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House of Assembly - Fifty-Fourth Parliament, Second Session (54-2)
2021-02-16 Daily Xml
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Bills

Termination of Pregnancy Bill

Second Reading

Debate resumed.

Mr MURRAY (Davenport) (19:53): Can I start by endorsing all the comments made by the previous speaker, the member for West Torrens. I would like to congratulate him on his capacity to relay very deeply personal stories in a way in which I am still unable to so many years later, with the birth of my daughter who was premature and who suffered by having only my company for a considerable number of days until her mother was able to see her.

This bill has been the subject of much discussion in my community, the vast majority of which has been opposed to it, in particular to the late-term part thereof. As a result, and I guess in keeping with the way in which I intend to do business or do things, I have had an opportunity to engage in quite forthright conversation with many people, part of which has entailed the provision by me of a written statement to anyone who has expressed to me a view on this subject.

I will now read that statement into Hansard. It is dated 20 October. I am providing this for reasons of clarity, transparency and commitment to, as I said, anyone who has expressed a view. It is headed 'Statement regarding the Termination of Pregnancy Bill':

I have received many emails regarding this Bill, most of them advocating for the way I should vote on it.

As a result, I want to take the opportunity to unequivocally set out my opinion, so that everyone can in turn be in no doubt about where I stand.

Much of the public comment and indeed one of the major reasons posited for the necessity for this Bill is the 'Decriminalisation' of abortion, and instead having it as part of the Health Law and practice. Other reasons include the need to update the legislation in line with contemporary practices such as telemedicine, and the need to redress access inequality, especially for women from regional areas.

I have no problems either with these stated aims, or with the way in which this bill addresses them.

The Bill is largely based on a report prepared by the South Australian Law Reform Institute (SALRI).

The SALRI report recommendations are not only devoid of any moral and ethical framework, but as a consequence they are deliberately calculated to treat the foetus as an abstract thing, without any consideration of its viability or potential, let alone its nascent rights.

SALRI explicitly recommend unfettered abortion no matter what age the foetus is.

The Bill embraces this 'abortion to birth' SALRI recommendation, albeit with a minor modification that after 23 weeks gestation two doctors must agree to the abortion. That is, 23 weeks and below there are now no restraints, and above 23 weeks there will be the same controls/pre-requisites in place as is currently the case, all the way through until birth.

At 23 weeks a foetus is considered 'viable' with contemporary medical care. That is, it can live and survive by itself, from about the 23-week gestation age.

I am opposed to the abortion of any foetus in excess of 23 weeks gestation. I don't consider the 'approval' of two doctors in the Bill as any more of a safeguard than the current situation, which requires the same two-doctor approval process.

As a consequence of the 'abortion to birth' provision in the Bill, I will vote against it. If this provision is removed, and as a result a foetus over 23 weeks is protected, then I would support the Bill as an improvement over the current regime.

I trust this helps explain my position and in particular my rationale in arriving at it.

Please feel free to contact me if you have any questions, concerns or comments.

The practical problem I have with this bill, by way of reinforcing some of the points made by the member for West Torrens, is that what should have been a straightforward series of measures has been turned into something that, in my view, no normal person can support. The current abortion law is not, I would submit, broken, but I would concur that at the age of 50-plus years it needs a bit of a touch-up. Don't we all at that age?

It is worthwhile considering, just by way of context, that the law was made back when we made cars, TVs, fridges and washing machines. We had an oil refinery here, and we had cheap, plentiful and reliable power. We called mothers and babies just that. I note that mothers have now become 'persons' and the child or baby reference in the current act has been completely overlooked in the bill. More particularly, we had no internet and we had no ultrasound.

Back then, there was no need at all to ban abortions being done because the baby was a girl, for example, or the gender was wrong, because they usually did not know what the sex of the baby was beforehand. These days, of course, we know the baby's gender via, for example, ultrasound, and this in turn opens up the possibility of babies—or foetuses, if you prefer—being aborted because of their gender. The proponents of this bill have so far successfully voted against a ban on abortions being performed for reasons of a baby's gender. These measures are in place in many other countries where baby girls can be vulnerable, and I posit the question: why can that not be the case here?

