CONSENT TO MEDICAL TREATMENT AND PALLIATIVE CARE (VOLUNTARY EUTHANASIA) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 14 October 2009. Page 3568.)

The Hon. G.E. GAGO (Minister for State/Local Government Relations, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises, Minister Assisting the Minister for Transport, Infrastructure and Energy) (21:17): I rise to support this most important bill. I am aware of the hour and I am also aware that most members wish to speak this evening on the bill, which I know is contentious, so I will keep my comments brief.

My very strongly held views about supporting voluntary euthanasia are already well documented on the Hansard record, because I have spoken in support of this on a number of occasions in this place. In light of that, I will keep my comments brief. I have been a longstanding member of the South Australian Voluntary Euthanasia Society (SAVES) for many years. It is a fabulous organisation, and I admire and commend the society for its work organising and rallying public awareness and opinion around this important issue.

As we have seen, over the decades the general public's support for euthanasia has steadily increased. I understand that support for voluntary euthanasia is presently sitting at around 87 per cent. However, that is not the point. I think that, irrespective of public opinion, the purpose of parliament is to ensure that we provide leadership and are responsible for good legislation and good policy in terms of what is in the best interests of the public. In accordance with that view, I support this legislation.

I think it is most important that voluntary euthanasia be a matter of personal values and ideals and personal points of view, and I respect that. However, what I find very hard to understand is why those of a particular point of view or persuasion want to limit the freedom of choice of others, and that is what is occurring here. This legislation is not forcing voluntary euthanasia on anyone. It is leaving the ultimate choice of whether or not one believes it is appropriate for them up to the individual to choose. However, by not supporting this the few impose their view on others and we limit that freedom of choice.

I have not always held this view about voluntary euthanasia; in fact, when I was much younger I opposed it. It has taken a lifetime of experience, particularly the work I did as a healthcare professional, a nurse, to completely turn around my view, and I am now a strong supporter of and advocate for voluntary euthanasia.

Surveys quite clearly demonstrate that euthanasia is occurring, that our healthcare professionals are already involved in acts of euthanasia. In fact, I would hazard a guess that not only is it occurring but that the surveys show only the tip of the iceberg. We know these acts are occurring, and they are occurring in an unregulated and unlawful way at great risk not only to patients but also to those healthcare professionals who feel that, in the name of humanity, they have no other choice but to support people who are in a hopeless, terminal and distressing condition.

The bill before us provides an abundance of safeguards and measures to protect the general public from any abuse in terms of voluntary euthanasia. I will not go through them all, because they have already been outlined and are on record, but there are a series of checks, measures and safeguards, hoops that people have to climb through, before they could have access to voluntary euthanasia treatment. So I believe there are adequate protections within the bill to ensure that abuse does not occur.

People are concerned that passing legislation to support voluntary euthanasia would lead to the slippery slope argument that families might begin to pressure relatives, accuse them of being burdens, and make them feel as if they have no other choice but to take up the option of voluntary euthanasia. The argument can be extended to say that we will then become hardened to that, and that the next step would be euthanasing people with disabilities, malformed children or handicapped people. The argument goes on and on. I believe it is a false argument, and I think it involves a fair bit of scaremongering. If you look at countries that have voluntary euthanasia and those that do not, you can see that acts of illegal euthanasia occur in both, so I do not see that the arguments necessarily stack up.

I will not go through the individual studies, but I challenge the interpretation of those studies. I think some of them include acts promoting a more rapid death as acts of voluntary euthanasia—for instance, administering an analgesic for the purpose of pain relief but, in administering it, it may shorten someone's life. In some studies, those sorts of incidents are recorded as acts of euthanasia, so there is a bit of argy-bargy that goes on in the interpretation of some of those surveys.

From a personal point of view, and from some of the work I did, it is quite clear that palliative care is not enough. I have put on the record before, and I will do so again because I think I need to, that this is not a criticism of our fabulous palliative care workers in this state. The work that is done here in South Australia is leading the nation in a number of respects. They do amazing work and provide fabulous care and treatment for many patients who are in incredibly tragic and difficult circumstances. They offer relief, care and hope to many patients and their family and friends; however, that is not the issue.

I worked as a healthcare professional for many years, and I worked in the area of health for much longer, so I think that my observations are legitimate. I know from those observations that palliative care does not always work, and it does not always offer relief to those suffering from terminal illness, which can be extremely painful and distressing and result in a very undignified end to their life they do not deserve.

I will not go into detail, but I have been in a position where patients have begged and pleaded with me to help end their life because of the horrendous state they were in, and those memories will remain with me until the day I die. Palliative care does not afford satisfactory management of pain and suffering in all cases for a number of reasons, some of which are related to an individual's response to medication—individual tolerance levels are different, etc.—and people's reactions vary, as well.

There is a great deal of variation in the response to the side-effects of different medications, and sometimes those side-effects—such as hallucinations and people being rendered into an unresponsive state, where they lose awareness and control and do not know what they are doing—are unbearable. Many people find that intolerable and a complete loss of dignity, and I believe that it is important we offer people alternatives to that.

I have been on the record before outlining in detail my support of voluntary euthanasia, and I continue with that support. I hope that honourable members support this very important piece of legislation.

The Hon. B.V. FINNIGAN (21:29): I rise tonight to contribute to this bill introduced by the Hon. Mr Parnell. This bill seeks, for the first time in a state in Australia, to establish a regime of active voluntary euthanasia and self-administered voluntary euthanasia, or physician-assisted suicide, as it is described in some places. I would like to discuss three general principles in relation to the debate and how we should approach it.

The first is that I think we need to try to be dispassionate and objective in considering the question of active voluntary euthanasia. We need to try to think about it as a health and public policy issue and not be too personal or emotional about it, and I acknowledge that this is an extremely difficult thing to do. Probably the most difficult thing most of us will face in our lives is losing someone we love very much; indeed, it is extremely difficult to deal with. It is very hard as human beings not to let our personal experience shadow how we think about any issue, but particularly one that is so necessarily emotive.

Nonetheless, as legislators I do believe that we have a responsibility to try to think about the issue dispassionately and objectively and think about whether it is a sound public policy. In my own instance, I have lost both my parents to cancer. They both received excellent palliative care and died at home with their family close to hand. They did have, I think, as peaceful a death as it is possible to have, but that should not be why I oppose active voluntary euthanasia. What has happened in my own personal circumstances or in my family cannot be the main guiding principle when it comes to making up my mind about an important piece of legislation such as this, which I acknowledge is a difficult thing to do.

We need to look at euthanasia not as a Christian or moral issue. It is certainly an ethical issue, and a very important one, but it is not one that is about whether or not you think that God exists, and if he or she does whether or not he or she decides when life ends. It is not a Christian or moral issue in that sense. It is not about who you think has the right to decide when you end your life, even though it is sometimes characterised in that way. Indeed, the debate is often characterised in the sense that all reasonable and rational people want active voluntary euthanasia and it is only a small group of religious zealots who try to stop it because they think it is playing God.

If people think that I am exaggerating that point, we have to look only at the article in today's Advertiser which says precisely that zealots are prolonging people's pain because they are opposing active voluntary euthanasia. Advocates for euthanasia indeed often advance this principle. The South Australian Voluntary Euthanasia Society (SAVES) website includes a quote from Jim Soorley, a former Catholic priest in Queensland, who I think became lord mayor of Brisbane, or ran for it. His quote states:

It's about time all the moralisers, right to lifers and interferers got out of the way.

That is the attitude that I think a lot of euthanasia advocates take, that is, that this is a secular country, it is a secular issue, and so why do Christians try to tell other people what to do? Mary Gallnor, in her letter to legislators, which is on the SAVES website, says:

I put it to you that it is also time for us to restate vigorously and often that there is no place for religious dogma in the parliament of a secular democratic country.

Very clearly an argument advanced by those who support euthanasia is that everyone really supports this; it is just a bunch of Christians who are trying to stop it. Yet we have seen, certainly in this debate, that people who are Christians advocate support for legal voluntary euthanasia. Indeed, the SAVES website includes documents from the group Christians Supporting Choice for Voluntary Euthanasia, as well as some articles by Christian theologians which oppose the official church teaching.

Whilst the leadership of most Christian churches is clearly opposed to euthanasia, some Christians do not agree. On Monday I was pleased to be able to meet with representatives of Christians Supporting Choice for Voluntary Euthanasia who believe that the church hierarchy is not in step with the faithful and that the principle of Christian compassion demands support for active voluntary euthanasia. We have different points of view within the Christian community, and there are those, such as the Christian Supporting Choice for Voluntary Euthanasia, who say that their own faith motivates them to support legal voluntary euthanasia.

This is an interesting theological and pastoral debate, but it is certainly not one for the parliament of South Australia. Different Christians will have a different perspective on active voluntary euthanasia. Some may disagree with their church leaders. I believe we should listen respectfully to church leaders and other Christians, and any organisation that wants to put forward their point of view. They are certainly entitled to participate in public debate, as I have said before on the record, but I do not believe that that should determine what we do as legislators. I think it is very important that we do not think of this as a Christian or moral issue in the sense that the only people who oppose it are doing so out of some sort of dogmatic reason.

This bill is about active voluntary euthanasia. It is about doctors being able to end human life by a lethal dose. It is not just about an assisted suicide measure, although the bill does allow that. This bill goes further than the situations in a lot of other jurisdictions which are often quoted as places where there is euthanasia. In many of those places, in fact, there is not active voluntary euthanasia where the doctor takes the physical step of ending someone's life.

Intent is very critical in how we do things. We often hear that euthanasia is happening because of the principle of double effect, which is simply that, when we relieve people's pain with doses of morphine or other drugs (which can be quite high), those doses will hasten a patient's death and that is the same as active voluntary euthanasia. Well, I suggest that is certainly not the case. Intent is absolutely important. There is a very clear difference between relieving pain and treating someone, giving them palliative care which may hasten death, and that is universally recognised as legitimate, appropriate and humane. It is a vastly different proposition from establishing a legal framework for doctors to administer lethal injections, overseen by a government board.

Voluntary euthanasia will inevitably mean some cases of involuntary euthanasia. I am not suggesting that that would involve all or even a majority, but certainly one is too many. If under this legislation anyone is subjected to involuntary euthanasia that is one death too many.

I turn now to the provisions of the bill. Even if I was a supporter of active voluntary euthanasia, I could not support this model. A lot of people will talk about the safeguards in it, but it is important to remember that they are, essentially, visiting a doctor or, under the amendments proposed by the mover, a specialist and then being signed off by a government appointed board.

I believe that the model that exists under this legislation is fundamentally flawed in a number of respects. First, and perhaps most critically, is the definition as to who can access active voluntary euthanasia. Under this legislation you do not have to have a terminal illness to obtain active voluntary euthanasia or a prescription for a lethal dose. Clause 19 provides:

(1) This section applies to the following persons...

(b) an adult person who has an illness, injury or other medical condition that...

(ii) irreversibly impairs the person's quality of life so that life has become intolerable to that person.

That is not a definition that provides a tight restriction on who can access active voluntary euthanasia. That definition could apply to someone suffering from chronic depression or rheumatoid arthritis, or the early stages of multiple sclerosis or Alzheimer's. I am not suggesting that is the intent of the mover of the bill or those who support the bill, necessarily, but we cannot determine the application of a fundamental clause of the bill once it leaves the parliament.

The act is justiciable—and explicitly so—in relation to refusals by the board to approve voluntary euthanasia, so when cases go before the Supreme Court there is no doubt that one of the key issues it would consider is the application of clause 19 and the meaning of it. As we know, courts can take a different view from what the legislature may have intended and could apply a fairly wide interpretation of clause 19(1)(b)(ii). I am not suggesting it would become a matter of triviality that people would be able to access euthanasia for something minor but, nonetheless, they may well be able to access it for conditions considerably beyond the intent of those supporting this bill. All bills are subject to courts, of course, so we can never tell what is going to happen, but a definition such as this and a provision that allows appeals to the Supreme Court in relation to decisions of the board undoubtedly invites legal action, and the courts may interpret the statute much wider than those supporting it intend.

Secondly, I think the voluntary euthanasia board of South Australia is a seriously flawed idea. Having obtained the necessary medical consent from one physician—potentially from only one physician or specialist, with these proposed amendments—the patient is then in the position of waiting on board approval of their request. I understand that the mover intends this as a safeguard, but I submit that it is open to many pitfalls. The board has to be able to meet and, while a quorum of three is sufficient, I am sure we all know what it is like to coordinate schedules of busy people—even to do so with three of them may be difficult and would cause undue angst and anxiety to patients. I think when those who are supporting active voluntary euthanasia are saying that it is about relieving people's anxiety about pain and ensuring they have at least the option of euthanasia, if not to carry it out, I think this really places quite an intolerable burden on them.

The board must unanimously agree (or, at least, the three, four or five members sitting) on a request for active voluntary euthanasia or a request to get a lethal prescription. This could certainly lead to great heartbreak, I think, for the people who are requesting voluntary euthanasia because, if a person who is appointed to the board is not well disposed or even opposed to the practice, they may decide to veto a number or even half of the requests.

There is provision in the bill for them to be dismissed by the Governor, but I think that is a potential mine field and would open up the system to a lot of litigation. The potential opposite problem is that the board would become a rubber stamp and essentially safeguard a meaningless provision. I cannot quite see a way in which this board would effectively work. I think it is likely to be either too onerous or not sufficient in rigorously assessing requests for voluntary euthanasia. Because of the way it is set up, I do not believe it would be an effective safeguard.

I turn to arguments that are advanced in favour of active voluntary euthanasia on a regular basis and respond to them. The first is that it is working well in foreign jurisdictions. It is important to examine other places where active voluntary euthanasia is in place, mainly in Oregon and Washington in the United States, where they have physician-assisted suicide, and the Netherlands, where it is broader. It is important to remember that the law in Oregon and Washington is very different from this proposal. Both are only applicable to patients diagnosed as having less than six months to live. While that, too, has an element of subjectivity and there is obviously a judgment involved in classifying someone as having less than six months to live and it is a matter of medical opinion, the definition is not nearly as wide open, in my view, as that which applies in this bill.

Both Oregon and Washington have laws that provide for physician-assisted suicide. They provide for a prescription for a lethal dose to be given to the patient, not for the doctor to deliver it. Oregon is often held up (including, I think, by the Hon. Mr Parnell in his briefing note) as a good model of law in relation to this area, but there is certainly evidence of problems in the administration of the law in Oregon. I draw honourable members' attention to the Michigan Law Review Volume 106: 1613 of June 2008, and an article headed 'Physician-Assisted Suicide in Oregon: A Medical Perspective'. This goes through a number of various cases in Oregon and highlights some of the problems.

One of the issues that is raised is that people who are seeking euthanasia have to be given a thorough explanation of what the alternatives and options are, and I believe that is part of the Hon. Mr Parnell's bill, that the medical practitioner has to give them information about their prognosis and what treatments and so on are available. Here is an example of one of these in Oregon where a physician said this:

There is, of course, all sorts of hospice support that is available to you. There is, of course, chemotherapy that is available that may or may not have any effect, not in curing your cancer but perhaps in lengthening your life to some extent. And there's also available a hormone which you were offered before by the oncologist—tamoxifen—which is not really chemotherapy, but would also have some possibility of slowing or stopping the course of the disease for some period of time.

The patient said: 'Yes, I didn't want to take that.' The doctor said: 'All right, okay, that's pretty much what you need to understand.'

I hardly think that any of us would judge that that is a sufficient means of going through the options with a patient. I am not suggesting that those who are supporting or advocating this bill would say that that is acceptable, but it is an example of what can happen under this sort of system.

