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Legislative Council - Fifty-First Parliament, Third Session (51-3)
2008-11-12 Daily Xml
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CONSENT TO MEDICAL TREATMENT AND PALLIATIVE CARE (VOLUNTARY EUTHANASIA) AMENDMENT BILL

Introduction and First Reading

The Hon. M. PARNELL (16:58): Obtained leave and introduced a bill for an act to amend the Consent to Medical Treatment and Palliative Care Act 1995. Read a first time.

Second Reading

The Hon. M. PARNELL (16:59): I move:

That this bill be now read a second time.

This bill is about voluntary euthanasia. Normally, when putting together a speech on a new bill, one leaves it to the end to thank various people who have assisted in the process, whether by their inspiration or by their perspiration. However, I want to acknowledge at the outset that this bill builds on the work that has been done previously by many other MPs and community groups, both in this state and elsewhere.

I particularly acknowledge the Hon. Sandra Kanck, who has previously introduced bills on this topic during her 14 years in this parliament. Also, the Hon. Bob Such, the member for Fisher, currently has a voluntary euthanasia bill before the House of Assembly. Other MPs in both houses of parliament have been working on this issue longer than I, and I acknowledge their role. I am also grateful to Senator Bob Brown and Colleen Hartland, the Victorian MLC who recently proposed similar legislation in the Victorian parliament, for their support.

However, at the forefront of campaigning for voluntary euthanasia law reform have been members of the South Australian Voluntary Euthanasia Society (SAVES). I am a member of SAVES, and I have spent many hours talking to SAVES members—in particular, Mary Gallnor and Frances Coombe—about this bill and how we can best achieve the law reform that we know is supported by the vast majority of South Australians.

In the past three decades, surveys have consistently shown that a majority of Australians believe that terminally ill individuals should have a right to seek and obtain assistance to end their life with dignity. In 1962, it was close to a majority, at 47 per cent; by 1978 it was up to 67 per cent; and in 2002 it was 73 per cent. An independent poll conducted by Newspoll last year found that 80 per cent of Australians are in favour and just 14 per cent are opposed. The figure for South Australians was 81 per cent in favour.

By the time we debate and vote on this bill next year, nearly half the members of the Legislative Council will be new members who have never before debated a voluntary euthanasia bill. Those who have considered it previously may also have changed their position, either for or against. That is why I think it is appropriate to bring this bill back before the parliament.

My bill is different from earlier bills, but the underlying principles are still very much the same. I do not propose to go through a comparison of all the different models of voluntary euthanasia legislation that have been advanced or proposed in Australia or throughout the world. I will leave it to others to do that. However, what I will say is that my bill seeks to focus on the rights of the sufferer. Other bills have focused more on the protection of doctors. My bill includes such protections, because that is a necessary and incidental aspect of the bill. However, my focus is on the right of the patient to choose the time and manner of their death when suffering becomes intolerable.

That is why I have sought to incorporate these voluntary euthanasia provisions into existing state law that deals with the rights of patients to give their consent to medical treatment. I think this is a very important feature of the bill, because the administration of voluntary euthanasia is in every sense a form of medical treatment. All of us are aware of the role of medical treatment aimed at curing disease, healing wounds or alleviating symptoms. However, medical treatment can also consist of helping a sufferer to bring an end to unbearable suffering, and that is what this bill seeks to do.

One thing that I have noticed as I have followed debates around voluntary euthanasia over the past several years is that many of the most passionate advocates of voluntary euthanasia have come to their position as a result of the experience of a loved one, particularly in the final stages of life. I could spend a considerable amount of time going through case studies of people who have suffered and are still suffering in order to add weight to the arguments in favour of this bill. Without doubt, the stories would be dramatic and heart-wrenching and none of us would be unaffected by the human tragedy involved, regardless of our stance on voluntary euthanasia.

However, I do not propose to go down that path. This is not a bill that I am promoting because of my personal circumstances or even the circumstances of anyone particularly close to me. I do not have personal first-hand stories, and I do not at this stage propose to recount the stories and experiences of others. When we reach the committee stage of the debate it will, no doubt, be appropriate to look at cases where law reform would or could have made a difference to individuals.