Further questions include: why do we need to force doctors to provide written referrals against their will to other doctors for someone seeking an abortion, when the need to do so has long since been obviated by the introduction of the internet? I would invite anyone who is interested to google 'Adelaide abortion'. You can get all the information you need to access abortion services, make bookings, etc. There is no practical need for another doctor who does not wish to be involved to do so.

The other question I have is: why are we arbitrarily removing and replacing the notion of viability as the basis or the underpinning of the way in which we govern abortion? Why do proponents of the late-term parts of this bill have difficulty understanding the deep scepticism people have about relying exclusively on members of the medical profession and their judgement in this matter?

Many normal people and so-called normal MPs, me included, support the need for the existing abortion arrangements and the need to update those arrangements to decriminalise abortion and to streamline its delivery and administration. However, we do not support extremist hardcore measures such as allowing abortion because of a baby's sex or aborting a perfectly healthy baby anywhere up to five minutes before it is due to be born.

In closing and to be clear, I support many of the stated aims of the bill, including decriminalising abortion, addressing inequality of access for regional women and implementing telehealth measures. I will be supporting amendments to remove the extreme measures with an object, if they are passed, to passing those remaining parts of the bill.

Mr PICTON (Kaurna) (20:01): As with all pieces of legislation, I listened to the community I was elected to serve and represent and considered the detail of the legislation before us. I thank the many people who have contacted me to share their views on this legislation. I have read and listened to everyone who has made contact and tried as best as I can to understand their point of view. This is an issue where people with intelligence, people with love in their heart, can come to starkly different positions.

Clearly, on an issue like this there is not going to be a way of pleasing everybody. I know, for instance, that I will have a difference of opinion on this legislation with many of my good friends, including in this parliament. I acknowledge that the member for West Torrens has agreed to pair with me for the second reading debate as I have to go and help with a family illness later, which highlights how different people can come to different conclusions.

As always, I strive to come to the conclusion that I believe in my heart is the best outcome for our state. As per other conscience issues, I do not feel that I automatically fit into one camp or the other, but I take the issue at hand, listen to the community, examine the legislation, look at the amendments, apply principles and try to seek the best outcome. I do acknowledge when it comes to an issue like this that particularly involves the health of women that, as a man, there are certainly things I will never experience. That is not to say that men cannot have a view—and certainly in this parliament—but I do think very clearly about the different experience women have in life.

When I walk through a park at night, I generally feel safe and that there is no risk to my safety. In my workplace or in the community, I am not discriminated against on the basis of my gender. I have never been a schoolchild who felt uncomfortable or missed participation because of the natural part of life of having a period. Likewise, I will never give birth, I will never breastfeed and I will never conceive, and I will never be faced with the difficult choice of an unwanted pregnancy.

I do know what it is like to be an expectant dad, to be nervous about scans. I know what it is like to support a woman. These are very important, but they are obviously different from experiencing many of those things that a woman experiences directly. But it is my job as a member of parliament to empathise and try to understand what these women face in these difficult situations. These are clearly women who are facing difficult situations, and I have faith in our fellow human beings to know that these decisions are not taken lightly or flippantly, as some of the commentary has seemed to suggest in the public debate.

There are a number of principles that I have taken in considering this legislation: the importance of women's access to health care, the difficult circumstances that some women face and our need to allow women to make decisions about their own bodies, and the high standards and professionalism of our doctors and other healthcare practitioners. I have determined based on these principles that abortion should be safe, should be legal and should be accessible for those who need it, and therefore it should be removed from the criminal law. Let's be clear that the evidence around the world is that making abortion illegal, as some of the people who have contacted me I think very clearly would like to do, does not stop abortion but just makes abortion practised unsafely.

As I said, I have read all the material, the letters, the emails, the petitions and more that I have been sent. I have spoken to people who are concerned about certain aspects, some of which they have heard from the campaign material and some of which, from my research and my understanding, I do not believe is necessarily borne out by the bill before us: firstly, the argument that this is an extreme law. Of course, we are one of the last places in the country to enact that law. This is legislation that in fact, in a number of ways, is more conservative than what is in place in other states around the country.

