Contents
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Commencement
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Parliamentary Committees
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Parliamentary Procedure
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Ministerial Statement
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Bills
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Petitions
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Parliamentary Procedure
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Ministerial Statement
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Parliament House Matters
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Question Time
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Grievance Debate
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Bills
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Parliamentary Procedure
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Bills
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Personal Explanation
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Bills
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Resolutions
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Bills
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Answers to Questions
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Estimates Replies
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Bills
Termination of Pregnancy Bill
Second Reading
Adjourned debate on second reading (resumed on motion).
Mr KNOLL (Schubert) (15:39): To continue on from where I left off talking about some of the fundamentals, some of the reasons why we are even able to have this debate today stem from the advances in medical science that have happened over past decades and centuries.
We as a species, we on this earth, have actually been phenomenally successful at doing these things. Life expectancy in recent decades and centuries has improved dramatically, infant mortality has dropped dramatically, diseases that were once fatal are now chronic, and all these advances help to improve the quantity and quality of life that we enjoy, but the advancement of science does also give rise to opportunities and for individuals to make decisions for themselves about terminating or not terminating pregnancies in the modern era.
I think, though, also at its most fundamental this debate is about at which point does an unborn child have rights independent from its parents. Again, I come back to that point of when life begins. Is it at conception? Is it at birth? I think that trying to grapple around the idea of when an unborn child, or indeed a child that is born alive, begins to have its own rights and independence from the rights and choices that its parents and mother choose to make is the most relevant one here to us today.
My position on these issues has always been clear: I am for life in all of its forms. The gift of spending a few precious years on this earth is the most fundamental gift we are given. In fact, without it there are no other gifts that can be given, and the joys, trials and tribulations that come with the journey of life are all that we have. Whether it be in this debate or other debates where we challenge the very concept of life and our control over it, my position as being somebody who is for, in reasonable circumstance, helping to defend life is a value that I will continue to hold inside and outside this place.
I am lucky to have been raised by two loving parents and to grow up with three loving—if sometimes precocious—brothers. I can only imagine how difficult it was for my parents to try to steer and control four boys, all headstrong and all with their own characters, through to adulthood with the strength of character and moral courage in this age where teenagers often are indulgent and show degrees of disrespect.
Looking at my family, I can only now say that my mum and dad did a pretty good job. From an early age they taught us the value of personal responsibility; whether it be earning our own money, owning and learning from our mistakes, making decisions for ourselves and living with those consequences, we were taught that our actions had consequences, and this was no more important than during our teenage years.
As we began to go out and bring girls home for dinner and take them out on dates, we again had this concept of personal responsibility ingrained in us front and centre. I do remember dad having a conversation with the four of us using humour and some bad language to try to convey a point about how personal responsibility extends to when teenagers engage in relationships.
The fundamental advice, cleaned up for the benefit of this chamber, was very much that those decisions that we chose to make and those actions that we chose to undertake could have consequences, and for us those consequences and the responsibility that come with that would need to be upheld, and in no uncertain terms as we went out into the world and engaged in teenage life we took those values with us and we took those responsibilities very seriously.
I do very much agree that women in desperate situations and in situations not necessarily of their own making have difficult choices to make. An argument that is often played out in this space is that the man, the father, can walk away but that the mother cannot. A mother has to gestate and then give birth to a baby whilst a father can simply walk away and disappear and not have to take responsibility for those actions.
To that argument, I would say that more should and needs to be done to make sure that fathers are responsible for their half of the equation and that the answer here is to make sure that, as it takes a couple of people to create a child, it should be that a couple of people together, both a mother and a father, take responsibility for that child and, everywhere that we see fathers not living up to their responsibilities, to take action so they live up to the consequences of their actions.
This is something that we as a society and potentially that we as a parliament need to deal with and reinforce because those responsibilities should not be easily abdicated, as it takes a mother and father to create a child and therefore it should take a mother and a father to take responsibility for that child.
We get to what I think will be the crux of the debate, and that is when the rights of the mother and the choice that the mother wants and seeks to make, and the difficult choice they are often faced with, collides with at what point an unborn or newborn child has their own rights. I think it is a debate and a question that has evolved over time as advances in medical science have given us new opportunities to help babies survive at earlier and earlier stages in a woman's pregnancy.
What has come out in the health advice that has accompanied the SALRI report is that at 22 weeks and six days babies are considered viable. That is something that everyone in this debate so far that I have heard accepts and understands that there is now a line at around 22 weeks and six days where foetuses are viable if they were to come out into the world.
That line helps to create for us a point at which we can start to discuss the rights of unborn and newborn children independent of their parents. The point at which that child is able to viably live out here on this beautiful earth independent of their mother, I think, is the point at which we can start to rebalance this equation. That is why, as we get into the amendment the Minister for Environment and Water has tabled, this is a worthwhile conversation for us to have.
I would like to put on record some comments that have been made by various health and medical professionals in the field, who took the time to come and speak and address members of parliament a couple of weeks ago. The first of these is Professor R.J. Norman, who is a Professor for Reproductive and Periconceptual Medicine at the University of Adelaide, a founding director of the Robinson Research Institute for reproduction at the university and has founded a number of fertility companies. He says:
In this bill we are operating a dual standard. 'We deny human rights to a viable fetus, yet in premature birth we strive our utmost to preserve human life. Logically there is no difference between the potentially disposable material in the womb at 23+ weeks and the sacred and inviolable rights that are conferred upon the baby at birth.' [Toolis 1999]. My recommendation is that in the case of a normal fetus, the primary aim should be to deliver it alive and provide life-giving support for the child and perinatal psychological support for the woman involved.
We then had the opportunity to hear from an adjunct associate professor in obstetrics and gynaecology at Flinders University, who said:
Today you heard arguments as to why abortion after viability, 23 weeks, should not be allowed: because the live birth option is safer for the mother from 23 weeks, and humane to the baby, and because the evidence from Victoria clearly shows it's open to abuse—patients will request it and there are doctors who are prepared to do it.
A third comment from Dr Roy Watson, who is a specialist obstetrician and gynaecologist and a past Vice-President of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, states:
Firstly, is the matter of gestation. I find it abhorrent that this legislation would allow aborting a baby at term for any reason, but certainly for maternal psycho-social reasons. Even when it is necessary to end a pregnancy beyond fetal viability to safeguard the health of the mother, this can always be done in a way so as to allow the child to continue their life. Almost everyone with whom I discuss this issue agrees that feticide after the point of viability is not acceptable.
I think those comments from respected experts in the field, which I put on the record for the benefit of the chamber and for those tuning into the debate more broadly, all grapple with this concept of what we do after the point of viability. Again, given that medical science has advanced to a point where we are able to keep children alive from 23 weeks on, I think it is very worthwhile for us to have the debate at this point.
I will certainly be supporting the Minister for Environment and Water's amendments on that basis, on the basis that we need to balance the rights and the individual choice that women need to make for themselves, whilst also protecting the rights of unborn and newborn children. Those two sets of rights are not mutually exclusive in almost all circumstances, but in some circumstances they can be at the exclusion of each other. This parliament needs to make a decision on at what point the rights of one outweigh the rights of the other. I would contend that the point at which a foetus is able to viably survive beyond the womb would be a logical point for us to draw that line in the sand.
Unfortunately, these debates can often be characterised in the media and more broadly as being a binary choice: that you are either with us or you are against us. In this instance, I think there is sensible middle ground. I think that from the conversations I have had with members of my community, decriminalising abortion is a positive step. I think that it is, again, a question that was settled some 50 years ago, and we have a piece of legislation in place now that does not reflect contemporary practice but also does undue harm to women in the process.
The other side of that equation is that, in dealing with the concept of what is appropriate in terms of late-term abortion, there is middle ground for us to be able to decriminalise on the one hand but create a sensible middle ground way forward when it comes to late-term abortion. For the benefit of the house, I have drafted some amendments in relation to language that is used throughout the bill.
Without reflecting on a vote of the house, it was a concept that this parliament debated in the Statutes Amendment (Gender Identity and Equity) Bill back in 2016 where there was an attempt at that time to change the concept of 'a pregnant woman' into 'a person who is pregnant', essentially using gender-neutral language to describe women as part of that statutes amendment bill.
At that time, this chamber overwhelmingly voted to reject that proposition on the basis that what we should be dealing with in legislation should be based on biological fact, as distinct from the more fluid concept of gender. In no way would this amendment do anything to stop or halt women, or people who do not identify as women, being offered the care that they need; in fact, the current practice provides those opportunities, whilst the current legislation does not use gender-neutral language.
Again, the debate that was had at that time was that our legislation should focus on biological sex as opposed to the more fluid concept of gender, so I put forward these amendments on that basis. I also note some of the outrage around the Australian National University putting out a publication in recent days seeking to change a whole heap of language around parenting. I think it is something that is slightly different from the debate we are having now but no less instructive in terms of the response from the community.
To be able to gestate and give birth is fundamental to what makes a woman a woman. To bring back legislative language based on biological sex as distinct from gender, I think is an important way to go to make sure that we have legislation that reflects more closely medical science and biology.
I know that as we go through the committee stage of this bill there are going to be some tough decisions and some tough conversations that this chamber is going to have to have, but I do look forward to it being done in a spirit of open-mindedness and in a spirit of seeking to grapple with some of the most fundamental questions about when life begins and what is appropriate for this chamber to make decisions on in relation to those questions and what the answer we ultimately come to means for our community at large.
Certainly, everybody I have spoken to on all sides of this debate is seeking to grapple with answers about those fundamental questions and we all do so coming from a good place. I think that is the spirit in which this debate will occur. I am looking forward to that being the spirit in which this debate occurs so that the South Australian people can see that we, as their representatives, are doing our job and taking on these questions and deliberating on these things in a way that would make them proud, regardless of whether they agree with the individual decisions that we in this chamber have to make.
Ms COOK (Hurtle Vale) (15:56): I rise on behalf of my community and South Australian people in general to speak on this very important bill. It was 50 years ago that we, as a state and a parliament, had the argument about termination of pregnancy and whether it was a health practice that should be offered within our health service. We know that that decision was a very difficult decision.
I feel a great deal of responsibility in terms of making my decisions in relation to the termination of pregnancy amendments. We are making this on behalf of a diverse range of people in our community. For some, this is the most challenging and devastating decision that has to be made. Over the last few months, I have personally experienced some of the most terrible emails, threats and allegations about being a baby killer, someone who condones murder and someone who is condemned to hell for my values.
I have turned up at my office and found letters under the door accusing me and my team of endorsing infanticide, murder and some of the most awful things. Before starting to receive these things, not once had I ever thought that it was possible for this type of material to be printed or presented, mostly anonymously, I might say, in terms of the handwriting on them. Some have certainly had the endorsement of the Christian lobby and some have been organised mail-outs and contributions.
In saying all that, I feel very sad for people who are very challenged by this. I am very challenged by this as well, but what I have to do is draw on experiences I have had, not just in parliament but in my clinical experience as a registered nurse for nearly three decades, working across a range of hospital settings. I spent some time working in what was called the family planning unit at The Queen Elizabeth Hospital. I did a few shifts there, which was part of our registered nurse training. Back then, as a young woman who was not a parent at that stage, I remember thinking how awful and devastating it would be for those women coming in there and making those decisions. Not once did I consider, as is the allegation, that people are just careless and could not care less about the life they are carrying. This is not the experience I have had, particularly in terms of late-term pregnancy.
Some of the allegations and language being used about pregnancy to birth termination are that somehow this is some kind of easy option after having stress incontinence, pain, vomiting, nausea and sickness—the whole horrid thing that can come with pregnancy. Some of you might have sunshine, lollipops and unicorns, but, buddy, I am telling you that is not the case for many women who are pregnant.
To think that somehow these women could wake up one morning pregnant with a full belly and think, 'I'm just sick of it now. I might just change my mind and I might just go off and get rid of it.' That is just fanciful, hurtful and evil nonsense. That is not what happens. These women who are forced to make a decision later in pregnancy, because of a range of medical conditions with them or their baby, are going through absolute hell. It is not because they have just changed their mind and want to get rid of this baby.
