Zed Seselja (ACT, Liberal Party, Assistant Minister for Science, Jobs and Innovation) Share this | Hansard source

In considering this bill, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, we first have to define exactly what it is we are debating. Some have suggested we, particularly those of us representing territories, should put aside our views about the rights and wrongs of assisted suicide and simply debate the merits of territory rights. I reject this view for a number of reasons.

When the Andrews bill was debated in 1997, a conscience vote was granted by both major parties because it was recognised that this was an issue of such profound importance and, where there are such strong convictions, the vote should not be determined by the parties but by the individual senator or member. If it were an issue of territory rights, no doubt each of the parties would have a party position, because, on other occasions when territory rights have been considered in this place, a conscience vote has not been not granted. For instance, in 2001, this chamber voted to overturn Northern Territory laws on mandatory sentencing. I note that not only was this a party lines vote but the Labor Party, including the Territory Labor senator, and the Greens voted as a bloc specifically to overturn a law that a democratically elected parliament had enacted. As Lindsay Tanner stated in 1997 when debating the legislation that this bill seeks to overturn: where would territory rights advocates be if this were not about euthanasia but about capital punishment? He went on to say he suspected that there would be some who would be only too happy, too ready, to join in overruling the Northern Territory parliament should it decide to reintroduce capital punishment.

In correspondence I have had with people in Canberra, views have, of course, been mixed, though there is a tendency to support or oppose this bill, depending on which side of the assisted suicide debate one finds oneself on. Many of the people who support this legislation would be very happy to see Commonwealth intervention if the tables were turned and it was a different piece of legislation that was being debated. While parts of the media seek to suggest that Canberrans are of one mind in wanting more autonomy for the Territory parliament, I don't have people banging down my door asking that 13 individuals in the ACT assembly be given unfettered power. In fact, the more than 50 per cent of Canberrans who voted for a party not in government often feel completely disenfranchised by the way their government completely ignores their wishes. While I know less about the Northern Territory, I do know that, when given the opportunity to have less Commonwealth intervention in their affairs by becoming a state, Territorians voted in 1998 to remain a territory. This vote occurred after the Commonwealth had used its territories power to overrule the Northern Territory's assisted suicide legislation.

This brings me to the issue of assisted suicide. I oppose assisted suicide. I have no doubt that, if this bill passes the parliament, we will see assisted suicide in the ACT at least; therefore, I cannot support the bill. It's impossible, of course, not to be moved by the plight of terminally ill Australians who are suffering. There is no doubt that not enough is being done to ensure proper pain relief and palliative care is available to more Australians, and I'll come back to this later in my contribution. The question we have to ask as legislators is: will crossing this ethical threshold lead to better or worse outcomes for Australians, particularly our most vulnerable—the sick, the elderly, the disabled, the depressed and the lonely? Experience overseas suggests it will not. Former Prime Minister Paul Keating got to the heart of the matter last year in relation to the Victorian laws, saying:

What matters is that under Victorian law there will be people whose lives we honour and those we believe are better off dead.

He goes on to say:

… advocates support a bill to authorise termination of life in the name of compassion, while at the same time claiming they can guarantee protection of the vulnerable, the depressed and the poor.

No law and no process can achieve that objective.

Does anyone really believe that laws passed by 13 Labor and Greens members of the ACT assembly, with no house of review, would be anything but an even more extreme version of the Victorian law with fewer safeguards? In fact, the sponsor of this bill, Senator Leyonhjelm, suggests that is exactly what he is hoping a territory legislature will deliver. In the Australian Financial Review, Senator Leyonhjelm recently wrote that, while the Victorian legislation was, in his words, 'a step in the right direction', he lamented the fact that the law only allows for euthanasia for the terminally ill. No doubt Senator Leyonhjelm is confidently hoping that the ACT assembly or the Northern Territory legislature will deliver a no-holds-barred version of assisted suicide. It's a legitimate fear. Supporters of this bill are very clearly leaving open that possibility, and I think it's clear that, if this bill passes, assisted suicide will be legal in the ACT before long.