Many people I have spoken to are surprised by those facts, having been told we were going out on a limb here in South Australia, supposedly supporting extreme legislation. They are surprised to know that similar or even further laws are in place in other states, such as New South Wales, Victoria and Queensland. From the evidence before me, I do not believe we have seen in those states the kinds of problems that are being predicted to happen here.

Secondly, there are arguments that this legislation allows on-demand abortion until birth. From what I have seen that is simply incorrect. The legislation very clearly states that two doctors must deem a late-term termination as medically appropriate in all the circumstances. On demand is not medically appropriate in all circumstances. Doctors cannot keep their registration who act so recklessly, so against medical practice and standards.

Further, the bill outlines that doctors must have regard to the medical circumstances and the professional standards and guidelines that apply to the doctor. As per the experience in other states that have already legislated similar provisions, there are going to be very limited situations in which this applies. In fact, I believe the largest likelihood of this legislation is that we will see earlier abortions rather than moving abortions later by allowing broader and easier access to abortion drugs. They are currently significantly restricted to being available only in a hospital. There will likely be a significant reduction in surgical abortions being necessary.

While I have no doubt that there are some people who are against this bill and are across the detail, others have seen just some of the campaigning advertisements and have not got the total picture of what is actually being proposed. Asking people whether they support abortion on demand up to birth elicits one answer. Asking people whether they support protections, where two doctors would have to sign off on such an abortion being medically appropriate in all the circumstances, and I believe would get a different answer from the community.

That is not to deny that there are difficult moral questions involved—moral/ethical questions, questions of faith that are deeply held by people that certainly I and everyone in this house has had to grapple with and consider as part of this. No doubt for some this will be about the detail as we get into the committee stage. I appreciate those members who have submitted some amendments, and there are some that I may consider when we get to the committee stage of the debate.

As part of the preparation of this debate, I appreciated the opportunity to visit the Pregnancy Advisory Centre, which is where the majority of terminations in South Australia happen, and meet their hardworking staff who provide some of the more difficult and complex health services we have in our state. However, I quickly learnt about how those staff, but more importantly the women who come to the clinic, have been let down by short-sighted penny pinching by this Liberal government. The staff there told a very confronting story, a Yes Minister style of bungling that is having real consequences for women every single day.

The staff told me that in early 2019 the air conditioner to the PAC operating theatre completely broke down. The theatre was unusable from that point on. The expected cost to repair the operating theatre was $100,000, but the government, the local health network, the bureaucracy, the minister, refused to pay the money to fix the air conditioning. That meant that that operating theatre has had to be closed.

It means that women are now forced to go from the Pregnancy Advisory Centre to The Queen Elizabeth Hospital standard elective surgery theatres to get surgical abortions happening now. Women receive those, lined up in the same pre-surgery and post-op areas, as other men and women—significantly, usually older people getting their elective surgery operation, getting their hip operation, getting their knee operation—women in very desperate, difficult circumstances. This reduces their privacy. This reduces the amenity for these women, having to share a very small number of toilets. This reduces the capacity of the clinic from 16 people per day down to 12 people per day.

People who were against abortion might say, 'Well, that's a good thing,' except for the fact that this means waiting times are getting longer. Because it takes longer now to get through, that means people are therefore having those terminations later than they otherwise would have. I do not think anyone would want to have those terminations later when they could be earlier.

This is clearly an unacceptable situation that has continued for the past two years. Here we have one part of the government advocating this bill for women's rights and another part of the government advocating against late-term abortions, and they are all part of a government that is reducing the access and increasing waiting times, meaning that abortions are needlessly happening later, all for a cost of $100,000, which is, in the context of the state budget, a very small budget compared to advertising for SA Water fees or land tax reforms.

Sadly, the equipment and infrastructure have now been stripped, so it is much more expensive than $100,000 to fix the services in the Pregnancy Advisory Centre. I have been trying to obtain documents via FOI on this subject since August 2019—18 months ago. The government have refused to provide access to these documents for that significant amount of time, despite the fact that we have a ruling from the Ombudsman, given in July last year, saying that they should release those documents.