The most comparable jurisdiction in relation to this bill is the Netherlands, which has practised euthanasia for some years under common law, and it is now covered by a statute. There is certainly clear evidence over many years of a high number of cases of involuntary euthanasia in the Netherlands from the Remmelink Report (which I am sure members would have come across) and onwards. In fact, there seems to be an extraordinary number of cases of euthanasia in the Netherlands, full stop, and certainly a large number of cases of involuntary euthanasia.

I draw the attention of honourable members to the Journal of Medical Ethics 1999:25, an article entitled 'Voluntary euthanasia under control? Further evidence from the Netherlands'. This was a study of 4,500 cases in the Netherlands. It indicated that 900 of the 4,500 (so, 20 per cent of the patients) had not had an explicit request. So, 900 patients—20 per cent of the 4,500 patients whose lives the doctors had said they had actively and intentionally helped to end by euthanasia or assisted suicide—had had their lives ended without their explicit request. In a third of the 900 cases, although there had been a previous discussion about possible termination of life and although some 50 per cent of these patients were competent at the time of their death, their lives had been ended without their explicit request.

That study also indicated that, in 17 per cent of 3,600 cases of euthanasia or assisted suicide, doctors stated that alternative palliative treatment options existed, but in almost all these cases the patients did not want them. So, one could argue that that is because the patients were determining their own health care, but I think one would also have to wonder how well the patients were being informed and educated about what the options were.

There are also clinical problems with the administration of this law. I draw the attention of honourable members to an article in the New England Journal of Medicine, Volume 342, No. 8, 'Clinical problems with the performance of euthanasia and physician-assisted suicide in the Netherlands'. A study there of 649 cases found that in assisted suicide there were complications in 7 per cent of the cases and problems with completion in 18 per cent. The problems with completion included a longer than expected time to the death of the patient, a failure to induce coma or the induction of a coma, followed by the awakening of the patient. In 18 per cent of cases of assisted suicide the physician decided to administer the legal medication, thus it became euthanasia. So, in 18 per cent of cases of assisted suicide the patient had self-administered, but the physician determined that it was not working sufficiently or that there were problems, and so they actively then ended the life.

I think that gives the lie to the concept of a peaceful death with no problems, as euthanasia is often painted. Of course, people undergoing palliative care and coming towards the end of their life do have health problems. I am not suggesting that it is all smooth sailing. Of course, anyone at the end of their life (unless it is sudden) with a terminal illness will generally have some health problems as they go along. However, the picture is often painted that active voluntary euthanasia takes all that away; that it is a system where people can die peacefully and quickly with their loved ones around them and not have to endure any sort of suffering at all.

I do not think that is the experience that has been shown in the Netherlands—and it makes sense. As we know, when prisoners are being executed (which is obviously a different kettle of fish in that they are not people who are terminally ill or suffering from a particular condition), it is extraordinary the way the human body fights back, and there is no doubt that that will happen to some degree when euthanasia is being administered.

I would imagine it would be very traumatic for the patient and the family for someone to wake from a coma having thought that they were on their way to death and then the doctor having to administer a lethal dose on top. I think it is important to remember that euthanasia is not a panacea. It does not mean that you remove any potential medical problems and that the death is always smooth.

The second point I address is that public opinion is overwhelmingly in favour of active voluntary euthanasia. This is an extremely commonly advocated argument and, indeed, the people at the rally today were wearing T-shirts I think that said, 'I am one of the 87 per cent.' There are two questions here: first, is this measure of public opinion correct; and, secondly, if it is, are we obliged therefore to pass the bill? Firstly, in relation to whether it is correct, I believe it is hard to truly judge public opinion on important questions of social policy.

Polls are notoriously unreliable on these sorts of issues. It is quite easy to poll people about who you are going to vote for: X, Y or Z. When you poll them on questions about the end of life or other social policy questions, I believe that the responses are far more unreliable. Poll questions tend to invite a yes answer. If you look at the questions that are asked by Newspoll and Morgan, it is very much, in my view, structured to invite a yes answer. The Newspoll one which was distributed by the honourable mover today says:

Thinking now about voluntary euthanasia. If a hopelessly ill patient experiencing unrelievable suffering with absolutely no chance of recovering asks for a lethal dose, should a doctor be allowed to provide a lethal dose or not?

Of course, that is a very loaded question, because it assumes a whole lot of things.

First, that is not in fact what this bill does. The question asks: should a doctor be allowed to provide a lethal dose? This bill allows doctors to provide a lethal dose. It also allows them to administer—that is, to physically inject or whatever—the lethal dose to the patient. In that question it is not clear that that is what is being asked, but it also sets up a very one-sided situation. All the poll questions are similar, where they say: 'Should someone in interminable pain who has consistently requested euthanasia and who is of sound mind be allowed to request euthanasia or be euthanased by a doctor?' In my view, that does not provide a complete picture, because it does not address the question of safeguards and the question of consent and informed consent.

Indeed, I am aware of qualitative research which suggests opinion is more divided when people examine some of the complexities of the issue. The only real guide to public opinion, I think, that we can look at is in the United States, where there have been plebiscites in a number of states. In Oregon in 1994 (which led to the statute it has), 51.3 per cent voted in favour and 48.7 per cent against. But, again, it is important to remember this is for doctors to be able to provide a lethal dose only: it is not for active voluntary euthanasia. In Washington in 1991, an initiative to allow doctor administered voluntary euthanasia was defeated, with 46 per cent in favour and 54 per cent against. However, in Washington in 2008, physician-assisted suicide was voted for: 57.8 per cent in favour; 42.2 against, again, only to allow doctors to provide a lethal dose for self-administration, not active voluntary euthanasia.

In California in 1992, there was a ballot provision for physician-assisted suicide: 46 per cent voted in favour and 54 per cent against. In some of those cases, obviously in Oregon and Washington, the majority was in favour—narrow majorities—and I think that is probably the best indicator we have of public opinion. I think it is fair to say that most people would acknowledge them as liberal-minded states that tend to be considered on the centre or left of the political spectrum in the United States.

That is not to say that that should be our particularly strong guide, but I think that, when we constantly hear it said that over 80 per cent, 85 per cent or 87 per cent of people support voluntary euthanasia, we need to look at when people have had an opportunity to vote on it, what has been the outcome? Nowhere has active voluntary euthanasia, as provided for in this bill, received majority support in a plebiscite, to my knowledge; and only in two states of the US has physician-assisted suicide received narrow majority support in that sort of plebiscite.

The second point in relation to public opinion is that, even if we accept that these assessments of public opinion are correct, should that be the only measure? If public opinion so measured in this way showed 80 per cent of people supporting capital punishment or legalising heroin, would we then say we were obliged to follow? I make no comment on those issues.

Regardless of one's views on those matters, we as legislators would have a duty to examine all sides of the issue and not see public opinion polls as the principal argument in favour. I would be very surprised if people in this house were to advance the argument that, because 85 per cent of people in an opinion poll supported something that they abhor and believe to be fundamentally unjust, they would therefore say that we should nonetheless go ahead and pass it. But it is an argument almost constantly made in relation to active voluntary euthanasia, even today highlighting those advocating support for this proposition as being 87 per cent in the most recent Newspoll survey. As I outlined, the proposition in that poll is not clear, but certainly it says that a doctor be allowed to provide a lethal dose and not actually administer it.

The third argument I raise, which is very common, is that we put pets out of their misery, so why do we not do the same to humans. That is summed up by a flier in the Christians Supporting Choice for Voluntary Euthanasia information, headed 'Die like a dog. I wish'. I should say at the outset that I am very fond of dogs and other animals and I am not suggesting that their lives are of no value. It is true that we routinely end the life of dogs, cats and other animals, and I am puzzled as to why advocates for active voluntary euthanasia advance this argument, as it is surely an analogy they would prefer not to own.

We put down dogs and other animals because we, creatures of another species, make a value judgment about their quality of life and subject them to involuntary euthanasia. We decide that they are suffering or that their life is not worth living any more, and we put them down. That is surely not what we want to see in voluntary euthanasia and, indeed, that would be something that the proponents would say is very much not within the confines of this bill. It seems a very odd analogy to talk about what we do to animals. The reason we put down pets is that it is motivated by compassion but also we accept that their life is not equal in value to the life of human beings, generally speaking.

We could give dogs chemotherapy, kidney transplants and palliative care; we could have a massive public hospital system to look after dogs and cats, but we do not do that and that is generally because, while we value animals and love them—they can be a very important part of people's life and they can be heartbroken when their pet dies—we do not accord the life of an animal the intrinsic worth and protection accorded to human life. That is why we consider it legitimate to put them down, and for us to make that judgment, it is not because we have more compassion for them than we have for fellow human beings.

The fourth argument I would like to address—and it is a common one that we hear—is that it is happening now so let us regulate it and control it. This argument suggests that, through double effect and sometimes deliberate euthanasia against the law, voluntary euthanasia, or involuntary euthanasia, is actually common, and therefore if we regulate it, control it and have a system to monitor it, that will be a better way to deal with that situation. Bob Such, the member for Fisher in another place, a strong advocate for euthanasia, said on radio today something to the effect, 'Let's be honest about it; it's happening, let's strictly regulate it.'

This is not backed up by sufficient coronial evidence or criminal prosecutions, in my view. There are few cases where it is shown that there have been these cases happening. However, if we accept this line of argument, and if we believe that physicians are carrying out euthanasia now, when the potential consequences are criminal charges, imprisonment and a loss of their livelihood, why do we expect they would be strictly law-abiding under a system of legal active voluntary euthanasia? It seems rather incongruous to me to suggest that people are committing involuntary euthanasia on the sly, yet if we have a system where they have to fill out some forms, it goes to a board and gets filed by a registrar, they will then utterly comply with the law. At the moment they are risking imprisonment and losing their medical licence. If that is a problem (and I do not believe the evidence is that it is widespread), it is not to be addressed by legalising the situation.

Finally, people will not feel pressured into active voluntary euthanasia is an argument often made. There is no real evidence that people will feel that they are obliged or ought to do the right thing and end their own life. There is really no way to tell whether or not people will feel pressured. There are certainly examples in other jurisdictions where family members have been instrumental in bringing about active voluntary euthanasia.

Just pointing again to that Michigan Law Review article I cited earlier, which refers to the law in Oregon, there was the case of Joan Lucas, where her children sent an ambulance away when she attempted suicide, saying, 'We couldn't let her go to the ambulance. They would have resuscitated her.'

Joan was required to get a psychological evaluation as part of her applying for a physician-assisted suicide. Because she could not attend the psychologist's office the family assisted her in taking the psychological test that many members would be familiar with (the Minnesota Multiphasic Inventory) by reading out the questions and writing down her answers. That hardly constitutes a satisfactory way to evaluate somebody's psychological state, but it does highlight that there are cases where the family do play an instrumental role in bringing about euthanasia.

I find that very confronting, because it is certainly not something that would happen in my family, regardless of people's views of euthanasia, but, similarly, I feel that way when I see wills being contested in court sometimes and things like that. The reality is that there are bitter family disputes on occasion. I am not suggesting that it would be an avalanche or that everybody getting euthanased would be not consenting or pressured into it, but it is undoubtedly a problem.

The South Australian Voluntary Euthanasia Society website says, 'A desire not to be a burden on the state or one's loved ones is a legitimate concern, and should not be mistaken as evidence of abuse.' I believe the fact that someone may feel a burden is indeed a concern, but a concern in that we should address that they even feel that way. We should never accept that feeling a burden is ever a reason to end someone's life. I am not suggesting that that is what that organisation is advocating, I do not believe that they would feel that, but the fact that that quote is there suggests that a desire not to be a burden is a legitimate concern. I have to say that I find that statement in itself concerning.

Again, pointing to the Michigan Law Review article, it notes that executives of the major organisation advocating and supporting physician-assisted suicide in Oregon, Compassion in Dying, indicated that that group were involved in three-quarters of physician-assisted suicide cases since the implementation of the Oregon law. That would certainly be a concern for me and I would not want to see a situation where advocates for voluntary euthanasia are actively involved in turning up to people's homes to assist them in getting through the active voluntary euthanasia process. It should, surely, only be between a patient, family, physician and their existing support network, but there are certainly instances there where three-quarters of the cases have involved this particular organisation, sometimes a stranger at the end of the phone line who ends up becoming involved. That would be a concern to me.

What is the answer if we do not have active voluntary euthanasia available? I think it is clear that we need good palliative care—and we do enjoy an advanced system in this state—and general care and compassion in our hospital, health and hospice system. There is no doubt that palliative care is advanced and advancing all the time, as indeed treatment and relief for pain caused by cancer is advancing all the time, which is, I guess, the predominant cause of terminal illness and certainly the leading condition that people requesting euthanasia generally suffer from.

I have been struck by how many of the letters and emails that I have received are more about a fear of what might happen rather than what is happening. We certainly need not only the provision of good care but good education about what the treatment possibilities are. Many people are guided by a fear of indignity and loss of their autonomy, rather than incurable pain. There is no doubt that losing your autonomy or control of your bodily functions would be very unpleasant for those of us who are used to having our own autonomy, but we have to remember that a lot of people live with that for many years, and I do not think we should make a judgment that people's lives are automatically not worth living because those factors have come about, because there are many people who, on that rationale, would have long periods of their life not worth living, or that their quality of life would be intolerable.

If a forty year old were to have a stroke and suffer severe paralysis, surely we would not seriously be saying that their life is then intolerable and they should be able to obtain a lethal injection, even though they might have years and years of life left. Similarly, I have heard people say many times, 'If I were to be in an accident and become a paraplegic, I wish someone would put me out of my misery.' It is very unfortunate that people could feel that they could not lead a fulfilled and active life as a paraplegic potentially for years. I think that is something we need more education about because a person can live a productive, fulfilling and dignified life even though they may suffer from a severe medical condition.

I oppose the bill before the council tonight for the reasons that I have outlined. The bill would, for the first time in South Australia—indeed, in any Australian state—allow a situation where going to see a physician or a specialist twice and by filling in some paperwork approved by a board would then lead to a situation which would culminate in a doctor administering a lethal injection and ending a person's life. I believe it would be a terrible step for us to take as a legislature to allow that situation to occur, to set up a framework where doctors can actively, wilfully and irrevocably end a human life with a lethal injection. I believe that would be an incredibly retrograde step, a harm to our society, and I urge all members to oppose the bill.

The Hon. J.M.A. LENSINK (22:06): I last addressed the Legislative Council on this matter in November 2003 and, while I was supportive in principle at that stage of the framing of that particular bill, mainly based on my liberal view that people should be able to make the choices that they choose to make rather than being subject to the requirements of the state, my concerns related to elder abuse and coercion. Like the Hon. Gail Gago, I have worked in the hospital system and am aware of some of the pressures that family members can place on their loved ones.

Also, because when we are talking about a matter which is as serious as deliberately ending somebody's life, which under other circumstances is murder and prosecutable, we need to make sure that the legislation is very strictly framed. I would also like to thank all of those individuals who have written, phoned or emailed me in relation to providing their point of view. I think one of the jobs as a legislator is to use our judgment and to take into consideration the views of our constituents but, on this matter, I would have to say that people are either in favour or against and there is not much of a middle path. If one is trying to do a survey of whether or not people say 'I urge you to support this', it is academic really and ultimately we have to consider all of the different matters before us and apply that in the best way we are able.

I stated in my previous speech that the only circumstances under which I would support a bill in favour of voluntary euthanasia would be under fairly narrow circumstances—that is, for somebody who is terminally ill, who has no prospects of recovery and for whom their illness is keeping them in a state which is beyond bearing.

Palliative care has come a very long way and continues to make advances, but the reality is that it cannot help everybody. There are people who have illnesses and diseases that just cannot be assisted through palliative care means. I also appreciate the current legislation that we have which enables a person's death to be hastened through the double effect.