Voluntary euthanasia is not a particularly Australian, or even a western, concept. Some jurisdictions, such as Colombia in South America, have passed comprehensive legislation. However, other jurisdictions dabble about the edges, such as Uruguay, Norway or Denmark, where the approach is based on allowable defences to criminal charges associated with death.

In March this year the Luxembourg parliament voted to legalise voluntary euthanasia, but the most recent jurisdiction to adopt it was the U.S. state of Washington, which voted in favour of law reform in a referendum-style vote last week. Known as Initiative 1,000, the people of Washington state voted 59 per cent in favour and 41 per cent against the Washington Death with Dignity Act. Their experience was no doubt informed by their neighbouring state of Oregon, the only other American state with a similar law, and under that law some 341 patients have committed physician-assisted suicide in the 11 years that law has been in effect.

It is important to note in relation to the Oregon experience that a third of those persons who passed the rigorous qualification process and obtained medication did not actually take the drug: the mere availability of assistance gives people pause for reflection and means that they do not feel that they have to act precipitately. A significant factor reported in Oregon is that the existence of the act permits physicians, patients and families to have open and honest conversations about all the available options—conversations that previously had to be either avoided or held in covert language for fear of overstepping legal boundaries.

There are problems with the present system where we do not have voluntary euthanasia on our statute books. Under the present system, if a patient comes to a doctor to request assistance to die, the doctor should by law turn away the patient, knowing that the patient who is determined enough may end their life in whatever violent manner is available to them. Four elderly Australians kill themselves each week by violent and undignified means. What a terrible decision to ask a doctor to make! We know that the impossible nature of such decisions has led to doctors offering assistance to patients to die, against the law. They risk their jobs, freedom and reputations. Why should they have to do this work in the dark without support and without regulation?

This legislation proposed in my bill will bring it into the light—the bright clear light of formal requests, witnesses, independent advice and a government-appointed expert panel. Each medical professional will decide whether or not they will be party to an assisted death, and this is how it should be. Just as I say that certain patients have a right to choose whether to live or die, so too doctors should be able to choose to not be part of any such arrangement. There should be no consequences for those who choose not to participate.

The debate around voluntary euthanasia should not be seen as a competition between voluntary euthanasia on the one hand and palliative care on the other. Palliative care will nearly always be the first port of call for those suffering. The instinct to live is powerful in nearly all of us. While we recognise that death is inevitable, most of us do not want to die any time soon and most could not seriously contemplate taking our own life. When it comes to palliative care, medical literature suggests that, despite the excellent work of medical professionals and the latest medical advances, even the best modern palliative care is simply unable to relieve the suffering of all those near the end of life.

Around 5 per cent of those suffering late stage cancer have symptoms that cannot be relieved to the sufferer's satisfaction, without placing the sufferer in a medication-driven coma. Palliative care will continue to give most people a higher quality of life in their final stages. Modern drugs and pain relief have vastly improved and will, no doubt, continue to do so. However, it does not work for everyone and we need to acknowledge that fact. At this point we have a choice: do we simply acknowledge that palliative care is not effective in some cases and say, 'Bad luck, we tried; you must now suffer as best you can until you die', or do we acknowledge that there are alternatives? We can give control back to the sufferer and allow them to end their life on their own terms.

It may or may not be a dignified death but, if it is the exercise of free will by the sufferer, we must ask ourselves: what right do we have to stand in the way? The problem, of course, is that some people see a stark difference between standing in the way of a sufferer who wants to end his or her life and putting in place a mechanism that allows that person to exercise that right within a legal framework.

In order to understand the need for law reform, we need to understand the present system. Since 1995, in South Australia patients have had the right to refuse medical treatment under the Consent to Medical Treatment and Palliative Care Act. This means that patients may hasten their deaths by refusing treatment. This even includes patients for whom standard medical practice might bring about successful treatment. Refusing treatment is not a great option for people wanting to reduce their suffering. They might live on, enduring terrifying pain and suffering, including shortness of breath or being unable to swallow food or drink, with nothing to look forward to but suffocation or starvation.

Patients may also refuse food and drink in order to hasten their own deaths. This is acceptable to some sufferers but not others. Nobody disputes the fact that patients are killed every day by their medical treatment. In many cases, death is the inevitable outcome of that treatment, yet the law focuses almost entirely on the mind of the doctor rather than the outcome for the patient. We refer to this as the principle of double effect.

