Voluntary Assisted Dying Bill 2017 Second Reading

17 Oct 2017

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I rise to speak on behalf of the Greens to the Voluntary Assisted Dying Bill 2017. The Greens will be supporting this bill. Voluntary assisted dying, or dying with dignity, has been a long-held policy of the Greens. It is worth pointing out that whilst I personally support this legislation, this is also a matter of policy for the Greens. Whilst I understand that this is a free vote for other members of this chamber, I am certainly urging all members to support this bill, and I am urging them to support this bill for the following reasons.

Firstly, we know that people with a terminal illness are suffering terribly because of that illness at the end of their lives, and in certain circumstances that suffering cannot be relieved by even the best of palliative care.

Secondly, we know that in these circumstances people are already taking actions to end their lives, whether that is through the refusal of treatment that can result in people ending their lives still in suffering and pain; whether that is increasing pain relief, such as morphine, to the point where a person loses consciousness, goes into a coma and eventually dies; or whether in some cases that is taking their own lives through suicide or through being assisted by a loved one to do so.

Thirdly, in this bill people with a terminal illness whose suffering from that illness cannot be relieved will be able to end their lives on their terms and to die with dignity. Even if they do not choose that option, they will enter the final stages of their life with the knowledge that they have that choice to do so.

Finally, there will be rigorous safeguards around the process for voluntary assisted dying — from the request to the administration of the drugs — through the oversight by the Voluntary Assisted Dying Review Board. It is for these reasons that I am urging members to support this bill.

This bill is a culmination of many years of campaigning and hard work by organisations and advocates for dying with dignity, including the Greens. In this Parliament we have pushed for the law to be changed and have previously brought forward our own bill. We were the only party to take to the previous election a commitment to introduce a framework for dying with dignity. It was in 2008 that Colleen Hartland, the Greens spokesperson for health, introduced a private members bill to the Council to make that happen.

In her second-reading speech Ms Hartland raised issues that are still relevant today, including the fact that since 1988 patients have been able to refuse treatment but that in some instances it is simply not enough and can result in terrible pain and suffering before a person dies; that a doctor can prescribe pain relief such as morphine to a point where a person loses consciousness — but that still raises many questions around consent, intention and a patient’s wishes; and that these difficult decisions, when a person is at the end of their life and experiencing suffering that is beyond relief, need to be made where the patient has the knowledge that they have the option to end their life on their terms. It is nearly 10 years since that bill was defeated. This issue of euthanasia was certainly something that I was aware of and supportive of around 10 years prior to that, when I was at high school, and it has been many decades prior to that that this issue has been discussed.

This bill has been a long time coming, and many people have suffered needlessly in the meantime, so certainly it is important that Parliament supports this bill so others will not have to suffer needlessly and can approach the end of their life with the knowledge that they will have a full range of options available to them, including voluntary assisted dying.

I think it is worth pointing out that voluntary assisted dying does have overwhelming support in the community, with research showing that around three-quarters of Victorians support these laws. While it is often portrayed as a deeply divisive issue, I think it is clear that politicians have been out of step with the wider community on this issue.

In regard to the Prahran electorate, I have had correspondence from local constituents both for and against the bill. In August I held a community forum where I was joined by Dr Rodney Syme from Dying with Dignity Victoria, who spoke about the legislation, and also by Sue Jensen, who spoke about her experience with cancer, her desire to have the choice of voluntary assisted dying and why it is important to her when facing the end of her life. The forum was very well attended, and not one person expressed their opposition to dying with dignity. There were some questions around the detail of the legislation but overwhelmingly the room was in support, so I am absolutely confident that I am representing the overwhelming majority of Prahran constituents, who support this bill.

Like Sue’s story, there are many stories of people suffering at the end of their lives and of people who have a terminal illness and want these laws to ensure they have the choice, if they need it, of voluntary assisted dying. For some there will be personal stories of family members or friends in similar circumstances. I am not one of them who has that personal story or personal connection, but nor do you need one to support this legislation. We know about the pain that people experience at the end of their lives when suffering a terminal illness and about the lack of the best palliative care to alleviate that pain. The ability under these laws to be able to die with dignity and have the choice of voluntary assisted dying and to have the safeguards put in place by this bill should lead us to supporting it.

