House of Assembly: Thursday, September 29, 2011

Contents

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

Committee Stage

In committee.

(Continued from 28 July 2011.)

Clause 2 passed.

Clause 3.

Mr GARDNER: I move:

Page 2, after line 23 [clause 3, inserted section 13B(1)]—After paragraph (b) insert:

(ba) the defendant referred the person to an independent medical practitioner (being a medical practitioner registered under a law of this state as a specialist in respect of the kind of illness, injury or other medical condition from which the person was suffering) who confirmed in writing the defendant's diagnosis that the person was suffering from a qualifying illness; and

(bb) the defendant referred the person to an independent medical practitioner (being a medical practitioner registered under a law of this state as a specialist in respect of mental health) who advised the defendant in writing that, in his or her opinion—

(a) the person was not suffering from depression; or

(b) if the person was suffering from depression, that fact alone did not cause the person to request the conduct to which the charge relates; and

Very briefly, during my second reading contribution on this bill I made it very clear that I could not support this bill without some significant changes, and, on that basis, I asked parliamentary counsel to prepare some amendments dealing with the issues that I identified. I might just go through them briefly once now, if that is all right, and then I can just refer members to this contribution and my second reading speech in future amendments.

The three significant aspects that I thought were most unfortunately lacking from the original presentation of this bill were, first, a clear determination that a request had been made by the patient. The amendments seek to require that that be in writing in the presence of an adult witness who is not the defendant or an employee of the defendant.

The second significant amendment that I propose, as I outlined in my second reading contribution—which I felt was a significant absence in the original bill—relates to the fact that I feel that it is important that a second opinion be provided. The amendment requires that the defendant (that is, the doctor) referred the person to an independent medical practitioner being a medical practitioner registered under a law of this state as a specialist in respect of the kind of illness, injury or other medical condition from which the person was suffering who confirmed in writing the defendant's diagnosis that the person was suffering from a qualifying illness.

For anybody who was seeking to go down this path, it would be an absolute travesty if they were wrongly diagnosed in the first place, and that is the reason for this safeguard being sought. The third major lack in the original bill, which I described as a litmus test issue, was a requirement for a psychological assessment. Therefore, the amendment I have proposed provides:

(bb) the defendant referred the person to an independent medical practitioner (being a medical practitioner registered under a law of this State as a specialist in respect of mental health) who advised the defendant in writing that, in his or her opinion—

(a) the person was not suffering from depression; or

(b) if the person was suffering from depression, that fact alone did not cause the person to request the conduct to which the charge relates;

For members, or anyone else who may be interested, I refer them to my second reading speech for more background—that is the basis on which I move the amendments today.

The Hon. S.W. KEY: I thank the member for Morialta. He has been quite consistent in his view about the need for these particular safeguards. I say 'consistent' because, in the negotiations I have had since the start of the year on this bill, there seems to have been different views about whether or not there was a need for a second opinion. I must say that people in the medical profession initially were opposed to the concept I had raised in discussion about whether or not there needs to be a second opinion and whether there needs to be more than presumably the case notes that I understand a doctor, and certainly the health staff who are supporting the patient, would normally keep.

On that basis, when I had the bill drafted, I did not include those safeguards because the view just before the bill was drafted was that, in fact, they were not necessary. However, on reflection, and certainly from the feedback I have had from the community, it seems to me that the member for Morialta's amendments are warranted, and I certainly support them.

Members may notice that, on the basis of the feedback I have had most recently, including from the AMA, I might add, I have also tabled some proposed amendments that are very similar to the member for Morialta's amendments. However, I defer to him, and I would be more than happy to support the amendments the member for Morialta has put forward. I think they are well thought out, and I think they will work in the situation we are dealing with. On that basis, I will be withdrawing the amendments I have put forward, which are listed as 88(2) under my name.

The Hon. R.B. SUCH: I welcome these amendments. Without taking anything away from the member for Ashford, who I know is committed to people's wellbeing and quality of life, some people have called the original bill as presented to parliament a voluntary euthanasia bill. I do not believe it ever was or would have been in that format. It focuses on the medical defence aspect. I am not against that; I am just saying that I think it is wrong to call that original bill a voluntary euthanasia bill.

