Concetta Fierravanti-Wells (NSW, Liberal Party, Minister for International Development and the Pacific) Share this | Hansard source

I rise to speak on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 and, of course, this is one of those very, very difficult issues of conscience. Can I say at the outset, before I make some personal remarks, I do want to set out some parameters and indicate that the government does not plan to repeal the Euthanasia Laws Act 1997 and has no intention of reconsidering the self-governing acts of the Northern Territory or the Australian Capital Territory at this time.

The Australian government recognises that members of the community have strong views about dying with dignity, compassion and minimal pain. The underlying principle of our investment in health services is quality of life, and this includes, of course, end-of-life care. The Australian government believes that people should have access to quality palliative care and relief from pain and suffering and that, where possible, people should be able to choose the extent of active medical treatment they receive.

The Australian government provides funding for a number of initiatives to encourage delivery of quality palliative care and to improve access to services for people who are dying, including advanced care planning and the documentation of end-of-life care wishes. The Australian government will monitor and consider the impacts of the Victorian voluntary assisted dying legislation on various programs, noting that the Victorian legislation will come into effect from mid-2019.

Euthanasia was unlawful in Australia in all states and territories until the passage of the Voluntary Assisted Dying Bill 2017 in Victoria in November 2017. State governments are generally responsible for laws pertaining to voluntary assisted dying and euthanasia. Recently, several states and territories have revisited their voluntary assisted dying and euthanasia laws. On 22 November in Victoria, the Voluntary Assisted Dying Bill 2017 passed the upper house, and it passed the lower house on 29 November 2017. As I said, the legislation comes into effect from 19 June 2019.

In New South Wales, the Voluntary Assisted Dying Bill 2017 was defeated in the New South Wales Legislative Council on 16 November 2017 by one vote—20 votes to 19—and I'm very pleased, as a senator from New South Wales, that that did happen.

In Western Australia, the parliament has established the Joint Select Committee on End of Life Choices to inquire into the need for laws in Western Australia to allow citizens to make informed decisions about their own end-of-life choices. The committee is due to report by 23 August 2018.

In the ACT, the government established a Legislative Assembly committee to examine end-of-life choices in the ACT. The committee will report its findings to the assembly by the last sitting week of 2018. The Commonwealth euthanasia laws would need to be repealed for the ACT to legislate for voluntary assisted dying. The Commonwealth Euthanasia Laws Act 1997, which inserted limited provisions into the self-government acts of the Australian Capital Territory and the Northern Territory, prohibits the legislative assemblies of the ACT and the Northern Territory from making laws permitting euthanasia.

The Commonwealth government is carefully considering any possible interaction between the Voluntary Assisted Dying Act 2017, which was recently passed in Victoria, and relevant Commonwealth provisions. We do not, as I said, support the establishment of national voluntary euthanasia laws. We don't propose to repeal those laws, and we have no intention of reconsidering the self-governing acts of the Northern Territory or the Australian Capital Territory at this time.

Under the Therapeutic Goods Administration and the Office of Drug Control, there are approved medicines that, in various combinations and in high doses, could be used to effect euthanasia; for example, anaesthetics, painkillers, sedatives and neuromuscular blockers. These medicines would not require specific import for this purpose.

The use of such existing medicines in those combinations would be considered an off-label use—that is, outside the current TGA registered indications for these products. This is not illegal, but off-label use must be in accordance with good medical practice. The Medical Board of Australia is responsible for defining such practice. Preparation of a specific combination of high-dose medicines could—but not necessarily—be carried out by a compounding pharmacist within the state of Victoria. Compounding by a pharmacist for an individual named patient is regulated by state law and not Commonwealth law.

The potential to import specific drugs to facilitate euthanasia rather than using combinations may require the issue of an import licence from the Office of Drug Control if the substance to be imported is otherwise a prohibited substance. There are provisions under the Therapeutic Goods Act 1989 whereby doctors may obtain access under the special access scheme to unregistered medicines where such use is medically required. The Medical Benefits Schedule does not provide specific benefits for specific euthanasia related services and, at present, the Pharmaceutical Benefits Advisory Committee, the PBAC, has not recommended a medicine for listing on the PBS for euthanasia purposes.