One of the government's fundamental duties is to ensure that its laws protect the most vulnerable in society. As Lindsay Tanner stated, back when debating the law that is being sought to be repealed here:

… there is a very different question at stake here; that is, not whether in some individual circumstances there is something morally wrong, but whether the state should legalise and indeed can safely legalise such practices.

The reality is that the state cannot safely do so. Last week, we saw shocking reports that a nine-year-old and an 11-year-old became the youngest ever to be euthanised under Belgian law. Many who favour assisted suicide would say, 'That would never happen here.' To quote Paul Keating again:

… once termination of life is authorised the threshold is crossed. From that point it is much easier to liberalise the conditions governing the law. And liberalised they will be.

He continues:

The experience of overseas jurisdictions suggests the pressures for further liberalisation are irresistible.

So what is the experience overseas? Well, in Belgium, kids are now being killed by doctors with the authority of the state. That jurisdiction brought in assisted suicide in 2002 with apparently strict parameters that only those in constant and unbearable physical or mental suffering which could not be alleviated would be able to make requests for assisted suicide. In a relatively short time, this has expanded so that, in 2015, 15 per cent of cases did not involve people who were terminally ill and included those with depression—and now even children.

In Oregon in 2016, 19 years after the introduction of assisted suicide, nearly half of the people killed under the scheme cited concerns about being a burden to family, friends and caregivers as a reason for it, compared to just over a third who cited inadequate pain management as their reason.

Professor Margaret Somerville writes in The Guardian:

In the Netherlands, euthanasia is no longer restricted to competent adults with unbearable suffering able to provide informed consent. It's now available to children, newborn babies with serious disabilities, and people with dementia and mental illness, such as depression, without physical illness. There are movements to legalise access to inflicted death for people "over 70 and tired of life" or who feel they have a "completed life". Likewise, after just over a year of legalised euthanasia in Quebec, there are calls for it to be extended to "euthanasia on demand", that is, that there should be no requirements for access by a competent person.

So it's difficult to see how the logic pointed to by Paul Keating about further liberalisation, which is being played out everywhere that assisted suicide is allowed, would not apply in Australia's territories.

Victoria's Labor Deputy Premier, James Merlino, pointed to studies that have shown that, in jurisdictions which have legalised assisted suicide, the rate of unassisted suicide also rises. With all we do as a government and a society to discourage suicide, particularly by our young people, what message will we send if we open the door for state-sanctioned suicide? How much does legislation such as this undermine the amazing efforts of so many to discourage suicide in our society? And, of course, we've seen the example of high-profile assisted-suicide campaigner Philip Nitschke, who in 2014 advised a 45-year-old man, who was not terminally ill, on acquiring and subsequently taking life-ending drugs. Nitschke said:

If a 45-year-old comes to a rational decision to end his life … they should be supported.

Palliative care has come a long way. However, governments need to invest more in it. Of course, assisted suicide is much cheaper than palliative care, which provides a perverse incentive. Professor Ian Haines, a medical oncologist, tells of his support for euthanasia due to the traumatic passing of his aunt in 1969 in the absence of quality palliative care. However, now his views have changed. He says:

The advances in the skills, availability and knowledge in palliative care since those days have been phenomenal.

He goes on to say:

I have received many euthanasia requests from patients and families over my 34 years in full-time oncology practice, some very passionate, but I have invariably found that they quickly disappear as reassurance and adequate medication doses provide the comfort that is desired …

The reality is that palliative care, properly resourced and administered, provides a whole-of-community response to a patient and has the capacity to nurture people towards a dignified death.

According to an open letter to the Victorian parliament published by a number of palliative care professionals:

Current Australian data indicates that no more than 2 in every 100 Palliative Care patients would be in moderate or severe pain at the end of life. In these unusual cases where when all other methods of palliation for pain and other symptoms is inadequate, and if the patient agrees, palliative sedation therapy is available to provide adequate relief of suffering.

They further note:

It would be unethical for any state jurisdiction in Australia to move to legalise for assisted suicide or euthanasia whilst many ill, aged and disabled Australians cannot yet access the support that they need. Such a move would not enhance choice, but instead reduce choice around the care and support for those in real need.

