CONSENT TO MEDICAL TREATMENT AND PALLIATIVE CARE (TERMINATION OF PREGNANCY) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 27 October 2010.)

The Hon. I.K. HUNTER (16:11): I rise to oppose this bill—a bill I consider to be offensive, condescending and, at best, insincere. As the Hon. Dennis Hood first outlined in this place on 27 October 2010, this bill would require a pamphlet be given to every woman seeking a termination outlining so-called alternatives for their consideration. On the face of it, you could argue that that is an innocuous enough measure, and you could also think that it does not go much further than we already do. But do not be fooled. I say to honourable members: do not be fooled. It is part of a strategy that has been used here in Australia and around the world, and I will come to it presently.

It is important to understand the background on this issue if we are to understand the motivation behind this sort of legislation. In 2007, the Australian Election Study found that 57 per cent of Australians support the right of women to have an abortion 'readily when they want one', while another one third support abortion in 'special circumstances'. Only 4 per cent of respondents opposed abortion under any circumstances. Most recently, the Medical Journal of Australia published a study in July 2010 that found a clear majority of Australians believe that abortion should be 'lawful without question' in a woman's first trimester and 'lawful depending on her circumstances' in the second trimester.

The bill before us today once again highlights Family First's paternalistic and patronising approach to women's rights. Family First has a history of attempting to chip away at women's rights to control their own fertility, body and health. Most recently in South Australia, the Hon. Robert Brokenshire's Consent to Medical Treatment and Palliative Care (Parental Consent) Amendment Bill was one such attempt, a sneaky bid to stop teenagers accessing safe, medically supervised abortions.

I note that this particular bill was singled out for praise by the Australian Conservative website in its review of SA Family First's achievements in 2010, such as they are. This same website, Australian Conservative, recently ran an article praising this current bill, with the headline 'Family First bill aims to wind back abortion in South Australia.' Let me repeat that, as it is important in understanding how Family First narrowcasts its messages: 'Family First bill aims to wind back abortion in South Australia.'

I would also like to draw the council's attention to a recommended link found on SA Family First's own website. I believe this recommended link reveals something of Family First's motives and campaign tactics for this debate. The Family First website recommends a link to another website called Human Rights for Unborn Children. It states:

Human Rights for Unborn Children is a grassroots advocacy group, made up of everyday Australians, campaigning to protect the rights of unborn children. In a society where there are more rights for animals, trees and the environment than for unborn children, we know it's time to make a stand.

The contact details for this group simply list a postal box address in Clare, South Australia.

The Hon. A. Bressington: How terrible.

The Hon. I.K. HUNTER: The Human Rights for Unborn Children's website suggests, the Hon. Ms Bressington, and I quote, that 'women often choose abortion because they view adoption as a fate worse than abortion'. The website calls on people 'to take a stand against abortion after rape or incest without apology', and I repeat 'to take a stand against abortion after rape or incest'. The website goes on in quite graphic detail, and honourable members can check out the rest of the website if they dare.

It would be understandable if the ordinary person assumed that Family First held similar views to those highlighted on the Human Rights for Unborn Children website. After all, it is a recommended link on the Family First website. As we know, most Australians do not subscribe to Family First's patronising and paternalistic ideology. The majority of ordinary Australians support a women's right to control her own fertility, and that includes access to contraception and abortion. While a woman seeking an abortion should be offered counselling, that counselling should be non-directive, non-compulsory and non judgemental.

Family First's bill implies that women who seek an abortion have not considered all the options available to them, that they need to be walked through their personal decision-making processes. This suggestion is utterly offensive and ultimately unhelpful in reducing the number of abortions that take place, which is after all the stated aim of this bill. If Family First were really sincere about wanting to reduce the number of abortions taking place, then they would stop the guilt trips and concentrate on initiatives that have been proven to reduce abortion rates around the world: better sexual education and better access to contraception.