The law accepts that doctors may administer drugs knowing that they will hasten the death of a patient as long as the doctor intends only to relieve pain. The principle of double effect includes the deliberate sedation of patients to deep unconsciousness for the purpose of relieving suffering. This is called terminal sedation. While the patient is sedated they receive no food or fluid, and it is anticipated and expected that they will die.

The principle of double effect relies on the fact that you cannot read a doctor's mind. Kay Koetsier, in her paper The Intent to Kill, discusses the fact that the same dose of morphine causing the same death can be two different things. Her paper states:

If a doctor gives increasing doses of morphine, over a period of time, to a cancer patient who is incurable and in great pain, and the patient dies as a result of that medication, it is very unlikely that the doctor's treatment will be questioned. But if that doctor gives the same patient one large dose of morphine which ends the patient's life, at the patient's request, then the doctor's actions are very likely to be questioned and he or she may even be prosecuted for murder.

Many of us have difficulty understanding why a doctor's intention when treating a terminally ill patient seems to be legally more important than the outcome of that treatment.

She goes on to say that the uneasy law surrounding the principle of double effect leads to a morbid game between the doctor and the patient:

...whereby if the terminally ill person says: 'My pain is unbearable', not 'I want to die', the dose of pain medication can be gradually increased until death results.

In my view this is not acceptable. A dose of morphine is a dose of morphine. The doctor's mind is important, but the patient's wishes are more important. If the patient says that they want to live as long as possible, then let the doctor do what he or she can to prolong life and relieve suffering, but if the patient is ready to die of a terminal or incurable illness, or if the patient is suffering profoundly and has given up the fight after considering every alternative, then let us give them the right to ask for assistance to die in a way the sufferer believes is dignified and consistent with their values.

Nobody should doubt that laws such as the one that I am proposing today are controversial. Passionate views are held both for and against. I do not propose to deal with all of the arguments that are likely to be raised against the bill, but I do want to touch on two of the most commonly cited objections. They are religious views and the 'slippery slope' argument.

In relation to religious views, I mentioned earlier the 2007 Newspoll that showed that 80 per cent of Australians supported voluntary euthanasia with appropriate safeguards. The same poll determined that three out of four Catholics and four out of five Anglicans are in favour of reform. Nine out of 10 Australians who identify as having no religion are also in favour of reform.

I want to read briefly from a letter that I received about a year ago from Reverend Trevor Bensch, who is the Baptist chaplain at the Queen Elizabeth Hospital and the Calvary Hospital in Adelaide. Reverend Bensch wrote to me—I imagine he wrote to other members of parliament as well—in connection with the Voluntary Euthanasia Bill that the Hon. Bob Such introduced into the House of Assembly. I spoke to Reverend Bensch recently and obtained his permission to use his name and to quote his letter in Hansard. He wrote:

My approach to the issue of voluntary euthanasia is from the position of a liberal Christian who seeks to find the way that is most consistent with what we know about the teaching and example of Jesus. The guidance that I get, mainly from the four gospels, could be put under four headings:

1. The importance of every individual person.

2. The need to make the most of each day.

3. The obligation to relieve illness and suffering wherever possible.

4. To do for others what you would want them to do for you.

My support for voluntary euthanasia comes from these with an element of my own selfishness. I had no control over my entry into this world but I want some control over the exit. I want the right to say when I have finally had enough.

Through many years of hospital chaplaincy I have continued to be inspired by the courage with which most people bear serious illness, even when it is terminal, but I cannot agree with those who say suffering is good.

He concludes his letter by saying:

Of the Christian values, compassion must surely be near the top of the list. I urge you to support and vote for the Bob Such Voluntary Euthanasia Bill.

Aside from religious views, the most common argument against voluntary euthanasia is the so-called 'slippery slope', which goes something like this. Once we as a society acknowledge and recognise the right of a person to choose their own death, it is only a small hop, step or jump away from more radical changes. Opponents of voluntary euthanasia predict a society where the elderly, the sick, the disabled or the inconvenient are regarded as dispensable and encouraged to end their burden on society by ending their life.