This is not a baby that you can, as I have been told, wrap in a blanket and love and hold for the next 50 years of its life—because that is not what is going to happen. That is simply not an option for the women who face this. There are long discussions and long speeches that could be made about a whole range of things within this bill, but that is one facet that I have just found the most hurtful nonsense coming out of the anti side and does not reflect the women I have seen going through this awful experience.
I also feel for the country women, women in the rural setting who are forced to drive hundreds and hundreds of kilometres in their cars to go to Adelaide because they have to have two medical practitioners to certify and offer simple—simple—treatment and medication. That has got to stop. We have got to have a situation where that woman can go hand in hand with her loved one, with her partner, knowing that her family is at home to love her.
That is not what happens now: she has to sit around in a hotel room somewhere waiting to bleed and miscarry. It is disgusting. That is not what should be happening. This piece of legislation will help to correct that. It will stop this from having to happen. We can have one practitioner prescribe and administer this medication, this treatment, or we can have not just a medical practitioner but a nurse practitioner. They are suitably qualified and educated to do this. I implore you to consider this when you are debating this bill.
We are not having an argument about whether termination should happen. We had that debate 50 years ago and we stopped dozens of women dying from haemorrhage, from infection and from backyard butchery. We stopped that from happening. That is over. Let's move on to the next step. The next form of decency is where a woman can go home to her loving husband or partner and have her children in her home with her and have the procedure done in her town. That is what we want to see.
We also do not want to see women who are having late-term terminations—and they still do and they still will have them—have to get in a plane and go interstate and have it without their partner, without their husband or without their children in the home with them. It will still happen. They still do it now. It is not like this is a new treatment that we are getting kicked off the ground. What we are doing is we are saying that it should happen here so they can be loved and cared for.
I thank you for the opportunity to be able to debate this and the Attorney-General for bringing this bill to the house. It is a very challenging piece of legislation. There is much more in it and we could get very technical. I have medical training, but I am not going to get technical. It is not about that. This is about compassion and this is about doing what is right for people, not just women. I am not even going to start going into gender identity. We can talk about that in the amendments, good grief. This is not about that.
This is about compassion. This is about providing our community with options that are loving, caring and supportive. I support the bill in this form. I am prepared to listen to amendments and I am prepared to take guidance on those, but I will be supporting the bill.
Mr PEDERICK (Hammond) (16:04): I rise to make a brief contribution on the Termination of Pregnancy Bill. I support the current legislation in regard to abortion law in this state. The Termination of Pregnancy Bill would permit abortion for any reason up to 22 weeks and six days' gestation and beyond that, right up to birth if two doctors agree it is appropriate. I strongly oppose up to full-term abortion.
Women seeking an abortion will no longer need to attend a hospital in an attempt to liberalise the use of do-it-at-home chemical abortions—for example, RU486. This is particularly dangerous to women in rural areas. Health practitioners will also have their right to conscientious objection severely eroded. They will be required to participate in an abortion in cases of emergency and must at all times refer patients seeking an abortion to another health practitioner—in other words, making them a party to the act. The vast majority—and I stress 'vast'—of the contact to my office, especially across my electorate of Hammond, is opposed to this bill; therefore, I will be opposing the bill.
Ms BEDFORD (Florey) (16:07): Reproductive rights have come before the house many times since my election to this place in 1997. Conscience issues rightly demand a greater amount of engagement with the community and a greater amount of research, deep thought, reflection and deliberation.
As on previous occasions, my office has been inundated with form letters and emails, often hundreds a day, from people all over the state. Phone calls and personal visits have also been received, mostly from people outside my electorate, and I have had the opportunity to discuss the bill with unknown individuals who have approached me in shopping centres or on the street. I can assure you, each and every person, and especially each and every constituent, I tell them I hold their views front and centre in approaching the deliberations here today.
The core issue for me is this bill sees the removal of terminations from the criminal statutes to health legislation. It seems within the community this is mostly not a point, or major point, of contention. The fact women even have to consider the prospect of a termination rather than anticipate with great joy the arrival of a baby is a great shame. I say 'women' with mixed feelings because some of my constituents are very disturbed the term 'women' has been removed from the bill intended to empower women in favour of the term 'people'. The South Australian Law Reform Institute report recommended this replacement of terminology and it is a notion that has already been accepted elsewhere, having gone through in the successful New South Wales abortion legislation.
I truly believe no woman ever wants to be in the position of considering an abortion for any reason. The fact society at large has not yet fully addressed the issue of birth control—that is, preventing unwanted pregnancies—is another great shame. It is a fact of nature that not all foetuses are healthy or viable. Congenital abnormality and deformity are things every mother worries about. Reactions to confirmation of terrible news about the unlikelihood of having a healthy baby range from, 'No matter what, I will continue with this pregnancy,' to considering all other options. There is no one-size-fits-all outcome; it is a deeply personal and distressing decision.
If as a society we are to coerce someone to carry every foetus to full term, it also leads us to consider and enforce the options of relinquishing and adoption, both of which have had their own unique and different heart-wrenching issues for a mother. But it would be a happy situation indeed if all adoptions ended up as a perfect solution for the child. We all know that is not always the case, as generations of stolen Aboriginal children show us, as do the terrible stories from children who have survived in orphanages until adulthood. The desire to know and be with your family is very strong. For the relinquishing mother, in most cases there is always the longing to have known your child, and from accounts I have heard lives are never quite the same.
If as a backup to good sex education and birth control the next thing the state could provide is an assurance of full and total support for single parents, I believe terminations would not necessarily ever be considered. When a baby remains in a situation where a parent or the parents have insufficient support, we all too often end up with cases of dysfunctional parenting, resulting in shattered lives. I also believe most parents do their best, or try to do their best, and while children may have less than perfect families they still love their parents. However, all too often children are removed from their families because they are at risk.
In this state, at this very moment we have over 4,700 children needing foster care, and these are just the children we have already removed, not counting the children we know about and have not yet acted to protect. It is a continual concern for me that, while there is rightly great concern about the right to life, no similar concern seems to exist to the same level about the right to a safe, secure and fulfilling life for a child. This situation must be addressed, for if people have such a deep commitment to an unborn life surely they can find it in their hearts to bring that same determined concern and action to the support of the hundreds of children and families who need assistance.
It is the finer detail of the bill where concerns are raised about all manner of definitions and situations. As a person who has always advocated pro-choice—that is, to support people to make their own fully informed decisions—I bring this view to my deliberations on this bill. For example, while I gave it great thought at the time, I did not want to access IVF procedures at a time when becoming pregnant seemed to be impossible. In reality, I was just far too impatient. Nevertheless, I decided that if no children was to be my fate I would accept that.
Nor do I feel I would want access to organ transplantation. The question about giving one of my organs to one of my family might need more thought. This does not mean, however, I would ever wish to impose my views on others or impede any other person's access to these procedures. These decisions are best made by individuals in consultation with their medical practitioners, and often the original inclination may not be the final decision. So, too, I believe it is a person's right to have a termination, a decision that must be made with full information of all the pros and cons and with the non-judgemental support of counsellors, medicos and healthcare workers.
It has been heartening to hear from the Australian Medical Association, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Australian Nursing and Midwifery Federation, the Human Rights Law Centre, among other peak bodies, and a large number of health professionals, that the number of abortions is decreasing, particularly the number of late-term abortions. At the many briefings I attended, there was information about the length of time it takes for some pregnancies to be confirmed and that this can lead to a late-term abortion. While this is not the optimal situation, the pregnant woman's informed wishes must be respected.
I will consider the many amendments we have been given in the past 24 hours, amendments to the original bill we were asked to assess. I put on record now my disappointment the amendments have been provided so late as to prevent full consultation with the community I represent. In any case, that is the nature of conscience issues. Many fervently held views are competing for attention and acceptance. I will listen carefully to all the debate on amendments and explanations put to us in committee before making my final decision.
Ms LUETHEN (King) (16:14): This is such a sensitive bill because it is about the lives of babies and mothers. As such, and because I take my role as both a community representative and a legislator seriously, I have dedicated significant time to deliberate on this proposed private member's bill by the Attorney-General. I have been closely reviewing all debate in the upper and lower houses on this bill.
Most importantly, I have been listening to the feedback from constituents living in King to help me understand people's views and experiences on this most important topic. Additionally, I hold this feedback from people living in my community foremost in my mind. In preparation for this debate, I have considered expert advice and evidence and considered my own thoughts and experiences, too, because this is a conscience vote. I am so thankful to the many community members who have made representations to me or who have provided their views to me when I have asked.
This is an emotional topic about a critical decision. Can I say that what I have consistently heard from individuals is that this decision about what to do is gut-wrenchingly difficult. My heart goes out to any woman or couple having to consider a decision about the life of a baby or her life in some of the exceptional circumstances that I have learned can arise. I thank every woman, man and couple who have shared their terribly difficult personal experiences with me to help me understand further the unforeseen complications that can arise when a girl or woman is pregnant. The key themes that have emerged from personal views presented to me in the King community include:
a view that women are responsible human beings who should be trusted to make the best decisions about their own lives, and they can make their own choices about receiving medical care;
an overall consensus that preserving the life of the mother or baby is a critical decision;
that abortion should not be considered a criminal act; and
some views presented to me that I should just vote down the bill in its entirety and, if I do not, people have threatened that they will not vote for me.
I make it very clear that the decision I make on this bill will be guided by facts, by listening to the medical experts, community views and my own views on this conscience matter. I will not be persuaded to vote a certain way due to the threats that have been made to me by some community members. This bill is about mothers, babies and families and deserves to be contemplated in a well-considered and respectful way. I have prayed for guidance on this important deliberation, and people have kindly prayed for me too.
Some people have asked me to simply vote the bill down. I have learned in the past three years in this place that, in any vote on a bill, the decision is between at least three positions: firstly, supporting the proposed bill; secondly, supporting the existing law and continuing without any changes; and thirdly, supporting the proposed bill with amendments, which I believe will enhance the legislation. There will be a number of amendments tabled in this place, and I will be respectfully considering each of these.
It is important to remind ourselves of what is already in the existing law today so that it can be accurately compared with the new proposed law. On that front, it is important to note that the principle at stake in this bill is not whether abortions will become available in South Australia. That matter was considered by the parliament in 1969 and, for more than 50 years, terminations of pregnancy have been widely available in South Australia during the first 28 weeks of pregnancy.
Additionally, early non-surgical termination has been available in Australia since 2012. Provision also exists in the current law in section 82A of the Criminal Law Consolidation Act for terminations to take place after 28 weeks in circumstances where a medical practitioner is of the opinion, formed in good faith, that the termination is immediately necessary to save the life of the pregnant woman or prevent grave injury to her physical or mental health.
In 2018, the majority—91.1 per cent—of pregnancy terminations were performed in the first trimester. The proportion performed in the second trimester was 8.9 per cent, consistent with the average over the past five years. The proportion of terminations performed at gestation 20 weeks or over was 2.1 per cent. The current practice of termination of pregnancy is that 0.1 per cent of terminations have occurred over 22 weeks and six days' gestation. In South Australia, there has not been a recorded termination over 27 weeks.
The proposed bill suggests several changes. The framework for the legislation would remove abortion from the criminal code. The time frame for the standard consideration of a termination to be allowed would be reduced from 28 weeks to 22 weeks and six days.
After 22 weeks and six days, the bill allows for a termination to be performed by a medical practitioner on a person who is more than 22 weeks and six days pregnant, where the practitioner is acting within their scope of practice, and the practitioner has consulted with another medical practitioner and both practitioners consider that in all circumstances the termination is medically appropriate. In determining whether or not a termination is medically appropriate, a medical practitioner must consider all relevant circumstances, the professional standards and guidelines that apply to the medical practitioner in relation to the performance of the termination.
