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Legislative Council - Fifty-First Parliament, Third Session (51-3)
2008-11-26 Daily Xml
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CONSENT TO MEDICAL TREATMENT AND PALLIATIVE CARE (VOLUNTARY EUTHANASIA) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 12 November 2008. Page 639.)

The Hon. SANDRA KANCK (20:45): I am delighted that, in this my final week of parliamentary sittings (well, I think it might be), I have an opportunity again to address the issue of voluntary euthanasia. I begin my comments by addressing those members who are convinced that they will never, ever desire to access voluntary euthanasia under any circumstances, and I ask them a question: does your personal conviction that you will not need it—or do not want it—give you the right to impose that view on others? Should your Christian belief system be imposed on the small number of people who might, under certain circumstances, want to end their lives using legal voluntary euthanasia?

I respect your right not to access it. I will not impose it on you, so why then do you not have the mutual respect of others who might need it in the future? In terms of my understanding of the Christian religion, a religion that purportedly places a high value on love (and I think that, from my upbringing, St Paul said that the greatest of these is love), a compassionate response to people with unremitting suffering ought to be forthcoming. The God I was brought up to believe in would not have wanted to see people facing suffering that cannot be alleviated. Some people in our churches and some of our politicians speak of a right to life, but a majority of parliamentarians and a minority of moralists who support them are insisting on an obligation for people to continue living, insisting on an obligation for some to die in pain and insisting on an obligation for some to die without dignity.

I ask those members who are considering voting against this bill: when did a right to life become an obligation to continue living under any circumstances? If we are religious we should use the beliefs to inform our decisions along with science and evidence, but we should not let religion make the decision for us. Having twice introduced my Dignity in Dying Bill (a bill for a referendum on voluntary euthanasia and a motion in support of voluntary euthanasia) and supported Anne Levy's Voluntary Euthanasia Bill (and produced dissenting recommendations about that bill when it was referred to the Social Development Committee), I am sure that most members in this place are aware that I am passionate about legal voluntary euthanasia.

It is 13 years since the first voluntary euthanasia legislation was introduced in South Australia by John Quirke. I had expected that it might take 10 years to get something passed, so I am very disappointed that no progress has been made and that yet another bill is necessary. After all, it took only 10 years of motions and bills for women to get the right to vote in the late 19th century in South Australia. When I moved a motion about voluntary euthanasia and suicide two years ago, there was much controversy, but I quote a letter to the daily newspaper supporting my action, as follows:

As a health carer it has become clear to me that, after all of the technological interventions required to assess and reach the diagnosis, it is the person left with the multiple organ system failure who is left to decide when to let go and whether or not their bank balance is enough to pay for another day.

Some will tell you that pain can be alleviated (at least in most cases) and, therefore, voluntary euthanasia is not needed. But it is not pain that is the issue for most people seeking voluntary euthanasia, although it might be a component. The multiple organ system failure quoted above is an example. Palliative Care Australia's policy statement states:

Palliative Care Australia:

Acknowledges that while pain and other symptoms can be helped, complete relief of suffering is not always possible, even with optimal palliative care.

Recognises and respects the fact that some people rationally and consistently request deliberate ending of life.

Unfortunately, Palliative Care Australia offers no solution to that, just a recognition that palliative care will not always be able to reduce the suffering.

Around the world, support for voluntary euthanasia is gathering strength, the most recent success occurring just three weeks ago with a majority vote for Washington's 'Initiative 1,000'. That will be physician-assisted suicide, similar to the law in Oregon which has been in place since (I think) about 1995. The Netherlands, Switzerland and Belgium have legal voluntary euthanasia and there are degrees of it in other parts of the world. In Germany, assisted suicide is not a crime, although it cannot involve a doctor.

Despite being a devout Roman Catholic society, the High Court of the Republic of Colombia declared assisted voluntary euthanasia to be legal as far back as 1997, although the parliament has not progressed guidelines that would be required for its implementation. In Uruguay, the criminal code allows judges to forego punishment for mercy killing under certain conditions; and in Norway and Denmark, extenuating circumstances may result in charges of assisted voluntary euthanasia or physician-assisted suicide being withdrawn or dismissed by the courts.

In South Australia, the act which this bill is amending, does allow disconnection from a life support system. The Consent to Medical Treatment and Palliative Care Act also allows doctors to provide terminal sedation (as it is known in the trade). This means that a doctor can up the medication to alleviate the patient's discomfort, even though it might mean the earlier death of the patient, and provided there is no stated aim of bringing about an earlier death, the doctor is protected from any legal action. That has now been in place for 13 years and it has provided a degree of comfort to many sufferers and their families, and I have not ever heard a single complaint about its operation.