I do not accept that this is the inevitable, or even a likely, outcome of us now accepting that a person's fundamental rights as a human being include the right to end unbearable suffering through voluntary euthanasia. If I thought otherwise I would not have introduced this bill. The reality is that values change as society changes. It is up to all of us to ensure that the core values of compassion and the dignity of human life are enduring, and I do not think it is valid to deny the rights of this generation based on fear of what a future generation may or may not do. This is an issue to which I will no doubt return later in the debate, once we have seen how the various arguments are presented.

I now want to briefly outline how this bill would work in practice. Because every circumstance is different, and because this bill is aimed at a range of circumstances, I will use a hypothetical example based on typical circumstances. I will talk about a hypothetical patient called Ruth. Ruth is a 50 year old woman with an aggressive and painful form of bone cancer. She has adult children and two grandchildren. She would dearly love to see her grandchildren grow up, but the cancer is getting the better of her. The cancer has no cure, and she has tried every form of treatment, including palliative care. She knows from her doctors that she will die, probably within a few months, but of course she does not know exactly when. She already finds the pain intolerable.

She has discussed her options with her family and her medical carers and has decided that she does not want her final days to be a living hell of uncontrollable pain where she has no control over any aspect of her life. She wants help to end her life at a time of her choosing.

Under this bill, she will need at least two appointments with a doctor at least 24 hours apart before the process of authorising her request can be commenced. However, in practice, she is working with the doctor who has helped her through her whole experience with her illness, and this doctor knows her well. This doctor is prepared to help fulfil her wish to die with more dignity than if she were to allow her disease to run its full and inevitable course. Nevertheless, her doctor wants to be sure that Ruth is acting of her own free will, that she is of sound mind and that her decision-making ability is not adversely affected by her state of mind. The psychiatrist to whom she is referred certifies to this effect and the doctor then sends all the paperwork, including the independently witnessed request, to a registrar for inclusion in the register which is to be created under this bill.

The request is then managed by a new Voluntary Euthanasia Board of South Australia. That board has powers of direction either on its own volition or on an application by Ruth, her doctors or the registrar. The board includes medical and legal experts appointed by the government. Before Ruth's doctor can prescribe and supply her with the drugs that will end her life, the doctor must consult the board and follow any of its directions. If, at any time, there is any indication that Ruth may not want to go ahead or may want to delay the act of voluntary euthanasia, then the process stops.

There are appeal provisions to the Supreme Court in relation to decisions or directions of the board if there is any dispute. At the end of the day, Ruth is able to end her suffering after having had the opportunity to farewell her family and friends whilst she was able. Her death was of her own choosing and in her own time.

In conclusion, I advise members that I now intend to allow this bill to sit on the Notice Paper for many months before progressing to a vote. When that day comes, I hope it will be a conscience vote for all members. When voluntary euthanasia has been debated in the past, political parties have always given their members a conscience vote, rather than a requirement to follow a party line. I hope that this arrangement will be followed in relation to my bill. I have no reason to suspect that this will not be the case; however, I make this plea now to all political parties to allow a conscience vote for your members.

Finally, I ask honourable members to come to this bill with an open mind, regardless of how they may have voted in the past or otherwise expressed their views. There are so many different permutations and combinations of measures and safeguards that could give effect to the concept of voluntary euthanasia. I believe that the model in this bill is a good model; however, I am open to suggestions from members for improvements. I am more than happy to work with members to consider issues such as whether the scope of the bill is too narrow or too broad. Are people not covered who should be, or vice versa? Are the safeguards adequate? Are the safeguards too onerous? Are they simply hurdles that make it harder for sufferers to exercise their rights without actually improving any accountability? All of these matters are open for discussion and negotiation. I look forward to those discussions.

At the end of the day, I want to give effect to what I believe is right. I want to legislate in a compassionate but cautious way and I want what most South Australians want—that is, a legal mechanism for people who are suffering intolerably to be helped to end their suffering. I commend the bill to the council and I seek leave to have the explanation of clauses inserted in Hansard without my reading it.

Leave granted.

Explanation of Clauses

Part 1—Preliminary

1—Short title

2—Commencement

3—Amendment provisions

This clauses are formal.

Part 2—Amendment of Consent to Medical Treatment and Palliative Care Act 1995

4—Amendment of long title

This clause amends the long title of the Act to reflect the changes made by this measure.

5—Amendment of section 1—Short title

This clause amends section 1 of the Act to reflect the inclusion of the regulation of voluntary euthanasia in the matters covered by the Act.