Why would a mother consider a termination? Today, genetic testing has the capability to identify which foetuses with congenital abnormalities have a syndrome, which would also often indicate an intellectual disability. The routine morphology ultrasound is completed at 20 weeks' gestation in the vast majority of pregnancies in South Australia. If an abnormality is identified on the ultrasound, it may represent an isolated, treatable, congenital abnormality—for example, an isolated congenital heart lesion amenable to surgery soon after birth—or it may be the earliest evidence of a genetic syndrome.
This testing can be done but takes three-plus weeks from the time of the ultrasound to provision of genetic results. An upper gestational limit of 22 weeks plus six days for termination of pregnancy means there is insufficient time for genetic results to be returned to a woman in a way that gives women choice regarding termination of pregnancy. If genetic results are returned just before 22 weeks plus six days, there is significant time pressure on women to make what is likely to be one of the hardest decisions of their life.
Removing the upper gestational limit for termination of pregnancy allows time for genetic testing, testing that has the capability to provide women with the opportunity of the most informed choice, including how to prepare to care for a baby that is born with abnormalities. I have been told today that people can be rushed into making a decision and that this could lead to people requesting a termination when with more information they might not have made this decision.
To understand in more depth what is medically appropriate, I have sought further information about the sorts of circumstances within which a termination after the prescribed period might be authorised. I have learned during my research that many medical groups have confirmed that terminations are only carried out in the most compelling of circumstances, where women and their partners are faced with terrible decisions, such as cancer or severe foetal abnormality, often only diagnosed at 18 to 20 weeks. I have been advised that when New South Wales considered its legislation last year it found that in Victoria there was no increase in late-term abortions after terminations were decriminalised in 2008.
There is common ground across my community regarding the sanctity of life of an unborn child. We all agree on this. That is why it is so very important to separate facts from fiction in what is being proposed. Some community members have presented fears, suggesting that if the proposals are accepted then more women would have late-term abortions for any reason and that the two doctors who are required to determine if the termination is medically appropriate may go rogue with their responsibilities. The idea that the bill might lead to a jump in terminations is at odds with the Australian statistics, which show that abortions in SA have decreased significantly from 1999 to 2018, and evidence from other states shows reforms have not led to a rise.
It has been suggested by some community members that the bill will allow for terminations to be performed up to birth on demand, including in situations where the baby is viable with no indication of congenital abnormalities and the mother has simply changed her mind, perhaps at 37 weeks. I reject this proposition because the additional presence and approval of the two medical practitioners after 22 weeks and six days' gestation recognises that terminations at a later stage of pregnancy involve complexities that merit the involvement of a second practitioner who must agree that a serious medical condition exists. The decision to impose a gestational limit of 22 weeks and six days is supported and considered appropriate by the Australian Medical Association (AMA) and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
I have been advised that South Australian doctors are held accountable, firstly, under codes of conduct under the Medical Board and AHPRA, and, secondly, professional standards under professional bodies (such as the AMA and colleges), health service policies, procedures and credentialing requirements and the overriding principles enshrined in medical and health ethics, which they must comply with. I am advised that doctors must act ethically, and if they do not I am advised that they risk losing their right to practise.
In the last three years of data collection there have been five terminations of pregnancy between gestations of 24 weeks to 26 weeks. This has demonstrated that later gestation termination of pregnancy is exceedingly rare, and it is not expected to change under the new bill should it pass into law.
To recognise and acknowledge some of my constituents' concerns about the legitimacy of medical practitioners' decisions, I foreshadow an amendment in my name which replicates clause 6(2) in substantially the same terms but which imposes an additional legislative requirement on both of the medical practitioners to consult with the pregnant person when considering whether a termination is medically appropriate.
This addition is an important safeguard in ensuring that both the medical practitioners separately consult with the pregnant person, not just each other, in determining whether or not the termination is medically appropriate in all circumstances. While the advice I have received is that a medical practitioner would always consult separately with the patient as a matter of good clinical practice, my hope is that this amendment will reduce concerns that this would not already occur.
This amendment will also expand the clause to consider the professional standards and guidelines that apply to the medical practitioner in relation to the performance of the termination of a baby. I have been advised that polling across Australia shows 80 per cent support for a woman's right to choose, including an overwhelming number of women who identify as religious.
As I have been doorknocking the past few weeks and attending community events, I have been asking pretty much everyone for feedback on this important topic, and the majority of men and women I have asked told me they support the proposed changes. There are also certainly people against, and their concerns largely come from a decision of concern for the babies. This is why I will move amendments, why I am taking the time to explain my position in the chamber today and why I will seriously consider other members' amendments too.
I have learnt that there are serious circumstances where rape, incest and abuse to girls and women are not apparent, or the pregnancy is not diagnosed until a more advanced gestational age. Requiring a woman to continue a pregnancy in such circumstances is advised by health professionals as unreasonable.
I cannot imagine instructing a young girl who has been raped that she has no choice in the matter about what she will choose to do if she is pregnant. People do not like to contemplate and talk about rape, abuse and incest because it makes us feel awful and uncomfortable, but we must think seriously about these prevalent issues in our community today. We must consider these situations and victims, as we consider this bill, with love, kindness and compassion.
I believe we must consider the serious psychological impact that continuing a pregnancy can have on the woman and her child in situations such as rape and incest, and because I am committed to South Australian children growing up more safely, to protecting our most vulnerable community members, and because I am dedicated to putting a stop to sexual abuse of children, I am made aware of more real-life stories of child rape than perhaps a lot of other members.
The statistics show that in South Australia there were three abortion procedures performed for children under 15 in 2018. Child sexual abuse is a topic no-one wants to talk about, but ignoring and hiding from the frightening reality of it is only putting more and more of our children at greater risk than they already are. According to the Australian Institute of Criminology, up to 30 per cent of children experience some sort of child sexual abuse.
Between 5 per cent and 10 per cent of children experience severe sexual abuse. Children with disabilities are up to seven times more likely to be sexually abused than their non-disabled peers. That is three in 10 children in your local childcare centre who could be experiencing some sort of sexual abuse at home. That is six children experiencing child sexual abuse in your average primary school classroom.
A woman I know who was courageous and open about her own life story has given me permission to share some of her story to illustrate a real-life example of incest. She was pregnant as a nine-year-old girl, raped by her uncle and, because of the hidden incest in her family, was forced to give birth. She grew up in a family who denied the incest. Her baby son was given to her aunty and grew up in another family. Her son did not know who his real mum was. She told me her son now suffers with serious medical conditions. Her son then married a person he thought was his cousin who was actually his stepsister.
There can be lifelong adverse impacts for people impacted by these types of situations and it must be stopped. In this case, this brave woman revealed her abuse to her subsequent grown-up children from her own marriage, and her children have found this too hard to accept and now refuse to see her. Fractures in families can continue for decades. It is my position that girls and women who have been raped need to be given a choice. Being denied abortion in these circumstances can have serious implications for the children born of an unwanted pregnancy as well as for the existing children in the family.
A South Australian social worker and experienced child sexual abuse counsellor in the northern suburbs provided me with her views on this topic. She said:
My work with childhood sexual assault survivors often exposed me to adolescent girls experiencing pregnancy as a result of sexual assault. In more than one instance the perpetrator has been an adult relative from within their own family.
One young woman did not come forward until four months into the pregnancy because the perpetrator was a step parent who was a powerful figure within his own religious community. She had self-harmed extensively as a reaction to the abuse and upon realising the pregnancy had researched amateur techniques for performing a home abortion. Had her mother not noticed when the pregnancy was beginning to show, she would have potentially been at risk of permanent harm.
In this case, the young woman went interstate and accessed services as the waitlist was too long in South Australia for her to be within the (current) required South Australian time frame. While this particular young woman's family had the means to fund this option, many women, particularly those from low socioeconomic backgrounds do not…
Domestic violence and the need to escape it, is a frequent barrier to women accessing an abortion in the first 23 weeks of pregnancy...There have been numerous cases of women both being denied access to abortion by the perpetrator, giving birth to the child and having both the newborn and other children placed at further risk.
Mr Speaker, I share the above situations so that you, other members and my constituents can begin to understand how serious these situations can be. I have no doubt that most people who have made a representation to me have done so because they have a sincere, compassionate concern for women and babies.
As well as reflecting on my constituents' feedback, I reflect on my own life experience in this debate. Having had two babies, I know personally what it is like to have scans and feel and see a baby grow in my belly, and I have learnt how protective a mother becomes. Because I am a mother, I am very aware of why it is very important to protect the lives of babies with this legislative change. That is why I have asked the Attorney-General so many questions about the clauses of this bill and why I have read the background reports from experts.
Abortion is for women and their partners a heart-wrenching decision, and I foreshadow further amendments in my name. Thank you for the opportunity to speak today.
Mr BROWN (Playford) (16:34): I risk to speak on this bill, as I prefer to do on matters of conscience, so that my constituents may have an indication of my reasoning to judge me on as well as being able to judge me on my vote. I will be opposing this bill at its second reading. I do so not because I object to taking the statutes that govern the medical termination of pregnancy in this state and moving them from the criminal law to a standalone act. That is a reform that is indeed long overdue.
I also do not object to the reform of the laws governing access to termination before the viability date. The law should work in practice just as it does on the page. The law, as it currently reads, is a fiction. The considerations, processes and safeguards felt necessary in 1969 have now long been effectively ignored by our health system in order to achieve what our community expects of it.
If these were the only components of this bill, I would probably be inclined to support it as presented. However, there are so many more things that this bill does, things that I know a number of members will be seeking to amend, and I indicate I will be supporting the majority of the amendments that have been circulated by members. I will personally be moving amendments, including to ensure that those seeking a termination are offered the opportunity to receive independent counselling, including that provided by the Pregnancy Advisory Centre.
I will also be moving an amendment to make it unlawful to perform a termination for the purposes of sex selection. It is true that the evidence of sex selection terminations occurring in Australia is only anecdotal. However, I believe that just like female genital mutilation, which this parliament has also rightly condemned, it is a practice we know occurs overseas and one we should make clear is not welcome here. I will consider which amendments, if any, are passed before deciding which way I will vote on this bill at its third reading.
Mr DULUK (Waite) (16:35): I also rise to speak to the Termination of Pregnancy Bill 2020. As many members have indicated so far in their deliberations, this is a complex, sensitive and challenging issue for all South Australians. At the heart of it, we are talking about matters of life and conscience. Therefore, we must tread with extreme care and caution in legislating for such action and always undertake this debate with respect and decency.
I think the Attorney mentioned the need for respect and decency in her media comments yesterday in the paper, and the descriptions of the 'Wicked Witch of the East', 'murderer' and 'baby killer' are completely unnecessary from all sides of the debate. There is no place for that type of emotive language. It is not appropriate, it does not help and it does not help deal with that issues we are talking about in front of us.
Other comments—and I am sure all members have received these through their correspondence—include, 'You have no right to comment on this legislation because you are a male,' and also that my view does not have a place in this debate. We are all here as members of parliament. We are here to work with legislation and the debate that is before us, and it is incumbent on all of us to participate in the debate in a respectful and thoughtful manner.
Regardless of which label you choose—'foetus', 'collection of cells', 'unborn baby'—it cannot be denied that we were all in this position once; we all share in that common experience. As legislators, we have that delicate task of balancing the needs of the unborn child and that of the mother, finding the best ways to support them both in providing the best and safest health care available to them right across our state.
Within this bill, we are dealing with matters that impact on women, couples and their families, and at times it can be very difficult to discuss, as the member for King so eloquently put in her contribution just then. There are strong arguments from pro-life and pro-choice advocates and both are very passionate about their views. During my time in this place, just as you have, Mr Deputy Speaker, I have sat with people on both sides of the issue and had many discussions with constituents about their thoughts on abortion, its decriminalisation and on certain late-term aspects of the bill.
As the member for Playford put in his remarks just then, I do not think there are too many in this entire house who do not support moving the bill from the criminal code to a general healthcare code. But that, in essence, is not what we are actually dealing with in this draft legislation before us. I think there is a raft of other measures in this debate.
