Jacinta Collins (Victoria, Australian Labor Party, Shadow Cabinet Secretary) Share this | Hansard source

I too thank Senator Fierravanti-Wells for her contribution—both the personal and the broader policy considerations. They are very pertinent.

I might commence by briefly reflecting on some of the background to this matter. I asked colleagues in the chamber earlier today about who still remained in the Senate from when we considered the Andrews bill in 1997. There are four of us: Senator Macdonald, who was in continuation on the last occasion when this matter was being discussed, Senator Carr, me and Senator Abetz. As we reflect on the relatively high turnover of the Senate in recent times, it is interesting to note that there are only four of us who were here in 1997—20 years ago—who still remain.

When I reflect on that discussion—and it is perhaps the last time I dealt with my own views on this issue—it happened in a different context and it was done in a different manner. Earlier this week I made a brief statement in relation to formal business, or housekeeping as we call it, and I'll make a similar reflection now. I thank Senator Leyonhjelm for raising this matter. It's a very important issue, and it certainly warrants senators discussing issues such as this regularly, but I'm not sure that the general business part of our program is the best way to proceed with a bill of this character. It will surprise Senator Leyonhjelm to know when the last occasion the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 was before us. It was as long as 12 months ago. Twelve months ago, 16 February, we had some second reading debate speeches and then nothing further in relation to the debate on this bill.

So last year was the last time, but there have been a few other occasions where this issue has also been raised; however, never with the priority that was accorded this matter when, back with the Andrews bill, the Howard government ceded government business time for that bill to be addressed as part of government business. Indeed, the program for the Senate during the time in which it was debated allowed time for all senators to seriously consider the issues, to inform themselves on the matter, to respond to the public debate on the issue, and, indeed, to form their views. I don't think the piecemeal way in which general business deals with issues, which is in snippets, is the best way for an issue as serious as this to be addressed and to be brought to the fore of the minds of all senators concerned.

Perhaps the other personal reflection I would make, Senator Fierravanti-Wells, still here in the chamber, is that my personal experience didn't really fit your 'three Gs' characterisation. I was very fortunate. I, like you, had all the resources of someone in senior public office. It was ahead of the period when I was the Minister for Mental Health and Ageing, but I'm a professionally qualified social worker; I know how to work systems. I could identify the elements that would best assist in the situation, but even I was confounded by the funding arrangements at the time. Of course, for families contemplating putting a family member into aged care, to understand even the basic funding arrangements, to make the financial arrangements to best care for their family member and then to supplement them with all the other known supports that will ensure quality of care is a matter, I think, we're yet to succeed on. Palliative care is the other side to that situation. But, even ahead of palliative care, the transition between acute hospital care and aged care is one where, if someone doesn't have a very proactive family member, it is all too easy for hospital teams to conclude that not much more can be done.

I remember my father, after his first stroke, went into rehabilitation arrangements, and we made a transition back home. I remember the next occasion when he had a stroke and ended up in acute care. The suggestion was that his cognitive capacity, due to dementia, was such that not much more could be done. We ignored that advice. Our government of the day, I think, had established a transitionary rehabilitation program where those things could be measured outside of an acute hospital environment. My father was able to return to one of the joys of older people, which is being able to consume good food rather than live the remainder of his life consuming slush, because he had family members that could advocate and could work within a system to ensure the quality of his care was the best he could receive.

The final point I'd like to make, without going into too much detail—though I probably could—is a credit to Villa Maria. He was placed in a nursing home that was established probably about 15 years prior as what we would regard as best practice. It had dated a little bit by then, and it wasn't the best practice in dementia care as we could consider it at the time. But the care and the preparedness to go above and beyond routines is what that home and that organisation offers a lot of elderly Australians, and I want to pay credit to them.

With that background, let me say that voluntary euthanasia is a serious issue with a profound effect on all in our community. All of us would have a story. Too often it is characterised by simplistic and emotional language and reporting which hampers a reasoned debate, which is part of my reflection on dealing with matters such as this in a piecemeal fashion. My opposition to voluntary euthanasia is twofold: firstly, that it cannot be safely legalised; and, secondly, that euthanasia laws pose profound risks to many people who are ill, vulnerable and/or disabled. I have the deepest sympathy for people in severe pain and distress who are terminally ill and seek relief from their suffering. Palliative care, as I mentioned earlier, is one area we can do much, must better. But I do not believe that euthanasia, where life can be legally extinguished by another human being, is the solution.

Euthanasia advocates argue that society should legalise what already occurs in the medical profession. But I'm not sure that characterises what happens in medicine particularly well, and also I don't think that's sufficient justification to change the law. If doctors are breaking the law when euthanasia is illegal, what realistic constraints are there were it to be legalised? I have grave concerns about the lack of protection for those seeking a lethal injection or assisted suicide. What protection does a person in pain and severe distress, who may ardently believe that they wish to die at the time that they make the request, have?

How is the administration of a lethal dose by a third party a matter of individual rights or liberalism? I think that, too, is a question that needs to be challenged. As politicians we must accept responsibility for the vulnerable and disadvantaged and offer them protection beyond a superficial freedom of choice.

It is argued that the right to die is a matter of individual rights, that it is an individual choice and a matter of personal dignity. I have a different view about what constitutes personal dignity. What the individual wishing to die is asking is to be killed by another party. What is being requested is for the doctor to determine whether a patient will have a worthwhile life. Should we as a society endorse some people's suicides and not others? We must always balance individual rights and the public interest. While many people may wish to have the right to choose the timing of their death and the circumstances, that in itself is not a strong basis for social policy.

Another argument is that doctors, as part of palliative care practice, are presently killing patients by administering pain relievers in doses that are lethal. This goes back to my earlier point about how well characterised existing medical practice is. The point here is that palliative care experts intend to relieve patient pain, not to kill, and that is critical. We need to invest more in good palliative care. A 2015 Victorian Auditor-General report found that, while access to palliative care in the state has improved:

… some metropolitan community palliative care services are struggling to cope with demand …

Indeed, aged-care facilities are also struggling to do this well.

It would be wrong not to look at overseas experience. Legalisation begins with tight restrictions that get expanded over time. The Netherlands was the first country to legalise euthanasia, in 2001; now the age of eligible patients is 12. In Belgium there are no age restrictions. The category of what constitutes an illness is ever-expanding as well, with the Netherlands now considering euthanasia for—I don't know how you would define this—'completed life'. I agree with Senator Leyonhjelm when he said in his second reading speech that this is an issue about all of us; indeed, that is why I believe you must balance individual rights with the public interest.