I think people need to remember that, when we are talking about voluntary euthanasia, we are talking about voluntary euthanasia, not euthanasia without the voluntary component. It is important that people's wishes and desires are respected and that we do not simply have a mechanical process which allows a medical officer to end someone's life simply on the basis of their own judgement.

The reality is, of course, that every day in South Australia medical people are making decisions about ending someone's life, either through increasing pain relief, or maybe even involving things like chemotherapy, to a point where it will ultimately bring about the end of that person's life. I think people who suggest that it is not happening are kidding themselves, but you are not going to get doctors coming out and saying, 'I helped end someone's life today,' because they do not want be put in court and run the risk of prosecution. It is a reality—even recently someone said to me that their relative was dying and that they hoped that the process could be speeded up so they put pressure on the medical officers to end the life sooner rather than later.

I commend the member for Morialta for his amendments. I think they are reasonable and sensible, and I notice that the member for Ashford is willing to accept them. I think they put some useful safeguards into this bill and ensure that it moves from simply being a bill defending the actions of a medical officer to ensuring that it is focused on the wishes of the person whose life is coming to an end. I welcome these amendments.

Amendment carried.

Mr GARDNER: I move:

Page 2, line 26 [clause 3, inserted section 13B(1)(c)]—After 'person' insert:

, such request having been made in writing and in the presence of an adult witness (not being the defendant or an employee of the defendant)

As I said before, all the amendments were outlined in my earlier contribution. Amendment No. 2 is the one specifically requiring that requests be made in writing and in the presence of an adult witness who is not the defendant or an employee of the defendant.

Amendment carried.

Mr GARDNER: I move:

Page 3, after line 14 [clause 3, inserted section 13B(2)]—After paragraph (b) insert:

(ba) the defendant referred the person to an independent medical practitioner (being a medical practitioner registered under a law of this state as a specialist in respect of the kind of illness, injury or other medical condition from which the person was suffering) who confirmed in writing the defendant's diagnosis that the person was suffering from a qualifying illness; and

(bb) the defendant referred the person to an independent medical practitioner (being a medical practitioner registered under a law of this State as a specialist in respect of mental health) who advised the defendant in writing that, in his or her opinion—

(a) the person was not suffering from depression; or

(b) if the person was suffering from depression, that fact alone did not cause the person to request the conduct to which the charge relates; and

Amendment No. 3 is very similar to amendment No. 1; in the drafting of a bill sometimes things need to be written twice obviously.

Amendment carried.

Mr GARDNER: I move:

Page 3, line 16 [clause 3, inserted section 13B(2)(c)]—Delete:

'request (whether express or implied) of the person' and substitute:

express request of the person, such request having been made in writing and in the presence of an adult witness (not being the defendant or an employee of the defendant)

Amendment No. 4 is very similar to amendment No. 2—similar text but in a different part of the bill.

Amendment carried.

Mr WILLIAMS: I have a couple of questions on the clause I want to ask the proponent of the bill. The bill seeks to insert into the Criminal Law Consolidation Act new section 13B, supposedly to correct or right a wrong, or to correct something that is missing.

This part of the act, where we are inserting this new section, is about offences against the person, namely murder, conspiring or soliciting to commit murder, causing death by an intentional act of violence, manslaughter, criminal liability in relation to suicide, criminal neglect, defence of life and property, defence of property, etc. My question is: how many people in the history of this state have been charged under part 3 of the Criminal Law Consolidation Act whose charge would fall within the ambit of this proposal or proposed new section 13B?

The Hon. S.W. KEY: I thank the deputy leader for his question. My understanding from both the AMA and the Law Society is that in fact this defence has not been warranted for quite some time. There has been some case law that has changed the situation, though, in that it is now possible under certain circumstances for a patient to refuse treatment and it is also possible for a patient to refuse to eat or have any sustenance, but I do not know what other members in the chamber think.

It seems to me that they are pretty extreme measures that a person would have to take to have their choice of ending their life under certain circumstances made possible. It seems to me that while people, as I understand it, have not been charged in the way that the deputy leader has described, things have moved on to the point where that defence—and certainly people in the medical profession have said to me that they believe that this defence should be made available to them.