Family First need to understand that abortion rates for individual countries do not reflect just the sexual behaviour of people; rather they reveal the level of comprehensive sex education and effective contraception available to citizens. It is no coincidence that those nations that do provide comprehensive sex education and effective contraception to their citizens are the countries with the lowest abortion rates. That is why US teenagers have higher pregnancy rates—birth rates and abortion rates—than adolescents in other developed countries.

So let us be clear: this notion of requiring directed information to women who seek an abortion is simply a thinly veiled attempt at shaming women. Increased access to sex education and contraception are the proven tools that we should be using to address this issue. So, the question needs to be asked: why aren't Family First demanding these initiatives? Anti-abortion campaigners, conservatives and Family First members are smart enough to recognise that abortion is so widely accepted in Australia that simply declaring their complete opposition is politically ineffective. So they try to make the process of getting abortion more and more restrictive, by introducing legal restrictions, such as compulsory counselling, for example.

I note that the tactics being used by Family First are similar to those used by conservatives both interstate and overseas. I will take a brief moment to reflect on recent comments made by the Reverend Fred Nile, leader of the Christian Democratic Party and member of the New South Wales Legislative Council. The Hon. John Gazzola groans, but bear with me. I believe that Reverend Nile's comments echo the tactics being used here by Family First with this bill. Following the recent state elections in New South Wales, Mr Nile confirmed to the Daily Telegraph that he would raise abortion in parliament as a priority. He said:

I would like it to be banned, but that is like raising a red flag to a bull. I would like to see abortion laws refined so either women will be shown an ultrasound of their foetus before the procedure, as they do in some parts of America, or they have to see a councillor once they make the decision.

Very familiar sounding tactics. It is no coincidence that they should be familiar. These are exactly the same tactics currently being used by conservatives, republicans and tea party enthusiasts in the United States, with a spate of state and federal legislation currently being debated, all designed to complicate the abortion process and restrict women's access to health services.

I note that similar legislation—similar in spirit—to this Family First bill has recently been introduced in about 16 American states. Just this week in North Carolina members of their state house voted to override Governor Perdue's veto of the Abortion—Woman's Right to Know Act, which requires a doctor—I say again, 'requires a doctor'—to give a woman an ultrasound prior to an abortion procedure and to describe her foetus in detail, including the size of organs and limbs, whether she wants to hear it or not. The act dictates that if a woman refuses to view the ultrasound images or listen to the foetal heartbeat, the doctor must record and keep her name on file for seven years. That is what legislation in the US is attempting to do.

The bill also stipulates that the woman has to wait 24 hours before having an abortion, which forces her to make multiple trips to a clinic. The act also requires the physician to hand the patient a document—sound familiar—that says that she is terminating the life of a separate, unique human being. When Governor Perdue vetoed the bill on 27 June, she said physicians must be free to advise and treat their patients based on their medical knowledge and expertise and not have their advice overridden by elected officials seeking to impose their own ideological agenda on others. Her criticism can be directly levelled at this Family First bill. This is the road down which conservative politics is travelling, and this is the path Family First would ideally have us take here in South Australia.

Family First members are fond of using the slippery slope argument when opposing progressive legislation. Well, here is their slippery slope. First, you require the doctor to give a woman a leaflet and next you require the doctor to give her an ultrasound of her foetus. Start with forcing doctors to show women maybe ultrasounds, photographs, pulses, heartbeats—where will it end? That is their slippery slope.

I recently had the opportunity to see some of the Congress debate on an anti-abortion bill and was struck by comments made by representative Bruce Braley from Iowa. Representative Braley opposed their bill, stating, 'If you remember only one thing about this bill, remember this: it is a solution in search of a problem.' He goes on to say:

Don't be fooled by this bill...The debate is about whether politicians sitting in Congress—

or the Legislative Council—

should dictate the personal, private medical decisions of the American people. It aims to impose intrusive government rules on personal medical decisions. The bill's supporters don't want abortion, any abortion, to be legal in the United States, and so they are adding as many bureaucratic rules as they can come up with...And that is why I ask my colleagues to reject this bill.