I was very happy to speak to one constituent in Dr Roger Hunt who is a specialist in palliative care of some 25 years. I have had a little bit to do with him because I worked at the Repat in Daw House, which is the palliative care unit at the Repatriation General Hospital. His particular experience I found very valuable, given that he has worked in this area for some time.

I think that we need to be realistic about what actually happens in hospitals and the pressure that health professionals are put under by people who ask, 'Can you help me?' If the doctor is to literally interpret what they understand, they are really being asked to hasten their end. The law as it stands is trying to interpret whether or not the doctor is to be prosecuted for a double effect. It is trying to interpret the intent of the doctor, which I think is really unfair; it leaves them quite vulnerable.

A lot of people who have contacted us have various concerns about this, which I can understand, but I think they have misunderstood the legislation before us. I think it is important for us to understand what this legislation is and what it is not. The withdrawal of treatment is not voluntary euthanasia. We are not seeking to use this device as a Darwinian economic measure to do away with people who are no longer useful to society. That is inhumane and monstrous, I think, to all of us. We are not seeking to assist people who may be depressed or suicidal to end their life early. This is definitely for people who do not have any prospects of recovery.

I, clearly, will be supporting this legislation. I would like to commend the honourable member for having structured the bill in what I think enables it in the most appropriate of circumstances. I do not have the concerns that I had previously, so I commend this bill to the council.

The Hon. DAVID WINDERLICH (22:12): I will be supporting this bill. I would like to acknowledge the work of the Hon. Mark Parnell in bringing this to the parliament, the long-standing work of the South Australians for Voluntary Euthanasia (SAVE), and the work of earlier parliamentarians such as the Hon. Sandra Kanck and the Hon. Anne Levy.

My father took about nine months to die from a brain tumour. He was a Lutheran minister of religion and would never have chosen voluntary euthanasia. I certainly would like that choice. The exercise of his view would prevent me from exercising my choice in the future. This bill and my philosophy of allowing people to choose would allow people like my father and others who oppose voluntary euthanasia not to make that choice. I think the issue of choice over one of the most fundamental decisions in life is very important, and it clearly comes through again and again in the views of people who support this legislation and in the views of the general public.

The point was made today at the rally, and it has been made many times, about the importance of compassion in allowing voluntary euthanasia. I am struck over and over again by the stories that people tell (at today's rally, other rallies and emails) of how they found it heartbreaking to witness the suffering of a loved one. It is not heartbreaking in the sense that they were at all weak or wanting to avoid their responsibilities, but simply because they desperately wanted to relieve someone's suffering; they do not want to see their loved ones suffer.

I think courage is also important in a decision like this. Courage is partly about resisting some of the intensive lobbying that has occurred by organised lobby groups, but I think it also involves the courage to make a very big and difficult decision. When we think through legislation like this it is very important to be very clear on both sides. I would like to briefly talk about a couple of points of view which I think reflect a lack of clarity in thinking.

I believe that the notion that life is sacred which is implicit in the views that are put by many people who oppose voluntary euthanasia is actually not truly held in a universal sense by those people, unless they are radical pacifists. There are many contexts in terms of nations going to war or other decisions that governments make when it is clear that life is not sacred. So, what we are talking about—and I think it is important to be clear about this—is an important but more subtle principle, which is that we should not actively take life in a medical context. That, I believe, is the underlying argument of those who oppose voluntary euthanasia.

There is concern that this legislation will be abused. Any legislation can be abused. If we applied that principle, we would not pass legislation here. We would not have the existing legislation relating to palliative care, where there is also potential to abuse terminal sedation and there is also potential to abuse disconnection from life support machines. We pass legislation because, on balance, we believe that it will do more good than harm. I think that is the only way in which we can approach legislation and the only way in which we can approach this bill. We cannot conceive of legislation so perfect that it will not be abused.

There is a view that this is part of a slippery slope that leads to a devaluing of life. I think this is of concern and not just in relation to this legislation. There are many pressures that could lead people to minimise or attempt to evade their sense of duty and responsibility to others, and it is possible that some people may view this legislation in that context but, again, it comes back to my earlier point, which is that it is about balance and whether the good will outweigh the harm and the sorts of safeguards we can build in—and I believe this bill does have strong safeguards.

As I said earlier, our current approaches do have risks of abuse. Almost all the arguments you could advance against voluntary euthanasia you can also advance against current approaches to ending life which are currently legal but which are also subject to pressures and, more importantly, which are conducted in a more subtle code. One of the advantages of explicit voluntary euthanasia is that it regulates the process of ending life, makes it explicit and makes it possible to monitor and review what is going on. I do not believe that is something we have now.

The Hon. Bernard Finnigan said that he did not believe that there was sufficient evidence that doctors were involved in ending life. I am no expert on these matters, but I have been told by doctors that this is going on and I have been told by individuals that this is going on. I think there is no doubt that it is.

People who oppose this legislation put a lot of store in palliative care. Palliative Care Australia has the following policy statement:

Palliative Care Australia acknowledges that, while pain and other symptoms can be helped, complete relief of suffering is not always possible even with optimal palliative care, and recognises and respects the fact that some people rationally and consistently request a deliberate ending of life.

It does not go further than that or provide any specific solutions, but it does recognise the dilemma. Although palliative care is vital, and the people who work in this area must be wonderful and outstanding individuals, there is a significant minority of people who cannot be helped by palliative care.

The Hon. Bernard Finnigan spoke of the importance of not just following public opinion, and I agree with him entirely. I think we should follow our consciences on this, try to think very clearly and try to follow our deepest beliefs. However, I believe there is a fundamental problem with imposing our views on others in this way about one of the most fundamental choices in life.

There are potential problems of abuse with legalised voluntary euthanasia, as I said, but in the end I think we have the prospect before us of dealing with real, existing problems and suffering now. There are people dying in pain and there are people dying without dignity. The hearts of their families and their loved ones are being broken while watching this process go on.

We know that this is a real and existing problem. I believe that this bill is a way of addressing that problem. We will have to manage the problems that come with our solution and, again, that is an inevitable process of legislation. However, we have something before us that will enable us to respond to a very real problem that is facing many people in South Australia today, so I think it is worthy of support.

The Hon. CARMEL ZOLLO (22:20): As one would expect, this matter is one of conscience in the Labor Party. Since being elected to this parliament, I have had the opportunity to place on record my views on this matter on several occasions. Regardless of which version of voluntary active euthanasia has come before us, I am yet to be persuaded to vote for it. Like the bills that came before it, a healthy campaign has emerged, both for and against. I acknowledge all the many emails and letters received and the sincerity with which people hold their views. Upper house members who are members of the two major parties have only one staff member, and it has been impossible to keep up with the responses.

Without doubt, in the majority of cases, they are views based on people's own personal experience and observations of their loved ones and friends. However, more recently, I have noticed that the against letters are from medical practitioners. Having listened to and then read the contribution from the Hon. Dennis Hood, I commend him for his thorough analysis of the legislation before us.

I have not looked it up, but I think it is the first time that a voluntary active euthanasia bill has been presented as an amendment to the Consent to Medical Treatment and Palliative Care Act. I am of the view that this bill does not limit the application of the voluntary active euthanasia to the terminally ill and that the Hon. Mark Parnell's bill casts a very wide net indeed.

I have asked the parliamentary library to provide me with a precis of the Consent to Medical Treatment and Palliative Care Act because that is the act we are seeking to amend. The palliative care act deals with consent to medical treatment and regulates medical practice so far as it affects the care of people who are dying. I was referred to Adam Rothschild's paper, which provides a very useful summary of the act, as follows:

In South Australia, the Consent to Medical Treatment and Palliative Care Act 1995 (SA) allows persons over the age of 18 to make anticipatory decisions regarding medical treatment if the person is either in the terminal phase of a terminal illness, or in a permanent vegetative state and is incapable of making a decision regarding medical treatment when the question of administering treatment arises. Under these circumstances the Consent to Medical Treatment and Palliative Care Act 1995 allows a form of advanced directive, there being a commitment to follow an anticipatory direction where it is a consent to, or refusal of, treatment, as long as there is no reason to believe the person has revoked or intended to revoke the direction. An advance directive under the Consent to Medical Treatment and Palliative Care Act 1995 is therefore limited to the terminal phase of a terminal illness and permanent vegetative state.

It goes on to state:

A medical power of attorney may be given to an adult agent while the grantor is of sound mind, which may be exercised if the grantor becomes incapable of making decisions on her or his behalf.

I will also quote two other sections of Rothschild's summary, as follows:

In the absence of an express direction by the patient or the patient's representative to the contrary, a medical practitioner is under no duty to use, or to continue to use, life-sustaining measures in treating the patient if the effect of doing so would be merely to prolong life in a moribund state without any real prospect of recovery or in a permanent vegetative state. However, the Consent to Medical Treatment and Palliative Care Act 1995 specifically rejects euthanasia, defined as medical treatment administered for the purpose of causing death, and assisted suicide.

The act allows a legally competent adult to make an advance directive as to their future medical treatment and palliative care. However, a direction given pursuant to the act must relate to a terminal phase of a terminal illness or permanent vegetative state, and be documented on the prescribed form.

So, clearly our existing act must relate to that terminal phase of a terminal illness or permanent vegetative state. I am in agreement with the Australian Family Association (SA) and Family Voice Australia in their observations that the two—that is, palliative care and voluntary active euthanasia—are distinctly different actions with different intentions.

For the information of honourable members, the summary and the two papers provided to me are entitled, 'Capacity and medical self-determination in Australia' by Alan Rothschild and 'The Law and Practice associated with Advance Directives in Canada and Australia: Similarities, Differences and Debates' by Margaret Brown. As I said, they were provided to me following my request, and can no doubt be made available to other members for their perusal.

Detractors of our current act, which this bill seeks to amend, will say that it is not foolproof in every case because a small percentage of people may not have their pain fully relieved. The other issue that is often mentioned in relation to our act is that some doctors do not feel comfortable in administering pain relief to their patients if the outcome of that action assists in hastening a patient's death. I can only say that the legislation before us now, and other similar bills in the past, are even less foolproof.

What is important here is intent. My conscience tells me that there needs to be a line in the sand. I believe that when a doctor is looking after a patient in the terminal stage of a terminal illness and medication is administered to relieve pain, then what is of the utmost importance is the intention, and that is in accordance with the current act.

My conscience also tells me that there are some very good reasons for not supporting this bill. As a member of parliament I do not believe that the bill is a good piece of legislation; that is, I believe that this legislation, as I have just mentioned, is not foolproof. I firmly believe no active voluntary euthanasia legislation can be.

Because this is a conscience vote I place on the record that, regardless of any religious belief, I believe that it is also morally wrong to support active voluntary euthanasia. Whilst it is not the main guiding reason, I am certain that my religion has also shaped my views in relation to this issue, and I have no problem with placing that on the record. The Hon. Dennis Hood has already placed on record the response received from the Most Reverend Philip Wilson, the Archbishop of Adelaide, after the Hon. Mr Hood took the opportunity to write to the heads of several churches. Clearly, I do agree with the Archbishop's view.

The Hon. Bernie Finnigan has just made a very eloquent contribution, and I commend him for covering the many issues this bill raises in a very comprehensive manner. As mentioned earlier, the act that this bill seeks to amend specifically rejects euthanasia, which is defined as medical treatment administered for the purpose of causing death and assisted suicide. As has already been mentioned by the Hon. Bernard Finnigan, earlier this week the Hon. Bernard Finnigan, the Hon. Russell Wortley and myself met with the Christians Supporting Choice for Voluntary Euthanasia group. I have to say that I obtained the impression that this particular group was set up to counterbalance the view that Christians generally would not support voluntary active euthanasia. I thank them for going to the trouble of not only coming to see us but also preparing briefing papers for us. I am unable to support them, as I mentioned but, nonetheless, I acknowledge the sincerity with which they hold their view. I believe that the net the Hon. Mark Parnell is casting is far wider than palliative care and those in a vegetative state, and I will not be supporting this bill.

The Hon. D.W. RIDGWAY (Leader of the Opposition) (22:30): I rise to speak to the Consent to Medical Treatment and Palliative Care (Voluntary Euthanasia) Amendment Bill and, as members are well aware, in my first term of parliament I made an extensive contribution on the Hon. Sandra Kanck's bill at that time. The Hon. Bernard Finnigan talked about removing personal experiences from the debate but, clearly, we all draw on those for our judgment on a whole range of issues we debate in parliament.

Sadly, since the debate on the last bill of this type in the chamber, my father-in-law has passed away. I mentioned him at the time of that debate and, for my benefit and for that of members, I will refresh our memory of his story, which I guess is the genesis of my views. My father-in-law was diagnosed 15 or 16 years ago with pancreatic cancer and given three months to live. I mention this because—

Members interjecting:

The Hon. D.W. RIDGWAY: I like the way I am interjected on by my colleagues on the back bench.

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): Totally out of order.

The Hon. D.W. RIDGWAY: Exactly. He was given three to six months to live, and at that time he was given no medical treatment that could help them, so he went off and used alternative medicine. At that point, I do not think he would have ever have considered any form of voluntary euthanasia: he was going to fight to the bitter end. Luckily, not only for my wife and her family but also for the extended family, he managed to live another 15 years.

Sadly, he died earlier this year of lung cancer. I suspect that once he reached a particular point along that journey—and a pretty unpleasant journey it was towards the end—some way of ending it all may well have been a better option for him and for the family. He is no longer with us, but my wife and her mother, sister and brother spent some good times and also some pretty tough times with him towards the end.

I have always been a great fan of choice for people, and I think that this bill provides that choice. I have always been a little concerned about advance directives or advance requests, as they are called in the bill, and I am pleased that this is addressed by making them renewable every five years. I will now draw on another personal experience.

My mother is in a nursing home in Bordertown. She does not talk at all any more and is in what I would call a less than desirable place in her life, and she has been there for some years now. She said that she never wanted to go there, but I am not sure whether that is still her view. However, I am sure that the renewal process the Hon. Mark Parnell talks about in this bill would have allowed her to make some judgment. If my mother had made the decision 10 years ago, 'If ever I go to a nursing home, I wouldn't wish to be there and I'd want you to turn the lights off,' as she once said, I do not think this sort of blanket advance request would be appropriate.

I remember that, when we last discussed this issue in this place, the Hon. Diana Laidlaw said to me, 'If ever I am incontinent, that's it. I don't want to be here.' I said to her, 'But, Di, if you still enjoy a cigarette,' and I am not sure whether she still smokes, but she did then, 'a glass of wine and seeing your nieces and nephews growing up, getting married and having kids, and the only thing you have to deal with is incontinence, it is not as good as you are today, but maybe it is not as bad as being euthanased'. She said, 'No, no, no.'

That is why I think the Hon. Mark Parnell's bill now allows people to review that along the journey because I think that is important. We make statements when we are young, fit and healthy, and, as our life progresses, we realise that our focus and things that are important to us do change. Nonetheless, this bill still provides people with that ultimate choice. I refer back quickly to some of the comments I made in my original contribution. In particular, I made a trip to the Netherlands. In the very first year I was in parliament I went to the Netherlands to speak not only to the people who were pro-euthanasia but to those who were against euthanasia.

While I had the utmost respect for the Hon. Andrew Evans, who was here prior to the Hon. Robert Brokenshire, he spoke to those people who were certainly opposed to euthanasia but he did not take the time to get the balanced debate. I left Australia with an open mind. I did not have a view one way or the other. I wanted to talk to those people in another country where we know it is available and used, and I came back with what I suggest is a more balanced view because I listened to both sides of the argument.

