Don Farrell (SA, Australian Labor Party, Deputy Leader of the Opposition in the Senate) Share this | Hansard source

I rise to speak on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I would like to start by recognising that many, if not all, in this place, and those watching will have experienced the suffering and the loss of someone dear to them. It's natural to be saddened by a loved one's suffering and passing, and it's natural to want to help to ease their pain. I think we all understand that it is a very sensitive issue and a very personal one. This debate will no doubt be a difficult and emotional one for many of us. In recognition of that, I hope this will continue to be a debate that is conducted respectfully and with the awareness of the emotions it will no doubt bring for many of us.

This bill does not of itself legalise assisted suicide and euthanasia. But it's very clear from its title, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, and from Senator Leyonhjelm's public comments, that this bill's objective is to pave the way for the legalisation of assisted suicide. That's why it is important that this bill, as it should be, is being treated as a conscience issue. Speaking on the bill today, I'd like to address two main points: firstly, the core issue of the conscience matter, of assisted suicide; secondly, the circumstances that have brought us to this debate today. As I've just outlined, the bill's core objective is to facilitate the legalisation of assisted suicide, so I do not intend to address the issue of territory rights, other than to say this is one of many issues in which the Commonwealth has sought to regulate the territories.

It is, however, the issue at the heart of the bill that I wish to address—assisted suicide. As I mentioned in my opening remarks, the suffering and passing of loved ones is something that most, if not all, of us in this place are likely to have experienced. We're all acutely aware that with life comes death. Obviously it's an extreme emotional experience and it is human nature for our emotions to influence our thoughts on such matters. I'm sure everyone in this place can sympathise with those who have had to witness and deal with loved ones towards the ends of their lives. While I expect much debate on this issue will focus on details, as has been the case with previous debates in state parliaments, my view is that we must not avoid addressing the fundamental realities of assisted suicide.

Paving the way for the legalisation of assisted dying would be an irreversible step over a major ethical threshold. As a society, we should give very serious consideration to the potential impacts of taking such a step—as former Prime Minister Paul Keating described—as abandoning the golden principles. It's also pointed out in typically blunt fashion what is proposed when we talk about euthanasia or assisted dying, which, in his words, would be 'permitting physicians to intentionally kill patients or assisting patients in killing themselves'. Unsurprisingly, whilst there is a range of views within the medical profession, as there is in society in general, the Australian Medical Association has serious concerns. The Australian Medical Association is against the legalisation of euthanasia and assisted suicide. In its position statement on the issue, the AMA says:

The AMA believes that doctors should not be involved in interventions that have as their primary intention the ending of a person's life.

It's my view that governments, too, should not be involved in interventions that have as their primary intention the ending of a person's life.

The comments of Paul Keating that I referred to earlier come from a piece he wrote following the approval by the Victorian lower house of the Voluntary Assisted Dying Bill 2017. That piece by the former Prime Minister summed up the key issues very succinctly. In that piece, he said:

… the 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. This is the point. If there are doctors prepared to bend the rules now, there will be doctors prepared to bend the rules under the new system.

He goes on to say that his opposition to the Victorian bill was not about religion, and that his concerns were shared by people of any religion and no religion; it is the principles that matter in public life. He says of those principles:

They define the norms and values of a society and in this case the principles concern our view of human life itself. It is a mistake for legislators to act on the deeply held emotional concerns of many when that involves crossing a threshold that will affect the entire society in perpetuity.

This is an emotional issue, but we must not let emotion cloud fact. It's also an issue of conscience, and for some people, that conscience may be informed by their faith. But, at its core, as Paul Keating alluded, it's an issue of principles—the ethics rather than the morals.

This is the point that former South Australian Attorney-General Michael Atkinson also made during a debate on this issue in the South Australian parliament. He said:

If my opposition to AVE is based on ancient wisdom, it is not that of Jesus of Nazareth but Hippocrates of Kos, who lived some 350 years before.

He was of course referring to the Hippocratic oath, that well-known early expression of medical ethics, the principles of which remain of significance today. I'm told that one of the earliest surviving copies of the Hippocratic oath includes the words:

I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.

In Australia, the modern expression of medical ethics is in the Australian Medical Association's code of medical ethics. I would like to read from the section of the code that deals directly with assisted suicide. The AMA's code of ethics says:

It is understandable, though tragic, that some patients in extreme duress—such as those suffering from a terminal, painful, debilitating illness—may come to decide that death is preferable to life. However, permitting physicians to engage in assisted suicide would ultimately cause more harm than good.

Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks.

Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

(a) Should not abandon a patient once it is determined that cure is impossible.

(b) Must respect patient autonomy.

(c) Must provide good communication and emotional support.

(d) Must provide appropriate comfort care and adequate pain control.

The section on euthanasia is similar but goes even further, warning that the practice would be 'difficult or impossible to control, would pose serious societal risks' and could readily be extended to incompetent patients and vulnerable populations.

Advocates of assisted suicide often highlight patient autonomy as a reason. But, in the broader context of the code, that point refers to things like a patient's right to decline medical intervention or to ask that intervention be stopped, even when that decision is expected to lead to his or her death. Indeed, the code makes it very clear that respect for a patient's autonomy does not extend to providing for assisted suicide or euthanasia. It's important to note that the Australian Medical Association's code of medical ethics warns that assisted suicide and euthanasia would be difficult or impossible to control and could be extended to patients for whom these practices are not intended.