Since July, the government have been told to release documents about this closure and they have refused to do so, clearly in a political attempt to deny the public and this parliament information about what is going on in that regard before this important debate. In 2019, Stephen Wade, the health minister, told estimates:

A plan for a permanent solution for both its procedural and ambulatory components of care is being developed, with constructive input from both staff and community stakeholders.

That is now proved to be completely bogus. Since then, nothing has been done. There is no permanent solution, there is no input from staff and stakeholders, and the latest plans released for The QEH development show that this supposedly temporary move to the operating theatres of The QEH with everybody else now looks set to be made permanent.

Another principle I take to this debate is that we should be doing everything we possibly can to avoid people being in the situation of needing to consider a termination to begin with. I suspect that many people on both sides of the debate would agree with that. This means sex education. This means sexual health programs. That means available contraception. Let's be clear that these programs have meant that the number of abortions in South Australia has actually been going down over the past 20 years. In fact, there was a reduction in the number of abortions of over 1,300 per annum from 1999 to 2017, despite an increase in the state's population.

Unfortunately, sexual health programs have taken a significant hit in South Australia in the past two years under this Liberal government. In the first Liberal budget, there was a ruthless cut made to sexual health programs. SHINE SA took the biggest hit. They were forced to close their only clinic in the northern suburbs and close their only clinic in the southern suburbs because of these cuts from the Liberal government. This ultimately meant a reduction in access to sexual health programs, a reduction in sexual education and a reduction in contraception services such as contraceptive implants.

The Marshall government was warned clearly at the time that such a cut was likely to lead to increased rates of unwanted pregnancies in our most vulnerable communities in the northern and southern suburbs. The AMA said at the time:

We believe the Government has not realised the impact this cut would have, and we are urging it to review its decision. If not, we fear the results: an increase in rates of sexually transmitted infections; a rise in unplanned pregnancies…

While addressing this legislation, this is only one piece of the puzzle. I implore the government to reverse those cuts, reopen those clinics in the north and the south, and ensure appropriate services are made available to help reduce the number of unwanted pregnancies in the first place.

Today, the Deputy Premier and other government MPs have talked about the need for having a respectful debate. In fact, the Attorney-General said, 'I find it personally disappointing that some have deliberately inflamed tensions and sought to use abortion as a political weapon.' Sadly, that principle is not being adhered to by her own party that she is the deputy leader of.

In fact, it saddens me to inform parliament that behind the scenes, a Liberal Party strategist told The Advertiser that they will use abortion as a political weapon in the lead-up to the next election. Chief reporter, Paul Starick, wrote in The Advertiser last week:

The Liberals are prepared to unleash social media hell for Mr Malinauskas if he votes against abortion reform, targeting swing voters in battleground electorates like Adelaide and Elder (inner southern suburbs). 'If he votes against abortion we will target young women voters. There will be a strong plan to very firmly portray him as a leader who’s out of step with young people,' a Liberal strategist said.

That is disgraceful. Shame on them. To use a conscience vote issue like this as a party political attack is a new low for the South Australian Liberal Party. For a party to say that they will 'unleash social media hell' is a clear threat at somebody's vote and it should be decried by all members of parliament. The Premier and Deputy Premier should take action against their own strategist in their own party for making such a threat. Everybody's view in this debate should be respected.

Lastly, in dealing with this legislation and particularly in my role as the shadow minister for health and wellbeing, I want to pay tribute to the thousands of health professionals who work in our health system caring for women and helping them with their pregnancy and often consideration of some of these difficult decisions. I know that your jobs are not easy, the pressure is significant and the standards of professional behaviour to which you abide are strenuous. Thank you for what you do every single day.

Deputy Speaker, today I have outlined my perspective, my principles and the approach I am taking to this legislation. I will be supporting the legislation to take abortion out of the criminal law and to catch up with the legal framework in other states.

The Hon. J.A.W. GARDNER (Morialta—Minister for Education) (20:16): I will speak tonight on the bill to share a brief outline of my views on this matter, and particularly for the interests of any constituents of mine who are interested. A number, I would say, probably in the order of 500 or 600, have expressed a view on both sides of the issue and I have written back to them, so I will paraphrase some of that information and add one or two other brief comments.