I remember going to the Mary Potter Hospice and talking to some of the nurses and nuns, and they said there was a small percentage of people where pain management and palliative care just did not work. There was a small group of people where nothing could help and there should be some mechanism to help them deal with it. The Hon. Bernard Finnigan talked about people who are not terminally ill but who are in a hopeless state. I cannot remember the person's name but I did visit her in Adelaide with the Hon. Angus Redford.

Mary Gallnor is in the gallery now. I do not ask her to yell out the name, but I do remember visiting her. I cannot lip read either, but she knows who I am talking about. We visited this lady who was living a life that probably none of us would really like to live. She had a disability. There was a possible surgical solution but if she took that surgical option there was a chance she would end up being in an even worse state than she was. She said, 'I am not prepared to take the surgical option because if I do and it is a failure, I then end up being either a paraplegic or a quadriplegic.' She had a significant spinal disorder. I am now getting the name. It was Jo Shearer we went to visit. The Hon. Angus Redford and I spent a couple hours, I suppose, with Jo Shearer.

It was a pretty moving experience. This woman had absolutely all of her faculties, her mental capacities. She was a very sharp lady but she was in a desperate situation. She would have taken the surgical option if she knew that, at the end and it all failed and she ended up being a paraplegic or quadriplegic because of the surgery, she could finish her life through euthanasia. My recollection is that her family had grown up. She was probably in her mid 50s, I suspect, at about that time. She was in a state in her life where she wanted to have that option. Sadly, we did not have that and a few weeks after Angus and I visited her she committed suicide.

It really brought home to me that, if we had the option, that woman would have taken that surgical option. It may or may not have worked but it would have given her a door out of the life she had because she was in a pretty tough situation when Angus and I visited, and potentially she was going to be in a worse state.

I will not go on for terribly much longer. I refer quickly to the 86 or 87 per cent of people that we hear today are supporting euthanasia. I know that the Hon. Mr Finnigan said that polls do not mean much. It is interesting that the team he belongs to—and I understand that this is absolutely a conscience vote—and the game that we all play in politics means that if we had 86 per cent or 87 per cent of the people telling us that something was right or wrong, I am sure that his leader, the Hon. Mike Rann, would certainly listen to what the polls were saying, and I think that is something that we have to do.

I know that my colleague the Hon. Rob Lucas always had a view that, notwithstanding the approximately 70 per cent when we debated it last time, certainly at that point he did not want to support the bill. My view is that, as legislators, if we have approximately 80, 85, 86 or 87 per cent of the community wanting a particular law, it is our role as legislators not only to provide that mechanism for them but absolutely to protect those who do not want it.

We are talking about a voluntary program. It is not mandatory, as much as looking across to the other side during a political debate it is something I might consider for some of my political opponents. At the end of the day this is voluntary euthanasia. Our responsibility in this chamber and in the parliament is to listen to the people. Some 87 per cent of people are saying that they want this option, some 6 or 7 per cent are saying they absolutely do not want it and about 6 per cent do not have a view. Our role as legislators is to find a mechanism that gives the 87 per cent a choice to use it and to absolutely ensure that no force, coercion or malpractice is imposed upon the 13 per cent that either do not have a view or do not want it. This bill goes a long way towards achieving all those things. With those few words I indicate that I will be supporting this bill.

The Hon. J.A. DARLEY (22:41): I indicate that I will be supporting this bill. We all are aware of the very clear divide between the supporters of voluntary euthanasia and the opponents of voluntary euthanasia. I am sure other members have received vast numbers of correspondence both for and against the bill. I am comfortable with individuals having choice. In this instance that choice would allow them to seek medical treatment in order to end their suffering from a terminal illness or other very serious injury or medical condition. Given the choice, I do not think this is a decision that anyone would make lightly, but I do agree with the Hon. Mark Parnell that a person whose suffering becomes intolerable should be able to access medical treatment to end their suffering.

The bill proposed by the Hon. Mark Parnell addresses this issue. Very briefly, it includes a number of protection mechanisms, all aimed at ensuring that an individual will be able to access voluntary euthanasia only after very stringent requirements are met. It will be available only to adults who are in the terminal phase of a terminal illness or who have an illness, injury or medical condition which results in permanent deprivation of consciousness or which irreversibly impairs the person's quality of life so that life has become intolerable to that person. Those individuals will also have to meet a number of legal requirements and assessments, including medical assessments, before a decision can be made by a government appointed board regarding their request.

I raised with the Hon. Mark Parnell my concerns regarding the model that is being proposed, and I indicated to him that I would consider the matter further if those concerns could be addressed. Those concerns relate to the issue of adequate safeguards. The Hon. Mark Parnell has introduced a number of measures which are aimed at ensuring that voluntary euthanasia is not open to abuse. I must say that I am not a huge supporter of bureaucratic processes, but I understand his reason for going down the path of establishing a government appointed board which ultimately would be responsible for declaring whether a request should be accepted.

My specific concern relates to instances that could potentially result in voluntary euthanasia being accessed for the wrong reason and, more specifically, where an individual wants to access voluntary euthanasia simply because they do not want to be a burden on their family if they become ill. If the individual discloses this as their reason, then obviously under this bill the request would be denied.

However, I do not think it would be impossible for an individual who is of sound mind to try to access euthanasia under the proposed model, whether it be through the advanced or active request mechanism, without disclosing the real reason behind that request.

I am satisfied that the amendments filed by the Hon. Mark Parnell further strengthen the protection mechanisms in the bill and address my concerns in this regard, and I thank the Hon. Mark Parnell for addressing this issue. In conclusion, as already mentioned, I do believe that individuals should have choice and, if a person's quality of life becomes so diminished and so intolerable to that person, then I also support their choice in seeking medical treatment to end that suffering.

The Hon. S.G. WADE (22:45): I rise to indicate that I do not support this bill. As a Liberal, I accept the right of each individual to personal autonomy, including the right to make end-of-life decisions. Suicide is not a criminal offence. However, murder is a criminal offence. Society, and each individual within it, has a strong interest in making sure that euthanasia does not become a cloak for murder. As a House of Lords Select Committee on Medical Ethics put it in 1994:

Society's prohibition on intentional killing is the cornerstone of law and of social relationships. The prohibition protects each of us impartially, embodying the belief that all are equal.

While suicide may be morally contentious, murder is not. There is a strong consensus amongst both religious and non-religious communities that murder is morally wrong. I appreciate that current law and practice is open to abuse, and that medical practice and palliative care can take us into grey areas that are morally and legally challenging. However, I think we need to be careful that, in our attempts to eliminate grey areas through euthanasia laws, we may merely shift the grey areas and in the process put more people at risk of intentional killing.

Of course, the key factor that turns assisted suicide into murder is the will of the person who dies as a result of the act. That can only be discerned prospectively. So, for me, the first test for euthanasia legislation is the level of confidence that it provides that euthanasia will not be administered against the will of the person who is to die. Are we sure that a person able to be killed by a third party wants to die and that that desire is ongoing and well founded? I do not consider that the bill meets this first threshold.

The test does not protect people from their transitory intentions. The test does not protect people from acting on situations that can be remedied. There is no requirement for a second medical opinion. There is no requirement for a psychiatric assessment. The oversight of the board is too passive. Given that the legislation is not limited to South Australians, I consider that the bill fails to address the evidentiary and cultural challenges in providing assurance of consent by a person from beyond South Australia. In 1994 an eminent House of Lords Select Committee on Medical Ethics came to the view that it was not possible to ensure that euthanasia is voluntary. It stated:

...we do not think it possible to set secure limits on voluntary euthanasia...issues of life and death do not lend themselves to clear definition and, without that, it would not be possible to frame adequate safeguards against non-voluntary euthanasia if voluntary euthanasia were to be legalised. It would be next to impossible to ensure that all acts of euthanasia were truly voluntary, and that any liberalisation of the law was not abused. Moreover, to create an exception to the general prohibition of intentional killing would inevitably open the way to further erosion, whether by design, by inadvertence, or by the human tendency to test the limits of any regulation. These dangers are such that we believe that the decriminalisation of voluntary euthanasia would give rise to more, and more grave, problems than it sought to address.

Whilst I do not go so far as to say that a sufficiently robust euthanasia law is not possible, I do know that this bill is not sufficiently robust. However, for me, this bill should also not be supported because it does not protect the vulnerable. The House of Lords committee also commented in its report, as follows:

We are also concerned that vulnerable people—the elderly, lonely, sick or distressed—would feel pressure, whether real or imagined, to request early death. We believe that the message which society sends to vulnerable and disadvantaged people should not, however obliquely, encourage them to seek death but should assure them of our care and support in life.

Even if a robust euthanasia regime could ensure that every act of euthanasia is voluntary, the vulnerability of significant sections of the population means that the clear assent of a person may yet nonetheless not be truly voluntary: elderly people who choose to die because they consider themselves to be a drain on health resources, lonely people who feel socially excluded and choose to die because they are devoid of hope, and people with a disability who feel devalued and rejected.

A request of euthanasia may be documented, but if the choice is significantly impacted by duress, abuse, social disadvantage and so on I do not consider that it should be regarded as voluntary. Our first response to a person who says that their life is not worth living should not be to terminate that life but to say: 'What can we do as a society to support you to live a valued life?'

I would like to focus in particular on one vulnerable group: people with a disability. I am concerned that the bill discriminates between people with disability and people without disability. I appreciate that that would not be the intent of the honourable member who is sponsoring the bill but, in my view, that is its effect. When the general public talks about euthanasia, they are usually talking about the terminal phase of a terminal illness. People in this situation are covered by clause 19(1)(a) of the bill. However, the bill goes further. Clause 19(1)(b)(ii) entitles an adult to voluntary euthanasia if they have an 'illness, injury or other medical condition that irreversibly impairs the person's quality of life so that life has become intolerable to that person'.

These terms are so vague and so ill-defined that almost by definition most people with disability would be deemed to have an illness, injury or other medical condition that irreversibly impairs the person's quality of life. From the moment a person with a disability reaches the age of majority, or from the moment of acquisition of the disability, they would be entitled to voluntary euthanasia under this bill even though they may be expected to live for decades. There may not be any sign of a life-threatening illness. A person could ask for euthanasia when that person has recently acquired a disability before they have even had the opportunity to reframe their life expectations in the context of that disability. On the other hand, any other South Australian who found that life had become intolerable would not be entitled to voluntary euthanasia unless they came to meet other requirements of the bill.

In passing this bill, I believe that we would be creating a different standard for people with a disability. If euthanasia does not discriminate against people with a disability, why should it not be available to everyone, even without terminal illness or unconsciousness? I consider that this bill is discriminatory against people with disability and should be opposed.

Further, I consider that, given the widespread discrimination against people with disability, it is likely that euthanasia would undermine the rights of these people. There is a strong consensus view of the disability movement world wide against euthanasia. In fact, only three weeks ago a consortia of American disability organisations lodged a statement of claim in a court case in the American state of New Jersey to protect people with a disability from euthanasia. In part, that document states:

Amici Not Dead Yet, ADAPT, Center for Self-Determination, National Council on Independent Living, National Spinal Cord Injury Association, American Association of People with Disabilities and Disability Rights New Jersey…represent a very broad spectrum of people with disabilities, including people with physical, developmental and/or mental disabilities, and people whose disabilities were from birth or acquired during our lifetimes. Many are now or at some point have been labelled 'terminal' by a physician. Many have had doctors threaten to remove life-sustaining treatment on an involuntary basis and have had to fight to receive continued care. As in this case, financial motives of the caregiving institution are rarely far below the surface when such threats come to pass.

All 'end-of-life care' issues have been disability rights issues for decades. No-one, whether disabled or currently able-bodied, is immune from the pervasive societal assumptions that affix to the disability label. Fear, bias and prejudice against disability are inextricably intertwined in these assumptions. Our society values and desires 'healthy' bodies and minds. Severe disability is viewed as worse than death. Physicians, unfortunately, are not immune from such prejudice, and, in fact, have been found to be particularly susceptible to this sort of thinking. These views and assumptions are strongly opposed by people with disabilities…Doctors often acquiesce in societally-mediated feelings that death is preferable to disability. When conscious, though disabled, patients can come to be seen as candidates for euthanasia, how much easier it is to project similar fears onto people with severe brain damage…When medical professionals and the media use phrases like 'imprisoned by her body,' 'helpless,' 'suffering needlessly,' and 'quality versus quantity of life,' purportedly in a humanistic and compassionate way, they are really expressing fear of severe disability and a very misguided condemnation: 'I could never live like that'. For example, our society often translates these emotions into a supposedly rational social policy of assisted suicide or 'passive euthanasia' homicide. Whenever permanent disability is [defined] as the problem, death is the solution…The wish to die is transformed into a desire for freedom, not suicide. If it is suicide at all, it is 'rational' and, thereby, different from suicides resulting from [the same] emotional disturbance or illogical despair [that non-disabled people face].

The medical profession is not immune to these erroneous assumptions. Research shows that doctors frequently project the 'quality of life of chronically ill persons to be poorer than patients themselves hold it to be, and give this conclusion great weight in inferring, incorrectly, that such persons would choose to forgo life-prolonging treatment.' As long as physicians believe that a person with a severe disability has a 'life unworthy of living,' lethal errors and abuses will occur.

In support of the assertion in terms of the medical professions' negative view about disability, I refer to a report in the Annals of Emergency Medicine, which found that 86 per cent of spinal cord injured high-level quadriplegics rated their quality of life as average or better than average. Only 17 per cent of their emergency medicine doctors, nurses and technicians thought they would have an average or better quality of life if they acquired quadriplegia.

Australia also devalues the lives of people with disability. The commonwealth government recently released a major consultation document called 'Shut Out', which included the following comment:

In 2009, in one of the most enlightened and wealthiest nations in the world, it is possible for people with disability to die of starvation in specialist disability services, to have life-sustaining medical treatments denied or withdrawn in health services, to be raped or assaulted without any reasonable prospect of these crimes being detected, investigated or prosecuted by the legal system, and to have their children removed by child protection authorities on the prejudiced assumption that disability simply equates with incompetent parenting.

Addressing the 2006 Australasian Bioethics Conference in Brisbane, Kevin Cocks, a leading disability advocate and Director of Queensland Advocacy Incorporated, said that legalising euthanasia would present a threat to people with a disability because society believes they lack a 'good quality of life'. Mr Cocks said:

Many of the arguments in favour of voluntary euthanasia are informed by negative assumptions about the lives of people with disability…People with disabilities fear legalised euthanasia would only further institutionalise medical neglect due to a social consensus that their very lives are burdensome, undignified and inconsistent with a 'good quality of life'.

He said that, at present, there was arguably far greater public enthusiasm for people with disability being given assistance to die than there was for providing them with adequate assistance to live. Mr Cocks said:

While this is the case, people with disability remain possible targets for non-voluntary euthanasia.

In conclusion, I reiterate that my key concern is to support the prohibition of murder. That value is not a uniquely Christian distinctive: it is almost universally upheld in our community.

My Christian religious views have not predetermined my position. In this context, I express my respect for the work of Mr Ian and Mrs Nancy Wood and other members of the group Christians Supporting Choice for Voluntary Euthanasia, who sincerely and credibly argue for euthanasia from a Christian perspective. Whilst I could not share their support for this legislation, I honour their witness to the Christian values of respect, compassion and mercy.

I urge the council not to support this bill. It fails to provide sufficient assurance that a request for euthanasia is truly voluntary. I fear the bill would put social pressure on very vulnerable people to 'volunteer' for euthanasia, not for their own sake but for others. Further, the bill would fail to protect people with disability from a society and health sector which devalues them because of their disability. The bill fails to challenge the lack of acceptance and ensure meaningful support is provided to people with a disability that would make life not merely tolerable but valued and contributing. I urge the council to reject the bill.