Let me be clear: these sorts of political tactics are not pro-life, they are anti-women. They want to control women's choices in the mistaken belief that they know best. Any legislation that aims to exert ideological influence over a woman's reproductive choices is attempting to control her choices, and it is not about informing her and trusting her to make her own decisions. This bill is a thinly veiled attack on a woman's right to make her own decisions, and for that reason I strongly oppose this bill.

The Hon. J.M.A. LENSINK (16:21): I rise to indicate some personal remarks in relation to my views on this particular piece of legislation. I advise the Legislative Council that this is a conscience vote for Liberal members. We are a broad church and we represent a range of views, and I will put my personal views, therefore, which is no reflection on what any of my Liberal colleagues may believe.

I note from the honourable mover of this particular bill that it proposes that information be provided to women who are seeking an abortion with a view to providing them with alternative options of adoption and foster care. As might be expected of a member of Family First—and I would be, quite frankly, surprised if they were not pro-life—he makes that case quite straightforwardly. He says he is in the pro-life camp and that other members may be in the so-called pro-choice camp. He then makes a comment that 'Few people will ever change their mind on the rights and wrongs of abortion.'

I am one person who has changed their view on this particular issue. As a young person growing up in a conservative Catholic household, I thought abortion was wrong always. However, this ignores the reality of the situation that many women find themselves in. I think most of us would prefer that abortion was a last resort, but it is part of a very important range of options so that women are the people who have the ultimate choice over whether they should have children or not.

What I find disappointing in the honourable mover's remarks is the complete absence of any discussion about family planning and contraception, and I trust that he is not intending to wind that back. The preceding speaker talked about this being a slippery slope. I hope that in his summing up remarks he confirms that that is not to be wound back. There is a very important role for good education and sexual health services, which would mitigate the number of so-called 'unwanted pregnancies'. I think that term should be 'unintended pregnancies'.

A woman's control over her reproduction was described by the late, great Dr David Tonkin. He described the pill in the 1950s and 1960s as the final leveller. As he was speaking to the predecessor to our equal opportunity legislation, or the bill that he introduced, which was the first in any jurisdiction in Australia, he said:

The biological restrictions on women's activities have been largely overcome with the development of family planning techniques. One might say the pill has proved to be the final leveller.

I think that is very important. We can take that for granted in our Western country which has had access to good quality family planning and to safe abortion clinics for some time. I do believe that is supported by the vast majority of Australians.

I would encourage people to google an organisation called The Girl Effect, which looks at the situation in developing nations. It is recognised by the United Nations and other organisations that study these things that, if we can provide young women and girls with control over contraception and family planning, it will lead to much less poverty in those nations. As women and girls are provided with an education, they are able to contribute to economic prosperity, whether in a developed nation or a developing nation. In this website it is looking at the latter and how that drives down poverty in those nations. Otherwise, quite frankly, without access to those services, women and girls would live a life of abject poverty.

The provision of information may, on the face of it, appear to be harmless. Without thinking through all the implications of this particular bill, one may reach that conclusion. Quite frankly—and I am not putting it in the same terms as the previous speaker—this is dog whistling. This is all about abortion and what this chamber thinks about abortion. I am concerned that there may be further attempts which are an attack on the battles that have been won in the past on behalf of women to, ultimately, make sure that they have control over their fertility, family planning and contraception, etc.

In pondering this issue, I tried to think of other areas which could be broadly described as being in the health sector where we prescribe what sort of information is provided to clients. I did not come up with many. One that I did think of, because it has been a particular debate that I—

The Hon. A. Bressington interjecting:

The Hon. J.M.A. LENSINK: Well, informed consent in that respect. One that we did look at in quite a lot of detail in the lead-up to the 2006 election was in relation to autopsies. In that case we had a situation where pathologists were performing procedures on the bodies of loved ones and so forth and the families had no idea. There was a complete lack of transparency (in many cases those family members were completely unaware), and it was that lack of transparency and breach of trust which led us to try to prescribe—unsuccessfully, I might add; it has been an ongoing battle that I have been having on behalf of certain families, but I will not get distracted into that particular area.