Mr WILLIAMS: I thank the member for her answer. The other question I have comes up in both 13B(1)(a) and (b) and the same in 13B(2)(a) and (b) where we are talking about the defendant as follows:

(a) the defendant was, at the time of the conduct to which the charge relates, a treating practitioner of the person; and

The second part in (b) provides:

(b) the defendant believed on reasonable grounds that the person was an adult person of sound mind who was suffering from an illness, injury or other medical condition that irreversibly impaired the person's quality of life so that life had become intolerable to that person...

My question relates to the words 'a treating practitioner'. Is it the intention that that treating practitioner is the person or the doctor, I presume, who has been treating that particular illness or is it somebody else who has come in for another purpose?

The Hon. S.W. KEY: I think that is a really important question. If you look on page 4 of the bill, a medical practitioner is described as:

a person registered under the Health Practitioner Regulation National Law to practise in the medical profession (other than as a student);

Then there is a definition of 'treating practitioner':

of a person, means a medical practitioner—

(a) who is currently treating the person for his or her qualifying illness; or

(b) who is currently responsible (whether solely or otherwise) for the primary care of the person.

With the contribution and the passing of the amendments by the member for Morialta, we now have other health professionals involved in the process. As the member for Morialta has actually moved, and we have agreed to, that would include a person who is an independent medical practitioner—so we have now introduced that person into the process—and also, where necessary, an independent medical practitioner being registered under the law of this state as a specialist in respect of mental health as well as, as you know, the amendments seeking documentation that would support the request from the patient.

Mr PICCOLO: I will ask a couple of questions, if I could, similar to the questions raised by the Deputy Leader of the Opposition. In new section 13B—and this is one of the issues that seems to be sending out a mixed message, even though it is not intended—are the words 'if the death resulted, or was intended to result'. A lot of people have read that as given approval or seeking to allow doctors to undertake euthanasia with a patient. Can I perhaps get an answer about what the purpose of the wording in that section is?

The Hon. S.W. KEY: I would like to thank the member for Light for his question. The reason that has been put into the legislation, as I understand it, is to make sure that there is a comprehensive defence, and that would include conspiracy for murder. So we wanted to make sure that, through the legislation, we have put forward a defence that is as good as it can be. Obviously the defendant would still need to argue their case, they would still need to justify the process that they went through, but it was felt that that needed to be in there as well.

Mr PICCOLO: In clause 9 of its position statement dated 18 May 2011 the Australian Medical Association of SA states:

For reason of clarity the AMA(SA) considers it necessary for there to be a statement at the beginning of the Bill to the effect that the intention of the amendment is not to legalise euthanasia.

Could this clause be amended to clarify that?

The Hon. S.W. KEY: Members would have heard, when I was discussing the amendments that are being proposed by the member for Morialta, that as with any bill there has been a series of discussions about what should be in or out of the bill; what amendments need to be there. It has certainly been a moving feast with regard to the Australian Medical Association's position on what should be in and what should be out.

At the meeting I had with them last Thursday, despite all the work that had been done (not only by our parliamentary draftsperson but by different council members of the AMA), I decided that that was not necessary as an amendment. It is very clear that this is not a euthanasia bill; this is a defence for a medical practitioner who accedes to their patient's request under certain conditions for murder, manslaughter and assisting in suicide.

This is not a euthanasia bill and I think members in this house understand that, although they may have some concerns with the bill itself. But I think that has been established and I do not think it is necessary in this bill.

Mr PICCOLO: In clause 8 of the same position statement the AMA(SA), when they talk about clause 13B, state that clause 13B should be changed to omit the palliative care reference in 13B(5) and amended to the following. I will read the quote because I think it is very important because I will be seeking the members' response to their suggestion:

Parliament intends that conduct bringing about the end of a prescribed person's life is a reasonable response to such suffering in exceptional circumstances—

and this is the bit they add—

including where the prescribed person's suffering cannot be effectively relieved other than with treatment that has the effect of shortening life.

Does that clause, in effect, widen, if you like, the intention of the bill to actually legalise euthanasia?