How could it be any other way? How can people truly be exercising personal autonomy and choice when they are not being offered the best choices available?

In the ACT, where this bill would have its effect, there is no question that palliative care resourcing from the ACT Labor government has not been up to scratch. Dr Michael Chapman, Canberra Hospital's director of palliative medicine, says:

Our pressing priority to provide end-of-life choices in the ACT requires people to have real access to quality palliative care which is currently not always the case for many and not always the case when we need it. People often receive too little or too late or no services at all.

Dr Chapman's evidence to the inquiry into end-of-life choices in the ACT confirmed that there are just four full-time equivalent palliative medicine specialists operating in the territory—half the number required for the size of the population. And, given that the territory treats many patients from the surrounding regions, this number again falls short. The Hon. John Watkins, the chair of the board of Canberra's Calvary Hospital, also notes:

… rather than weakening current protections we should instead be talking about how we best support the dignity and personal needs of those reaching the end of their life in addition to their families and make sure that care is available and accessible to all.

It is significant to note also that the 2016 review of the National Palliative Care Strategy found that there remain significant barriers to access to palliative care services for a number of people within the population, particularly for the Aboriginal and Torres Strait Islander peoples and:

… there is work to be done in developing culturally specific activities to address the needs of Aboriginal and Torres Strait Islander peoples to help improve access for those who need it.

The report noted that Aboriginal and Torres Strait Islander Australians have not accessed palliative care services to the same extent as the general Australian population.

One of the most consistent arguments for legalising assisted suicide is about personal autonomy. However, overseas experience shows that personal autonomy is progressively eroded, with the most vulnerable feeling a burden on others or feeling pressured to do the 'selfless' thing and end their lives. One of the more horrible examples of this was reported in the Washington Times in October 2016. Stephanie Packer, a mother of four children, with a terminal illness, was denied coverage from her insurance company for chemotherapy treatment but was offered coverage for assisted suicide. Mrs Packer had initially been told that the insurance company would cover the cost of switching to a different chemotherapy drug, but the insurance company changed its position after the passage of the assisted suicide laws. This was a situation where a law about choosing to die ended up impacting on someone's ability to make a different choice. How's that for personal autonomy? How much easier will it be for governments to pay for euthanasia rather than treatment if these types of laws are passed?

Indeed, in Canada, with the introduction of assisted suicide in 2016, a report into the cost analysis of medical assistance in dying in Canada found:

… medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5 to $14.8 million in direct costs associated with its implementation.

The report states:

... as death approaches, health care costs increase dramatically in the final months. Patients who choose medical assistance in dying may forego this resource-intensive period.

The report states that, as death approaches, healthcare costs increase dramatically in the final months. Patients who choose medical assistance in dying may forego this resource-intensive period.

In my contribution, I've spoken a lot about the huge risks inherent in legalising assisted suicide, but don't just take my word for it. We debate many issues in this chamber, and how many times do people on all sides talk about the need to listen to the experts on questions of public policy? Let's listen to the experts. Let's listen to the Australian Medical Association, whose former president Dr Michael Gannon pointed out:

It has long been recognised that doctors who are closest to providing end-of-life care are those most likely to be opposed to physician-assisted suicide.

Let's listen to the World Medical Association, who said:

Physicians-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession …

and vulnerable people will be placed at risk of abuse. As I've already mentioned, the chair of the board that oversees Canberra's Calvary Hospital, the former Labor deputy premier of New South Wales, John Watkins, has written a letter that I'm sure every senator will have received. He states: 'Central to Calvary's mission over the past 130 years has been to care for the most vulnerable in our community, and we believe that encouraging laws to terminate life will disproportionately affect vulnerable groups in our society who deserve our care.'

Once again, let's be clear. This is not fundamentally about territory rights; it is about human rights. The passage of this bill will inevitably lead to assisted suicide in the ACT, almost certainly with minimal safeguards, as supported by the bill's sponsor. I will stand up for the human rights of Canberrans not to be pressured to end their lives. I will stand up for proper investment in palliative care. I will stand up for the old, the disabled, the sick and the lonely, for whom the passage of assisted suicide laws would see their lives considered less worthy. I will therefore vote against this bill.