As I said, this bill has generated strong views from my constituents, especially around changes to gestational limits. Certainly in my community, and I think across South Australia, there is very little support for what is called late-term abortion and allowing for the gestational limits to change that would allow potentially termination to birth, and especially a termination on a child in utero who is capable of being born alive and surviving independently of their mother. This step, I believe, is too far for many South Australians and, in fact, most Australians in general think it is a step too far.
A 2019 YouGov Galaxy poll found around 69.8 per cent of Australians were against abortion taking place after 22 weeks. The bill does allow for abortion at any stage up until birth, if deemed medically appropriate. I ask this house to consider if the current laws regarding late-term abortion are enough and whether they actually need to be extended.
In years to come we do not want to hold the same regrets that the late Hon. Mr Millhouse had, lamenting the wide interpretations that deviated from the legislation's original intent. I personally believe that being more specific about the circumstances around gestational limits would assist in this regard, and I will be supporting amendments with respect to that.
Currently, we have legislation that deals with late-term abortion in circumstances of medical necessity, such as to preserve the life of the mother. I do not know whether this bill, if passed, would increase the number of late-term abortions in South Australia. I would certainly hope that it does not. Evidence from Victoria suggests that it will, with a 2017 Victorian mothers and babies report showing that since abortion to birth legislation was legalised in Victoria in 2008, there have been an average of 65 late-term abortions a year in that state.
Let us not forget that with late-term abortion we are talking about a gestational stage when human life is viable and a foetus can survive independently of its mother. Medical advancement continues to demonstrate that this is the case. SA Health regards the threshold of viability to be from 22 weeks. Knowing this, it is interesting to also note that the gestational limits for abortion in other countries is as low as 12 weeks in Denmark, Norway and Switzerland and 14 weeks in Germany, France and Spain.
As has already been put on the record, there are other amendments and I understand the member for Playford seeks to move amendments around sex selection. This is another concern that constituents have raised with me, and the potential danger for sex-selective abortions to occur in Australia. Obviously, in my view no-one supports this and we should never open the door to aborting a child simply because of its sex. It is discrimination, plain and simple, and it goes against everything that our society has fought for for generations.
Whilst it is a practice that most Australians abhor, there are reports that indicate that prenatal gender selection is taking place in Australia. A La Trobe University study from 2018 led by Dr Kristina Edvardsson found that in Victoria from 1999 to 2015, around 108 to 109 males were born for every 100 females in certain community groups, higher than the worldwide ratio of 105 males born to every 100 females.
In these same community groups, the ratio is even higher for mothers who have had two or more previous births, with around 122 to 125 males born to every 100 females. This is a concerning development and one that has been brought up in other states when they have debated legislation similar to this bill, as outlined in the South Australian Law Report Institute report 'Abortion: a review of South Australian law and practice', October 2019, at page 322. It is a terrible practice that continues to occur in other countries around the world. While it may not happen much here in South Australia, I would hate to see any change in our abortion laws that would lead to this practice occurring.
One issue that has been raised with me quite a lot is the issue of conscientious objection by the medical fraternity in the bill's current form. Under part 2, clause 8(1)(e), the proposed legislation requires registered health practitioners who conscientiously object, to, and I quote:
(i) transfer the person's care to a registered health practitioner who, in the practitioner's opinion, can provide the requested service and does not have a conscientious objection to the performance of the termination or providing advice about the performance of the termination; or
(ii) provide the person with information on how to locate or contact such a registered health practitioner.
The bill, as it currently stands, forces conscientious objectors to be part of the termination process by referring the patient to a doctor who will perform the procedure or providing them with information on locating another doctor who will. Dr Joanna Howe, Associate Professor in Law at the University of Adelaide, states:
Those who argue that forcing doctors to refer for abortion is merely about providing access to healthcare fail to understand that the act of referral is no trifling matter for a doctor who believes medical termination involves ending the life of an in utero foetus.
This presents a great ethical dilemma for many South Australian doctors who do not wish to play a part in the termination of a pregnancy. The conscientious objection provisions within the current Criminal Law Consolidation Act presently protect the rights of persons, including doctors and nurses, to conscientiously object to playing any part in the procurement of an abortion. An open letter signed by some 50 South Australian doctors voices their concerns, and it goes on to say:
SA is the last remaining state protecting conscientious objection in abortion. We implore you to maintain the status quo with the existing clause written by the late Justice Millhouse.
The open letter continues to say:
The authors of the conscientious objection clause, including the AMA, insist that conscientious objection is respected by the Bill. That is entirely false because the new clause coerces doctors to act against their conscience and mandates punishment which may include deregistration. Nobody should be forced legally to do something which they find unconscionable. Let it be clearly understood that parliamentarians have demanded for themselves a conscience vote where abortion legislation is concerned. It is contradictory, even hypocritical, to demand conscientious freedom for oneself and then use that freedom to deny freedom of conscience to doctor and other healthcare practitioners.
Other sections of the letter state:
We write to appeal for the restoration of the current status quo on this matter which is crucial to the practice of medicine by good and conscientious medical professionals.
They go on to say that a referral is not needed from a doctor in South Australia in order to procure termination services. Of course, this information is available on the SHINE SA information memorandum, where it says:
You don't need a referral from a GP to access abortion services in Adelaide.
This was certainly reinforced to me when I visited the Pregnancy Advisory Centre with some of my colleagues as part of the SA Health briefings. I had an opportunity to speak to the people on the ground at the PAC who said that a referral from a GP is not required to access their services.
I believe the current Criminal Law Consolidation Act's conscientious objections are some of the most sensible in the nation, in terms of other jurisdictions. In her paper 'Medical referral for abortion and freedom of conscience in Australian law' 2019, Howe states:
The middle ground can be seen in South Australia. There, the refusal must be due to a conscientious objection, though this is not defined in the legislation. The person relying on a conscientious objection has the burden of proving their objection in any subsequent legal proceedings. An additional provision limits the situations where conscientious objections can be made. It is not available where 'treatment is necessary to save the life, or to prevent grave injury to the physical or mental health of a pregnant woman'. This is in the current Criminal Law Consolidation Act.
South Australia's approach appears to reject a pluralistic approach in that it permits conscientious objection, regardless of whether the motivation is religious or secular. There is also an element of pragmatism in that a claim of conscience could be scrutinised in the course of malpractice proceedings, thus placing some pressure on practitioners to ensure they have a defensible position in regard to conscientious objections but providing protection for deeply held beliefs. If the practitioner were unable to establish their actions were due to a genuinely held conscientious objection they would be potentially found liable for negligence.
Dr Roy Watson, who is head of Gynaecology at the Central Adelaide Local Health Network and a former Vice-President of the Royal College of Obstetricians and Gynaecologists, also commented in the MPs' briefing in relation to this debate on conscientious objection provisions. He states:
…threatening the loss of medical licence for refusing to be involved in a process with which one does not agree, and which may even be dangerous, is not going to help us maintain a rural medical workforce when solo practitioners feel that they need to compromise their personal convictions in order to provide other essential medical services to South Australian women. We should be doing everything possible to sustain an adequate rural workforce, and this threat is detrimental to that cause.
My final words, in terms of the conscientious objection provisions, come from respected Adelaide clinician Dr Elvis Seman, medical lead of Urogynaecology at Flinders Medical Centre and Associate Professor at the Department of Obstetrics, Gynaecology and Reproductive Medicine at Flinders University. He says:
The Bill targets, stigmatises and, in effect, criminalises conscientious objectors, with the potential threat of disciplinary action including deregistration, which destroys one's reputation and livelihood. We were all privileged to train and practice in a culture which respects conscientious objectors, and countless doctors like us would not be in medicine today if the current Abortion law did not protect our right.
I will be moving amendments that simply replicate the current conscientious objections provision within the Criminal Law and Consolidation Act 1935, being section 82A(5) and section 82A(6), into the bill we are debating at the moment. These amendments are supported by many current medical practitioners in South Australia. These amendments seek to provide plurality, pragmatism and legislative protections.
I will not be supporting this bill in many of its elements because it goes well beyond the decriminalisation aspects by permitting late-term abortion, for one, and a lack of clarity around conscientious objections. That is why I will be supporting those amendments. I understand members are tabling other amendments and I will see whether I am in a position to support those as they are progressed and debated. I believe this bill fails to achieve many protections for our most vulnerable. As I said, this is a matter that requires compassion and support. I know there are some amendments from the member for West Torrens and the member for King which I hope are successful to improve this legislation overall.
Mr ELLIS (Narungga) (16:51): I rise to make an ever so brief contribution on the Termination of Pregnancy Bill 2020. From the outset, I would like to thank the people of Narungga for sharing their thoughts and stories with me on this deeply emotive issue. The extraordinary volume of correspondence my office and I have received in response to this proposed bill shows how important this issue is to so many people. Overwhelmingly—but not exclusively—the phone calls, letters and emails that myself and my staff have received have been respectful and considered.
Again, I would like to thank all those who have contributed for taking the time to do so and for the manner in which they have done so. I always attempt to reflect the will of the electorate whilst casting my vote on conscience issues. My personal conscience is a consideration that I take into account, but I always do my best to reflect the will of the constituency—that is who elected me, that is who I represent and that is whose vote I am casting.
It is especially important in this instance, and I acknowledge that I am yet to be in a position to completely understand the emotions and challenges that come with expecting a child with a partner. For this reason, I greatly appreciate the conversations I have had with people who have been in this position. I acknowledge the extremely difficult situations in which women and couples find themselves having to make unimaginable decisions about terminating pregnancies due to the health of a baby or a mother. I have done my best to put myself in their shoes but I imagine there will be no substitute for lived experience.
There are parts of this bill which I believe have merit and against which I offer no objections. I am fully in favour—as have been a great deal of many other speakers—of shifting the termination of pregnancy from the criminal code into the healthcare legislation. It makes sense for pregnancy termination to be an issue of health for both mothers and babies. As I said, that makes perfect coherent sense to me. I acknowledge that there is merit in this bill for women and couples in the regions who require a termination—and I would like to emphasise the word 'require'.
I accept that there are circumstances in which the majority of society has grown to accept that a termination is necessary—for example, for victims of rape and sexual assault—but I have three concerns with this bill and without support for amendments addressing each of them, I will be unable to support the bill at the final vote. Those three concerns are: the lack of explicit prevention of late-term abortion, the lack of explicit prevention of sex selection abortion and the function of the conscientious objection clause.
Without the passing of amendments proposed by the Minister for Environment and Water I will be unable to support this bill. Without a shadow of a doubt, the single biggest complaint I have received from constituents and interested people with regard to this bill has been the concern that it will enable late-term termination. I share my electorate's view that full or late-term termination should not be permitted, nor enabled, with a few exceptions. I will require that they are explicitly excluded in order to satisfy the desire of my constituents that they do not become an unintended occurrence as a result of this bill.
I am concerned that the current wording of the bill before us, 'medically appropriate', leaves it open and ambiguous, and I prefer the very limited exceptions proposed by the member for Black in his amendments. We have heard from previous speakers that this will not occur in practice, but I would like to see it made explicitly so in legislation.
I will also support amendments filed by the member for Playford specifically regarding sex selection. While I am certain that the evidence provided by the proponents of this bill and by departmental officials is accurate, and that sex selection does not occur in South Australia, I see no harm in legislating specifically to prevent it from happening. As I have said, in my view and in the view of my community, there should be precious few exemptions for abortion, and biological sex preference should be one.
Finally, I will support amendments from the member for Waite regarding conscientious objection. I congratulate the proponents of this bill for recognising that there are health professionals who would not be willing to perform these procedures, and including an amendment as an acknowledgment of that. However, it is my view that, by compelling them to refer the mother to another healthcare professional who would be willing to perform that procedure, we would then be forcing them to facilitate that to which they conscientiously object.
I cannot support that and prefer that healthcare professionals are free to conscientiously object with peace of mind. As an aside, I sincerely hope that the amendments proposed by the member for Schubert are successful, as they represent the real-world biological differences between men and women.
As I have said, my primary concerns with this bill lie around the possibility of late-term terminations, and I would like to see them specifically excluded. I also believe that there need to be checks and balances to ensure that the parent or parents both recognise the enormity of the decision they are taking, and that they are completely safe in doing so.
