Kate Chaney (Curtin, Independent) Share this | Link to this | Hansard source

I move:

That this bill be now read a second time.

I am pleased to introduce this bill today because unlike many issues we face in this House, this is a policy problem with a simple solution.

Currently, doctors and pharmacists are at risk of criminal prosecution if they use telehealth, email, text or phone calls in relation to any lawful voluntary assisted dying services.

This means people who are:

have to travel for face-to-face appointments.

Even worse, patients that rely on telehealth services due to distance or discomfort don't have equal access to end-of-life services that are supposed to be available to anyone who qualifies.

This problem can be fixed by passing this bill, which makes a minor amendment to the federal Criminal Code to make it clear that voluntary assisted dying is not suicide.

This change has the broad backing of the states, medical professionals, academics and patient advocate groups.

It is simple and could be done today.

So what's the problem the bill aims to fix?

Let's look at four facts.

First: VAD is an accepted part of our health system

Since 2019, every state has passed legislation allowing VAD under strict conditions, with territories expected to legislate soon.

Within this legislation, every state already has strong safeguards—at least three requests that are voluntary and enduring, at least two assessments by medical practitioners, the consideration of all treatment options and detailed processes set out to ensure this very serious decision is given appropriate weight.

Second: telehealth is an integral part of our health system

Telehealth has been hugely important in improving the access of people in rural and remote Australia to a variety of health services, especially where specialists are needed.

Third: there's an anomaly in the federal Criminal Code that prevents telehealth from being used for anything to do with VAD

An amendment to the Commonwealth Criminal Code Act was passed in 2005, making it an offence to counsel, promote or provide instruction on suicide through the use of a carriage service. That was 12 years before any jurisdiction in Australia had a VAD law. The stated intent of the amendment was to target pro-suicide websites, internet chat rooms and online cyberbullying.

'Suicide' is not defined in the code, but has been construed in its literal sense as 'intentional self-killing'.

The federal Criminal Code over-rides state legislation so the laws made by the states allowing telehealth VAD services do not protect doctors and other medical practitioners.

But VAD is not suicide.

There is a huge difference between the act of a desperate person who takes their own life because they see no other way out and a rational decision made by a terminally ill person enduring intolerable suffering, after discussion of their options with their medical professionals.

Voluntary assisted dying is not about a choice between life and death.

It's a choice between a painful, drawn-out and possibly traumatic death, or a peaceful death with dignity.

Those who access VAD services are making a choice between a hard death or a calm death.

Fourth: there is a need for access to VAD services via telehealth

The way VAD laws have been taken up in every state shows the importance of choice, dignity and compassion when it comes to people who are terminally ill and suffering.

Not allowing the use of telehealth in relation to VAD undermines all three of these core values—people are robbed of the choice, or travel distances in pain, which robs them of dignity, in a system that lacks compassion.

At the moment, doctors have three choices for patients who want to discuss VAD services but can't get actually get to the doctors:

This means in many, many cases people are suffering greatly, especially outside capital cities. This is particularly bad in WA with our vast distances—there is a significant lack of equity in the provision of VAD services.

This tragic anomaly is causing unnecessary harm, pain and distress to dying people and also to their friends and families.

How the Bill solves the problem

This Bill makes a simple amendment, clarifying that lawful VAD is not within the definition of suicide under the relevant section. That's it. It's that simple. That's all it takes and it could be done today.

This Bill has very broad support

It is supported by medical professionals—VAD doctors, nurses, hospital pharmacists.

It is supported by State A-Gs—this has come up repeatedly on the agenda of the regular meeting of the Attorneys-General of all the States.

[Multiple State Attorneys-General and Health Ministers have told me they are keen to see the Act amended to protection partitioners and enable greater access, particularly for regional patients.]

It is supported by the community

There is an active Dying with Dignity community group in every State and Territory in Australia as well as the impressive Go Gentle working on this issue nationally.

In conclusion:

I commend the Bill to the House.

I cede the remainder of my time to the member for Kooyong.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

I second the motion. I'm proud to support this motion. The two most vulnerable moments of our lives are those in which we enter this world and those in which we leave it. When we are vulnerable, we rely on other people's care and kindness, and today I would like to acknowledge and thank the nurses, doctors, pharmacists and social workers who provide end-of-life care in this country.

Every state and territory in this country has passed laws permitting voluntary assisted dying. Voluntary assisted dying is the act of assuming control over one's inevitable and imminent death. It allows people who are suffering and dying to choose the manner and timing of their death. Suicide is the decision to take one's own life. They are not the same thing, and their conflation by this legislation is wrong.

The current legislation permits VAD, but it doesn't allow doctors and nurses to use telehealth to deliver VAD-related services. Healthcare professionals can't conduct reviews by phone. They can't check on symptoms, adjust medication doses or even email a script to a pharmacy. Best-practice care is generally face-to-face, and, in an ideal world, only a minority of VAD services would be provided by telehealth. But clinicians need that option so that they can provide adaptable, calibrated care.

Terminally ill people should not be required by outdated legislation to travel long distances for a 10-minute, in-person consultation or to pick up a prescription. Doctors and nurses should be supported in providing the very best care possible to dying patients. They shouldn't face prosecution for doing their job as well as they possibly can. Australia should not be a country in which people living in rural and regional settings receive worse end-of-life care than those living in the cities. This legislation has to be updated. In addition to the state Attorneys-General, doctors and patient support groups, there is broad community support for amending this law. The only thing standing in the way is the federal government. It's not this parliament's job to impede doctors and nurses caring for Australians in their final illnesses and in their deaths. I urge the government to let us debate and amend this bill in this House.

Milton Dick (Speaker) Share this | Link to this | Hansard source

The time allotted for this debate has expired. The debate is adjourned, and the resumption of the debate will be made an order of the day for the next sitting.