It highlights that in that situation we have vulnerable families who deserve to have access to information and not to be kept in the dark. However, I am wondering, in this instance, as the preceding speaker said, what is the issue that we are seeking to correct? Is the mover of the motion suggesting that general practitioners or medicos are deliberately withholding information from their patients? Are they not telling them what the options are—particularly because every doctor has to take the Hippocratic oath: 'First, do no harm.' I do think that in some ways this bill is a reflection on the entire medical profession.

There is a lot of reference to teens, and I would like to quote one of the comments made in the mover's speech. He says:

Many abortions, it seems, are due to women being pushed into the process by someone, whether it be a partner or some sort of conveyor-belt type mentality in some institutions, or simply a lack of knowledge of the alternatives.

That, and many other things, are quoted. I would appreciate some sort of reference because I think that information would be challenged. As I said, there is a lot of reference to teens. Young people are certainly the most technological generation, which is to be expected, yet this bill implies that women do not know how to access this information themselves. Indeed, to me, it implies that women are somewhat illiterate, they are intimidated or they need a nudge to do the right thing. That offends me and I will not be supporting this bill.

The Hon. P. HOLLOWAY (16:30): I rise to put the government's position on this particular bill. Perhaps I could firstly say that, of course, in relation to the subject of abortion, generally the ALP has had a long-held view that it is a conscience issue for members. However, in relation to administrative matters—which, essentially, is what this bill is about—of course, the party does take positions on it. In this particular case, I can indicate that the government will be opposing this bill, essentially because it unnecessarily legislates what largely occurs in any case.

The Consent to Medical Treatment and Palliative Care (Termination of Pregnancy) Amendment Bill 2010 proposes that, before any treatment for the termination of a pregnancy, the medical practitioner must ensure that the patient has been given a pamphlet which contains information with respect to the option of having the baby adopted, including general information about the processes involved, and information with respect to the option of having a baby placed in foster care.

Ninety-three per cent of terminations occur in metropolitan public hospitals. The source I use for that is the Pregnancy Outcome in South Australia 2008 Annual Report. Information provided by these hospitals and other relevant public health services via pamphlets and websites, include information about the options available, including continuing the pregnancy and becoming a parent and continuing the pregnancy and placing the baby for adoption or alternative care, that is, foster care. A number of resources are made available, including links to pregnancy and parenting organisations, including the Adoption and Family Information Service, and the Pregnancy Advisory Centre publishes a Continuing Pregnancy resource.

The doctor-patient relationship is at the heart of the Criminal Law Consolidation Act 1935 which, of course, is the relevant section in relation to termination of pregnancy. The patient confides to two medical practitioners who are able to determine the woman's circumstances and make a professional judgement.

In addition to the current requirement to see two medical practitioners who can offer counselling, a range of counselling services are available, including the South Australian Pregnancy Advisory Service, public hospitals undertaking the terminations, the 24-hour National Pregnancy Counselling Hotline and SHine SA. Support After Fetal Diagnosis of Abnormality (SAFDA) provides support for people before and after the termination of pregnancy, following the diagnosis of an abnormality. SANDS SA (the Sudden and Neonatal Death Support) offers support to people who have suffered the death of a baby anytime from conception through to after birth. This includes miscarriage, neonatal death, stillbirth, ectopic pregnancy and genetic/medically advised termination. Finally, counsellors in private practice also provide those services.

As indicated above, a range of counselling services that include the information as proposed under this amendment is already provided by the metropolitan public hospitals, where the majority of the terminations of pregnancy occur. So, for these reasons, the government opposes this bill.

The Hon. K.L. VINCENT (16:33): Given that it would seem this debate is going ahead today, I wish to place my position on the record. If nothing else, I feel that this bill serves as a good reminder to us that sometimes issues that seem simple at first can actually turn out to be the most complex.