Conscience votes are always extremely difficult. When I entered parliament three years ago I wanted to fix local roads, restore services to local hospitals and improve education outcomes in our electorate. Those are the things that personally inspired me to nominate for parliament and that I will continue to work on for as long as I am elected to represent the people of Narungga.
Issues that are a matter of conscience are vexed because people have passionate views on both sides of the debate. I have spent many, many hours listening to constituents, asking questions and researching this topic. Stories like the one I heard in Port Vincent recently, which has stuck with me and on which I keep reflecting, are evidence of the emotion with which many confront this issue.
I was approached by a lady with some urgency, and she urged me as her representative not to support this bill. She had been through an abortion in her younger days and had spent her life since regretting that decision. The emotion was clear as she recounted her story. She put to me the impact that taking the life of her baby had had on her mental health, and it had been a significant burden for her to bear for many years thereafter.
These are the stories of people's lived experiences that I value immensely. There have been countless other people within the community who have sought me out at a litany of other events to share their concerns. The people of Narungga elected me as their representative, and I intend to represent them as best I can in this place. I also take this opportunity to thank sincerely those MPs and interest groups who have provided briefings on this topic, and those on both sides of the debate for providing as much information as they possibly can; it has been an invaluable help in attempting to make up my mind on these issues.
As I mentioned, there are parts of this bill I can support, but without sensible amendments I cannot support the bill in its entirety. These are life-changing decisions, and life-ending decisions for the infant, and the bill requires significant, measured debate. I look forward to working with colleagues in this place to make sure that there are safeguards in place to protect the lives of unborn children, as well as the physical and mental health of parents, especially mothers.
Mr SZAKACS (Cheltenham) (16:58): It is safe to say that good people bring differing but deeply held views to the table on this debate. These views are influenced by their values, their faith, their life experience and often, if not all the time, a combination of all those things. I will be supporting reform because of my values, my faith, my life, but not lived experiences.
I have been open and honest since the day I stepped foot into this chamber about my support for both decriminalisation of abortion law in this state, as well as meaningful law reform more generally. It is my view that decriminalisation and law reform are not divisible.
I have also trodden carefully as a man in this debate. I do not have lived experience, but I bring values and empathy. I do not know what it is like to carry a child, but I know what it is like to be a father. I also know what it is like to be an ally, to be an activist and, when it comes to honesty and truth in my approach to public policy, to be truthful and not to equivocate when it comes to the tough issues, particularly when we are asked to exercise our conscience.
I reaffirm today my pledge in my maiden speech, and that is my support for this bill. I reaffirm my position and my support for this bill because I see a woman not only and singly defined as a vessel for procreation but as an equal, free to exercise their choice, their bodily autonomy and deserving of a law and legal framework that reflect and protect this. I do so because I support a legal framework that supports our health and medical practitioners to provide health care and support just as they do in every other aspect of health care. I do so because I am driven by my values—in this case, that abortion should be legal, affordable and safe.
This reform will support a woman's right to seek a termination as well as and in perpetuity a fundamental right and protection for women exercising their choice in a fundamentally different path. I do so with a responsibility, one that I carry humbly but also closely, as the member in this place representing the Pregnancy Advisory Centre in Woodville Park. I speak today to pay my sincere thanks to the medical professionals, the staff, their supporters both current and past, who have dedicated themselves to the care of these women in our community. Often, these women present and seek the support of the Pregnancy Advisory Centre in the most difficult circumstances.
While we talk rightfully and sincerely about the mental health impact on women as they find their choices through termination, let's not forget, as I know we do not, the staff who work in this space who undoubtedly also pay their own toll when it comes to their own mental health and wellbeing. I do so, as I always have, to proudly stand up for workers no matter what they do and how they do it.
I also lend my voice and give my vote to a movement for change that has been 50 years in the making; 12 years before I was born this law was brought in. This reform and the movement for reform have been led by some of the most incredible women in the state, activists from all political persuasions, all walks of life, women who continue to inspire me and many of my colleagues in this place. Today, those torches are carried by organisations like SARC, EMILY's List and Labor for Choice.
To those activists I say clearly, precisely and humbly that your dedication over the years inspires me and gives cause to the way I exercise my vote in this place. For me, when it comes to health care and to women's productive autonomy, I support each and every choice equally. I put my trust in the medical professionals, women and their families. These choices are often exercised in the most difficult of circumstances. After 50 years, reform is well and truly overdue.
Mr WHETSTONE (Chaffey) (17:03): I, too, rise to make a contribution on this very emotive issue. We know that there are many representatives in this chamber who have been lobbied for a significant period of time. Those people have gone to their representatives, their members of parliament, to express their view and, in most instances, to express an opinion. They have opinions far and wide, but they have an opinion one way or the other.
I would like to thank all the constituents in the electorate of Chaffey who have either met with me one way or another. Whether it is in my Politics in the Pub, whether it is in street corner meetings, whether it is my post office gatherings, whether it is just in conversation, people always feel obliged to come up and express their opinion.
I have had many of them. I do not have the numbers, but there are many. Those opinions have come from all corners of the electorate, remembering that I live in a regional electorate that has different measures from some others of how they view society. What I would say is that they have a view: some are pro-life and some are there for reform.
It is my view that I have given everyone my ear. I have given everyone the consideration they deserve and listened to their point of view, listened to their opinion, whether it be an uninformed opinion, or whether it be because they are part of a group—a church group, a lobby group or a community group—or just part of that community. It is my responsibility to give them a listening ear and make sure they walk away satisfied that I have given them the opportunity to express their point of view.
It has given me the capability to speak to a vast collective of opinions and to those who have been through it. My mother is 82 years of age and I have even had sit-down conversations with some of her friends, nursing colleagues of hers from yesteryear. They have told stories of the women who came in in early days for an abortion for one reason or another. Again, those reasons are many and varied as to whether the abortion was through circumstance.
A lot of women in the early days were forced to the hospital by their husband or their partner because they did not want that first child, or they were of a view that they did not want that child, which was number—I am not going to say the number, as there are different reasons for that number. Of course, as the member for Cheltenham has just said, there has been a significant amount of pressure put on women, whether it be due to mental health, whether it be as an upstanding community person, or whether it just be out of the fear of what has been part of their history with childbirth. Sometimes women have been persuaded to have an abortion; sometimes they have made their own collective decision.
Some of those sad stories from those I sat down with have also come from the very young. I have quite a young family: my youngest daughter is 18 and my eldest son is 30. I have also had the opportunity to sit down with my children's friends as a collective to have that conversation so that they can either express their opinion or they can express an experience they have had, whether it is with a family member or friend or someone within their social circle. Everyone has a story to tell of the impact it has had on them, and I think it has been said far and wide that this bill is long overdue.
My view is that we now make this a health issue, of the like of a healthcare code, away from a law bill, and I think that has merit. What I would say is that listening to all the issues around what was or what is the current law proves to me that there are many and varied reasons for women to have an abortion. Whether it is early in the piece or whether it is later in the piece, they have to be supported by the health system and they have to be supported by their collective family or community should they have to make a decision one way or the other.
I recently sat down with one of my family members and consoled them at length. A pregnant girl had to make a decision on what to do because the baby had a serious medical issue. We talked through it, and she decided to go ahead with the pregnancy. I think she was given the support that I could give her through circumstance. My advice was that it would have to be a health professional who would give her some level of assurance that she would be satisfied when that child was born.
Again, as someone having a listening ear, I have an opinion, but as a collective here in this chamber we have the responsibility as legislators to make the decision on behalf of our constituencies. Morally, we also need to make a decision on what we think is best for modern-day society because it is evolving. I think in today's society we have to reflect on not just what public pressure is telling us but what morally is right for a legislator to make that decision.
I have spoken to many health professionals in order to get their opinion, making sure that I am listening to a collective of opinion. I am listening to a collective of mothers, mothers-to-be, couples and married couples who have made a collective decision along the way. I must say that through this exercise I have sat down with hundreds of people, whether they be couples or individuals. It has certainly given me a much clearer understanding of what it is going to mean to them and the pressures it puts on us as legislators to make a decision in the best interests of not only our communities but today's society.
That is something that has kept me awake at night because I truly care about the common good of today's society. Speaking to many doctors, nurses and healthcare professionals, they all have a story to tell. They have given me a collective of stories and opinions, whether they be professional or whether they be private. You can ask a doctor about the experiences that he or she has had. They will always give you their professional opinion, but normally they will also give you their personal opinion, and those opinions come with a wealth of experience.
The bill is there to accommodate what we think is reform needed here in South Australia. I did hear one of the members saying that if a woman cannot get the care and what she wishes here in South Australia, she will travel interstate. That is something that was not presented to me by individual people. I think it weighs quite heavily on us as legislators to maintain a steady course in making that decision with that in mind. I have seen a number of MPs come to this place this last week with amendments to the bill, and I think that is healthy, robust democracy, and some of it is applaudable but some of it is not. That is something we will work through in the committee process.
I will also take the opportunity now to listen to the remainder of members. I think I have listened to every contribution here in the chamber from MPs. For different reasons, they have had their opinion swayed by their community, swayed by their personal opinion and also some, I am sure, swayed by personal experience. That is also very healthy, that we have a wide and varied understanding of the different situations because one size does not fit all. Again, I will continue to listen to the contributions here on this very important day.
I must say that I have had a number of phone calls today with people expressing their view that this is an important day for South Australia. Yes, it is. It is an important day for the democratic system and it is also an important day for the South Australian parliament to make a decision, one way or the other. It will be presented, and it will be something that will go down in the history books as providing what today's society is looking for. It is looking for leadership, it is looking for a decision and it is also looking for South Australia to fall into line with the national agenda. I will listen carefully and continue to be a part of the debate.
Mr BELL (Mount Gambier) (17:15): I will be very brief. I want to make sure that my comments are on the record for my community to understand where I am coming from in making a contribution on the Termination of Pregnancy Bill 2020. As the member for any community, but particularly my community, I make sure that I consider and respect the views of my electorate. I take that trust very seriously, particularly when it comes to complex issues such as this one.
Over the last number of months, as many here have already spoken of, I have listened to both sides of the debate and attended every forum that I can, and if I cannot attend I make sure that Kate Hill from my office attends and then we have discussions and briefings about it. I would also like to thank all those who took the time to contact my office or have come to see me in my office, or allowed me to do a home visit to their home and sit at their kitchen table to discuss this very important issue and hear their personal stories and opinions and views on this.
I really want to put on record the respectful nature in which that has occurred. I have heard other MPs here talking about some pretty ordinary behaviour, but I would have to say I have not experienced it in my electorate. In fact, everybody has been respectful and we have had a robust discussion around the legislation. Many of the points that I would make are echoed in the member for Narungga's contribution. In fact, I thought it was a brilliant contribution to this place.
One of the fiercest critics I have is my daughter, Jordan Bell, who is nearly 18,. Unfortunately, I am seeing a tendency that she may want to come into this place at some stage, which is something I will probably be discouraging. As an 18 year old, she certainly has a lot of opinions which lead to robust discussion, which for a father and daughter to share that interest to the point where she is reading Hansard and she is picking—
Members interjecting:
Mr BELL: Yes, it is quite scary, as I said. But it is really healthy for a father and daughter to be able to argue different points of view. She will call me a 47-year-old white male and ask what right do I have to have an opinion on this, and I will push back. She is not the elected member, so when she is she can have her own opinion.
Up until 23 weeks, I support nearly everything in the current bill. I would like to see the amendment on sex selection put in there, but up until 23 weeks I am very supportive. I genuinely believe in the right of somebody to choose the journey that they are on and not have a 47-year-old white male, as my daughter would say, putting my opinion on that. However, there is a critical point, and that is the point of viability outside the womb, and I do not think this bill satisfies my concern around this. When people say it will not happen, as a legislator—and I will put a legislative hat on—it is no comfort to say it will not happen if indeed it can happen. It might be a very rare exception or a very good lawyer—we need those, of course—but it is the point of a legislator to try to move forward as robustly as we can.