In brief, I am keenly interested in the views of my constituents, particularly in matters related to votes of conscience, if you like. I seek to read all the correspondence I get, I listen to the arguments, I obviously bring my own views and experience to the table and I apply my judgement to the legislation at hand.

Every single piece of correspondence from a constituent, whether it is a relaying of ideas that they have had suggested by others or whether it is drawing on their own personal experiences and expertise, is a piece of correspondence that conveys to the local MP their views and has value and merit, and I take the time to read and consider them, particularly as sometimes there are new things that you have not necessarily considered. That, of course, is also true sometimes in the debate.

I think there have been some useful contributions through the course of this debate and I look forward, particularly should the bill pass the second reading, to hearing more in relation to specific proposed amendments, which will obviously change the tenor of the application of the proposed legislation to certain aspects of the bill, which I will go into in a moment.

It is important, as some have already identified, to identify in relation to any vote on any bill that the decision in question is between supporting the new proposal or supporting the existing and continuing without any changes. Sometimes it is important to remind ourselves in that context of what is already in the existing law so it can accurately be compared with the new proposed law.

I identify that a number of the pieces of correspondence I have received suggest a reflection on a preferred alternative course of action rather than comparing the proposed law with what is already in legislation. Tonight, as some have said, the principle at stake is not whether abortions will become available, which was considered in the parliament in 1969. For more than 50 years, terminations have been widely available during the first 28 weeks of pregnancy according to the current statute.

Provision also exists in the current law for terminations to take place after 28 weeks in circumstances where a medical practitioner is of the opinion formed in good faith that the termination is immediately necessary to save the life or to prevent grave injury to the physical or mental health of the pregnant woman.

The bill being considered by the parliament this evening, and potentially over the course of this week, proposes several key changes we are being asked to consider: firstly, the framework for the legislation to be moved from the Criminal Law Consolidation Act into a standalone piece of legislation, the Termination of Pregnancy Act; secondly, the time frame for the standard consideration of a termination to be allowed to be reduced from 28 weeks to 22 weeks and six days; next, terminations taking place within 22 weeks and six days to require one doctor rather than two to be treating the patient.

The framework within which a termination could take place after 22 weeks and six days would require, according to the proposal, two medical practitioners to be of the view that the proposed procedure is medically appropriate, and I will come back to this matter which has obviously attracted the majority of consideration by those expressing opinions through the course of the debate. Also, the bill proposes a right for a medical practitioner to conscientiously object to participating in the procedure being enshrined in the legislation and also a new major indictable offence to be created for unqualified persons performing or assisting in the performance of a termination.

Obviously, the proponents of the bill have argued that the legislation essentially updates the existing rules in line with modern medical technology, providing a consistent framework within which members of the community can be clear about what the rules are and how the termination might take place within what rules and, of course, not necessarily just within a public hospital. I have sought further information about the sorts of circumstances within which a termination after the prescribed period might be authorised and there has been much discussion about that during the course of the debate.

Of course, the circumstances in question are usually described as where the mother's life is in jeopardy, similar to those envisaged in the current section 82 of the Criminal Law Consolidation Act. But we also have a number of amendments now tabled that would limit the application of this bill to those circumstances or similar ones. We will consider those tomorrow, I expect, assuming the bill is allowed a second reading by this house, which is of course a matter for all 47 members to consider in the coming little period.

I reflect that while much of the correspondence has suggested a vote for or against the bill, I would encourage anybody reading this contribution who has expressed such a view to reflect on the fact that the bill as a whole, as it will be defined by the third reading, depends on what happens in those amendments that will be potentially considered during the committee stage of the debate. I think that many of the things that are proposed in this bill are reasonably uncontroversial and, indeed, some would be described potentially by all sides of the debate as positive steps forward.

So that is my assessment. By and large, it does modernise the legislation in line with current medical practice and technology. Indeed, the reduction in gestation time before the stricter provisions for late terminations from 28 weeks to less than 23 weeks is a significant step that recognises the potential for a successful birth after that time as a result of advances in medical technology over the last 50 years. For that reason, along with others, I propose to support the bill at its second reading vote.