The current bill has been brought forward by the government following the recommendations that came out of the inquiry into end-of-life choices, which reported in June 2016. The committee’s work was integral to progressing this issue. They consulted extensively, and they travelled to jurisdictions where similar legislation was in place. From that report we learned that without voluntary assisted dying, people are choosing to end their lives often in distressing ways. Evidence given by the Coroners Court of Victoria and others found that around 50 Victorians a year are taking their lives after experiencing an irreversible deterioration in physical health. Many of these people have ended their lives in violent and horrific ways in order to end the pain while they were still physically capable of doing so. These deaths are incredibly traumatic for families and loved ones. The inquiry committee report noted:

While it is impossible to know whether people would have availed themselves of the option of assisted dying if it existed, the evidence suggests that decisions to suicide are desperate and occur in the absence of a less devastating alternative.

The committee strongly recommended that voluntary assisted dying be legalised in Victoria, and it proposed the legislative framework based on the advice, consultation and research it did.

It is fair to say that without the committee’s work and the recommendation in support of voluntary assisted dying, this bill would not be before this Parliament. I would like to acknowledge all the committee, including the staff and the Greens MP Nina Springle, who was on that committee.

In response to the inquiry the Greens did announce that we would be bringing forward our own bill if the government did not act. I have no doubt that this pressure from inside Parliament, along with the pressure from advocates in the community such as Dying with Dignity Victoria and Go Gentle Australia, and the extensive committee report pushed the government to act, because regardless of the government’s actions there was going to be a debate on dying with dignity laws in this term of Parliament. It was better that the government use the far greater resources at their disposal and take ownership of this legislation, which to their credit they did.

In December 2016 the government announced it would introduce a voluntary assisted dying bill and would be appointing a ministerial advisory panel to develop the framework for the legislation. The panel reported in July 2017, and the recommendations were adopted into the bill. I would like to acknowledge the panel members who developed that framework.

In terms of the detail of the bill, which is the critical part here, and in terms of the eligibility criteria, people will only be eligible for voluntary assisted dying in limited circumstances. Health practitioners will not be able to initiate a discussion or suggest voluntary assisted dying, to avoid any situation where they may pressure or encourage the patient. The patient must be an adult, an Australian citizen or a permanent resident and a resident of Victoria. They must have decision-making capacity, and they must be diagnosed with an incurable illness that will cause death within weeks or months. A mental illness or disability alone will not be sufficient to be eligible, and the patient must be suffering from an illness that cannot be relieved in a manner that the person deems tolerable.

In terms of the requests and assessment process, a person must make a clear and unambiguous request to a medical practitioner to access voluntary assisted dying. A person may withdraw from that process at any time. The request must be assessed by two medical practitioners. If deemed eligible by both medical practitioners, the person must make a written declaration witnessed by two independent people. Following that written declaration, they would need to make a final request at least 10 days after making the first request. The person making the request will self-administer the voluntary assisted dying substance, except in the rare cases when they are not able to do so. Any unused voluntary assisted dying substance must be returned within one month of the person’s death. In terms of the protections and offences, the bill provides protection from both criminal and civil liability to medical and health practitioners who act in accordance with the law. The bill will include a number of specific offences, such as the misuse of a voluntary assisted dying substance and inducing another person to request voluntary assisted dying.

There will be the establishment of a Voluntary Assisted Dying Review Board, which will be responsible for monitoring voluntary assisted dying activity under this legislation. The board will ensure that there is transparency through annual reporting to Parliament, and six-monthly reporting to Parliament in the first two years. This will allow the public to be fully informed about the number of people accessing voluntary assisted dying and the reasons for access. If the board identifies wrongdoing or potential wrongdoing, it will be required to refer the matter to the relevant body. This may be the Chief Commissioner of Police, the secretary, the State Coroner or the Australian Health Practitioner Regulation Agency.

If this bill were to pass, it would be a great achievement for this state. To allow people at the last stages of their lives who have a terminal illness, who are experiencing suffering from that illness that cannot be relieved, to give them the ability to die with dignity, to give them the choice to die with dignity, would make such a profound difference to people’s lives at the end of their lives. The overwhelming community attitude towards giving people this choice is to support these laws — for themselves, for their family, for their friends and for others. Let us as a Parliament meet those community values and expectations in regard to this issue. Let us not continue to impose an unjust system which allows suffering to continue. Let us support this bill. The Greens commend this bill.

Debate interrupted.

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