I wanted to give these parameters as a preface to our position, but I now want to add, if I can, some personal reflections on this issue. Recently, of course, we had the debate in the Victorian parliament. It was certainly a very emotional debate and it is—as it was in the New South Wales parliament. What was very clear from the Victorian debate was that there was opposition to this. In particular, the Australian Medical Association, Palliative Care Victoria and other organisations opposed it; and, of course, church members and faith leaders also came out against it.

Can I say that the taking of one's life—whether it be a son or a daughter, a brother or a sister, or a mother or a father—is a crime under the Commonwealth legislation and it is a crime under state law. I have spent many, many years involved in voluntary work in the community since the early eighties. At the age of 23, I was a founding board director of a nursing home in the Illawarra. So issues of ageing have been of particular concern to me, especially in culturally and linguistically diverse communities. To have a situation where potentially the sick, the disabled, the mentally ill and the elderly, often at the most vulnerable time in their life and often in circumstances where they cannot make decisions for themselves—to simply say that we can take that life, to me, is from a faith perspective not right. And from a humanity perspective it is not right either. Of course, we know that there are people who do want to push for voluntary assisted dying. I think it is the thin end of the wedge. We know that this has been the subject of consideration by various committees in the past. But I believe there is a silent majority in Australia who do not believe that voluntary assisted dying in our society is a road that we should be going down.

As I said, I have been involved since the early 1980s, and have seen so many different aspects of ageing and aged care. Indeed, I was a shadow minister for ageing. At that time, I had the opportunity to visit about a third of the aged-care facilities in this country. Of course, when you go through an aged-care facility, you often see people there who have no-one or who have only one or two people. One of the things that struck me very much, particularly now as we have so many people who have dementia, was that about two-thirds of the people who are in our nursing homes have dementia. It is one of the most heartbreaking things that I have seen.

There's another side to the whole ageing issue: I used to call it the 'three Gs' when I was the shadow minister. A former minister passed that to me and said, 'This is how I refer to it.' They are the three Gs: grief, because you are grieving—you are putting a loved one in an aged-care facility; guilt, because you feel that you can't look after them and you feel bad; and greed. Regrettably, if we have the situation where we do have euthanasia laws, I think that it is the third of these that could give licence to people who might be persuaded that this is the best thing for their mother, brother, sister or whoever—most especially their mother or father—and, therefore, they are encouraged to euthanase.

My father died a number of years ago through dementia. When I saw what he went through, particularly as an older person from a culturally and linguistically diverse background, it was very difficult. They're really the people in our society that I am particularly concerned about, because often they can't speak English very well. Sorry, this is a little difficult. They really are the people who I feel may be most vulnerable. Therefore, what I think is really important, as we consider these sorts of laws, is to make sure that we have good palliative care available—because, in the end, good palliative care is so important.

It's also very important that we provide support in our residential facilities to enable people to be comfortable at the end of life. Often, many people who have dementia get to a particular point when they say, 'That's it.' I don't know what happens. I know with my own dad that about three months before he passed away, he actually did recognise me, which was really good. My father had been suffering from dementia for about three or four years. And then one day he just suddenly decided that that was it, and he stopped eating. Then a week later he passed away. But my father was fortunate. He had good care; he had a family around him. He had somebody who understood the system and was able to ensure that he had the best of care. But not everybody is in those circumstances.

I know that we as legislators here always want to do the best; we always want to make sure that we put in place the best possible framework and the best possible parameters to assist people. This is an area that gives licence to take away a human life, particularly in certain circumstances; they may be financial or others. Unfortunately, if you do have this available, I think that it is the thin edge of the wedge. I think that it will lead to loss of life—taking life—in those circumstances. As a Christian and as somebody who doesn't believe in taking life like this, I think that it is something that will be very detrimental to our society.