Obviously, many people in the community have raised with me their concerns about the lack of definition in the legislation, about what circumstances the medical practitioners would need to consider before carrying out a procedure after 23 weeks. Alternatives to the mechanisms described in the bill for the procedures, as I say, have been tabled to be discussed if the bill passes the second reading, and there may yet be more amendments to come to hand overnight. Like all members I am sure, I will give serious consideration to those amendments during the committee stage of the debate.

There has been an enormous amount of expertise in the legal and medical recommendations of people with great levels of community mindedness and expertise in these areas that have been proffered to all members of parliament, indeed on both sides of this question, over what are the appropriate legal frameworks for what would happen after 23 weeks. I want to offer my thanks to those members of the community, the professions and from all over the community who have provided that counsel to me.

I will obviously be casting my vote for or against amendments as I see is in the appropriate best interests of the people of South Australia and that record, together with these comments, will give some reflection of my views on this matter for those constituents who may be interested.

The Hon. S.C. MULLIGHAN (Lee) (20:24): I rise to speak on the Termination of Pregnancy Bill. As many other members have already commented, this is a difficult bill for probably all of us; it certainly has been for some speakers today. It is a difficult bill for me. It is a complex bill. It is an amalgamation of a principle that I think every parliamentarian—in both houses, both here and in the other place—completely supports, that is, finally modernising the long-outdated legal treatment of abortion as being existent in some sort of grey area between the Criminal Law Consolidation Act and some vague provisions in other health-related legislation.

To my relatively unpractised understanding of how abortion services are provided in South Australia, it seems that, by and large—not entirely but by and large—the current actual provision of abortion services works reasonably well. A number of speakers from all sides of the chamber have recorded officially for the record their appreciation of the work that is done at the Pregnancy Advisory Centre in Woodville Park and of course in those other public healthcare facilities that also provide termination services but perhaps not quite to the same extent as the Woodville Park facility.

I am speaking principally of other public hospitals across the metropolitan area. It is also true that there are some non-public healthcare facilities, mainly a small handful of country hospitals that are not publicly owned or operated but are privately owned and operated, that conduct some of these terminations, but I will come back to that in some time.

The bill is an amalgamation of updating the law, which is long overdue I think we all agree. It is also combined with an attempt to significantly rewrite and redefine when terminations can occur, by whom they can be done and under what circumstances. It is a significant broadening of the current arrangements. As far as I can tell in the bill, it has been left up to the best judgement of medical practitioners to conduct terminations, in particular what we are referring to, perhaps colloquially, as late-term abortions.

These have certainly been the topic of the vast majority of representations that I have received. I am speaking in particular of those representations that I am grateful to have received from people who actually reside in the electorate that I represent in this place and not the deluge of representations that I have had from people who live in other places, including those very interested people who have taken it upon themselves to contact me from other jurisdictions around the country. I recognise their interest, but of course I am principally interested in what my constituents think, rather than what others would think had they been a resident in South Australia.

I am grateful for those representations I have received. I have to say, regardless of whether they have been in favour of this bill or against it, nearly all, with only a very small number of exceptions, have been very respectful and put their views to me in a way that genuinely seeks to enlighten me as to not only their views but what influences their views. I am very grateful for that.

I will try not to speak too euphemistically on this for much longer, but we have probably all been in receipt of some representations that have not been so magnanimously communicated to us. To those who may be paying close attention to this debate and who may have been the author of such communications, I might take the time to remind them that, while as elected representatives we should expect to get those representations from time to time and perhaps grin and bear it as we must, there are people employed in our electorate offices who perhaps do not deserve the fulsome—

The Hon. J.A.W. Gardner: Advice.

The Hon. S.C. MULLIGHAN: —advice—thank you, member for Morialta—that has been provided to our electorate offices. I am very grateful for the very calm and resilient way my electorate staff have received some of those representations.

It has been put to me that the vast majority of those people who reside within my electorate who have chosen to communicate with me to express their views on the bill are against the bill. Of course, I recognise that there has been a concerted campaign—not just in my electorate but across a range of other electorates—by some people with a particular interest to try to drum up support against the bill, and some of those representations reflect that. Nonetheless, that is certainly the advice I have had.