The Hon. S.W. KEY: Not being a lawyer I am not really sure how to answer that specifically except to say, along with what I have said in the past, that the discussions with the AMA were quite lengthy and ongoing and on balance I did not see the need for that particular amendment. Talking about palliative care I need to emphasise that like many members in this house I am a big supporter of palliative care. Like many of you, I have done fundraising in the area and I think that it is a really important part of our health system.

In saying that I am also aware of the number of people in the community who have argued—particularly the medical profession—that palliative care does not always work; it is not always the answer—depending on who you talk to. I refer to the recent opinion piece by Dr Roger Hunt in the The Advertiser where he says:

...despite optimal palliative care, and 5-10 per cent persistently ask clinicians to hasten their dying. Patients have a right to the relief of suffering, and doctors have a duty to relieve it.

So it is an area that certainly is of concern to many doctors, but I did not see why we needed to take out the reference to palliative care and decided not to.

Mr PICCOLO: I apologise if this question has already been asked prior to my entering the chamber. Can the member also just clarify why this proposed section 13B seeks to amend the Criminal Law Consolidation Act and not the palliative care act?

The Hon. S.W. KEY: The reason I would give, member for Light, is that this is not a voluntary euthanasia bill, although I have a bill on the Notice Paper, as members know, that amends the Consent to Medical Treatment and Palliative Care Act which is where I believe the voluntary euthanasia provision concerning the choice of voluntary euthanasia should be. This is a different attempt to look at defending the medical profession and the people who work with them if they are charged with a particular criminal offence.

The Hon. R.B. SUCH: Can the member for Ashford advise what legal or other advice she has had that suggested that the provision of her bill and these clauses would clarify and codify the criminal law to a point where it removes any ambiguity or vagueness or black hole, if you like, in the provisions of the law? Has she had any legal advice or advice from practising medical officers indicating that this bill and these particular clauses will clarify the law and codify it to a point where doctors will no longer be operating in an area that is subject to vagueness and possible misinterpretation?

The Hon. S.W. KEY: I thank the member for Fisher for the question. I have had considerable advice. I have relied very strongly, obviously, on our parliamentary draftspeople who, as far as I am concerned, are the experts in our lawmaking, but I have also sought advice from people whom I know operate in the criminal law area, as well as a number of doctors who practice in the end-of-life part of medicine and have raised with me the need.

As I said, things have changed particularly recently with the understanding that a patient can actually take action of their own accord and refuse to have sustenance, refuse to have treatment, and obviously die a very unpleasant death in many cases. Doctors—certainly the ones who I deal with and have talked to—are very concerned about that option for their patients and feel that they should be able, under certain conditions and obviously with proper safeguards, to accede to their patient's wish.

Mr PEGLER: I just have one question on the treating practitioner. If, for example, I was in hospital and somebody in my family has power-of-attorney, can they change my treating practitioner? Can that treating practitioner then proceed down this course of euthanasia?

The Hon. S.W. KEY: My understanding of the state of play with regard to advanced care directives is that depending on—are you talking about a medical power-of-attorney, for example?

Mr PEGLER: Yes.

The Hon. S.W. KEY: My understanding would be that, if you are giving your rights as a patient to someone else to act on your behalf, there would need to be some discussion with obviously the person who has your medical power-of-attorney but, at the moment, voluntary euthanasia is illegal, so I cannot see how someone who has medical power-of-attorney could make that decision.

This bill is very specific about the patient themselves, so I am not seeing anybody else being able to make that request. They have to be of sound mind and they have to qualify by having basically an irreversible condition, illness or injury, so that it does not look like they are going to get better any time soon and their situation is intolerable. It really is centred around the doctor-patient relationship, and it is centred around the patient in this particular defence.

Mr VAN HOLST PELLEKAAN: Member for Ashford, keeping away from the issues of whether euthanasia is appropriate or not appropriate, and sticking really to what the substance of your bill is about, as I understand it—that is, the medical defence aspect—are there any other examples you can give where there is a parallel in legislation?

