Lyn Allison (Victoria, Australian Democrats) Share this | Hansard source

The Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 is not about whether or not abortion is or should be legal. That issue was resolved decades ago by every state and territory government in the country, and women can terminate unwanted pregnancies provided they meet the criteria set out in those state laws.

This bill is not about the morality, the desirability or otherwise of abortion. It is not about whether women are wilfully having abortions when they should not or just because it is available to them. It is not about feminism or whether the clinics, public and private, are acting out of self-interest—and, believe it or not, some people say so. It is not about whether women can or should be coerced into motherhood or harassed and shamed out of terminating the pregnancy. It is not about the intimidation women experience from protesters outside clinics photographing them and accusing them of murdering children.

Laws and regulations do not change a woman’s determination to terminate an unwanted pregnancy, even if they do not protect her from this kind of intimidation. They just affect the safety and the quality of the experience. It is not about the safety of RU486. If it were, there would be no reason to not rely on the TGA’s assessment of the risk. It is not about the current rate of abortion and how to get it down. The current rate is 75,000 to 80,000 a year, and dropping by all accounts. It is numerically lower than it was 30 years ago in this country, when there were very many fewer women here.

We have the figures for Scotland, Sweden, England, Wales, Switzerland and other countries where overall abortion rates did not increase following the availability of RU486. After the introduction of RU486 in New Zealand, our nearest neighbour, in 2004 there was a very small decrease for the first time in seven years. Of course it would be good to reduce the number of unwanted pregnancies—there is no question about that—and the need for abortion that arises from those unwanted pregnancies. But there is no cause to panic. It has nothing to do with ethics, the absence of values in schools, women’s careers, the rights of the unborn or dodgy anti-abortion government funded pregnancy counselling.

Let us be frank. This debate is taking place because a very small number of determined Australians think that by defending the ministerial veto on RU486 there is a chance that abortions—a dozen, 100, maybe only one—can be stopped. I respect them for their tenacity and their conviction, but they are wrong and they represent the less than 10 per cent of the general population that holds that abortion should not be available to women, regardless of the method. No amount of push polling, or selective, creative interpretations of history, or manipulation of statistics or studies changes the fundamentals. Abortion is legal in this country. Democratically elected men and women in state and territory parliaments made laws with regard to abortion and the criteria that must be met to terminate a pregnancy—and they did this 30 years ago.

Women cannot and should not be coerced into motherhood against their will. Difficult as abortion is, women have terminated unwanted pregnancies throughout history, in all countries and in all cultures. Women have put their lives at risk rather than bear a child that they cannot rear, and there are numerous compelling and often complex reasons for this. Some women only discover when they are pregnant that they have a gynaecological cancer, and can lose not only their pregnancy but also their chance of ever conceiving again.

Parenting is not easy. It is no piece of cake if you are low paid, if you are in insecure work, if your partner is violent, if you have a serious anxiety disorder, depression or a disability, if you are in poor physical health, if you are single with two kids who are already a handful, or if your parents would banish you as an unmarried mother. The risks of having an unwanted pregnancy are high. There are many years between puberty and menopause. For typical women in sexual relationships for most of their 30 or so reproductive years, pregnancy is a possibility every single month, and that adds up to around 400 occasions in a lifetime. Sixty per cent of women seeking terminations were using contraception that failed.

The Reverend Dr Dean Drayton of the Uniting Church said this week:

The decision to have an abortion is not just a moral issue but a social one. While the current debate attempts to pass moral judgement on the act itself, it ignores the many emotional, physical, financial and social issues that often create a situation where a woman is forced to consider an abortion.

The Uniting Church hopes that those engaged in this debate do not lose sight of the complexity of the issues.

This is why it is galling listening to the men—and it is mostly men—who have such contempt for women who terminate unwanted pregnancies, who have neither compassion nor understanding of the huge and, for many, daunting task of taking an embryo the size of a grain of rice to adulthood. It is okay for people to hold particular ethical or religious views that lead them to oppose abortion but it is not okay for them to impose their position on others who do not. Women are fully human. We will act on our own set of values and can be trusted to make reproductive health decisions for ourselves or to share those decisions with those we trust. An estimated one in three women have had an abortion, and I am one of them.