In recent days, I've seen reports that question the idea that paving the way for assisted dying would be a slippery slope. But I've also read with concern the comments of Australian bioethics professor Margaret Somerville reported in The Sydney Morning Herald yesterday. The Sydney Morning Herald reports that Professor Somerville, who has spent decades observing euthanasia in Canada, has said that the international experience demonstrated that 'euthanasia was being used as a cheaper alternative to psychiatric and palliative care'. The professor is quoted as saying that it would be a 'societal tragedy if we allow this', and I agree with her. The article goes on to say that, in a paper published in the Journal of Palliative Care, Professor Somerville and nine of her international counterparts argued that voluntary assisted dying has gone beyond the aims of relieving pain and suffering and is now being misused.

What is very concerning is that Professor Somerville says that assurance by the 'proponents of euthanasia that it would not lead to a slippery slope have been proven wrong, with research showing that safeguards are routinely violated.' The professor was quoted in the article as saying:

In one study in Belgium, they surveyed doctors and found that 32 per cent had gone outside of the regulations.

That should ring huge alarm bells for anybody, because it implies that not only have safeguards failed through human error but also that some doctors may be choosing to ignore them. Professor Somerville also says:

… in many cases, pain and suffering were not the primary motivator for an assisted suicide request, with a fear of being a burden on relatives a more common reason in patient surveys.

She has also argued that 'in most cases pain or discomfort could be remedied through proper palliative care'. I'm sure many in this place have personal experience of loved ones who, approaching the end of their lives, have struggled with the idea they may be a burden on their families. This is not a belief that should be encouraged through the provision of legalising assisted dying.

In the course of the broader debate on this issue across the nation, we've heard stories of people whose personal feelings on the issue of assisted dying and euthanasia have changed when they've been approaching their own end of life. A decision to make use of assisted dying made while a person is suffering and at a low point and may believe themselves to be a burden cannot later be undone. Some in favour of assisted dying argue that we can never achieve safeguards in any area of the law that work 100 per cent of the time, but the very obvious difference in this case is that the failure of the safeguards can result in death, a failure that is irreversible. The report I mentioned earlier—that 32 per cent of surveyed doctors in Belgium had gone outside the relevant assisted dying guidelines in that jurisdiction—only adds to these concerns.

Outside of debate on this issue, we've also heard many sad stories of elder abuse. Unfortunately, there are those who would seek to exploit vulnerable people who are terminally ill and suffering. Under the model proposed in Victoria, patients would have to administer the lethal drug themselves. What safeguards can ensure that once those drugs are provided, they will not be misused by others?

I'm not insensitive to the hurt that can be caused by seeing a loved one in pain and suffering, but there is no way to provide adequate safeguards against the extension, misuse or abuse of legalising assisted dying.

It is not acceptable to put people at risk of dying against their wishes, be it through accident or malicious intent, when we can address the problems of pain and suffering through better provisions of palliative care provisions. We know it's common for patients to say that they don't want to be a burden on their families, but we must not legislate in ways that are likely to make the chronically ill, elderly, disabled or dying feel they are burden. It is society's duty to provide appropriate health care to those who need it, not to devalue lives by classifying groups of people as less worthy of living because they meet an arbitrary set of criteria that make them eligible to seek assisted death.

Having made my position on the real objective of this bill clear, I'd like to now talk about how we got to this point. Malcolm Turnbull brought this bill on for debate this week in exchange for Senator Leyonhjelm's support for the re-establishment of the Australian Building Construction Commission. The democratic rights of workers in the building and construction industry were sold out so that this bill could be debated. The Law Council said this about the ABCC bill:

… a number of features of the bill are contrary to rule of law principles and traditional common law rights and privileges.

Dr Nicola McGarrity and Professor George Williams from the faculty of law at the University of New South Wales said:

… the ABC Commissioner's investigatory powers have the potential to severely restrict basic democratic rights such as freedom of speech, freedom of association, the privilege against self-incrimination and the right to silence.

Senator Leyonhjelm says that the Prime Minister gave him a guarantee that Liberals would be given a free vote on the bill and that it would proceed for consideration in the lower house. Former Prime Minister Tony Abbott reckons that deals like this one are wrong and says that Malcolm Turnbull has ignored proper internal process. Mr Abbott told 2GB:

I am a little worried about secret deals and I am a little worried that undertakings might have been made which weren't brought to the party room and the prime minister likes to talk about due process – I am very concerned about lack of due process.

On this, I agree with Mr Abbott. In other words, this bill is tainted.

To sum up, I oppose this bill because, at its heart, it's about facilitating assisted suicide. I oppose assisted suicide because I don't think any safeguards could guarantee the protection of the lives of the vulnerable. I oppose assisted suicide and euthanasia because experts, including the Australian Medical Association, have warned that it will be difficult if not impossible to control and is the wrong way to deal with the issue of pain and suffering. I cannot support something that I believe will ultimately lead to people dying against their wishes. I would like to again quote former Prime Minister Paul Keating, who said on Victoria's assisted dying bill:

Once this bill is passed the expectations of patients and families will change. The culture of dying, despite certain and intense resistance, will gradually permeate into our medical, health, social and institutional arrangements. It stands for everything a truly civil society should stand against.