The Hon. J.M. GAZZOLA (23:00): As one would expect, the passage of this issue through parliament has been a most frustrating one. I remember speaking on Sandra Kanck's private member's bill, her Dignity in Dying Bill, in June 2002. On the parliamentary front there has been little progress since then, although public support for the right to die has grown and, according to the figures that we have talked about tonight, it has gone from around 47 per cent in 1962 to around 87 per cent across the country at the moment.

As we also know, there are two private members' bills in this parliament: the one we are debating at the moment—the Hon. Mark Parnell's bill—and also the member for Fisher's bill in the other place. Two bills at the same time in different houses represent the quiet frustration over the years as represented and reflected by the growth of high public support. Even those unmoved by consensus as significant as this must at least take heed of the fact that supporters for these bills have given a lot of careful thought to the issue.

The Hon. Mark Parnell has asked members to come to the debate with an open mind and, if by an open mind we seek to base our decisions on the ground of reason, we will have furthered the debate. As a parliament trusted with the responsibility to address and resolve these difficult public issues, we will be expected to reason through this issue, not cement prejudice and poor argument. We need to be relevant and responsible in the carriage and resolution of this bill. The important arguments that centre on euthanasia have not changed and have been, I believe, well discussed, so I will not reprise my arguments from the 2002 Dignity in Dying Bill.

This issue can only be resolved at the bench of reason, reason that was failed in 2002, and this issue will not go away if it is failed again. In closing, I acknowledge the contributions and representations made by the public to my office. I supported the Dignity in Dying Bill in 2002 and I support the Consent to Medical Treatment and Palliative Care (Voluntary Euthanasia) Amendment Bill.

The Hon. T.J. STEPHENS (23:02): I have made a contribution on this topic before, so I will not delay the chamber. My views have not changed. However, a couple of things have changed since my last contribution. I have been in the unfortunate situation of watching a very close relative, my father, die a very painful death from cancer, and it was horrific. I certainly empathise with those who take the time to tell me similar stories. I am concerned about vulnerable people. My views on this are primarily as a legislator. I am keen to go home at night, having done a day's work, knowing that I have not put somebody's life at risk who may be vulnerable. It is primarily for that reason that my views have not changed and are unlikely to change. With those few words I will not support the bill.

The Hon. R.D. LAWSON (23:03): This bill will amend the Consent to Medical Treatment and Palliative Care Act of 1995. Crucially, it will insert additional provisions into that legislation, but will also delete section 18 of the existing legislation. Section 18 is a saving provision and provides:

(1) This act does not authorise the administration of medical treatment for the purpose of causing the death of the person to whom the treatment is administered.

That principle is going out the window if this bill passes. The second saving provision is:

(2) this act does not authorise a person to assist the suicide of another.

Again that principle will be removed from the legislation and from our law. I believe the removal of those protections is a step too far. It is worth reminding members, some of whom were present in the parliament when that bill was passed after a very long debate, of the provisions of the Consent to Medical Treatment and Palliative Care Act, and in doing so I will endeavour not to repeat material that others have already canvassed.

Its essential provisions are as follows. In section 7 it allows a person over the age of 18, whilst of sound mind, to give an anticipatory grant to the consent of medical treatment or an anticipatory refusal to medical treatment, and that was a new provision.

It also provided, in section 8, for the appointment of an agent to consent to medical treatment: any person over the age of 18, while of sound mind, could give an agent power to make medical decisions for them. The medical power of attorney provision did not authorise the agent to refuse the natural provision or natural administration of food and water or the administration of drugs to relieve pain or distress, or to refuse medical treatment that would result in the grantor regaining the capacity to make decisions about his or her own medical treatment. That was an important provision.

The most important of the new provisions in that legislation appears in section 17, the care of people who are dying. It provides:

A medical practitioner responsible for the treatment or care of a patient in the terminal phase of a terminal illness...incurs no civil or criminal liability by administering medical treatment with the intention of relieving pain or distress—

(a) with the consent of the patient or the patient's representative; and

(b) in good faith and without negligence; and

(c) in accordance with proper professional standards of palliative care,

The section continues:

even though an incidental effect of the treatment is to hasten the death of the patient.

Secondly, section 17 provides:

A medical practitioner responsible for the treatment...of a patient in the terminal phase of a terminal illness...is, in the absence of an express direction by the patient...under no duty to use, or to continue to use, life sustaining measures in treating the patient if the effect of doing so would be merely to prolong life in a moribund state without any real prospect of recovery or in a persistent vegetative state.

Life-sustaining measures are defined as:

Medical treatment that supplants or maintains the operation of vital bodily functions that are temporarily or permanently incapable of independent operation, and includes...ventilation, artificial nutrition and hydration and [forms of] cardiopulmonary resuscitation.

These are important provisions. Unfortunately, the South Australian community has not used medical powers of attorney and advanced directions to the extent that was envisaged at the time. That is because, in my belief, there has been insufficient advertising of them, insufficient publicity and insufficient education, and the way to address that issue is to actually provide that education and to provide greater facilities for the use of these mechanisms, rather than the rather draconian solution proposed in the Hon. Mark Parnell's bill.

I commend the member for making the title of his bill the Consent to Medical Treatment and Palliative Care (Voluntary Euthanasia) Amendment Bill. I have previously deplored the fact that in the past legislation of this kind has been given catchy and alliterative titles, such as 'Dignity with Dying'. That subterfuge has not been adopted here. As the Hon. Bernard Finnigan mentioned in his contribution, sure, if you ask somebody in a survey, 'Do you favour dignity in dying, or dying without dignity?', obviously a large proportion of the population will prefer dignity over indignity, but that is not the question. This is not an either/or issue.

I note in passing that the Victorian organisation promoting euthanasia still uses the title Dying with Dignity. In a colourful and catchy pamphlet issued to members today, that organisation publicises the fact that it has many prominent and admired citizens who support voluntary euthanasia. But the question posed in the language of that pamphlet is that they are calling for the reform of law to allow a person suffering intolerably and without relief from a terminal or advanced stage of an incurable disease to seek medical assistance to die peacefully.

This is full of emotionally loaded language like 'suffering without relief' and 'to die peacefully'. I do not believe language of that kind is appropriate in a debate of this kind. It is fair enough in the court of public opinion in order to garner support and it is perhaps permissible to use emotionally charged language. I do not think it is particularly helpful to legislators facing the questions we have tonight.

The essence of this bill, as has been pointed out by others, is a new concept not previously seen in similar measures, and that is the notion of life becoming intolerable. Once again, it seems to me a fairly emotionally charged term but also one that is vague and not of definite meaning. It is highly subjective; it is not subject to any objective test. In the context of this type of legislation where it is going beyond the original act which is the person in the terminal phase of a terminal illness, it is unlimited in time. Young people can feel their life is intolerable. It may be as a result of some depressive illness or some other issue that I would not favour entitles a person to make what is termed as an 'active request'.

This bill is also full of, as I see it, hoops to jump through and they look like checks and balances and hurdles that must be cleared. They look like checks but in fact they are merely steps to dance through in order to achieve a desired result. I am not satisfied that these steps are true protection.

Many members may have heard this morning on ABC Radio a lady who called in to give a distressing personal example. She spoke of her mother's final years in a nursing home. I think she said it was in Port Pirie. Her mother was aged over 100 years and her final days were sad and distressing. Apparently she was in a nursing home and did not receive appropriate palliative care. The solution to that problem is better palliative care but the incident also brought home to me and highlighted the fact that the final days of many elderly people cause grief and great distress to their kith and kin.

This also contains a danger: is the call for euthanasia about relieving the suffering of those whose life is continuing or is it about relieving the suffering of those who are in the process of dying and may be well beyond caring about it? This leads to the question whether elderly parents, for example, in the terminal phase of their life will see the distress of their relatives, families and their grandchildren and feel obliged in those circumstances to relieve not their own suffering but the suffering they clearly see their families are undergoing. I think that is actually one of those issues that is not addressed by saying, 'We are putting in steps to prevent duress or inducement.' I believe that the circumstances themselves may force many people to feel that their life is not worth living and that, in order to put their relatives out of misery, they will agree to terminate their life.

The other issue, it seemed to me, about the example given by the lady on the radio this morning was that this bill will, in fact, not provide assistance to many people in that situation. Those people will not have given any advanced directions. By the time they enter that phase of their life, they may well have lost the mental or physical capacity to make any rational decision. This bill will not actually overcome that difficulty, which is inherent in life itself.

I am indicating that I will not be supporting this bill, but I should commend the supporters of it who have campaigned long and hard. The South Australian Voluntary Euthanasia Society has always presented rational arguments to members of parliament—I commend them for it; I am not patronising them by saying it—and the Christians Supporting Choice for Voluntary Euthanasia, which is a new group, have been active and I commend them for their forceful advocacy.

At the same time I should also commend those who are opposed: Family Voice Australia and Right to Life Australia have also been active in ensuring that members receive material to advance their particular cause. I commend also the hundreds of ordinary citizens who are bombarding members with their views. But, in the end, each and every legislator, in the exercise of their conscience, has to reach a decision about the worth of this legislation, and I say that I am unable to support it.

In concluding I want to read a passage from the famous author Morris West. In 1996, when he was 80, and well before the time he died, he wrote:

As a husband and father, I have executed what is popularly called a 'living will', expressing my wish that in the event of a terminal illness no extraordinary steps, medical or surgical, should be taken to prolong my life. My wife and children have read and agreed to the document. My doctors are aware of its existence. There is nothing in the document that solicits or demands the direct termination of my life. I do not believe that I have the right to lay the burden of this decision upon any other person, be they family or medical carers. I can only trust myself to their skill and compassion to make my exit as painless as possible.

I interpose to say that he is there describing the situation which applies under the existing Consent to Medical Treatment and Palliative Care Act in this state. He then went on to say, in a passage which I think is worth repeating, the following:

I have one very firm conviction. The ambiguities and the dilemmas created by terminal illness and terminal suffering will not be eliminated by legal documents. A law, however carefully it is framed, becomes immediately an anomaly. It is at once permissive and inhibiting. It is always—and unavoidably—intrusive. It will always be an abridgement of both liberty and privacy. It calls new presences in to places and occasions where otherwise they would have no right to be.

No place should be more private than the deathbed. No place should be more free from judicial surveillance and post-mortem inquisition of whatever relationships are active at that moment. If abuses occur they should be dealt with after inquiry under common law...What I do not want to see is the introduction of a new figure, a legalised terminator, opening the exit from life only after all the forms and protocols prescribed by an impersonal state have been fulfilled.

I see the Voluntary Euthanasia Board of South Australia as such an imposition imposed by the state. To my mind, the forms and protocols provided in this bill are those of an impersonal state. I do not believe that they are sufficient, nor do they justify the intrusion of the state into this area. This bill is not the solution to an inescapable fact of life; some people will always suffer at the end of life. It is our duty as a society to ensure that their suffering is minimised, but beyond that we should not go.

The Hon. C.V. SCHAEFER (23:20): One of the very early bills that I debated when I came into this place was the consent to medical treatment and palliative care legislation, and I seem to have been speaking to numerous bills to allow euthanasia on a roughly two-yearly basis since that time.

Those who have taken the time to read what I have said previously will not be surprised that I find myself in a position where I cannot support this bill. I, too, would like to acknowledge the sincerity of all concerned on both sides. There seems to be a view out there that there is a constant running poll and the more people who write or email saying that they are either for or against a particular bill the more likely one is to listen to them. On this occasion I think they have probably been roughly half each, anyway.

I have long held the view that we are put in this place to exercise our conscience to the best of our ability and so, as uncomfortable as that may be on numerous occasions, I think it is our duty to do exactly that.

This particular bill, although I know it has been prepared with the absolute best of intentions, is probably more cumbersome, yet it has fewer safeguards than many others. SAVES has put out a comparison sheet between the two most recent bills—the Such bill and the Parnell Bill. By way of some of those comparisons, the Such bill says that 'a person must have intolerable pain that cannot be relieved by methods that the person finds acceptable'; whereas the Parnell bill requires simply that they be 'permanently unconscious or'—not 'and'—'have irreversible impairment of quality of life,' which is not defined.

The Such bill says a request may not be made before the illness occurs; the Parnell bill says it may be made before the illness occurs. The Such bill says that a person must be examined by two independent doctors, and the doctors must agree that the request is justified by medical evidence; whereas the Parnell bill says that the person must consult a doctor and the doctor must be satisfied that the person is of sound mind, otherwise a psychiatrist must be consulted. That puts a huge responsibility, as I see it, on the single GP who has been consulted by that person.

The clause that concerns me most in this bill, as has been adequately and far more eloquently expressed by a number of my colleagues, is that which says that the person who requests euthanasia must, as a requirement, be an adult person, etc., who has an illness, injury or other medical condition that irreversibly impairs the person's quality of life so that life becomes intolerable to that person.

However, there is nowhere that I can see a definition of what makes that life intolerable for that person. Indeed, it appears to me that someone who has, for instance, been an outstanding athlete and finds themselves crippled with arthritis may find that their life has become intolerable by their standards. It just seems to me that there are too many loops in this legislation, aside from my personal objection to the right to request death.

As I have said previously, although there is a fine line, for me the line is in allowing someone to die with dignity and causing someone to die. It is one thing to do all that we can to relieve suffering, even if that does, in fact, hasten death. It is quite another to decide when that death will take place and by what method. I just find that the definitions within this bill are far too loose and far too open to abuse.

I will not go through the various reasons for voting against the bill but, as the Hon. Stephen Wade has adequately expressed, one of the fears one has is for disabled people and the devaluation of their life. The other thing is that people who say that, yes, they are in favour of voluntary euthanasia—and I am not talking about those from SAVES and those who are well informed and privileged, as we are, to have access to the legislation but the people who say, 'Well, if I ever get to that stage, turn out the lights' (as the Hon. David Ridgway said)—do not realise that there is no law anywhere in the world, as far as I can see, that would consider them eligible for voluntary euthanasia because, in most cases, they are elderly people who have reached advanced dementia and are therefore unable to express their views. As the Hon. David Ridgway also said, how are we to know when they reach that stage whether it would still be their choice to do what they said they would want done when they were a younger and more able person.

I am also concerned that under this legislation, as with many others, many of the international studies show that a large proportion of the people who request that their life be ended are, in fact, suffering from severe and undiagnosed depression. Someone said that this bill will do more good than harm, but I suspect that, if passed, it will do more harm than good and in some ways will make it all too easy for us to end lives, whether it is with the best of intentions or otherwise. I will not be supporting this legislation.

The Hon. I.K. HUNTER (23:29): I rise this evening to speak to the Hon. Mark Parnell's voluntary euthanasia bill. At the commencement of my contribution, I reflect on how many similar bills have gone before because the issue of voluntary euthanasia has been around for some time and is one that we keep returning to. Here in South Australia, euthanasia legislation has now been tabled 10 times in this parliament over the past 10 years—by the Hon. Sandra Kanck in this place and the Hon. Bob Such in the other place. Of course, before then, I understand the Hon. Anne Levy and the Hon. Frank Blevins also introduced somewhat similar legislation.

Western Australia has introduced legislation three times, and voluntary euthanasia legislation has been introduced into the Tasmanian, New South Wales and Victorian parliaments over the past decade. It is an issue that is not going to go away and, if the bill fails tonight, as I think it might, I confidently expect that it will be come back to visit us in the next session of parliament. That is not really surprising when one looks at the opinion polls, which we have already discussed this evening. As we know, the most recent Newspoll on the issue, published in The Australian today and taken this week, showed that 87 per cent of people in South Australia support voluntary euthanasia. Not surprisingly, the strongest support is amongst the elderly and those with disabilities—ironically the very people that the slippery-slopers argue need protection from this legislation.