6—Amendment of section 3—Objects

This clause amends section 3 of the Act to include the regulation of voluntary euthanasia among the Act's objects.

7—Insertion of Part 2 Division A1

This clause inserts new Part 2 Division A1 into the Act, making it clear that the provisions contained in that Part do not apply in relation to the administration of voluntary euthanasia.

8—Repeal of section 18

This section repeals section 18 of the Act (currently a prohibition on the administration of voluntary euthanasia) which becomes incorrect should this Bill become enacted.

9—Substitution of Part 4

This clause substitutes a new Part 4 and Part 5 into the Act as follows:

Part 4—Voluntary euthanasia

Division 1—Preliminary

18—Interpretation

This clause defines key terms used in this measure. Most importantly perhaps, it provides that the killing of a person will only be voluntary euthanasia (and hence not murder or suicide) if the relevant treatment is carried out in accordance with the Act.

Division 2—Requests for voluntary euthanasia

Subdivision 1—Active requests

19—Active requests

This section provides for the making of active requests; that is, a request by a person who is a person to whom the proposed section applies. Such a person must be—

(a) an adult person who is in the terminal phase of a terminal illness; or

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

(i) results in permanent deprivation of consciousness; or

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

Such a person can make a request that he or she be administered voluntary euthanasia.

The clause sets out the procedural requirements that must be satisfied in relation to the making of an active request, including the need for at least 2 separate appointments (at least 24 hours apart) with the medical practitioner to whom the request is to be made, the information to be given to the person, who must witness the making of the request and the steps those witnesses must take.

The clause also provides that, in the event that the medical practitioner suspects that the person is not of sound mind, or that the decision-making ability of the person is adversely affected by the person's state of mind, the medical practitioner must not accept the request unless the person has obtained a certificate from a psychiatrist to the contrary.

The clause also provides that an active request can be made orally if the person is unable to write, and sets out the procedure to be followed by the medical practitioner and witness in such circumstances.

The person's request may set out any directions or conditions the person wishes to be satisfied in the administration of voluntary euthanasia.

Subdivision 2—Advance requests

20—Advance requests

This section provides for the making of advance requests; that is, a request by an adult person who is a person who may or may not be in good health, but to whom proposed section 18 does not yet apply. The request of a person that voluntary euthanasia be administered to him or her cannot be granted until he or she does, in fact, become a person to whom that section applies.

The clause sets out the procedural requirements that must be satisfied in relation to the making of an active request, including the need for at least 2 separate appointments (at least 7 days apart) with the medical practitioner to whom the request is to be made, the information to be given to the person, who must witness the making of the request and the steps those witnesses must take.

The clause also provides that, in the event that the medical practitioner suspects that the person is not of sound mind, or that the decision-making ability of the person is adversely affected by the person's state of mind, the medical practitioner must not accept the request unless the person has obtained a certificate from a psychiatrist to the contrary.

The clause also provides that an active request can be made orally if the person is unable to write, and sets out the procedure to be followed by the medical practitioner and witness in such circumstances.

An advance request must also set out set out instructions in relation to determining what level of pain, indignity or other distress would make life intolerable to the person.

The person's request may also set out any directions or conditions the person wishes to be satisfied in the administration of voluntary euthanasia.

An advance request continues to be in force for a period of 5 years after the day on which it comes into effect (or until such earlier date as may be specified in the request), but a person can renew the request before it expires by taking the steps set out in proposed section 21.

21—Renewal of advance request

This clause sets out how a person can renew his or her advance request. Such renewal must occur before the request expires, and extends the life of the request for a further 5 years after the date on which the renewal notice is given to the Registrar.

No fee is to be payable for a renewal, and a request can be further renewed as needed.

Subdivision 3—Miscellaneous

22—Variation of requests

This clause enables a person to make certain variations to his or her request for voluntary euthanasia, namely the types of instruction or other matter referred to in proposed section 19(3)(e) or 20(2)(f) of the measure.

The variation requires the written authority of the Board, and the Board cannot authorise a variation if the variation significantly changes the nature of the request for voluntary euthanasia.

23—Interaction between requests

This clause provides that a person's request for voluntary euthanasia made in accordance with the measure automatically, upon registration, revokes any previous such request.