I guess I am really saying to the house that if these amendments can be passed—the ones I am really looking at are sex selection, defining of late-term abortions in specific terms and purpose-built abortion clinics that are for profit—and are addressed with the conscientious objection, I would be able to support this bill in an amended form.
If it goes through unamended, I am putting on record that I will not be supporting it, even though I fundamentally believe in most of the reasons that people will espouse. It should not be in the Criminal Law Consolidation Act. It should be in the health area, but I have to make a decision as a legislator going forward that what people say will not happen then cannot happen.
There are many other things we could talk about. I am passionate about adoption. I think we need to change our attitude in South Australia to adoption and really look at the New South Wales model, which went from two or three a year, which is similar to ours, to now 150 to 180 adoptions a year. I am really interested in support for expectant mothers to make very difficult decisions. I heard the member for Chaffey talking about the support he has been able to give to a family member. There are a lot of people out there who do not have that support around them or somebody who is capable of guiding them in the right direction.
Whilst I have put my points on record, I really would like to thank Kate Hill from my office. She has gone above and beyond. Every call has been answered and everybody has been met face to face. Even today, I think they spoke to four or five constituents on this issue because I was in Parliament House, so thank you, Kate. That is where I sit at this point in time.
The Hon. Z.L. BETTISON (Ramsay) (17:22): I rise today to speak in support of the Termination of Pregnancy Bill 2020. Termination of pregnancy has been legal in South Australia since 1970; however, in the 50 years since those laws were first enacted, there have been significant changes in our health system, including improvement in medical diagnosis and imaging, advancements in genomic testing, improvements to medical termination methods and the modernisation of health service provision, an example being telehealth consultations, which are now commonplace.
Our laws have failed to keep pace with these changes. As they currently stand, they create a barrier to safe and accessible health care for women. In particular, women who live in rural and remote South Australia are restricted in access to options that are available to metropolitan women. This bill provides a contemporary legislative framework for already existing lawful termination of pregnancy. For me, removing abortion from criminal law and regulating it as a health procedure is where it belongs. This bill reflects best clinical practice, promotes patient decision-making and respects individual autonomy of the patient whilst ensuring appropriate safeguarding and measures are in place.
In early 2019, the Attorney-General commissioned the South Australian Law Reform Institute to inquire into modernising the law and adopting best practice reforms in relation to lawful regulation of termination of pregnancy. The report was presented to the Attorney-General in October that year. The SALRI report made 66 recommendations, including that abortion should be removed from the criminal law and treated as a public health issue. I read that report and found it to be well written and a very thorough report encompassing all facets of the issues. I would like to recognise the work of SALRI and the diverse stakeholders who participated.
This bill repeals abortion from the Criminal Law Consolidation Act and will create the Termination of Pregnancy Act to regulate the termination of pregnancy as a lawful medical procedure. The bill is based on adapting our legislation to ensure it is effective in reflecting contemporary practices and services. We have seen dramatic changes in health technology. During a pregnancy, a woman may have a choice of a range of tests, including the Harmony test and the nuchal test and scan. They may make the decision to go ahead with CVS or amniocentesis, and our genetic testing capability has progressed rapidly in the last five years to the extent that it is now possible to test for many genetic syndromes.
Currently, a routine morphology ultrasound is completed at 20 weeks. If an abnormality is identified on the ultrasound, it may represent an isolated, treatable congenital abnormality, or it may be the earliest evidence of a genetic syndrome. The information gained from these tests and scans enables a woman to make a complete and informed choice about the health of their pregnancy. While advances in medical technology give us more information, currently there can be significant time pressure on a woman to make what is likely to be one of the hardest decisions of her life. It is important for us to give women time to talk with their families and their medical professionals. It is a time for them to make a decision to maybe continue with the pregnancy or maybe to make a decision to not.
Under the bill, a termination of pregnancy may only be performed after 22 weeks and six days, where two medical practitioners consider that, in all the circumstances, the termination is medically appropriate. It has been raised that this bill could lead to an increased number of late-term abortions. I do not support this belief. What this bill does is enable a medically appropriate model for late-term abortions, which recognises the very difficult decisions that are being made during this complex situation. It gives women, their partners, their families and their qualified medical and health professionals time to process and consider the options.
Under current legislation, there is no referral required from a GP to access public services, and women can self-refer. However, all women who access a termination of pregnancy are required to attend in person at a prescribed hospital clinic on at least two occasions. This is particularly challenging for regional South Australians, with a limited number of prescribed hospitals able to offer termination of pregnancy services.
In 2017, less than 20 per cent of women were able to have a termination in their regional area, with the rest needing to travel to the metropolitan area for the service. Under this new bill, in the cases of early termination, whilst there is still a requirement for a physical confirmation of the pregnancy by a doctor, an ultrasound can be conducted locally to confirm the pregnancy. These results are then returned to a telehealth provider and, upon confirmation, a subsequent consultation would be scheduled.
It is expected there will be a greater proportion of early medical abortions, particularly in regional areas, as women are able to have a termination of pregnancy closer to home. This is because of the removal of the prescribed hospital part of the existing legislation. This does not mean that there is likely to be an increase in termination overall in South Australia.
This bill preserves the right of a registered health practitioner to conscientiously object to provide or assist in the termination of a pregnancy. It creates a new major indictable offence for unqualified persons who perform or assist in a termination of pregnancy. It expands definitions of acts of abuse within the act to specifically include both coercing a person to terminate a pregnancy and coercing a person to not terminate a pregnancy.
This bill contemporises and consolidates existing legislation to ensure that terminations are legislated through a health perspective. It harmonises legislation to bring consistency with that already operating in Queensland, New South Wales and Victoria. I would like to thank all the stakeholders involved in bringing the bill in its current form today.
I acknowledge there are strong, deeply held views in this parliament and in our state about abortion, and I speak in support of this bill with the understanding that everyone in this house should be respected for their position.
The Hon. S.J.R. PATTERSON (Morphett—Member of the Executive Council, Minister for Trade and Investment) (17:31): I acknowledge from the outset that any time the parliament discusses matters relating to abortion many people have strongly held views about this. As such, this private member's termination of pregnancy bill is a conscience vote for Liberal members. Previous members have spoken of the very difficult and sometimes heartbreaking personal decision that principally women, but oftentimes their partners, have to make. It is not a decision taken lightly; it is an emotional decision that can cause anxiety and grief both at the time and long afterwards.
From my perspective, I have been incredibly fortunate to have been able to raise a family of four children with my wife, and I have not had to face some of the challenging and heartbreaking decisions that others have spoken of. Having four children has been one of the most influential aspects of my life. Undoubtedly, it has reinforced for me the need to value all lives and protect children.
I am also very mindful that it is very important as a member of parliament to respect all views in my electorate and use them to assist me in coming to difficult decisions, such as on the bill before us. My office has received a large volume of differing views since the legislation was introduced into the other place and, even prior to that, since the South Australian Law Reform Institute report into abortion was presented to government in October 2019.
I want to thank all those constituents who took the time to write to me and speak with me. I acknowledge that these contributions were heartfelt and would have been difficult and highly emotional on occasions for those people. As I have said before, being a father of four, it was hard not to be moved on many occasions.
The bill before us considers changing the present abortion laws in South Australia. The present abortion laws were introduced in 1969 and made abortion legal under certain circumstances, and it is presently dealt with under the Criminal Law Consolidation Act. At the time, South Australia was the first jurisdiction in Australia to do so. It is worth noting that relatively fresh in the mind of those legislators at the time was that in 1959 the United Nations General Assembly adopted the Declaration of the Rights of the Child. Part of this declaration stated:
The child, by reason of his or her physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth.
The abortion laws that were legislated in 1969 sought to protect the rights of two parties: the rights of the mother and the rights of the unborn child. Section 82A allowed for the pregnancy of a woman to be terminated if the continuation of the pregnancy would involve greater risk to the life of the pregnant woman or her physical or mental health than if the pregnancy were terminated, or if the child were to be born it would be seriously physically or mentally handicapped. The legislation also took into account the medical practices at that time that held that a child was capable of being born alive if the mother was pregnant for at least 28 weeks and only allowed terminations beyond this for the purpose of preserving the life of the mother.
These laws have been in place now for 50 years and society in South Australia has in the main accepted the operation of these laws. As time has progressed, there has been residual stigma attached to terminations for both women and medical practitioners by leaving it within the criminal code. Hence, one of the major reasons put forward for the Termination of Pregnancy Bill is the decriminalisation of abortion by removing laws in relation to the termination of pregnancy from the criminal law jurisdiction and instead placing them in health law and practice.
Decriminalisation of abortion by converting the existing laws from the Criminal Law Consolidation Act into a standalone health act such as this makes laws that can then allow them to be treated as health law, and that is a reform that I support. Equally, most constituents I have received feedback from during this process are also supportive, if this were the approach. The bill that we are debating also looks to update aspects of the legislation to take into account modern medical practices and is largely based upon the report prepared by SALRI.
One of these measures allows for telemedicine to be used for consultations and certainly the use of videoconferencing during COVID has clearly demonstrated that this is a technology that has great benefit and overcomes the tyranny of distance on many occasions. I am supportive of such a measure and believe it would be of great benefit to women from regional areas, as has been outlined by some of my colleagues who represent regional electorates. Also, when looking at the bill overall, I am reminded of the comments of Robin Millhouse, who was the Attorney-General when the existing abortion legislation was passed in 1969. In 2014, Robin Millhouse stated:
I deeply regret that the medical profession—and the lawyers—interpreted the law too widely.
He went on to say:
It has become abortion on demand. I did not intend it to be that.
This being the case, I feel it is important to ensure that if the Termination of Pregnancy Bill is passed, it does not allow for actions in the future that we do not intend to occur now. From my electorate's perspective, the community as a whole does not want abortion up to full term when the foetus is viable and the mother's life is not at risk nor do they want sex selection of an otherwise healthy baby.
At present, the legislation defines a viable gestation as being 28 weeks or more. Modern medical practices have meant that babies born prematurely between 22 and 24 weeks are able to now survive, albeit with the assistance of contemporary medical care. The bill enacts 23 weeks from which a foetus is gestationally viable. Hence, if there are amendments to the bill to safeguard the rights of a healthy foetus over 23 weeks, then I will support the bill.
Clause 6 of the proposed bill deals with terminations by a medical practitioner from 22 weeks and six days. The SALRI report provided South Australian statistics that in 2016 showed 90.2 per cent of abortions were performed in the first 14 weeks and 9.8 per cent between 14 and 27 weeks. The proportion of abortions performed from 20 weeks was 2.8 per cent. These later term abortions are small in percentage terms and, many times, are because of congenital anomalies, and the decisions taken by women and their partners are heartbreaking. The SALRI report acknowledges this complexity, stating:
During the later stages of pregnancy, abortion is an exception to a woman's general right to determine what medical procedures she will undergo and what relationships she will enter.
To address this, the bill proposes that two medical practitioners consider in all circumstances that the termination is medically appropriate.
The proponents of this bill assert that medical professional standards and ethics would not allow the termination of a healthy viable foetus beyond this 23-week term and I accept that most would not but legislative safeguards need to be put in place. Further, the Australian Medical Association of South Australia stated with respect to late-term abortions:
…the proposed legislation will make no change to current practices which involved intensive health and psychological support for a woman facing such a decision.
However, Dr Joanna Howe, Associate Professor in Law at the University of Adelaide, counters that, stating:
The current legislation prevents medical practitioners from advising on the possibility of termination after gestational viability.
This necessarily affects current practices as it means other forms of intensive health and psychological support are available to pregnant women but abortion is not available unless it is to save the life of the mother.
If the Termination of Pregnancy Bill 2020…were to be implemented, this would make a change to the current practices as it would enable medical termination to be offered by practitioners after gestational viability for a wide range of reasons pursuant to clause 6 in the bill.
Thus, it is incorrect to the AMA to assert that 'with respect to late-term abortions…the proposed legislation will make no changes to current practices'.