This issue even crosses the religious divide, with 85 per cent of people in a 2007 Newspoll survey who indicated that they supported voluntary euthanasia identifying themselves as Christian. I note that result with interest; it seems that the vast majority of self-professed Christians know very clearly where they stand on this issue, notwithstanding what religious leaders might be saying about it.

Occasionally we come to issues in this place that are considered serious moral questions, and voluntary euthanasia is one of those big moral questions for many people. However, for me the moral question is not the central question in this debate. With voluntary euthanasia, perhaps more than with other issues we may be faced with in this chamber, we are debating whether we should constrain the rights of the individual on a very personal matter—their life, and the ending of it—and in a very narrowly defined situation, in the case of this bill.

Of course I accept that we, as parliamentarians, do have the right and do have a responsibility to protect those people who cannot protect themselves or who are incapable of making decisions for themselves, but I have to seriously question whether we have the right to prevent people from making decisions for themselves when they are of sound mind and are making informed decisions. So I repeat, where it is something as personal as the ending of their life in the circumstances outlined in this bill, I tend to think that we do not have that right.

For me this is the crux of the debate. In a sense it does not really matter what I think about this issue. For me the question is: do I have the right to impose my ethical position on this issue on others who may or may not share that view, or should I allow individuals to make their own choice? Of course we need safeguards when it comes to such legislation, and we have debated safeguards at length tonight. I think the honourable member has included some sensible safeguards, and I welcome the amendments which further strengthen those safeguards.

I alluded earlier to many people arguing against voluntary euthanasia by referring to the so-called 'slippery slope', where legalising voluntary euthanasia will inevitably lead to involuntary euthanasia. Indeed, proponents of this position often cite a series of studies undertaken in the Netherlands to show that the legislation there is being misused. This is simply not the case, and it is unfortunate that one person's inaccurate interpretation of the findings of those studies has been used time and time again, repeated time and time again, by the anti-euthanasia lobby. As a matter of fact, those studies demonstrated that the legislation was working as intended, and the instances of voluntary euthanasia have actually decreased since the legislation was introduced in the Netherlands.

However, it is not only in the Netherlands that studies into euthanasia have been undertaken. A study undertaken right here in Australia and published in the Medical Journal of Australia in 1997 found that euthanasia, without patient consent, was being practised at a higher rate in Australia, where all forms of euthanasia are illegal, than in the Netherlands, where voluntary euthanasia is legal. Surely this in itself is a strong argument for legalising voluntary euthanasia so that we, parliamentarians and parliaments, can regulate it.

Before I conclude I would like to address the argument about the sanctity of life. I will do so by referring to an email I received from a constituent who contacted me earlier this week about the Hon. Mr Parnell's bill. She said:

My husband has multiple sclerosis and would just like to have the option to decide when and if it is time for his suffering to end. With MS he could be functioning one day and the next be a complete 'vegetable' (his words) and he wants to make a decision/have a choice while he is of sound mind that when he reaches a certain stage someone will then be able to end it for him. Just knowing that there is such a choice would make a huge difference to his daily life and give him peace that he does not have to think about how and when he may need to take matters into his own hands. It is hard for people to understand unless they are actually in this type of situation or are close to someone who is.

So, when people hold up the sanctity of life as a reason to object to voluntary euthanasia I remind them that what they are actually doing to people such as this is condemning that individual to suffer a slow, painful and undignified death, no matter what their personal view is. I do not think that is something we should impose on another person.

In essence, I can summarise my thinking on this matter as follows. If my moral or ethical world view is opposed to voluntary euthanasia, I can decide not to have voluntary euthanasia for myself, but I should not impose my morality on someone who believes differently and who is suffering terribly with no hope of recovery. Let them have the dignity to decide for themselves. For those reasons, I will be supporting this bill.

The Hon. R.L. BROKENSHIRE (23:35): I note that this is one of the few bills in this place on which there is agreement in both houses that this is a conscience vote. I acknowledge the honourable member and commend him for trying to alleviate suffering. In fact, in my own faith, teachings all my life have told me that we should show compassion to those who are suffering and to those who are dying. However, the advocates for this bill have missed one point: they claim that palliative care is incomplete and that it is not a total solution; of course, it is not.

We do not have a cure for cancer, but we do not give up simply because we do not have a cure for all cancer. We research, we spend money on research and we promote causes to try to find cures and ways to alleviate suffering and, indeed, improve quality of life. What we have not done to date, and what I will not be supporting today, is admit to defeat and the opportunities within this legislation to, effectively, choose death through voluntary euthanasia.

We already have advance directives for the terminally ill, and I commend people and the government of the day for what they do with palliative care. I will talk more about that later. However, we can still do a lot more to improve palliative care. We are discovering cures for diseases almost weekly, if not daily, and those efforts are the proper aim of compassion for the dying.

Members have talked about polls and so on and that allegedly 87 per cent of people now support voluntary euthanasia. If you want anecdotal evidence, my office has read and acknowledged all the correspondence that has come through to us from constituents, and from that correspondence we have calculated that about 60 per cent do not want us to support this bill and a little over 40 per cent do want us to support it.

We have looked at all the arguments and, as other colleagues have said, when people say that they want to see the Hon. Mark Parnell's bill supported, it is based on a situation they have experienced in their own family. In addition, in the time between the Hon. Bob Such's bill and this bill, we have had 10,000 plus signatures on petitions and so forth sent through to our office, so there has been some pretty strong intent coming that way.

I note with interest that those who want to see support for the Hon. Mr Parnell's bill say that really it is focused on about 2 per cent of the cases of terminal illness and incredible pain and suffering and that this would alleviate the problems for that 2 per cent. One of the things I am concerned about is that far more than 2 per cent might end up having voluntary euthanasia as a result of the fundamental flaws in the drafting of this legislation. Indeed, this legislation might be passed to assist that 2 per cent, but far more than 2 per cent could end up being euthanased.

The SAVES newsletter compares both bills: the Hon. Bob Such's bill in the other place and the Hon. Mark Parnell's bill. When you weigh up those two bills, I think that, with respect, the Hon. Bob Such's bill is probably—as I see it, anyway—a little softer on this subject matter than the Hon. Mark Parnell's bill. I note with interest some of the medical letters we have been getting. In fact, I have had more medical letters this time than at other times when these types of bills have been before the parliament.

Dr Pollnitz, was one of those people, and I want to highlight two things mentioned in the letter received from him. Dr Pollnitz, who is a medical doctor—I might add, with other medical qualifications—states in his letter:

Firstly, the proposed bill places great faith in the judgment of medical practitioners. I regret to tell you that we doctors are human and are liable to make mistakes. Even a good doctor can make a wrong diagnosis, and we can label an illness terminal when it is not. We frequently fail to diagnose depression and we are hopeless at predicting when patients are going to die.

Of course, we heard the Hon. Mr Ridgway talking about a situation such as that in the debate tonight. I agree with what Dr Pollnitz is saying here. We do hear of medical miracles, close calls and people recovering from comas which, using the language of this bill, would have been certified as permanent. The other thing Dr Pollnitz mentions, which takes me to one of my major concerns with this bill, is the subjective third limb of the types of people who can seek euthanasia.

Dr Such's bill requires someone to be in the terminal phase of a terminal illness. By contrast, this bill applies also to the so-called permanently unconscious and to an adult person who has an illness, injury or other medical condition that irreversibly impairs the person's quality of life so that life has become intolerable for that person. Dr Pollnitz points to the hypothetical, and I am quoting directly from his letter. Again, I remind members that he is a qualified medical practitioner with other additional qualifications.

He points to the hypothetical situation of an 18 year old diagnosed with diabetes who is required to inject himself with insulin for the rest of his life. He claims that, under this legislation, that person could get euthanasia. Dr Pollnitz says:

There are far too many subjective terms in that definition…for my liking.

Also, I think it is important to put on the public record the facts around clause 19(b)(ii), which refers to patients suffering from a whole range of illnesses that are incurable but not terminal. Again, this is hypothetical, but we have to look at the unintended consequences which I want to talk more about in a little while. It does, as I am informed by my legal adviser, indicate that people suffering health issues such as asthma, diabetes, arthritis or even a mental illness could request an end to their life. The patient only has to claim that his or her quality of life is intolerable under clause 19(b)(ii). With a few exceptions, effective pain management is currently available for even the most painful of cancers—and I do acknowledge with a few exceptions. I spent time with a good friend of mine the day before he passed away with cancer. It was not very nice but he did have a painless ending.

I will talk more about Holland in a minute, but just in some of the other correspondence and material I have been reading I noted that in Holland where euthanasia is legalised the termination of life without request is running at about 550 cases per year. I will finish with Holland now. I noticed a couple of members tonight talking about the situation there. I did spend some time in the Netherlands in 2000. Some portfolio responsibility work took me over there. I want to talk about the liberal attitudes, because that was mentioned by the Hon. Michelle Lensink. There is a lot of liberalisation over there. I visited so-called coffee shops, which are pot smoking rooms that people can go to at any time of the day and night, and they do indeed go there for morning tea and go back to work.

I visited injecting rooms, and I went right through the reasons why they had injecting rooms. The truth is that they were not 24 hour a day injecting rooms in any case, but, rather daytime injecting rooms. They had oxygen to revive them and nurses on stand by, but the reason for having injecting rooms was to stop the enormous number of people who were injecting in the reserves and parks around places such as Bern where I visited the injecting room.

I also went through three prisons while I was there. While they are liberal on illicit drug use, it did not stop the black market trade. In fact, I met and spoke with a number of women from Colombia who had been caught bringing black market illicit drugs into the Netherlands; it is just rife.

At the time there was talk about euthanasia in the parliament in South Australia, so I raised the issue with a cross-section of the people I was meeting. It was not like tonight where, allegedly, someone spoke to certain sectors of the Dutch community. I was meeting with a broad cross-section of middle managers who were responsible for managing public and social policy for the Dutch government.

The truth of the matter is that the absolute majority of them when I raised the issue said to me, 'Don't go down the path of the euthanasia legislation that we have in the Netherlands. It is scary and it is not working.' They did not have any specific reason for going one way or the other, but the absolute majority of all the people to whom I spoke said that to me. In fact, I guess it backs up a fact that has not been put on the public record tonight; that is, of all the hundreds of countries around the world less than a handful have implemented this type of legislation.

I also want to refer to what Dr Pollnitz said about medical practitioners making mistakes. It was not a mistake on this occasion, but I will give two examples. Only several months ago in the media there was a story from the United States of America about a person who had been in a coma for many years. A woman had been visiting her husband in a medical facility for all those years. The medical people did not think he would ever wake up, but he actually did and, while I understand he still has a long way to go before there is anything like a full recovery, he now has some quality of live with his wife and children. I wonder what would have happened if voluntary euthanasia had been available in that state of the United States. I received a letter from a practising therapist which states:

One discouraging day at work I bumped into an ex-patient, who now volunteers his time [at a particular facility in South Australia]. This patient used to be just like my clients, written off, in a vegetative state, with no awareness of others and no hope of recovery stated from the neurologist. This patient was walking, talking and eating independently six months later, and the recovery startled many people, and is often described as miraculous. This patient said to me that he did want to end his life in that vegetative state but couldn't tell anyone.

He is now incredibly thankful for his recovery and, according to the letter from the therapist (which we received on 14 October), he is living a full life.

This bill creates a number of legal minefields, not least of which is the option to prosecute for undue influence. That is more police work that they do not need and, more importantly, it is open to family members aggrieved by a death to press for charges against those close to the loved one who chose euthanasia. The penalty is not high enough to deter a desperate person. While this is exceptional, it does happen. In fact, I have been advised that on several occasions at least in the Netherlands a desperate person has wanted money from a person's estate or life insurance policy. Indeed, the investment and financial services association that wrote to me (and probably to other honourable members here in this house) expressed considerable concerns about the implications of life insurance policies. A person seeking euthanasia could commit a fraud upon their insurer by taking out one or several policies, and that needs to be worked through and I do not believe it has been in this legislation.

I also want to touch on the issue that has been raised by some of my colleagues that this bill allows people to make the decision themselves on whether or not they would sign off on voluntary euthanasia. I do not see that that would be the case a lot of the time. I think the decision would be made by someone with a medical power of attorney because the argument is so strong that it is in the last phase of a sad and unfortunate dying situation. I personally have a medical power of attorney but I do not believe the person who signed that medical power of attorney wanted me, if there was voluntary euthanasia, to sign off. It would put me in a difficult position, theoretically—not me, personally, because I know in this case that the medical power of attorney that I have is to ensure that very good palliative care is provided to that loved one, but it could put a lot of people in that position.

In closing, I return to the question of compassion. We must not give up on providing hope and the option of life to the suffering. Our pain at seeing others in pain should drive us to find cures and better ways of dealing with palliative care. Our laws already allow people who are terminally ill to refuse further medical treatment. Like some members, I was here when we debated the medical treatment and palliative care bill. It has not been put on the public record tonight, but that bill was introduced by the minister for health at that time who was a medical practitioner and had practised for quite a long period of time. I had very detailed discussions with the Hon. Dr Michael Armitage about all these issues and he convinced me that the best way to go was to support the medical treatment and palliative care bill, which I did.

Since then, things have moved on, and I congratulate the Hon. John Hill, the current Minister for Health. A constituent came to me recently who had been in a care situation for her husband during a significant period of illness and she raised some issues with me about how she believed palliative care could be improved. She said a lot of good things are happening in this state with palliative care, and I believe that, but she gave me some examples of what happens in Victoria because, through networks because of her husband's illness, she had started to investigate what other states were doing. I have sent that letter and some recommendations to minister Hill and he has taken that on board. I congratulate him on that, and I understand he is reviewing thoroughly issues around palliative care. I think that needs to be put on the public record.

I think it also needs to be public that, whilst this bill has been on the table for a year—and, as I said, I appreciate and understand the intent of the honourable member who has tabled this bill—only today the house received quite a lot of amendments to it, and that said to me 'unintended consequences'. I will finish by saying this. In the years that I have been in the parliament we have done the best we can as legislators, with unintended consequences. Governments put in regulations and often you find unintended consequences of those regulations. Here we have an opportunity to disallow regulations and revisit them. If you make a mistake and there are unintended consequences, which happens often with legislation, you can amend it.

I believe there are unintended consequences in this bill and, if it is passed and acted upon by a medical practitioner on behalf of a patient, you will not be able to reverse the unintended consequences because the person would have been euthanased. For those reasons, on a conscience vote, I do not support this bill.

The Hon. R.I. LUCAS (23:55): Over my years in politics I have been called many things, but I have never been called inconsistent in relation to my views on voluntary euthanasia, and in my contribution this evening I will certainly maintain what has been a consistent position over the many occasions that I have been asked as a legislator to vote on the legislation. I refer those persons who are unfamiliar with my views to the Hansard debates of 2003-04 and, certainly, a number of occasions prior to that. As a result of that, I do not intend, particularly given the hour, to repeat all the reasons why I have adopted the position I have adopted in the past and continue to do so. However, I want to address relatively briefly three issues.

I must admit that I (and, I assume, a number of other members) was offended at what I believe was the offensive language used by former Northern Territory chief minister Marshall Perron, reported in The Advertiser this morning under the headline, 'Hundreds die in pain as "zealots" block change'. The article stated, 'Mr Perron, however, says "fanatical" religious "zealots" are standing in the way of what should be a human right.'

Mr Perron is entitled to his views and to express them but, as I said, I abhor the demonising, as he has attempted to do, of anyone who has a different view from Mr Perron in relation to what is right or what is appropriate with respect to this difficult, complex and controversial issue. I think that portraying anyone who adopts a position different from his own doing so as a result of fanatical religious zealotry, as I said, is offensive to those members who adopt the particular positions that they do on this issue.