Fortunately, this bill is not about any of these things. The bill is quite simple. It removes the responsibility for approving the use of the abortion pill in Australia from the health minister and moves it to the agency that approves all other pharmaceuticals, the Therapeutic Goods Administration. Opponents of this bill have suggested that the TGA is not capable of correctly assessing the safety of RU486 and, by implication, that the Minister for Health and Ageing is. Both assertions are completely wrong.

The minister says that doctors cannot be trusted to use the drug properly, but doctors in the World Health Organisation, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Australian Medical Association, the Public Health Association of Australia, the Rural Doctors Association of Australia, the UK Royal College of Obstetricians and Gynaecologists, the International Federation of Gynaecology and Obstetrics, the US Food and Drug Administration, the American Medical Association and the American College of Obstetricians and Gynaecologists say that RU486 should be available to women as a safe alternative to surgical abortion, used in accordance with appropriate medical guidelines and supervision.

RU486 enables women to abort very early in pregnancy—indeed, as soon as the pregnancy is confirmed. Surgical procedures cannot be done before six weeks. It is ironic, I think, that opponents of abortion and RU486 also campaign against late term abortions but are silent on this benefit of this abortifacient.

But the key question here is who has the expertise to make a judgment about the safety and efficacy of a drug that is used for legitimate purposes. The current law not only gives the minister for health a veto over the availability of RU486; it specifically prohibits the assessment of safety and efficacy by the TGA before the minister decides. What a ridiculous system we have! How is the minister to make his decision without the input of the agency that has the expertise to do the assessment—particularly a minister who has no training in either science or medicine and who, I point out, is not a woman? The minister is not required to use any particular criteria in making his decision. The only process set out in the legislation is the requirement to inform the parliament if he approves an application, which will then go on to be assessed by the TGA.

The current minister’s opposition to any change has sent a clear message to possible sponsors of the bill: ‘Do not bother.’ So for 10 years none has, until now. Professor Caroline de Costa made an application to use RU486 for her patients, under the practitioners scheme. That process should take two to three weeks, but, six weeks later, she still has not heard back from the TGA. Other doctors have done likewise; they have made similar applications.

We have heard a lot about the importance of the parliament’s role in all of this, but the truth is that it has no role whatsoever. The decision is not disallowable, cannot be amended and is not open to challenge by parliamentarians or sponsors or women affected. There is no debate in this place. In fact, the parliament will not be informed of the reasons for the decision and will not even hear about it if the application is rejected.

RU486 is not a do-it-yourself, home alone option, as some would suggest, although many women choose RU486 because they see privacy and being in control as being advantages over surgical termination under anaesthetic. Supervision by a doctor is a must, as is access to emergency medical services. Everyone agrees with that. This bill does not change existing laws on abortion in Australia. If RU486 were made available, women and doctors would still need to comply with the relevant state criminal codes regulating the procedure.

It is not only women who may want to use the drug to terminate a pregnancy who miss out. RU486’s antiprogesterone action may be a useful therapy for conditions that include inoperable meningioma, Cushing’s syndrome, breast and prostate cancer, glaucoma, depression, endometriosis and uterine fibroids. Unfortunately, because of the current situation, Australians with these conditions miss out on access to this drug or are forced to cope with intolerable delays in trying to get that access. It is not enough to say that the current legislation allows RU486 to be imported under its special access scheme. In practice the scheme is unworkable. Doctors are worried about being involved in supplying a drug that the TGA has not been able to evaluate—and therefore for which it has not provided the normal assurances about drug use on which doctors depend for their indemnity requirements.

RU486 is safe and effective—not 100 per cent. No drug can claim that. Many other drugs are freely available but have many more side effects and pose much greater risks to the users. The opponents of this bill have made much of the small number of adverse effects associated with the drug, but I urge senators to look at the data carefully. At the end of the day, I urge them to make no judgment about the safety. That is the job of the TGA. No-one in this chamber is qualified to make that judgment, and they should not. All safety is relative, and risks are always weighed against benefits. So, for the sake of Australian women, I urge senators to support this bill.