By way of example, there is a legal defence for police officers against speeding if they are speeding in the course of their work, but it is not a legal defence against speeding purely for the purpose of speeding, so I do not consider that as a parallel. Are there any other parallels where this would be a legal defence that a doctor could use if necessary, if charged, to avoid criminal prosecution for ending a person's life, when the purpose of what they were doing was actually to end the person's life?

The Hon. S.W. KEY: While I understand that is a very good question, I do not know if I can give you a legal response; I am not a lawyer. The only defence that I think is probably closest to what I am talking about in this bill is the defence of provocation.

I think most people have heard of the 'battered woman syndrome', which I think is an unfortunate term. If someone in a domestic violence situation kills their partner or spouse and can argue that they have actually been provoked to do so, and there is a history of reasons why it has ended in the way it has, then there is a defence that is taken on board. I cannot give you any other legal precedents because I am not in a position to be able to do that as a non-lawyer.

Mr VAN HOLST PELLEKAAN: I respect that, and I am not a lawyer either, so I was not really looking for a legal answer but more of a community parallel. This is suggesting to offer a legal defence to a doctor who may or may not have committed what is technically a crime, when the intention of what they were doing was to commit the crime.

As I said, it is a different thing with speeding because the legal defence is that you would not be prosecuted for speeding because your purpose was not to speed; your purpose was to speed to achieve something else. I understand what you are saying about the 'battered wife syndrome'—and I agree, it is an unfortunate choice of words, but it is one that we would all understand. Is there any other way you could describe this bill, other than a legal defence, if charged for an action that was taken when the intent was specifically take that action and no other intent?

The Hon. S.W. KEY: I am not quite sure if I understand the question precisely, but basically what this bill seeks to do is provide a defence under certain circumstances. As I was saying earlier, the crucial thing for me is that there is a request made—and now, with the amendments that the member for Morialta has put up, it is a very clear request. There is a witness to the request, there is written documentation to the request, and there is also an independent doctor and, where necessary, a doctor with mental health expertise, as part of that process.

I think the trigger is that the request comes from the patient under certain conditions, and the next part is that there are checks and balances in place to make sure that the request is one that has come from the patient and that it is a serious request.

Mr PENGILLY: The question I put to the member for Ashford (and I have the utmost respect for the member for Ashford; I am not into platitudes, but she is a very good member and a very good lady), but the nagging doubt in my mind at all times with this type of legislation is that you have the absolute villain (or villains) like Dr Patel. There is no question that, overwhelmingly, the vast majority of doctors are wonderful people and do the right thing.

However, if you have a Dr Patel, a wolf in sheep's clothing, and another one of similar views—a psychiatrist, mental health expert or whatever—there is no provision to pull up these people and find them out. If this legislation were to go through they can use the defence mechanism via the legislation to get themselves out of trouble. I have this great nagging doubt in my mind that you cannot always be sure that everybody will act in the right way.

I am dreadfully concerned, member for Ashford, that there are evil conspiratorial people in this world and this nation, and that is the way it is. I cannot be sure that that may not happen; therefore I cannot support the bill, but I would like the honourable member's response to my concerns.

The Hon. S.W. KEY: I thank the member for Finniss for raising what is a very serious concern. My view would be that, whether or not this bill was around, there are people with evil intent. I am not sure that it really makes any difference one way or the other. The only thing I would say is that, because we have now shone a light on what is actually happening in many of our health areas, certainly people are aware that a proper case needs to be put.

Also, we have a whole lot of tests we have in this legislation that would need to be put forward for someone to be acquitted of a very serious crime, whether or not the patient actually dies. I share the view that there are evil people out there, member for Finniss, but I do not think this bill, if it passes, will either ensure that it does or does not happen. That is about the best answer I can give.

The Hon. R.B. SUCH: On my understanding, the actions of someone like Dr Patel would not qualify under this bill, and certainly not with the amendments moved by the member for Morialta. Neither would this legislation meet the criteria with the behaviour of Dr Shipman, who was even more notorious in the UK. As I indicated earlier in committee, doctors generally do not come out and say, 'Look, today I ended five lives.' Has the member for Ashford had any strong indication that doctors are doing this anyway, and doing it under the umbrella of a very grey area?