24—Revocation of requests

This clause sets out how a request for voluntary euthanasia can be revoked by a person. Any indication on the part of a person who made a request that the request is revoked, or even that they wish to revoke the request, will be sufficient to revoke the request. Such a revocation can occur at any time, and can be made even if the person is no longer of sound mind.

The clause also provides a duty on the part of medical practitioners and others to notify the Registrar in the event that they become aware that a person has revoked a request, and creates offences in relation to non-compliance with those duties where the person does not have a reasonable excuse for such non-compliance.

25—Documents to be forwarded to Registrar

This clause requires a medical practitioner to whom a request for voluntary euthanasia is made to provide certain documents to the Registrar, and creates an offence for non-compliance without a reasonable excuse.

Division 3—Voluntary Euthanasia Board of South Australia

26—Establishment of Board

This clause establishes the Voluntary Euthanasia Board of South Australia and sets out the nature of the Board's legal identity.

27—Composition of Board

This clause provides that the Board is to be made up of 5 persons appointed by the Governor, of whom 3 are medical or legal experts and 2 are nominated by the Minister. The clause also sets out certain requirements relating to the appointment of the Board members.

28—Terms and conditions of membership

This clause sets out the terms and conditions of a member's appointment to the Board, including that the member is entitled to remuneration, allowances and expenses determined by the Governor. However, a Board member cannot serve on the Board for more than 9 years in total.

The clause also makes standard provisions in relation to removal of Board members.

29—Presiding member

The Minister must appoint a member of the Board to be the presiding member at Board meetings.

30—Functions of Board

This clause sets out the functions of the Board, namely to advise the Minister and carry out any functions assigned to the Board under the Act or by the Minister.

In carrying out its functions, the Board must ensure that a person's request for voluntary euthanasia is carried out lawfully and in accordance with the wishes of the person.

31—Board's procedures

This clause sets out standard procedures that regulate how the Board functions and makes decisions.

32—Conflict of interest etc under Public Sector Management Act

This clause provides that, for the purposes of the Public Sector Management Act 1995, and in particular the conflict of interest provisions, a Board member will not be taken to have a direct or indirect interest in a matter by reason only of the fact that the member has an interest in the matter that is shared in common with persons in the medical or legal professions generally, or a substantial section of persons in the medical or legal professions.

33—Other staff of Board

This clause provides that the Board may have such other staff as it thinks fit, and clarifies the staff member's position in relation to the Public Service.

The clause also provides that the Board may make use of Public Service staff and facilities with the permission of the relevant Minister.

34—Annual report

This clause requires the Board to provide an annual report on its operations, and that report to be laid before Parliament. The report must include the information required by the regulations.

Division 4—Register

35—Registrar of Board

This clause provides for the appointment by the Board of a Registrar.

36—Register

This clause requires the Registrar to keep a register in relation to all requests for voluntary euthanasia made in accordance with the Act as amended by this measure, and sets out the information required to be kept on the Register.

The clause also sets out procedures for inspection of the Register, providing the Register with an ability to set conditions on such inspection and limiting the people who may inspect the Register to those persons who, in the opinion of the Registrar, have proper grounds for such inspection.

The Registrar is also required to take steps to safeguard the privacy of persons (other than the person forming the subject of the relevant inspection) whose details may be contained on the Register.

37—Registrar may require information

The clause confers on the Registrar a power to obtain certain information required to allow the Registrar to prepare and administer the Register, and creates an offence of refusing or failing to comply with a requirement under the proposed section.

Division 5—Board declarations and orders

38—Board declarations and orders

This clause provides that the following persons can apply to the Board for a declaration of the kind specified in proposed subsection (2) in relation to a particular request for voluntary euthanasia:

(a) the person to whom the request relates;

(b) a medical practitioner who is, or is likely, to administer voluntary euthanasia to the person;

(c) the treating medical practitioner of the person;

(d) the Registrar;

(e) a person authorised in writing for the purposes of this section by a person referred to in a preceding paragraph.

The clause requires that, if the person requesting voluntary euthanasia is not the person who applied for a declaration, then he or she must be notified of the application, and must be given a reasonable opportunity to be involved in the ensuing proceedings.