It is not voluntary euthanasia, however, and its value to suffering people is dependent on their affliction. If you have lung cancer and you have been hooked up to some technology to allow you to keep breathing, you can be asked to be disconnected from that machine, but if you had the bad luck, for instance, to develop ovarian or testicular cancer, you would not be on any life support system and therefore could not be disconnected from it. If you have intense pain, you can keep asking for the morphine levels to be upped until it ultimately kills you, but if the pain you experience is manageable or you have none at all, then that way out is banned for you.

In its current form, the consent act serves a purpose but it is limited. Inserting provisions similar to my dignity in dying bill in this act is a good way to go. I see this bill as being a great deal better than the one which has been introduced into the House of Assembly by the Hon. Bob Such which has extremely limited application. Under the objects of his bill, it states:

(a) to give a limited number of competent adults who are in the terminal phase of a terminal illness and who are suffering unbearable pain the right to make informed choices about the time and manner of their death;

I ask: what about the person who has oedema and has fluid running out of their skin and basically cannot leave their house because of it? What about the person who is vomiting up their own faeces and whose vomiting cannot be controlled? There are numerous awful examples like this and such people would not be able to end their lives in a slightly dignified way under the Hon. Bob Such's bill. As I say, it really has extremely limited application.

With regard to this bill, I think that the provision that the Hon. Mark Parnell has put regarding advance request is a little tough. He is requiring anyone who has an advance request under his legislation to renew that request every five years. I think that is way too short a time line. We can get a driver's licence that lasts for 10 years, and you can do a hell of a lot more damage with a driver's licence in 10 years than you can having a written advance request sitting in your bedside drawer.

Previously I had a directive under the Natural Death Act, which I signed almost 20 years ago, and only a few months ago did I replace that with a medical power of attorney, and I see no good reason why that earlier directive should not have remained in force until I tore it up. I do think that this is a bit unreasonable, and I suggest that other members might consider amending the bill to extend the time of applicability to at least 10 years.

The Hon. Mark Parnell referred in his explanation to opinion polls showing that 81 per cent of South Australians support voluntary euthanasia, but it is actually better than that. The particular Newspoll (the most recent one published in early 2006) showed 81 per cent support in the metropolitan area and 84 per cent in the non-metropolitan area, so I would take a guess that it probably means about 82 per cent.

The next of those Newspolls will be due for publication at the beginning of 2011. They became so predictable that they started conducting them once every year, then they went to every two years, and now they have gone to every five years because, each year, the level of support goes up and up and it is, as I say, very predictable.

In regard to those polls—and I am pre-empting anyone here who wants to try this trick—I have frequently heard opponents of voluntary euthanasia claim that, of course people will answer yes if they are asked whether they support voluntary euthanasia, because they think that they are being asked whether patients should be able to be disconnect from a life support system. The people who tell that story should know better, because the actual question that is asked—and it has been asked in every poll that has been conducted by Newspoll for the past 20 years—is:

If a hopelessly ill patient, experiencing unrelievable suffering, with absolutely no chance of recovering, asks for a lethal dose so as not to wake again, should a doctor be allowed to give a lethal dose or not?

So, although I will not be here when the Hon. Mark Parnell will ask for this to be a vote, I do caution people not to try that one on.

Returning to the bill itself, I was a little surprised and, I have to say, a little offended by the Hon. Mark Parnell's comments that, while the other VE bills that have been introduced in this parliament have focused upon the protection of doctors, his is focused upon the person suffering. I invite him to have a look at my dignity in dying bill, because I assure him that it really was about the suffering person. Admittedly it did have 14 hoops to jump through in order for the person to access voluntary euthanasia but, given that the opponents of voluntary euthanasia usually proclaim that there are not enough safeguards, I found it necessary to make it just that bit more difficult for the patient—

The Hon. J.S.L. Dawkins: I thought it was more than 14.

The Hon. SANDRA KANCK: No; 14 was the number of hoops, yes. I had that many hoops in order to appease the doubters. From my cursory glance at this new bill, I think that the Hon. Mark Parnell has put in a similar number of hoops. He will find that, despite that, there are some in this chamber who will still say that there are not enough, that the bill is not tight enough, that it is not stringent enough. One can put so many hoops into legislation such as this that the person will die in the process of trying to get through them all, but I think one has to strike a balance and I thought that 14 hoops were enough. Despite that one criticism of the Hon. Mark Parnell, I take the opportunity to commend him for introducing this bill, and I hope that there will be enough members with common sense, compassion and courage to support him when he takes it to that vote.

Debate adjourned on motion of Hon. J. Gazzola.

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