They are not sure that what they are doing is potentially a criminal act, and the fact that very few people have been brought before the court does not negate what I believe is the fact that, every day in South Australia, people are having their lives ended by doctors. I guess the issue is the intent: they do not intend to kill them, but they know full well that what they are doing will kill them, through pain relief or sometimes chemotherapy.

The Hon. S.W. KEY: I thank the member for Fisher for his question. Many doctors and people who come into the electorate office have talked to me about those situations that the honourable member has just mentioned. It is interesting that in one of the public articles put forward by a palliative care doctor that he says:

Commonly the only way to relieve suffering is with treatments that can hasten death, like continuous terminal sedation, accepted by palliative medicine specialists and the AMA.

I think that answers the member for Fisher's question; it is well known and publicly acknowledged.

In my second reading speech, I talked about the AMA policy and code with regard to relieving suffering and pain. It is obvious that in some cases that medication also hastens death. When I answered a question from the member for Finniss, I mentioned that part of what this bill will do if it does become law is make it a lot clearer about what really goes on.

I have had personal experience, as have my constituents and people out there in the community. Hundreds of people have written to me about their own or their family's circumstances, where they really wanted their doctor to shorten their life because of serious health issues that they or their family member experienced.

My understanding is that it does happen at the moment. I mentioned earlier the changes that have occurred over time regarding the rights of patients. I think we should be prepared to make sure that 99.9 per cent of our medical doctors and health staff are actually supported and have a defence.

Mr BROCK: First, I understand the member for Ashford's passion for this matter, and I compliment her for bringing it up. However, from my observation, this bill was for medical defences of a specialist who may bring forward the end of a life through whatever it may be. Unfortunately, it has now become very confusing in the public arena. We have two other bills going before this house: one from the Hon. Bob Such and also one on palliative care. The media is calling this a euthanasia bill, and that is where it is getting confused in the public arena. I think that is one of the things that needs to be clarified: this bill is about a medical defence for the medical practitioner.

The member for Mount Gambier's question was: if I have medical power of attorney for my parents, or whoever it may be, and the specialist attending my family will not go forward and accelerate the end of life or suffering for that particular person, what stops me from then going to another doctor who may be a bit more receptive to going in that direction? Have we thought of that?

The Hon. S.W. KEY: I guess there are two things about this bill that I would point out in particular. There is the definition I read out earlier of the medical practitioner and the treating practitioner, about who they are. The treating practitioner of a person means the medical practitioner who is currently treating the person for his or her qualifying illness, and who is currently responsible, whether solely or otherwise, for the primary care of that person. With the amendments that the member for Morialta has successfully incorporated into this clause, we also now have an independent medical practitioner, and, where necessary, a medical practitioner who has expertise in mental health.

We have an independent witness and we also have documentation. I think they are all important things to take on board. Just getting back to the substance of your question and also the question that the member for Mount Gambier asked me, regarding the person who makes the request, clause 13B(1) of the bill provides:

(b) the defendant believed on reasonable grounds that the person was an adult person of sound mind who was suffering from an illness, injury or other medical condition that irreversibly impaired the person's quality of life so that life had become intolerable to that person (the qualifying illness);

It is specifically talking about the patient-doctor relationship and the request of the patient. So, I think that answers your question.

Mr BROCK: Thank you, member for Ashford. That is on the Hansard now, and I can explain it to my constituents. I have had nearly 2,000 or more people write to my office—

An honourable member: Is that all?

Mr BROCK: That is a lot for my area; and 65 per cent of them are urging me to vote against this bill. So there is a lot of confusion out there—

Ms Chapman: It is only 10 per cent of your electorate.

Mr BROCK: It is only 10 per cent of my electorate, that's right. However, it is very confusing for the general public to understand where we are trying to go with this bill. Now that I have a bit of clarity on it I will go back to my people.

The Hon. S.W. KEY: Just in response to that, the member for Frome has been quite thorough in making sure that people in the electorate of Frome are clear about information, and I compliment him on that. He has, like a lot of us, been trying to make sure that not only does he stick up for his own principles but that he also listens to what the electorate says. So, congratulations.