As a number of other members have indicated, by and large, I think most of the lobbying that we have received on this occasion (as we have in the past) from both sides of the argument has been relatively considered and moderate and certainly has not included intemperate, offensive language such as that used by Mr Perron. Perhaps that is a product of his Northern Territory background and the way in which politics are played in the Northern Territory, and perhaps it is best left in the Northern Territory.

The second issue that I want to address is the issue (which is always raised, although the numbers change depending on the polls) that in some way the job of legislators is to reflect the majority view of the community. Over the years, I have had many an interesting argument with groups who have lobbied me as an individual legislator on a whole variety of issues, because I obviously (as do a number of others) take a strongly divergent view to that particular proposition. Indeed, if the view is put to me, 'Well, the numbers are 87 per cent, or 70 per cent,' or whatever it is, supporting voluntary euthanasia in one form or another and, therefore, I am obligated to represent the view, when I put the proposition to the people who lobby that way, 'Does that mean, for example, that because 70 per cent of people in polls support capital punishment you want me to vote for that legislation as well?' of course there is a cough and a splutter and very rarely do I receive a response to that particular proposition.

Indeed, I recall one of my first votes in the parliament, which was in relation to the proposition of whether or not we should have a casino in South Australia. Again, the majority view at the time was to oppose the introduction of a casino in South Australia, and I took (as did a number of other members) a different view in relation to that. I also get the argument in relation to the abolition of gaming machines in South Australia; that there is a majority view out there in the community that gaming machines should be abolished and, therefore, as a legislator I should reflect that particular view.

It may well be that I am a supporter of minority causes, but in relation to this issue and, indeed, that particular argument, on this occasion I again reject strongly the proposition that our task here as legislators is simply to reflect the majority view. If that is the case, you might as well not have members here. You can conduct a referendum, a poll or a plebiscite and implement whatever the result of that exercise might be.

Our job as legislators is to make judgments and decisions. We have been elected to positions of trust and responsibility by the people of South Australia in one way or another, whether it be the House of Assembly or the Legislative Council. We are required and asked to make difficult and complex judgments on a whole range of issues, and in many areas they will not reflect the majority view of the populace. Ultimately, we have to answer to our parties and the electorate at election time in relation to the views that we happen to express.

However, it is a recipe for anarchy, in my view, to put the proposition that we in parliament should be here simply to reflect the majority view of the electorate on this issue because, in my view and my judgment, you cannot just pick the issue because it happens to coincide with your views on this particular occasion. If you want the majority view on voluntary euthanasia, then you will have to accept, if you want to follow the logic of the argument, the majority view on capital punishment and a whole variety of other things as well.

The final point that I have heard in this debate—and I am not just talking about the debate this evening, although it has occurred with some contributions—generally in the community leading up to this one is that, just because you as an individual have a particular view, you should not impose your view on others. What a wonderfully illogical proposition that is to a parliament. We spend half of our waking life making judgments about laws that impose the views of individuals and, ultimately, the majority in the parliament that restrict or limit the activities of individuals.

I remind members of the laws that we passed in relation to the banning of the use of illicit drugs. If you follow the proposition that, if an individual wants to have the right to voluntary euthanasia it does no harm to anyone else—let them have that right; do not impose your view as a legislator—how is the argument different in relation to whether someone wants to use heroin or, indeed, a range of other illicit drugs? If they are doing no harm to anyone else, why should they not have the right to do that?

As I said, we spend half of our waking life in this parliament looking at a variety of laws which, in one way or another, impose restrictions which, in the interests of a public benefit test, a public interest test or what we believe is right or wrong, we make judgments about, whether it is a conscience vote, a party vote or whatever it might happen to be, but they are judgment calls which we are asked to undertake as individual members of parliament. Ultimately, if there is a majority view that is reflected in this chamber and another chamber, that will become a new law, an amendment, or whatever the case might be.

As I said, it is a wonderfully cute line that you hear being mouthed on the front steps—and some of my colleagues in another place have parroted it to me, 'Just because you have a view, you shouldn't impose your view on others.' I am one member; I am entitled to express the view that I have in this chamber, based on the judgment that I have made over a number of years in relation to this issue. I respect the views of others who might have a different view and, ultimately, our democracy works on the basis that, if a majority of people either agree or disagree with me, and if the same thing occurs in the House of Assembly, then there will or will not be change in this area. However, those of us who have a particular view are entitled to express it and we are entitled to express it without the likes of people like Marshall Perrin describing us as 'fanatical religious zealots'.

The Hon. J.S.L. DAWKINS (00:05): Initially I would commend the Hon. Mark Parnell for bringing this legislation to the council. I note the safeguards he has made as a high point of the bill. I also note his willingness to amend the bill to tighten it even further. Further, I acknowledge the longstanding work of members of the SAVES group; we should acknowledge them in this place as all being committed volunteers who have been working for many years sincerely towards their aim.

I have been sponsoring legislation in relation to altruistic gestational surrogacy for a number of years, and I hope that that might get a bit closer to fruition in the next 24 hours. The amount of time I have been working in that area and with people in the community pales into insignificance compared with the time spent by the volunteers who make up the SAVES group, and I pay tribute to them.

Voluntary euthanasia was one of the first conscience issues placed in front of me when I entered the Legislative Council more than a decade ago. In fact it was in 1998 that the issue really came up for the first time, and it was about whether a voluntary euthanasia bill would be referred either to a select committee or to the Social Development Committee of the parliament. That was the time I really started to think about the issue. I have previously demonstrated my support for voluntary euthanasia legislation and will continue to do so in relation to this bill.

Part of the reason I took a view in favour of voluntary euthanasia involved family experiences I had encountered, and some other members of this chamber have referred to the experiences they have had with loved ones. Certainly issues relating to both my father-in-law and my father, when they passed away within 14 months of each other, influenced me strongly to consider supporting voluntary euthanasia.

Another aspect is the fact that I remember vividly being confronted by someone who asked how could I, as a former chairman of the Parliamentary Christian Fellowship, possibly support voluntary euthanasia, and I took some time to explain my views to that person. That question certainly exemplified some of the thoughts being expressed that people who supported voluntary euthanasia were exclusively non-Christian. I am very pleased that the group called Christians Supporting Choice for Voluntary Euthanasia has been established and again, like the members of SAVES, they are all volunteers and give of their time to this cause. I will quote to the chamber the self-description of that group, namely:

Christians who believe that, as a demonstration of love and compassion, those with a terminal or hopeless illness should have the option of a pain free, peaceful and dignified death with legal voluntary euthanasia.

I thank all who have contacted me about this legislation by mail and email, and a small number who have taken the trouble to contact me on the telephone.

The Hon. R.I. Lucas: The Hon. Mark Parnell gave them your telephone number.

The Hon. J.S.L. DAWKINS: I think they can find me. I must say that I sincerely respect all of the views put forward. I have some friends here tonight, not that far away, who do not share my views on this, but I trust that I hold their respect, as they do with me. By passing this bill we would not be imposing voluntary euthanasia on those who are opposed to it, but we would be giving everyone the choice. I support the bill.

The Hon. P. HOLLOWAY (Minister for Mineral Resources Development, Minister for Urban Development and Planning, Minister for Small Business) (00:10): I indicate briefly that I will not be supporting the bill, consistent with the view I have taken when this matter has been discussed on previous occasions. I say that notwithstanding the very good debate that has taken place tonight. I do not believe that I can add much to it from that particular perspective, given some of the very eloquent contributions that have been made.

Simply, I am a supporter of palliative care, even taken to a fairly extreme level; that is, a level which would lead to lack of consciousness and ultimately, of course, the death of the person who is being given the palliative care, or the earlier death than might otherwise be the case had the care not been given. Whereas I support that philosophy—the underlying philosophy in relation to palliative care, even taken to extreme levels— I think it is important that the underlying philosophy is the relief of pain and suffering. That is always the objective test and the underlying motivation.

I think the problem is that once you start to get into the area of voluntary euthanasia you are really working backwards. You are working from the outcome, which is death, and you then have to work backwards and set up a whole structure of tests, bureaucracy and the like by which that is measured. To me, that is where the problem essentially lies.

In fact, there is really not much difference, I think, between the views of most people here. No-one wants to see anyone suffer. Would there be a jury in this state that would ever convict any doctor where a person is suffering the final stage of an illness if they are administered pain killing drugs that led to death? Of course no jury will convict anyone for that occurrence. I believe that the underlying philosophy of the particular legislation is important because it does reflect community values.

A philosophy that is motivated by the relief of pain and suffering is important, it is honourable, it is decent. The problem is that when the legislation works backwards, when the death of the person becomes the principal focus and we work back to justify it, I believe that that does, inevitably, create some problems. It does affect society in how it thinks in relation to these things, even though, as I said, the outcome in the case of the administration of palliative care taken to the extreme is the same. I do not intend to take any more time of the council in relation to this subject other than to indicate that I will not be supporting the bill.

The Hon. A. BRESSINGTON (00:13): I also rise to speak to the Consent to Medical Treatment and Palliative Care (Voluntary Euthanasia) Amendment Bill. Since coming to this place I have learned quite a few lessons. I would like to, No. 1, put on the record, straight up, that I did not come into this place with a view on euthanasia, for or against. It was an issue that was out of my reality, if you like, prior to coming here. In fact, this has been a debate that I have dreaded having to be involved in since I have come in here.

I have tried very hard to avoid the moral argument, and also the emotive argument around this. I will put on record that I have been involved with two people who have gone through palliative care, who have had a palliative care order in place, and who have received the kind of treatment that the Hon. Paul Holloway just spoke of. I was present for their death and it was peaceful. It did not take days for that to occur; as a matter of fact, of both of them the longest was 24 hours. I have seen no proof that palliative care, as the Hon. Paul Holloway put it in the extreme, does not achieve the outcome of pain relief and assist people to pass in a peaceful way.

However, what I have based my decision on is the fact that the legislation that we pass in this place on such issues like this is social justice. I believe that every single one of us in here has a responsibility to backtrack and to look at what our record is like. I have to say that I have found nothing since I have been in here that I can hang my hat on to say that I have faith in a government (any government) that would be responsible for administering and enforcing this legislation or in the bureaucracies that underpin that government.

I have seen cases with WorkCover. The Hon. Mark Parnell and I were criticised heavily for running a filibuster against that particular piece of legislation where injured workers are now no longer the primary consideration of a corporation that was originally established to protect those injured workers; now it is bottom line.

The Housing Trust, a government department set up to provide affordable housing for working class people, is now nothing more than welfare housing. If you are not drug addicted, mentally ill, homeless or all three, you have no hope of getting a home with the Housing Trust any more. We talk about slippery slopes—there is one.

We have people living with disabilities and their carers who cannot get respite or the equipment that they need to look after their disabled loved ones. I have asked numerous questions in this place based on cases where parents are desperate to get a wheelchair or a lifting device so that they can give their child a bath. One not so far away was only seven years old. We have actually seen a situation in this state where a parent was driven to kill her own child because of the absolute stress and duress of having to try to cope with a system that simply does not seem to care.

We have child protection. I see day in, day out—and I am still hearing stories—where children are removed who should not be removed, where children are left who should not be left. We have a department that is highly dysfunctional and has been described as pervasive with a rotten culture. We have seen minister after minister come through this place who has been able to do nothing to rein in that culture, and I am not saying those ministers do not have the political will: my point here is that we seem to have great difficulty having ministers who can go to a CEO of a department and say, 'Get over here. Fix it and fix it now.' They can do it.

It is not all about funding. Why can't we in this place make sure that the Child Protection Act that we put forward is enforced to the letter of the law? We have social workers out there who are doing their own thing. What makes us think that setting up another layer of bureaucracy for this place to administer this particular bill is going to be any more effective than any I have just mentioned?

We also have foster carers—again, people of goodwill and good heart—who volunteer to look after our most vulnerable children who are treated like crap. The second that they ask for any support or services, their children are removed. Why? Because they dare ask for some sort of support for the children that they have volunteered to look after.

Not only are they expected to cover most of the costs of raising those children but they are also denied—absolutely denied—the support services that those children need to cope with the trauma that removed them from their families in the first place. I know that other members in this place have had to deal with the same kinds of complaints, so it is not just my office. This is not just my imagination: this happens.

Then, of course, we have the mentally ill. Well, we have seen how that particular system is working. Try ringing ASIS. Try getting them anywhere to do an assessment on a person who is at risk and who is going to be a risk to other people. Try getting action for them. No; they are doped up, put out on the street and left to cope for themselves, and meanwhile mental health beds diminish.

Of course, we have my pet issue, which is drug addicted people, where, again, we have just given up. We provide them with drug replacement therapy; we try anything and everything but assisting them to stop using drugs. The organisation that I founded 14 years ago now—Drug Beat—to this day has not had one referral from Drug and Alcohol Services—not one, not because what we do does not work but because we are not recognised, because we are abstinence based. This is just another indication to me that, really and truly, we have people in positions of decision making and policy enforcement who run their own agendas regardless of the legislation that we are passing here. That is what makes me so nervous about this particular piece of legislation.

I am not going to criticise the bill. I am not going to pull it apart and say that it is bad legislation. I am just saying that, as a society, we are not ready for this yet. I do not believe we are responsible enough. If we were responsible enough we would have ministers in their portfolios making sure that their CEOs and their bureaucrats were doing as they are required to do by legislation. It does not happen. That is purely the only basis for my rejection of this bill.

I promise that, as I said, if I start to see one department, one social justice issue that I can hang my hat on and say, 'You know what? We're actually improving this; we're actually trying to make this better; we're actually trying to meet the needs of our most vulnerable', my vote would swing. Maybe that is a challenge. If the left wants it badly enough, get onto your ministers and get some action, get some improvement in the systems that we have, and maybe in four years' time we can have this debate again and the vote will be different.

Again, I stress concerns about the review process. There is no review process. We can kid ourselves that we can have select committees; we can have the Ombudsman's office. It was only three weeks ago that I was advocating for a foster carer who had had a child in her care for six years, and again asked for support for that child, and within 24 hours that child was removed. We did a public interest disclosure statement, and we forwarded to it to the Ombudsman's office, and the Deputy Ombudsman read the complaint, saw my letterhead, and said to the advocate, 'If Ann Bressington is involved in this case, then we probably won't investigate.' That's the depth of our review process. I might be a pain in the butt to some, but if they are going to base their decision on whether or not to investigate, we should be very afraid—very afraid.

I do not believe that the review process for a euthanasia bill or for the enforcement or implementation of this legislation would be any more rigorous. I do not believe it would be any more effective and, as I said, I certainly have no faith in the processes that we have in place. Meanwhile, while we have our Attorney-General and our Premier saying that we have plenty of mechanisms in place to deal with corruption—we have Ombudsmen, commissioners, and God knows what—I have not had one favourable outcome for anyone who has made a complaint to a commissioner or to the Ombudsman's office. Sorry; I tell a lie: I had one, and it took 6½ years.

So, if we are going to really go down this path of voluntary euthanasia, that could quite easily slip into involuntary euthanasia. It has happened before. We cannot just say that it will not happen because this is Australia. We have to put those mechanisms in place to make sure that we can cope with the fact that some people may not do the bidding of this parliament. I do not believe that that would come as a surprise to anyone sitting here.

We also have issues with victims of abuse in state care. We have a government that is slipping and sliding and dodging and weaving, rather than paying these people the compensation they deserve. It is finding every loophole it can to avoid its responsibility to that group of people.

The Office of the Public Trustee has just finished an inquiry—not pretty stories at all. Most of all, we have a culture in this state—and I will be blunt—where we create villains out of victims. We have a blueprint whereby anybody who dares to make a complaint against a government department or a government department worker is quite easily labelled as unstable, belligerent, vexatious or inarticulate.