Dr Howe then goes on to state:
The Victorian Mothers and Babies Report of 2017 shows since abortion to birth was legalised in Victoria in 2008 there have been an average of 65 late term abortions a year solely for maternal psychosocial reasons. These are not reasons to do with fetal abnormality or maternal illness, or situations of rape or incest.
To me, Dr Howe's statements clearly demonstrate that the law has a significant role to play in determining how the medical professionals have acted in the past and may act in the future. Importantly, it is my view that it is necessary to legislate against practices relating to the termination of pregnancy that the community as a whole do not want.
It is therefore important that the bill be amended so that terminations of healthy, gestationally viable foetuses over 23 weeks are ruled out so that it more explicitly protects the rights of both the mother and the unborn child. There should be no ambiguity that, even as medical practices and standards evolve over time, we do not allow two medical practitioners to say the termination of a healthy gestationally viable foetus is medically appropriate because there are no laws being broken.
If I could now move on to clause 8, which deals with conscientious objection of health practitioners to either perform or assist in a termination or also provide advice about the performance of a termination, in the proposed bill clause 8(1)(d) outlines that, in such cases, the health practitioner must immediately notify the person, and clause 8(1)(e) requires the health practitioner to transfer the person's care to a medical practitioner that does not have a conscientious objection or provide the person with information on how to locate such a health practitioner.
As we have discussed, people have strongly held views against abortion and this includes doctors. One of my constituents, Dr Cathy Peterson from Glenelg, met with me in regard to this clause, and she stated, 'I am totally in favour of informing the woman in front of me of my position.' However, Dr Peterson is opposed to the second part of that two-step legal obligation, stating:
…as to me, both referral and provision of information are effectively the same, ethically they have me participating in an act that I object to—killing a human that can sustain its own life outside the womb. This information is also easily available with a simple internet search, and no referral needed, so why is this clause necessary?
Another practising doctor in Morphett, Dr Elvis Seman, explained to me in graphic detail the process of terminating a pregnancy in South Australia after 17 to 20 weeks, via dilation and evacuation, and also 20 to 23 weeks, by injecting potassium chloride or digoxin directly into the baby's heart to cause a fatal heart attack.
Dr Seman outlines that it is more than just religious beliefs that give rise to some health practitioners opposing abortion. It is their understanding of the process and the fact that studies are starting to understand that babies in the womb feel pain from at least the second trimester that gives rise conscientious objection. Dr Seman argues as an alternative:
In the case of a viable child in the womb (23+ weeks gestation), the safest and most rapid delivery for both woman and child is Cesarean section. This can be accomplished in 30 minutes from decision to delivery. In contrast, most elective abortion procedures performed after 22 weeks require days to accomplish and carry a greater risk of immediate maternal death than vaginal birth or Caesarean section.
Dr Joanna Howe, whom I referred to previously, also adds:
In short, to refer for abortion is not a passive step. It is to begin the process of procuring an abortion. Freedom of conscience demands that doctors who believe abortion ends the life of an unborn child should not be compelled to begin the abortion process.
My view is that if the effect of this clause of the bill is that practising and caring health practitioners, such as Dr Peterson and Dr Seman, are forced to leave the health profession or, equally, that young people who are opposed to abortion never enter medical practice, then society is the worse for it. As such, I will be supporting amendments that accommodate conscientious objectors and allow health professionals to maintain their moral integrity.
This certainly sits comfortably with the democratic values that are enshrined in the Australian political system and institutions. Moreover, oftentimes regulation that seeks to override conscientious objection is generally ineffective in the face of genuine and strongly held beliefs. The freedom of conscience in the context of referral for abortion demonstrates that this parliament values human integrity and also promotes a society in which a healthy diversity of pluralistic views is tolerated. Having this pluralism in the medical profession will also ensure that there is a sufficient availability of health care for everyone, including those who are not seeking abortion.
Brooke from Somerton Park explained to me her daughter's experience of falling pregnant, going to pregnancy advisory services and feeling pressured to make a decision to abort swiftly. Her daughter made it clear that at the early stage she felt pressured and unready to decide, later informing them outright that she did not want to abort the baby. Despite this, she was contacted several times regarding meeting with a social worker.
It is my firm belief that accommodating conscientious objectors therefore avoids the creation, over time, of a monocultural medical profession where termination of pregnancy at late term may become more accepted over time and in the future allows the medical profession and lawyers to interpret the law too widely.
I close by stating that if this bill is to progress I will look to support amendments that ensure women accessing what is currently a legal medical procedure can continue to do so in a decriminalised environment, while at the same time providing protections for the unborn child and, in so doing, provide a balance that is of comfort to many people in our community who wish to protect unborn children.
The Hon. G.G. BROCK (Frome) (17:47): I, too, today would like to put my views into Hansard so that my electorate understands the reason for the way I intend to discuss this bill, the Termination of Pregnancy Bill 2020. Firstly, let me state right from the very start that this is a very emotional bill that has been brought to this house. It has passed the other place with a small majority.
Let me say that the right to have a child is a right for every woman in this world, and there are times when there are complications with a woman's carrying of the baby to the birth date. This has been the case over many years. My late wife and I suffered the loss of a child a couple of times due to medical complications, but both these times were very, very early in the pregnancy. However, the loss of the child on both occasions was very hard to overcome. In reality, it took us a long time to come to the understanding that it was not an abortion but a necessity for the health of my wife and the baby. But it was hard to overcome and hard to accept for many years to come.
Every baby is entitled to be born and to enjoy a life, in whatever situation. The joy of seeing a child grow is one that some people are not able to experience, due to complications with the woman, and in many cases the man also cannot produce a child. As I indicated, we thought we would never, ever be able to have a child.
This bill has been presented under government time and is classified as a conscience vote. However, even though the people across my electorate know that this bill is a conscience vote, I have gone out to my constituents to get their views on the original bill that has been passed in the Legislative Council and is with us today. As other members have mentioned, I respect the views of my constituents. I have attended numerous forums across my electorate, outside my electorate and also in Adelaide and I have had many occasions on which to get a far better understanding of the views of those people who have had experience of the very subject that we are talking about today.
I have listened to all the views from the supporting sectors of this bill and also from those who are opposed to the bill and gathered their views to get a far better understanding of the issues. I have been inundated with hundreds of emails and letters from those within my electorate, and also from people outside my electorate, giving me their views and their suggestions on the bill. I have mentioned this to people across the whole of my electorate when I have come across them and there has been an overwhelmingly large percentage who have indicated their views to me. This is a majority well in excess of 80 per cent in one direction and that direction is not to support the bill in its current form.
From discussions this morning with the government's spokesperson, related not only to me but also from our regular meeting the day before parliament with the Leader of Government Business, we were advised that the government would like all second reading speeches finished today, and I understand that, and for the committee stage to be undertaken tomorrow with a view to hopefully reaching a final vote by the end of the sitting week.
My frustration is that I have been able to get the views of my constituents in regard to the bill that was with us before the amendments. However, with the amendments, some of which we only received late last night and some today, I question how I would be able to get to my community with these amendments to gather their views, their ideas and suggestions. I was advised I would have from the close of second reading speeches until the start of the committee stage to be able to get whatever information I required.
I understand all that, but the point is I am one of those people who likes to communicate with my electorate as much as I can, especially with a bill that has been going on for many months. Unfortunately, with the amendments that are coming through I will have to do the best I can and take those into consideration. In my opinion, this is not a real democratic proposal but more of a statement that I am making. I feel I am not able to consult with my community and I feel very frustrated about that. However, as I said, I will do the best I can with those amendments and take them on board and perhaps make a few phone calls tonight. Whilst this is not sitting well with me, I will do the best I can with the very short notice and try to consider these amendments prior to voting.
I go back to my late wife. We were considering having a family and as she did not get pregnant after a couple of years we started looking at adopting a child. In our vision, if we were successful in adopting a child who may have been admitted to a state facility, that child would be given a strong, constant and loving environment. If a child is born and the mother does not want to care for the child, for whatever reason, then that child has every right to be able to continue their life in a happy and loving environment.
From my information I am led to believe that currently these children who are born and put into foster care come under the guardianship of the minister and are able to be looked after by the relevant government departments and/or fostered out to foster-parents. I have numerous contacts with foster-parents and these people do a really great job caring and loving these children. However, there are incidents where the baby may be under care for a period and then transferred to another family, or, as in many instances, families may be separated and the children placed with different foster-parents, sometimes not even in the same town or community.
This gets back to my late wife and our desire to adopt which, according to my information, is basically non-existent in this state. The member for Mount Gambier indicated that we should be looking more at encouraging adoption and making it easier because from my information there are only two or three children per year, maybe a few more, who are adopted. I have spoken to people who want to adopt and they are saying that it is very hard. I would encourage the government to look at opportunities to make it easier to adopt a child. It takes them away from the foster-parents, it takes them away from the care of the minister and it gives them an everlasting relationship.
The other concern I have is if a child is with a foster-parent they may be there for a period of time, then that child may be transferred somewhere else, then transferred somewhere else and somewhere else. As that child grows up, does that child understand the reason for it or do they believe they are not loved and, as a consequence, as they get older and reach adolescence may have chips on their shoulders?
Getting back to the bill, I cannot agree to it in its current form; however, there is a section I believe is long overdue, and that is that the issue currently comes under the criminal code. I believe it should be under the health act, and this has been mentioned by many people I have come across, including those who are strongly against the bill in its current form. They say that section should be changed. I have no issues with the current legislation—even the church and other organisations I confer with say it has been working very well—but let's take it out of the criminal section and put it under health.
As I have mentioned previously, I have canvassed my electorate and there has been an overwhelming indication that they do not want me to support this bill in its current form. Like other members in this house, I have also received copies of emails that have been sent to other MPs, but it is the views of the people I represent that I have taken into account in my statement.
In closing, I would like to sincerely thank everyone who has contributed to the information I have been able to gather, as well as the people who look after the women who have had to go through the experience of having an abortion, experiencing the loss of a child. It has to be very traumatic.
In some of my discussions it has been indicated that if a child is born and is not going to survive they wrap up the child in a blanket and put that child on the mother's chest for bonding. I cannot understand that. My daughter lost a little son, my grandson, 18 months old. On the day of the funeral she was in the parlour. She had the child in a blanket and she was saying, 'Dad, dad, he's not waking up.' That is a traumatic issue, and it has been with us for 12 or 13 years now.
If they do that with a mother, and that child is not going to make it, does that mother then say, 'By heck, I've made a mistake. Maybe I shouldn't have gone through with this abortion. Maybe I shouldn't have gone through with the procedure'? We have to think about the long-term impact on that woman, on her mental health for years to come.
I would also like to thank Mackenzie, the trainee in my office. We have acknowledged all callers and correspondence. I must admit that I was in my office one Sunday and the phone kept ringing, so I answered it, thinking was my partner, Lyn, asking where the hell I was on a Sunday. However, it was someone leaving a message about the Termination of Pregnancy Bill, and after 20 minutes I got off the phone. I did not answer any more phones, but there were more calls in.
When I came in the next morning we had had over 180 calls on the answering system and 130 emails, so the general public has certainly taken this issue into great consideration. This is an issue about which we, as legislators—and this has been mentioned before by the members for Narungga, Mount Gambier and others—have to very careful. Once legislation is in, where does it lead to?
I want to thank everyone. I know this is an emotional issue, and we have to show respect to people who believe in this bill and to people who do not believe in this bill. Everybody has a right to their view on this, and I ask everyone to respect their consideration of the way they are going to vote. Let's make certain we look after our children, and make certain they grow up to have a healthy life. I have to say that I cannot support the bill in its current form.
Sitting suspended from 17:59 to 19:30.
Mr CREGAN (Kavel) (19:30): This bill raises the most essential moral and ethical questions any member can be asked to resolve. I have considered this bill carefully. I have agonised over it. I believe that women should not have to navigate the criminal code in order to understand their reproductive health rights. Accordingly, it would be better if terminations were dealt with in health legislation. Nevertheless, this bill is so deeply flawed in its present form that I cannot in good conscience support it.