Can I also say that I think there has been some deliberate mischief that has happened with this debate. It serves the purpose of people who do not support voluntary euthanasia to argue that this is a voluntary euthanasia bill, but I guess the interesting feedback on all of that is that people in South Australia actually support voluntary euthanasia on the whole. Although there have been a few people in Ashford who have said to me that they do not support the amendment to the Consent to Medical Treatment and Palliative Care Act I have on the Notice Paper, very few people have said that they do not support the medical defence bill.

Once you explain that this is a medical defence bill—it does not mean that the person is going to get off, it does not mean that this will be a fail-safe way to start killing patients—then they feel quite comfortable with it. Obviously, if something gets into a law court you still have to argue your case. The only difference this will make is that parliament, if it accepts this bill and it becomes an act, will make it clear to the courts that we have considered, under certain conditions, the request of a patient to their doctor and that we are emphasising that doctor-patient relationship, with safeguards.

Mr WILLIAMS: I am somewhat confused at the member of the Ashford's claim that this is simply a medical defence bill and not a voluntary euthanasia bill. Let me explain. My understanding of voluntary euthanasia is that if someone wishes to end their life, by and large in this world, we would ask a medical practitioner to aid us in that wont. If that came to pass, we would have been through the process of voluntary euthanasia. That is my understanding; I might be completely wrong in that.

The member for Ashford's bill proposes that, as part of the medical defence, the defendant has to prove, on the balance of probabilities, that (and I am quoting from new 13B(1)(c)) 'the conduct to which the charge relates occurred at the express request of the person'. I am pretty sure I heard the honourable member say (because I wrote a note to myself) that it has to be proved that they are acceding to the patient's wish, and it certainly seems to comply with that.

I think the member for Light asked a question earlier about why the honourable member did not put a clause in this bill that expressly says this is not about voluntary euthanasia. I must admit that I am very confused. I think I understand what you are trying to do. I think you are trying to provide a defence for a doctor who is providing, I guess in most cases, palliative care—and probably extreme palliative care—but the doctor knows that it is going to bring about the death of the patient. Notwithstanding that, the doctor is doing exactly what he or she has been trained to do, and that is their role, but when you introduce subclause 13B(1)(c), which I read out—that is, 'the conduct to which the charge relates occurred at the express request of the person' involved—I think it brings a whole new element and, in fact, does make this a de facto voluntary euthanasia bill.

The Hon. S.W. KEY: I guess we are going to have to agree to disagree on whether this is a voluntary euthanasia bill or not. In my view, I am a supporter of voluntary euthanasia as a choice. I think it is best placed in the bill that I have before parliament, which is amending the Consent to Medical Treatment and Palliative Care Act. I think that is the place where the choice for those cases of people who cannot be dealt with, with regard to palliative care, needs to be.

I guess I have a more radical view about voluntary euthanasia as well, in that I think that there needs to be a lot of thought put into the patient's request. I am more interested in the patient's request and their view about what is intolerable than what the community view might be or what other people's views might be. Obviously, that needs to be qualified with proper medical advice and support, but that is the view that I have.

This bill, should it become law, will only provide a defence should someone—the treating doctor and the associated medical staff—be charged with murder, manslaughter or assisting suicide. You read the relevant section from the Criminal Law Consolidation Act, so I do not need to tell you about that. It is just to provide a defence under certain circumstances. That is what the bill is about; it is not a voluntary euthanasia bill. The AMA has its view, and I think the member for Light asked me that question. On balance, I did not see the need to put that in there.

The ACTING CHAIR (Ms Bedford): I am mindful of the fact that we can only really have three contributions from each member. This is your third.

Mr PICCOLO: Yes, this is my third.

An honourable member: He has lost count.

Mr PICCOLO: I haven't lost count. My question to the member for Ashford is as follows. I just want to clarify because some of the language being used this morning, whether by accident or intention, is starting to really blur this issue. I think I understand what this bill is intending. My question is: irrespective of who makes the request to actually end a life, if the doctor, for either the sole or primary intention, was to end a person's life, would this bill provide a defence?

The ACTING CHAIR: Do we understand that question?

The Hon. S.W. KEY: I am not sure if I do, Madam Chair. I need to report progress first of all, as I understand it.

Progress reported; committee to sit again.