We are unwilling, as a parliament, to recognise that sometimes the people we should be listening to above our advisers are the victims, most of whom are not alone in terms of the complaints they are making, and doing so at great personal cost to themselves, knowing damn well that they are going to be targeted and persecuted even further. What are we doing in this place to fix that?

Whistleblowers are held in contempt and yet here we are, talking about voluntary euthanasia, with all these safeguards and all these review processes, when we cannot even get it right on systems that have been in place for 30 or 40 years, or more. Why would we do it differently for this? They are the only objections that I have to this, another bill, something else concerning which we can put another layer of crap onto the mess that we already have and create more and more problems for the people who become trapped in the system—as they will, because they become trapped in every other system. So what? We have another lot of problems to solve over the next 30 or 40 years; give us something to do! I am sorry, I think not.

The Hon. M. PARNELL (00:28): I would like to thank all honourable members who have spoken. I want to particularly thank those who have wrestled with their conscience to work out how we can best serve the people of this state. As other members have said, we have all been contacted by hundreds of people, and I thank those South Australians who took the trouble to ring and write and send emails.

We also had a large number of people on the steps of Parliament House today expressing their support for voluntary euthanasia. I particularly acknowledge the South Australian Voluntary Euthanasia Society (as other members have done) and also the group, Christians Supporting Choice for Voluntary Euthanasia.

This bill has been on the Notice Paper for nearly a year and it is now time for us to decide, one way or the other, whether we think it should become part of the law of our state. There have been a number of developments in the past year but I do not propose to go through all of them. I will mention a couple of points and then I want to very quickly address some of the arguments that have been raised, particularly by those who have indicated they have difficulty in supporting this bill.

Much has been said about the opinion poll. In fact, it is quite timely that it came out only yesterday, the latest Newspoll, conducted this month (October). Over 1,000 Australians were surveyed and the result, as has been mentioned before, is that 87 per cent of South Australians support voluntary euthanasia.

The reaction to that poll has been quite varied this evening. A number of members have challenged the fact that the people polled knew what question they were answering. Some people have been questioning the ability of citizens to understand a question asked of them and what it means, and some members have raised what I would call the 'So what?' question—'So what if 87 per cent of South Australians support voluntary euthanasia?' I want to address both of those quickly.

In terms of the actual question that was asked, the Hon. Bernard Finnigan accurately referred to it, but I will do so again. The question was simple: 'Thinking now about voluntary euthanasia, if a hopelessly ill patient experiencing unrelievable suffering with absolutely no chance of recovering asks for a lethal dose, should a doctor be allowed to provide a lethal dose or not?' It is a fairly straightforward question; it is not that nuanced. People always say, 'Well, you get the answer according to the question you ask.' I think that is a pretty simple question, and 87 per cent of South Australians say yes and 6 per cent of South Australians say no.

Perhaps the more important question to pose—and the Hon. Rob Lucas went into this, as did the Hon. Bernard Finnigan—would be: 'Should it be enough for us that 87 per cent of South Australians are asking to pass a law such as this?' I think the answer is no, it is not enough, but the question is: is it a relevant consideration? Absolutely it is, and it is particularly a relevant consideration if what we as elected members are doing is considering actively opposing what our constituents say they want. I think it needs to weigh heavily on us before we just summarily dismiss not just this opinion poll but the one before that, the one before that and the one before that. We have to be very careful to be saying to South Australians, 'We don't care what you want.' So, I think it is relevant, but it is not determinative. It is not the only thing we have to take into account.

I think the opinion poll is one bit of information. I like to bring things to this place that are fresh, and you cannot get much fresher than yesterday's London Times. A remarkable opinion piece by Dr Raymond Tallis appeared in the Times, under the heading 'Why I changed my mind on assisted dying'. In the first line, the article states:

As a doctor I used to think palliative care was the answer. Now I realise that keeping people alive can be unspeakably cruel.

The reason why I think Raymond Tallis's views stand out among the hundreds and thousands we have is that he was the chairman of the Committee on Ethical Issues in Medicine at the Royal College of Physicians. In that role, his committee twice considered bills put forward for voluntary euthanasia by Lord Joffe. Those bills proposed to legalise the choice of physician-assisted dying for mentally competent people with terminal illness who were suffering unbearably at the end of their life. He says in this article:

On the first occasion, we decided to oppose the Bill and on the second, because we were divided, we opted for neutrality.

The doctor's position now is as follows:

The case for such a Bill to me now seems clear. Unbearable suffering, prolonged by medical care, and inflicted on a dying patient who wishes to die, is unequivocally a bad thing. And respect for individual autonomy—the right to have one's choices supported by others, to determine one's own best interest, when one is of sound mind—is a sovereign principle. Nobody else's personal views should override this.

The rest of the article basically explains the process that this fairly influential person went through in determining originally that voluntary euthanasia was a bad thing to his current position where he says now that it is something that is deserving of support.

I do want to address some of the arguments that have been raised—some of the ones that were raised a fortnight or so ago by the Hon. Dennis Hood, plus some comments that people have made today. A lot of the debate by members who say they cannot support this bill has focused on the detail, the safeguards and how rigorous or otherwise they are. However, what fundamentally underlies many of these contributions is the fact that those members will oppose it anyway. It does not matter what changes are made, it does not matter whether we bring in an extra doctor, or two doctors, or three doctors. If people are fundamentally opposed to it that is fine; that is their right. However, I would like the opportunity to explore the detail in this bill, to work through the different safeguards we have, and to test how rigorous they are. I will come back later to a process that we might adopt in doing that.

The Hon. Dennis Hood's speech was particularly comprehensive, as was the Hon. Bernard Finnigan's, but I do not think those contributions actually did justice to the fact that people are presently dying in torturous and cruel circumstances, and that palliative care is unable to relieve the suffering. Some members have said that they do not believe that palliative care is not up to the task, and we have had other members—the Hon. Robert Brokenshire was one, for example—who said that if we allow voluntary euthanasia we are somehow giving up on palliative care and that as a society we will stop trying to make things better for people in their dying days. I do not accept that.

Palliative Care Australia, which is the nation's peak body, acknowledges that palliative care does not work for everyone. We all hope that the proportion for whom it does not work reduces over time, but let us not deny the fact that there are people suffering because they cannot get relief. Members would also be aware of the fairly recent court case where it was determined that a competent adult can elect to die by starving himself to death to end the suffering, but our law currently prevents that same person the means to a quick, peaceful and dignified death. Those who are denying law reform in this area are saying, effectively, that that is a satisfactory situation, that the law should not be changed to allow a person to have a peaceful death. I do not accept that, either.

A claim was made by the Hon. Dennis Hood that we have elderly Dutch people wearing tags around their neck saying 'Do not kill me.' That has been discredited as an anti-voluntary euthanasia stance. We have to ask ourselves: if things are so bad in Holland, why does its democratically elected government of 16 million people continue to permit the practice? The reason it does is that the Dutch people support voluntary euthanasia.

Much has been said in relation to people such as Dr Philip Nitschke and his practices. I need to make the point that his is not the approach of groups such as the South Australian Voluntary Euthanasia Society. It could be argued that the reason Dr Nitschke has such a large following is that we do not have the law reform that this bill seeks to introduce, and people do end up looking for self-help options. My bill takes a very different approach. It seeks to normalise, to bring into the medical system, the important decisions about the end of a person's life.

I have said it before but I will say it again: the two most important words in this debate are 'voluntary' and 'choice'. I will be looking very carefully through the Hansard, because it is interesting that the people who have spoken tonight in favour of the bill have all used the word 'voluntary' in abundance, while the people who have opposed the bill have rarely used the word 'voluntary' at all. They emphasise 'euthanasia'. For me, euthanasia is the situation that has been described with the dog; it is not the dog's choice. This is voluntary euthanasia; that is, an adult who is competent making a free will decision about the end of their life.

A lot has also been said tonight about the fact that people can be depressed and that depression can sometimes go undiagnosed. I have tried to structure this bill in such a way that, if there is any suspicion that a person is not acting with free will, that their mental state (such as with depression) is such that they are not exercising free will, and that they can be treated—because a lot of mental illnesses can be satisfactorily treated—we would involve a psychiatrist in the process.

Let's not be unrealistic. Are people who are suffering the terrible conditions that have been described likely to be depressed as well? Too right they are—they are likely to be depressed. The question for us is: is their request for voluntary euthanasia being driven by their suffering or by their depression? If it is being driven by their depression, let's treat it and help them to get over any mental illness they have. Let's not deny them that right just because they are suffering terribly and also happen to be depressed because of that situation—they are likely to die very soon in terrible circumstances.

The main problem I have with many of the contributions is that people are happy to pull apart the detail and say, 'Well, that's got loopholes and that's not well enough drafted,' but few people have suggested an alternative to the problem, other than the status quo, and the status quo is unsatisfactory because of the suffering that results. I want briefly to go through some specific comments people have made this evening.

The Hon. Bernard Finnigan urged us to be dispassionate and, to a certain extent, I can accept what he says. There is head and heart in a debate such as this. I consulted both the head and the heart, and I found that this is a good public policy response. It is not just about raw emotion getting in the way, but neither are we robots or people who simply legislate for certainty, making every definition watertight.

We have to acknowledge that we live in an imperfect world, and we are doing our best to impose a system that creates the opportunity for people to live they best life they can and, in this case, when the suffering becomes intolerable, to die the best way they can. The Hon. Bernard Finnigan said that one inappropriate death is one death too many, and we can all agree with that. We all say that one death on our roads is one death too many and that one suicide is one suicide too many, but let's be realistic about what it is we are trying to achieve. We are trying to put in place a package of measures that helps people who are asking for help to end their life with dignity.

The Hon. Bernard Finnigan complained about the board to be set up under this bill. He said that one of the reasons it was flawed was that it was too slow. To be fair, the honourable member does not want it to work any faster; he does not want it to work at all. So, some of the criticisms of the minutiae are really detail that is overridden by the fact that many members, for their own reasons, do not want any law reform at all; no model is unacceptable.

That is fine, and I can accept that if that is people's view but, if not, let's explore what safeguards might be better than those I have put in place. I think they are adequate, but I am more than happy to talk to members, as I have done already in relation to the few amendments I have on file, and I will come back to those later.

As to the contribution of the Hon. Stephen Wade, I am always impressed by his dedication to his shadow portfolio, particularly in relation to people with disabilities. However, again, the tests he proposed that would make the bill acceptable to him would, in fact, make it unworkable. They would not work, and I do not think that that is necessarily a constructive way to approach this debate.

The honourable member spent a lot of time talking about people with disabilities. If more members had come out onto the steps of parliament this afternoon, they would have heard the contribution from Dr Paul Collier, who, as many of us here remember, ran in the last election on the Dignity for the Disabled ticket to become a member of this place. In fact, if I heard him correctly, it he intends to run again for the Legislative Council—someone who is a passionate advocate for the rights of people with disabilities.

His message to us is that it is not up to us—people who might not have disabilities—to tell anyone what they cannot have or to be somehow paternalistic about it. It would be a terrible situation if we said, for example, 'Well, voluntary euthanasia is okay provided you are not disabled because we need to look after you people better.' I do not think that is the approach. It is not what Dr Paul Collier was asking for. We need to have a system which applies to everyone and which treats everyone with dignity and as an individual.

The Hon. Robert Lawson's contribution I have summarised as the existing law is good enough, and I do not think that it is. As an eminent lawyer, he was critical of terms that he thought were emotionally charged, such as the term 'intolerable suffering', and bemoaned that there were not stringent definitions for terms such as that. The difficulty of course, as I said, is that we are not robots and certainly we are not legal robots. The legal system looks for as much certainty as it can, but the system within which we are working is an imperfect one. It is based on humanity and we do not have pain meters. We do not have any way of judging whether someone's suffering is intolerable other than that person's own perspective on their condition. Every case will be different.

The Hon. Robert Lawson said that he was not satisfied that the steps that I had put into this legislation were real protections. I think he used the words that they were hoops to jump through. That is one of the great dilemmas, and I will come shortly to what the Hon. Ann Bressington said. One of the dilemmas that we have got is that we want safeguards, but we do not simply want to put obstacles in the way of people so that they cannot ever use it. We have got to get the balance right. The Hon. Robert Lawson also posed the question about whether what we are trying to achieve here is to relieve the suffering of those who are left behind or are we really interested in the suffering of individuals?

I think that he has come to that view because many of the stories that people have told have been about family members or loved ones, but my experience, in terms of the representations that have been made to me, is that the people who are calling for voluntary euthanasia are saying that they do not want to go through what their mother went through or their father went through, or whatever. People are personalising it. They are seeing it as a right that they want to have for themselves, and they base that experience on what they saw their loved ones going through.

I have not had anyone write to me saying, 'I would have liked to have put down grandmother against her will.' That is not what voluntary euthanasia is about at all. As I mentioned before, in his contribution the Hon. Rob Brokenshire seemed to think that, if we embraced voluntary euthanasia, somehow that would stop innovation in relation to palliative care. The counter to that argument is that the state of Oregon which has voluntary euthanasia has the best palliative care in the United States. I think that we must be careful with attitudes such as that (that would somehow be admitting defeat), because it does deny the inherent good nature of people in this generation and the next who will continue to work to make life better for us all.

The honourable member also said that the police have better things to do than prosecute those who might be suspected of having exercised undue influence. He also went on to say that the penalties were too low. Well, we cannot have it both ways. If you are going to have a system where you want to stop people putting undue influence on those who might want to exercise their voluntary euthanasia rights, you must have penalties and you must have the ability for the police to prosecute those people.

The Hon. Robert Brokenshire acknowledged that I had tabled some amendments. He made the point that they had been tabled fairly recently, and I think he jumped to the conclusion that I was fixing up major flaws in the bill and that there were unintended consequences that needed to be remedied. That is not the case. The amendments I have tabled have been as a result of my discussions with individual members of this chamber, and the amendments fall into two categories. The first one is that it was pointed out to me that maybe the doctor who has agreed to accept a request by a patient for voluntary euthanasia is not an expert in that particular illness, so, I have incorporated an amendment to put that extra doctor into the equation—that you do have to then go to a specialist and you do have to get that specialist to report on your diagnosis, your prognosis and the options that are available to you. That is a sensible amendment. It was not anything to do with unintended consequences but, rather, to make sure that the best information possible was available to the person to exercise their choice.

The other amendment is in relation to this issue of possible coercion. It is one thing to make it a criminal offence and it is another thing to make a medical practitioner certify that they do not believe that a person is acting under coercion—that they are in fact exercising their own free will—but I have strengthened it by making it a positive obligation to make reasonable inquiries as to whether the person is acting of their own free will or under coercion.

If members have other amendments which they want to put to me and which would provide genuine improvement in this legislation, then I am happy to discuss them. If the bill passes the second reading stage tonight, we will have an opportunity over the next two weeks to make further improvements to this bill.

I note that the Hon. Ann Bressington in her contribution threw out some challenges, in particular in relation to the role of the government appointed board that I have incorporated into this bill. I accept the concerns she has expressed about various elements of government; and she went through a lot of those tonight. I share many of those concerns. Lots of things go wrong when government is involved, but I would like the opportunity to explore whether that system of a government committee is the best one or whether there is another way around it. If the bill were to pass the second reading stage tonight, we could do the committee stage in two weeks in order to explore those possibilities.

I ask all members not only to consider and judge this bill on the basis of your own view—although that is important—but also to consider whether or not you are prepared to deny it to the majority of South Australians who have asked us to seriously consider and pass law reform in this area, regardless of whether you yourself can ever envisage using this law; whether it is reasonable for you to condemn others to suffering and torment they do not want and for which there is a solution. The right to end a life of intolerable suffering is a basic fundamental human right we all should respect. Through this bill we can show compassion and, indeed, love for those who have called out to us for help.

The council divided on the second reading:

Second reading thus carried.