can say there are passionate advocates on both sides.
While I received many One Click Politics emails from those against the bill, I received a surprising number of accounts of raw personal experiences from people who had lost loved ones in situations where it seems pain and suffering could not be alleviated. Many of these were generated following a mail drop of Right to Life brochures in my electorate, which many of my constituents believed had been circulated by me. It prompted many people to contact my office and for us to then have conversations about the fact that I had not distributed them but then about their personal views and experiences. I received a petition with well over 350 signatures of people in my electorate asking me to vote against the legislation. I respect that there are strongly held views, but with this bill I have to do what I think is right.
It troubles me that there is such a divide between the views of the medical profession, very publicly stated via the Australian Medical Association and many other branches of medicine. We know that one in four people die without access to palliative care and this could be for many reasons. It may be a lack of services, and I do not doubt that there is ample evidence of this. When giving evidence at Goulburn Valley Health to the parliamentary inquiry a hospice nurse drew attention to the fact that there are doctors who know very little about palliative care and therefore do not refer patients to hospice services at their end of life. This does raise the question as to what level of care some people are actually receiving at end of life.
Shepparton has a wonderful hospice service and has had it for many years. It is a 24-hour on-call service, and I had the benefit of seeing this firsthand when my father died. He was diagnosed with cancer, and eventually, struggling with pain management, he and my mother left the farm at Jerilderie and came to our home in Shepparton, where with the assistance of the hospice service and family we cared for him for several weeks until he died.
I know that good palliative care and sedation will provide a comfortable death for many, but not for everyone, and it is clear to me from the accounts and the evidence that I have heard that many people do not get good quality end-of-life care. Yes, it would be wonderful if high-quality palliative care were available to everyone in Victoria, but it is not, and I am not convinced that in every case it provides the outcome that people are seeking, Dying with dignity for many people is about ending their life before they become totally physically dependent for all their needs.
There are some aspects of the bill which I believe could be improved upon. My first concern relates to appropriate referrals for the assessment of decision-making capacity of a person seeking voluntary assisted dying. The second relates to the qualifications of the coordinating medical practitioner and the consulting medical practitioner. I think it is important that one of them should be a specialist of a college other than the Royal Australian College of General Practitioners and that there should be a clear statement as to what relevant expertise and experience in the disease, illness or medical condition actually means — what it really requires.
Should the bill proceed to the consideration-in-detail stage, I propose to move some amendments in relation to the issues of concern that I have raised here. GPs often send people to a specialist in a particular field for diagnosis and/or treatment, and when it comes to death, such a final step should warrant an additional safeguarding level of expertise being engaged.
I have had cause to reflect continually on what has brought me to the position I am taking on this bill. I suspect there will be some in my community who will be very surprised by it. It has been a journey that I have taken very seriously and with considerable angst. I would like to thank everyone who has contacted my office to express their views and in many cases to share their experiences with me. While I have a broad acceptance of the concept of voluntary assisted dying contained in this bill, I reserve my final position until all amendments and consideration in detail of the bill have been finalised.