I will again consider the form of this bill after amendments have been moved. If those amendments do not adequately address deep moral and ethical concerns which arise in relation to late-term pregnancy terminations, the risk of gender selection terminations, conscientious objection protections for healthcare professionals and important allied matters, I will vote against the bill, understanding that the principle at stake now is not whether termination should be legally available in South Australia: that question was resolved more than 50 years ago.
I emphasise that this is a matter about which reasonable minds can come to different conclusions and can reason differently to that conclusion. I have very, very deep respect for those who have an alternative view, but I also ask that respect be given to those who have reached the same view that I have reached.
I am grateful to those members of my community who have contacted me to make representations before this debate. I welcome that contact. I have carefully considered those representations and, as earlier remarked, have come to a considered view. I believe that those things which are vital or important in life can be said briefly and hopefully with some elegance. This is my contribution.
The Hon. A. KOUTSANTONIS (West Torrens) (19:32): I rise to discuss this bill with great trepidation. I do not like this issue. I do not like this bill. I do not like being confronted with these matters, but I accept that they are before us and we must be held to account for our own decisions.
There has been a lot of debate in the parliament about how we should approach this bill. What I have discovered in my 23 years in the parliament is that the first casualty of these debates that attract a conscience vote is usually the truth, like in any war. I have found that through the advent of identity politics you are either with us or against us, and there is no space in between for reasonable people to come to reasonable conclusions about complex matters. We are being told by some to accept this bill unamended and, if we do not, people have used inflammatory language about how we should be considered. I reject that.
I also reject the notion that those who are opposed to this bill are somehow zealots. They are not. They are people of good conscience. I have seen them in my community. There are a number of people who support this legislation who live in my electorate. Make no mistake about it: the electorate of South Australia is just as conflicted about this bill as we are in this parliament. But my constituents know me. They have re-elected me now a number of times. I have been there 23 years—24 at the next election. I think by now they know what my views are.
But I do not use my personal views in opposition to this bill because, as I said earlier to a rally outside, the truth is that in the 21st century, in agreeing with my friend the member for Kavel, yes, this matter should be completely contemplated within a healthcare provision of an act rather than the Criminal Law Consolidation Act. It is unfair on people who are being confronted with abortion that they are subject to the Criminal Law Consolidation Act. It should be within the Health Care Act—that I accept.
I say to the Attorney-General and the drafters that, if this legislation had been merely about that and that reform, this debate would have been over months ago. I could be wrong, but I suspect that some proponents have seen this as an opportunity, and that disappoints me because it confronts me now with the choice of reading the legislation and speaking to experts in the field, and there have been numerous experts quoted.
The other thing about this debate is that everyone is eminently qualified in the medical profession to comment on this and we get a large diversity of views about what we should or should not do, so it is very difficult to try to understand exactly what a consensus approach is in the medical community. Is it the AMA's approach? I can list a long list of doctors who have come back to me and said that the AMA is not representing their members in this debate, and there are a large number of doctors who have said that the AMA absolutely represents their views in this debate. Who do we believe? All we have is the legislation before us. All we have are trusted people in the industry who we can speak to: doctors, obstetricians and experts—people in the field.
From reading the legislation, it is clear to me that it allows the termination of viable babies who are healthy. I think that is beyond question now. The proponents might have a legitimate reason to argue that, but I have not heard it. The only argument I have heard is that the statement I just made is incorrect. But from my reading of the legislation, and from briefing notes I received from academics about their interpretation of the law and from members of parliament who have clerked for chief justices of the Supreme Court, they have given us opinions that differ from the original version of what we are being told by the executive. So who do we believe?
I said earlier today in the caucus that the parliament today is a lot like 1890. This is what it was like before political parties. This is what the parliament would have been like, where members of parliament were elected without any political allegiance and every bill was considered on its merits—a radical concept—
The Hon. S.C. Mullighan: Terrifying.
The Hon. A. KOUTSANTONIS: It is a terrifying concept in the 21st century, but here we are. I have to say, as a Labor MP, that I cannot support this bill. I support the decriminalisation of abortion, but I do not support the Attorney-General and Minister Lensink's views on late-term abortion. I cannot, so I have proposed a series of amendments. I am going to announce to the house now that I will be supporting the amendments moved by Minister Speirs because I think those amendments protect the lives of viable babies. Why is that important to me? I am the father of a 10-year-old daughter who was born at 26 weeks—26 weeks. My wedding ring could fit around her ankle and she is now the tallest girl in her class.
We were offered abortion services with the complications that Tia went through. I very rarely speak about these personal matters. I have not attempted to try to politicise these personal matters, but I do so now to explain to the house and to my constituents my views on this bill. My daughter was in the NICU in the Women's and Children's Hospital for a month and in SCBU for two months before we took her home on New Year's Eve in 2010-11.
Tia was in a humidicrib next to babies who were born with their intestines not yet developed or outside their bodies. I am still friends with families who lost their children who were born hours after Tia. These are confronting issues that affect all of us. All those families were offered the same services, but I keep coming back to this one fundamental point: Tia was viable. She was viable; she could live on her own.
Can I support legislation that would have allowed me and my wife to terminate Tia's life? I cannot. I cannot do it; however, I also understand the proponents who speak of those families who choose to do so. I understand their pain and I understand what they go through. I think Minister Speirs' amendments deal with that adequately. We are talking about healthy, viable babies. They should be given every opportunity to live and I will be voting for that.
Of course, it does not always have a happy ending. It can have a very sad ending and I grieve for the families who have had those sad endings. I know, from personal experience, families who have gone through abortions—close, personal friends. It is traumatic and I in no way make a judgement about what they did. I do not, but I do point out that the current legislation that was settled 50 years ago has allowed a process of safe, legal and rare abortions to occur in this state to protect the lives of mothers. What we are seeing now is a radical departure from that, and that is what concerns me.
That radical departure needs to be dealt with and we are going to deal with it with amendments. I do not know whether those amendments will be successful, but it is difficult. The amendments I will be moving talk about three key issues for me, and I am considering a fourth. The first issue is that I had no concept about what practically happens during some abortions. I thank the Attorney-General for her frequently asked questions, as I discovered for the first time, to my horror, that some babies are born alive during an abortion.
I did not believe that because, again, I go back to my initial point about truth being the first casualty of these debates. Whenever someone tells you something and they are from a particular cohort of either pro-life or pro-choice, you assume there is bias in what they are telling you. So when someone tells me, 'Children are born alive,' I think to myself, 'Well, you would say that because you want me to vote a certain way,' but the Attorney gave me clarity on this matter. It does happen and that horrifies me—the idea that in the 21st century South Australian citizens are being born and left to die who survive an abortion. I understand there are complexities and my amendment deals with healthy viable babies who survive abortions and have a prospect of life. They should be offered medical attention. That is point 1.
I will move on to point 2. I am not sure my amendment adequately deals with it all, because again it is so difficult to do this as a private member without the resources of government. I would have hoped the government would have done this. Point 2 is that I do not want to see—and I do not think the parliament wants to see this either—the growth of a private industry around the provision of late-term abortions.
If Minister Speirs' amendment is unsuccessful and late-term abortions to birth are to be legal in this state, they should only be performed in public hospitals and not for profit. They should be approved not just by two doctors but by two obstetricians—specialists in the field, not just general practitioners. Again, I suspect that amendment will not be successful.
The third amendment I am contemplating is the trade—and, again, I did not believe this happened—in the foetal matter of successfully aborted babies, a difficult subject to contemplate and talk about, but we are confronted with it now. I understand the need for medical research—I do—and many people, on their driver's licences, opt to donate their bodies to science or give their organs for transplant or medical research. That is great, but I am deeply concerned about the idea of a trade for profit in successfully aborted babies' material. These are confronting things to talk about.
The other amendment I was considering, rereading the bill again, talks about what is a medical practitioner and what is a health practitioner and the definitions. I will flesh this out in committee, but my understanding is that a health practitioner basically could be a nurse or someone who is regulated under the national law, but not necessarily a specialist, and can administer abortion services. I will leave that for the parliament to consider.
A medical practitioner might be someone who is not necessarily a specialist in pregnancies. Surely this parliament has the maturity to say, 'Well, if you are going to consider late-term abortions, perhaps the people who should be approving it should be specialists, unless there is an urgent need to safe the mother's life.' Again there are other clauses that kick in when it comes to saving the mother's life. Again, I am very concerned about the ability to shop around and get people to approve these things.
I also want to make this statement to make it fundamentally clear: I do not believe that anyone who is thinking about a late-term abortion would walk into a doctor's surgery chewing gum saying, 'I've just changed my mind.' These are serious considerations, generally on the back of horrendous news. I have also been at the other end of an unsuccessful pregnancy, where my son was born, only briefly lived and then died. We were offered abortion services again and we refused. It is confronting to have that conversation with your obstetrician and your doctor about ending the life of your child—it is horrific. We were confronted with this over a period of weeks. My wife worked so hard to try to get that baby to viability. We got past viability, we kept on going and going, but he just could not make it.
These are the difficult questions you have to tackle, but the current law that was in place at the time dealt with our situation adequately. We were able to access all the services we needed to make the decisions we needed to make as a family. There did not need to be any change to the law. Indeed, every year there are improvements in medical science about viability, and that age is getting younger and younger. As I said earlier, 26 weeks, my son died at 24 weeks; these things move by the year.
We are attempting to say—again, we are being asked to agree—to 22 weeks and six days. There will be advances again, but the last amendment to this legislation was 50 years ago. I often wonder, without making any comment about people who support this bill or do not, whether future generations will look back and talk about the way we treated pregnancies in the 20th and 21st centuries and just think, 'They got it wrong there. They were at the early stage of their development about how they thought about pregnancies and they got it wrong'—maybe, maybe not.
The last issue I want to address is about men having a view about this issue. It is complicated. I understand that many people think that men should have no say in this matter, that this is about a woman's right to choose about the treatment of her body. I understand that. I would not like the idea of anyone else having a say about what I could do to my body. I completely understand that conceptually, but practically, in the real world, there are two people involved in a pregnancy, and fundamentally three, if not more, depending on how many people are growing inside a womb.
We have to ask ourselves a fundamental question: do those people who are in the womb deserve rights? This is the eternal question. I think yes. My faith tells me that life begins at conception. I accept that, but I also accept that I cannot legislate that, and I do not intend to because it is not where the Australian public are. The Australian public do want safe, legal and rare abortions—absolutely—but I do not believe the South Australian public want what the Attorney-General is offering. And I do believe, fundamentally, if they knew what she was offering, what the government is offering, they would be horrified. I do not believe that is where middle Australia is at. So we are somewhere in between decriminalisation and abortion to birth. I think the amendments proposed in this house meet the right balance.
I also want to reject the bullying and the threats on either side. I say to all my colleagues, all of them: vote with your conscience not your political affiliation, not your loyalty to any one person or another or a faction or another, and I will defend your right to have a conscience vote to the end on these matters. But I also say to the people who accuse me of being a religious zealot because I dare to go to church every Sunday: I do not care. I am a Christian. I profess my Christian faith and I do so openly, and I will not be lectured by anyone in the Labor Party or the Liberal Party about my faith. My faith is my own.
People talk about the Labor right doing certain things to try to manipulate things. That is not true. There are people on both sides of this debate of good conscience who are trying to do the right thing. We are ordinary people, ordinary citizens who have been given the information. We are just trying to navigate this to try to do the right thing. I do not hold a grudge against anyone who votes for or against this bill, but my conscience says I cannot support it as it is. At the second reading speech, if the minister insists on proceeding with late-term abortion, I will vote against it.
I do support decriminalisation; I put that on the record. However, at the end, if the amendments are not passed, I will be a vote against the bill. That makes me sad because surely it is not beyond our wit to have a split bill, where we could have had decriminalisation at one end and the other measures in another bill, so we could have the reform the Attorney-General says is long overdue and then have a debate about the rest. But, of course, politics being politics, let's lump it all together and try to get it through. Well, we could have a disaster, a compromise or a defeat, depending on your perspective. I hope we can have a cordial debate and get through it. I apologise to my constituents who want me to vote a different way, but I am who I am.