The general concept of this bill, that is, informing individuals and couples of their options when it comes to pregnancy, is something that I do support, but I must say that I am concerned that the way this bill is structured might mean that the information given out could be more hindrance than help. I am not, and I do not believe that anyone is, pro-abortion, but I make no secret of the fact that I am pro-choice on the issue of abortion, and it is in this context that I raise my concern about this bill.

The Hon. Mr Hood stated, when introducing this bill, that he believed that there is 'no such thing as an unwanted pregnancy'. I believe what he meant was that there is always someone out there, be they a foster or adoptive parent, who is ready and willing to take care of the child. This may well be true. I do hope so. However, whilst I would not dare to insinuate that the Hon. Mr Hood is lacking in biological knowledge by any means, I would make the point that a child and the pregnancy from which that child results, though intertwined, are two separate things—two separate experiences, if you will.

Pregnancy, as I am sure we are all aware, is one of the most life-changing and all-consuming experiences a person, a couple or a family can go through, and much of the time this is a wondrous thing. However, there are also many circumstances which may mean that a pregnancy is not going to be embraced and enjoyed by the woman and others involved: instances, for example, where the pregnancy is the result of rape; instances where the mother is very young or where carrying out the pregnancy is almost certain to put the health or even the life of the mother in serious jeopardy; or, less extreme but still relevant, an instance where the woman simply does not want to be pregnant and finds the change in and disruption to her body burdensome and terrifying, rather than enjoyable.

I am fortunate in that I have not been in any of these situations, so I would not dare to speak for these women who have, but I do suspect that it would be asking a lot of them, to say the least, to expect them to go through what could be potentially lifelong physical or mental anguish for the good of someone else getting a baby out of it. Indeed, some women and families do choose to do this, and I applaud their bravery, but at the end of the day this is far too complex and subjective an experience for it not to be up to the individuals involved. For these reasons, I disagree with the Hon. Mr Hood's assumption that no pregnancy is unwanted, and it concerns me that his intention for this legislation is built on that foundation.

I have further concerns about this bill in that, while I believe that distribution of honest, impartial and informative pamphlets about pregnancy options is a good idea, I do not believe that this bill sets out how this distribution must be done in enough detail to ensure that a woman will not feel pressured about her choices. The bill states that a woman must be given the information about options 'at the time of personal examination by the medical practitioner who will be performing the termination'.

Clearly, this implies that the information will be distributed once the woman has already decided to have an abortion. I entirely object to this, as I think a woman who has already made the decision to have an abortion might feel that her doctor thinks she is doing the wrong thing if said doctor begins informing her of her options at this late stage. This worry of mine is further compounded by the fact that this bill does not specify that abortion must also be listed as an option in the pamphlet, so it is hardly putting all the choices on an equal footing.

If the proposed information could somehow be distributed at an earlier stage in the process of decision-making, I would be much more inclined to consider this bill. I understand that there have been conversations around that issue, and I look forward to seeing the results of them but, as the bill stands, it is far too vague and under-detailed to reassure me that there is no possibility that it could be used to intimidate or shame a woman out of having a termination. I will never use my vote to support a measure that could lead to such an appalling curtailing of choice.

Indeed, I would suggest that if the Hon. Mr Hood wants my help in lowering the number of abortions performed in South Australia, he should introduce legislation that addresses the reason for most abortions. Most abortions, I would argue, are a result of unwanted pregnancies. If the Hon. Mr Hood can reconcile himself to the existence of such pregnancies, then maybe we could work together on implementing a more thorough and effective safe sex education program throughout the community. That way the people who do not want to get pregnant will know how to avoid it, and they will not need to even consider the option of abortion.

To me, that would be an effective and ethical way of lowering the abortion rate, but somehow I unfortunately suspect that the Hon. Mr Hood might not be interested in supporting this method, just as I am not interested in supporting his, as a woman, as a person and as a human rights activist.

Debate adjourned on motion of Hon. B.V. Finnigan.