Other people I have spoken with who have raised the bill with me have expressed some concern and alarm at how this bill has been represented in the media. Almost to a person those people have said they do not like the concept of termination at a very late stage, up to and including perhaps when an otherwise successful birth may occur. I have to say that to an extent I share that concern.

While I understand what the authors of the bill have sought to do in trying to ensure that the parliament and the people of our state can have faith in how late-term abortions may happen, by requiring that not only is it based on a medical practitioner's advice but in fact it is based on the advice of two separate medical petitioners, the way in which the bill is worded is that it should be deemed by those medical practitioners as 'medically appropriate', which is the term used in clause 6.

I have listened carefully to some of the contributions that have been made by other members. That 'medically appropriate' in clause 6 is followed up quite quickly in clause 6(2)(b)—that it will not only consider the relevant circumstances, as you would expect, in 6(2)(a), but 6(2)(b) provides that it would also countenance 'the professional standards and guidelines that apply to the medical practitioner in relation to the performance of the termination'.

In effect, what we are seeking to do is change the law for perpetuity, or at least change the law until it is subsequently changed by a future parliament, trusting that the two medical practitioners will deem whether a termination is 'medically appropriate' and that it will have regard to the professional standards that exist at the time. I do not know what 'medically appropriate' means; in fact, I do not think anyone in this place knows what 'medically appropriate' means.

I do not think a doctor could actually elucidate what 'medically appropriate' means. They may give some examples of what they would consider to be 'medically appropriate', but I do not believe they would be able to adequately legally define it, particularly if it came to the point when that definition needed to be tested—for example, if there were a question whether a procedure had been conducted appropriately or not. I am speaking, of course, if it were to be tested in a court of law, that place where legislation is tested from time to time.

Even in the Australian Medical Association's submission to the Law Reform Institute, at the beginning of its submission they themselves say that 'abortion is an issue with complex medical, ethical, legal and social aspects'. We are here to decide upon this bill, and I agree with the AMA in this regard, that we are to consider these complex medical, ethical, legal and social aspects; however, the bill restricts the consideration of a termination solely to those medical considerations.

'Medically appropriate', I could hazard a guess—I will not, though, because I am not a doctor, I am not a clinician, I am not a medical practitioner—but I think the fact that we cannot point to what that means, that we cannot get an accurate idea about the circumstances under which that termination may occur, would necessarily give us all pause for thought about what the circumstances actually would be in practice for a late-term abortion.

Of course I agree with the entreaties that have been made to date that somebody does not simply decide in the third trimester that suddenly they want an abortion. Of course I do not think anyone realistically expects that to be the case. I am very sympathetic to the argument which is very reasonably and frequently put that, with current medical technology, when a woman is expecting a baby, is pregnant, and is going through the range of tests that usually happen at 20 weeks, if there is something that is found in the course of those tests they would want a period of time to contemplate whether they needed to avail themselves of a termination.

Certainly, a number of representations have been put to me where that advice might not have come at 20 weeks; it might have come a little bit later—a week or two weeks later. Of course, somebody should have the opportunity, as time goes on, to think all of those issues through, and that might not be able to be done by 22 weeks and six days or, as the AMA suggested in their submission, at 24 weeks or by what I understand to be the case in practice at the moment, 28 weeks; it may be beyond that.

In that case, then you would think that it is not unreasonable that there is a time frame that is available. That is really the thing that I am finding difficult to weigh in my own mind about whether we have a much broader, greater provision for late-term abortions than what the current practice is in this state. I find that very difficult, I have to say.

I also find it difficult because this bill broadens what is currently happening in South Australia—and that is where terminations are nearly exclusively occurring in public healthcare facilities, with the exception, as I said, of those ones which have been conducted in regional areas, in country hospitals which are not owned or operated by the state—and merely requires that they occur in facilities which are regulated by state and national law which are prescribed facilities.