Proposed subsection (8) sets out a number of orders that the Board can make if the Board is of the opinion that it is appropriate to do so. These orders enable the Board to:

(a) declare the request to be void and of no effect;

(b) postpone the administration of voluntary euthanasia for a specified period (being a period not exceeding 1 month) to enable further inquiries to be made in relation to the request;

(c) impose such conditions as the Board thinks fit on the administration of voluntary euthanasia to a person;

(d) make any other order the Board thinks fit in relation to the request (including an order that the person submit to an examination by a medical practitioner, or by a medical practitioner of a class, specified by the Board).

Such orders allow the Board to perform the task of effectively overseeing the administration of voluntary euthanasia, as such administration cannot lawfully proceed without any orders made having been complied with.

The clause also creates offences for contravention of such orders, or conditions imposed by such an order, and sets out procedural matters relating to hearings under the section.

39—Powers of Board in relation to witnesses etc

This clause makes standard provisions in relation to the ability of the Board to summons witnesses and documents etc, and require the witnesses to make an oath or affirmation and answer questions.

40—Access to Board records

Unless the Supreme Court orders otherwise, records of proceedings under proposed section 38 are not open for inspection.

41—Finality of declarations

A declaration of the Board under proposed section 38 (as opposed to an order under that proposed section) is not able to be appealed against or reviewed in any way.

Division 6—Appeal

42—Right of appeal to Supreme Court

This clause provides a right for a person to whom section 38 applies in respect of a particular request for voluntary euthanasia to appeal to the Supreme Court against an order made by the Board under section 38 (but no other matter) in relation to the request.

Division 7—Administration of voluntary euthanasia

43—Administration of voluntary euthanasia

This clause sets out how voluntary euthanasia can be administered to a person in accordance with a request for voluntary euthanasia. The medical practitioner must take a number of steps before proceeding to administer voluntary euthanasia, each designed to ensure that the relevant request is still in force, that the person does not wish to revoke the request and that the person is a person to whom voluntary euthanasia can be administered in accordance with the Act.

The clause also provides that, in administering voluntary euthanasia, the medical practitioner must give effect, as far as is practicable, to the wishes of the person.

44—Report to State Coroner

This clause requires a medical practitioner who has administered voluntary euthanasia to provide a report in the prescribed form to the Coroner, and requires the Coroner to provide a copy of the report to the Board.

Division 8—Offences

45—Undue influence

This clause provides that anyone who dishonestly or by undue influence induces another person to make a request for voluntary euthanasia under the Act is guilty of an offence, the maximum penalty for which is 10 years imprisonment.

46—False or misleading statements

This clause provides that anyone who makes a false or misleading statement in relation to a request for voluntary euthanasia under the Act, or in relation to a revocation or purported revocation of such a request, is guilty of an offence, the maximum penalty for which is 10 years imprisonment.

Division 9—Miscellaneous

47—Certain persons to forfeit interest in estate

This clause provides that a person who is found guilty of an offence against proposed section 24(5) (failure to notify Registrar of a revocation of a request for voluntary euthanasia) or proposed section 45 (undue influence) forfeits any interest that he or she may have in the estate of a person to whom voluntary euthanasia has been, or is to be, administered.

48—Protection from liability

This clause confers immunity on medical practitioners who administer voluntary euthanasia in accordance with the Act, and such persons who may assist in such administration.

49—Person may decline to administer or assist the administration of voluntary euthanasia

This clause protects the right of a person, or a body of person, to refuse to be involved in the administration of voluntary euthanasia without fear of discrimination or victimisation.

50—Cause of death

This clause provides that the cause of death of a person to whom voluntary euthanasia has been administered will be taken to be the person's illness, injury or medical condition that was the basis for the application of proposed section 19 to the person. The clause further provides that the administration of voluntary euthanasia to a person is not homicide or suicide.

51—Insurance

This clause prevents insurance companies from discriminating against people who have requested voluntary euthanasia, or to whom voluntary euthanasia has been administered. The clause creates an offence for an insurer to ask a person to disclose whether they have made a request for voluntary euthanasia, and provides that the clause applies despite any agreement to the contrary between the parties.

52—Confidentiality

This clause protects information gathered in the course of the administration of the Act, limiting the distribution of the information to the circumstances set out in the clause.

Part 5—Miscellaneous

53—Regulations

This clause provides a regulation making power for the purposes of the Act as amended by this measure.


Debate adjourned on motion of Hon. J.M. Gazzola.

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