Julian Leeser (Berowra, Liberal Party) Share this | Link to this | Hansard source

Tonight I rise on a matter of conscience—one that requires us to reflect on life and death, medicine and technology. As many know, I feel very passionately about the issue of suicide. I spoke about my father's death by suicide in my maiden speech to this place. Over the past seven years since that time, our approach to mental health and suicide prevention has been rightly changing. Positive changes have seen reduced stigma around mental health and suicide, as well as additional funding for vital services such as Lifeline and increased Medicare support for psychological services, which we have committed to restore.

There are many dimensions to our work preventing suicide—research, community building, addressing stigma and attitudes, skills investment, as well as changes in laws and policies. Part of the work is also about countering the efforts of those who seek to monetise or exploit people's suffering by promoting suicide. That's why the Howard government, in 2005, introduced new criminal offences in the Commonwealth Criminal Code. Those offences related to the prohibition of the use of a carriage service for suicide related materials. The purpose of those offences was to target websites, groups and individuals seeking to incite people—particularly young and vulnerable Australians—to die by suicide. The Criminal Code has been part of a wall of defence that ensures it is difficult for vulnerable people to access 'how to' materials.

I am concerned that a concerted push is underway to weaken or rewrite these offences. The push has been driven by some pro-euthanasia groups and lobbyists who recognise that the Criminal Code acts as a direct impediment to their work. Part of the change they want to introduce is to allow telehealth to be used to refer, counsel or assist people in relation to euthanasia. The push to allow telehealth consultations on this most serious matter should not only concern opponents of euthanasia such as myself but also the many fair-minded people on the other side of the debate.

Telehealth has been an important and welcome change in medicine, but the limits of telehealth are well known. There are benefits in face-to-face consultations that are lost when online or on the phone. They include the ability to undertake a full medical examination of a patient. We have seen the challenges with the use of telehealth in related areas as new telehealth businesses have entered the market. For example, last month The Age reported concerns about new appetite suppressant weight loss drugs and the potential for those drugs to be accessed by people with eating disorders. The Age found no proof of identity was required to access these drugs. Prescriptions are being given in huge numbers without a doctor ever physically seeing a patient. The expanding use of telehealth has resulted in the Medical Board of Australia issuing a guideline titled, 'Telehealth consultations with patients'. The guideline says of telehealth:

However, it is not appropriate for all medical consultations and should not be considered as a routine substitute for in-person consultations. The standard of care provided in telehealth consultations may be limited by the lack of in-person interaction and capacity to carry out physical examinations.

Telehealth offers convenience medicine. There is a trade-off between thoroughness and speed. While we might be prepared to accept this trade-off for common medical issues such as coughs and colds and the administration of routine treatments, decisions about euthanasia are the most serious decisions possible. For that reason alone, the use of telehealth in this area must be governed by the highest standards. The idea that an assessment can be made by a doctor who does not know a patient, or who has not even physically examined them, marks a serious departure from the promise of the states and territories to run regimes with serious safeguards. The same argument applies for doctors who are registered for assessments of patients considering euthanasia.

I appreciate that most health professionals who operate within the system do so with a mindset of good faith, but on a matter of such seriousness, we can't rely on good faith alone. If the euthanasia system exists, it must have processes, standards and safeguards that operate within a setting of respect for the seriousness of what could happen. The move to encourage the use of telehealth for euthanasia undercuts every promise made by those proposing and promoting euthanasia. They promised safeguards. They promised caution. They promised the seriousness befitting this most profound human subject. Now those promises are being sacrificed on the altar called convenience.

The concerns I raise are shared by many within the medical profession. Recently, over a thousand medical professionals signed an open letter on telehealth which in part said:

Further relaxation of criminal codes to facilitate telehealth for VAD assisted suicide would remove protections owed those vulnerable to suicide under duress and in need of palliative care, aged care and mental health services, especially so in regional and remote Australia.

I call on the government not to amend the Commonwealth Criminal Code.