As the member for West Torrens and other members have said, this means that a much greater proportion of terminations will be able to occur in private facilities. This alarms me greatly. Yes, of course, like everybody else I have great faith in our medical profession and in doctors, but there will be a conflict for a medical practitioner when somebody approaches them in their private clinic, which is being operated by them necessarily as a business—to provide a living for themselves and their families—and there is a choice between offering a termination, which they can provide for a fee, or perhaps providing another option which does not have that outcome.

I am really uncomfortable with that conflict because I do not believe that conflict exists at the moment with termination services. This bill, perhaps looking to just provide as broad a brush as possible, provides for that possibility, and I am grateful that there is an amendment on file which seeks to address that, because, other than those small number of terminations which occur in country hospitals, I am aghast that we would be opening up a private industry where private clinics can be conducting these terminations with the inherent conflict that that has for those doctors.

I am also deeply uncomfortable, by default or perhaps by no fault of the way the bill is drafted, that abortions generally but particularly late-term abortions will not only be available, if they are medically appropriate, but presumably if they are requested and approved for the purposes of gender selection. I am aghast at that. Despite the assurances that 'that won't happen; people don't do that; and, in fact, if you raise that that's actually a cultural slight on some cultures and beliefs', that is rubbish. The fact that we would have a bill or a potential law which provides for that I am not comfortable with.

As the member for Mount Gambier said, we all have a responsibility to decide what will be laws. We decide not based on assurances or intentions. We legislate to define the parameters of what is possible and hence legal and what is prevented and hence illegal. We necessarily have to be specific and we necessarily have to be precise about that and we have a provision in the bill that, perhaps unconsciously, allows for an abortion, let alone a late-term abortion, for gender selection purposes.

I must admit that I am interested, but I am perhaps less settled, in my view on conscientious objection, because on my first reading of the bill it seemed that the bill attempted to provide for a regime where doctors can exercise a conscientious objection, and to the drafters of the bill I think that that is a good thing. However, I was somewhat surprised that I still received many representations, particularly from some doctors, and have also seen amendments on file around conscientious objection. I am looking forward to hearing more about that in the course of the debate.

I think that this is not just the third conscience issue I have had to deal with since I have been a member of parliament for nearly seven years now. We have actually had several more, but perhaps there have been three significant conscience matters in the last five or six years. The first one that I had to confront was about voluntary euthanasia. I am not afraid to say that I initially approached that debate not being in favour of voluntary euthanasia.

I received a lot of representations, particularly from my own constituents and also from people who worked in palliative care and in other parts of the medical profession. A number of colleagues, both on my side of the chamber and the other side of the chamber, worked very hard to put up a ream of amendments to try to tighten what had initially been proposed into a bill. When it came to the second reading, I made my contribution and indicated that, should those amendments be supported, I would be happy to support that voluntary euthanasia regime, hence I voted for it at the second reading.

When we came to the prostitution debate—I was going to say last year, but I do not know if it was last year as 2020 was such a blur for us; it might have been 2019—I was tempted to vote for that bill at the second reading, even though I was still deeply uncomfortable with the bill. I voted against it at the second reading because I looked at the amendments on file and I realised that, even if all of those amendments passed, or even if the amendments that I was in favour of passed, that bill still would not satisfy me in order to have a regime of decriminalised or legalised prostitution in South Australia.

So I come to this bill, where we have a bill that will be voted on at the second reading. We have a range of amendments on file. This is probably the first time, out of these major issues of conscience, where I still do not genuinely know whether to vote in favour of it at the second reading. I still do not know that those amendments can satisfy me.

I think that the Minister for Water has placed on file amendments that seek to tighten the scope of late-term abortions, and I am grateful for his efforts in that regard. I did not think I would be thinking this, let alone saying it, but I am not sure whether that amendment goes far enough for me still. I would have liked a little bit more articulation about the circumstances under which there could be late-term abortion.

But I think I can say in summary in the closing contribution on this debate that I am trying my best with this bill. It is still leaving me very uncomfortable. I do not think I can support it, despite the good work of members who have filed amendments. I wholeheartedly agree with the decriminalisation. I had always considered myself to be a supporter of choice and a woman's choice for abortion, and it does genuinely grieve me that I do not think I will be able to support this bill.

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