House of Assembly: Thursday, May 19, 2011

Contents

CRIMINAL LAW CONSOLIDATION (MEDICAL DEFENCES—END OF LIFE ARRANGEMENTS) AMENDMENT BILL

Second Reading

Second reading debate reading resumed.

Mr BIGNELL (Mawson) (11:40): I find it quite sad when we are talking about life and death issues that the members for MacKillop and Bragg want to talk about the rats and mice of the political process.

Ms CHAPMAN: I have a point of order, Madam Speaker. First, the speaker in making that statement is offensive to the matters that we are dealing with in relation to the charter of health and community complaints. It is not a rats and mice issue and I find it personally insulting, and I am sure the people who want this issue raised in the parliament feel the same.

The SPEAKER: There is not really a point of order because it is not something that we would consider a point of order; but, member for Mawson, I think you should continue with your remarks and refrain from making such comments.

Mr BIGNELL: Thank you, Madam Speaker, and I will return to the area I was talking about before the disruption, which is the health professionals who help people in their dying days. In particular, I thank all the staff—the doctors, nurses and all the other staff—at the Daw House Hospice where dad spent some time.

In those final few days when he was very weak, as I was saying before, he wanted to return to Penola near where we grew up in the South-East of South Australia to say his final prayers at the church where Mary MacKillop did so much of her work. He asked the doctor about this and the doctor—who had a great sense of humour and was very helpful and tried to help dad as much as he could—said, 'Look, Trev, you are too weak but if we give you a blood transfusion it might give you the strength to make that final journey to Penola.' It was the June long weekend.

The doctor came in after the transfusion and said, 'I'm sorry, Trev, the transfusion has not done its job and you are too weak to go.' The doctor left the room and I was thinking, 'Thank goodness for that,' because I did not really want to get in the Tarago with my sisters and make the drive down. Dad, in his normal, fairly stubborn way, said, 'Right, pack the Tarago: we are off.' My sisters duly met his wishes. I said, 'Dad, I'm not coming to Penola with you. It is going to be like Weekend at Bernie's, driving around the South-East with a dead guy in the car.'

That is the sort of thing I am talking about. In those final months you have your tears and your laughs, and we had lots of laughs. There was a lot of black humour between my dad and me, because I spent time driving him to medical appointments and to sort out his legal and business requirements in those final days. It is very hard to tell people not to fear death but, when you have lived through it with a close relative, you realise it is something that we all have to face up to and everyone is going to handle it differently.

Once again, I thank all those medical professionals with whom we came into contact in those three months before dad's death back in 2001. I stand here today not backing voluntary euthanasia but backing those doctors and nurses who do so much for people in their final days. So I will be supporting the Criminal Law Consolidation (Medical Defences—End of Life Arrangements) Amendment Bill.

Ms THOMPSON (Reynell) (11:44): As have other members, I have received a number of letters and various messages from people within my electorate and people outside my electorate.

As with other matters of conscience, my view is always to seek to allow all individuals to exercise their own conscience and provide a framework whereby, no matter what a person's religious or ethical views, they are able to enact them. I believe that today we have a society which is sufficiently mature to enable us to provide respect to the various views that are genuinely and very firmly held by many people within our community.

For those whose views mean that life must take all natural courses and not have medical intervention in many ways at all, such as some religious groups, I respect their views. For those who will accept a level of medical intervention but not to the extent that it in any way shortens life, I respect their views. For those who believe that they should have more control over the quality and quantity of life, I respect their views. This bill seeks to enable the participants in the process, and any doctors and any health workers, to enable that last group I mentioned to have their wishes accommodated. The wishes of the first two groups are already accommodated, but the wishes of the third group are not always under current laws.

Of the many communications I received, the one that best reflected and said far more eloquently than I possibly can the views that I hold came from Graham Nerlich MA, B. Phil (Oxon) FAHA, Emeritus Professor of Philosophy in the University of Adelaide. It was interesting that, on top of all the very heartfelt communications I received from doctors describing some very difficult situations in which they have seen their patients, it was a philosopher whom I found most useful in considering the rationale that I hold in relation to respect for people's views. Professor Nerlich writes:

Doctors often face a cruel dilemma where a patient suffers an illness, injury or medical condition that irreversibly impairs that person's quality of life so that the life becomes intolerable to that person and beyond the reach of even the best palliative care. If the patient pleads for the doctor to end their suffering by ending their life the dilemma is especially agonising.

The proposed amendment provides neither a direction, nor an advice nor a permission as to what the doctor may do in such circumstances. It imposes no duty on the doctor. It is merely a defence against prosecution brought against him or her, and any ancillary workers, in the event of their granting the patient's request.

Ethically, each person has a right to their own life. The right imposes duties on others towards them. But it does not follow that people have duties to themselves to preserve their own lives under all circumstances. The state does not, and should not, prevent them from choosing to risk death in the ordinary course of life. It does not bar them from choosing deliberately, to seriously endanger their life, either in attempts to aid or rescue others. It does not even legislate against reckless risks, taken for frivolous thrills. Nothing prevents anyone from laying their life down deliberately in time of war, for instance. In the painful medical dilemma, patients may competently and responsibly choose to forgo their right to life. It follows that they thereby cancel the ethical duty on the doctor to oppose a patient's free and competent request in the circumstances described in the amendment.

He then adds that the AMA's clauses 10.3 and 10.4:

…make it obvious what would move a doctor to take the step and risk prosecution: it is proper responsible medical compassion. Thus the proposed defence against prosecution is ethically justified. I support it in the strongest terms.

I think that says far more eloquently how I see the importance of this parliament enabling people to exercise their own conscience, make their own decisions and not stop willing practitioners from assisting people to exercise their own conscience. As said by Professor Nerlich, it does not impose an obligation on the doctor; it does not impose any particular rights on individuals. We already have a very good act relating to palliative care, but this enables people to make a decision to say, 'I have had enough.' It does not allow prior directives. It is very, very modest in what it does allow, but it does allow the parliament to give our citizens more rights in the exercise of their own conscience and their own views.

The Hon. A. KOUTSANTONIS (West Torrens—Minister for Mineral Resources Development, Minister for Industry and Trade, Minister for Small Business, Minister for Correctional Services) (11:50): I rise to exercise my conscience on this matter and to oppose the bill. I do so not in any way to attempt to criticise those who are proposing this. I do not think anyone who proposes this is not of goodwill, and I think that the same should be said of those who oppose legislation like this. I have been in parliament since October 1997, and I have opposed every attempt, every measure, to bring about this type of reform. I do so with one fundamental belief, that is, that doctors should do no harm. As the member for Reynell just said, this is a very modest step forward, but it is how you get larger change later—with modest reforms.

Personally, I feel that my conscience says that I must do all I can to make sure that no-one is harmed who does not wish it upon themselves. It is a very sensitive and difficult area in which to legislate. I completely sympathise with all the heartfelt cases used as examples for this legislation to be amended. However, examples do not make good law. It is a difficult decision. I make a point of letting my constituency know before every election my views on this matter. I do not attempt to hide it.

I know it is overwhelmingly popular in my electorate. In fact, I would go as far as to say that 85 per cent of my constituents support this measure, and I publically proclaim to all of them that I will be voting against it, and I said so before the election. I will say so during my four-year term, and I will say so again at the next election. The reason I say it is that I have a conviction that all life is sacred and that doctors should do no harm. With those few words, I oppose the legislation.

Debate adjourned on motion of Mrs Geraghty.