I move:

That so much of the standing and sessional orders be suspended as would prevent the following from occurring immediately:

(1) the Member for Curtin presenting a Bill for an Act to amend the Criminal Code Act 1995, and for related purposes;

(2) debate on the second reading of the bill proceeding immediately for a period of no longer than one hour; and

(3) any questions required to complete passage of the bill then being put without delay.

I do not move a motion like this lightly—suspending standing orders is an extraordinary step—and I recognise the House doesn't take it lightly either. But I'm asking for one hour of debate and a vote on a bill that has been sitting on the Notice Paper for three months, that was first introduced to this parliament more than two years ago and that fixes a single, narrow, well understood problem.

I'm asking for that hour because every week this parliament delays is a week in which dying Australians and their families continue to suffer for no reason connected to their own choices, their own illness or their own state's laws but because of an accident of Commonwealth drafting two decades ago. Voluntary assisted dying, VAD, is lawful in every Australian state and the ACT, with the Northern Territory expected to follow this very month. Every one of those jurisdictions has a tightly regulated scheme. A person must make multiple formal requests for VAD to a doctor, including one in writing. They must undergo independent clinical assessments by doctors who've undergone mandatory training. There's a requirement for independent witnesses as well as independent board oversight of every case to monitor compliance, track medication, review cases and report directly to parliament.

Australian VAD laws are considered some of the most prescriptive, the most highly regulated, in the world, and the safeguards are working. VAD deaths make up a tiny proportion of all deaths in Australia, between one and three per cent annually, consistent with other countries where assisted dying is legal. There have now been more than 7,000 voluntary assisted dying cases across Australia since 2019. Each has been examined by a government appointed independent review board, as well as parliamentary reviews and independent studies. There has been no evidence linking VAD frameworks to elder abuse or coercion.

Yet sitting above all of that carefully built state and territory law is a Commonwealth provision, subdivision G of the Criminal Code, aimed at pro-suicide websites and chatrooms, inserted in 2005, more than a decade before any Australian jurisdiction had legalised VAD. This provision makes it a criminal offence punishable by fines of more than $300,000 for a doctor to discuss lawful voluntary assisted dying care with a patient over the phone, by email or by videocall. The practical effect of this provision is that no part of the VAD process can occur by telehealth, not one consultation. Every assessment, every request and every question a dying patient has for their doctor between appointments must happen in person, no matter the distance, the pain or the time that patient has left. Australia's the only country to criminalise the use of telehealth in relation to VAD appointments this way.

I want the House to understand what that actually means for real people, because I don't think this parliament has properly reckoned with the human cost of this anomaly. Researchers at QUT's Australian Centre for Health Law Research spent years interviewing patients, family caregivers, doctors and nurses across Victoria, WA and Queensland precisely about this. One doctor described the law bluntly. The barrier around what can and can't be discussed over a carriage service in the era of telehealth is, in their words, 'just crazy'.

Consider Brian Dick, an 81-year-old man from Swan Hill dying of prostate cancer. Despite a broken back and broken ribs from a recent fall, Brian had to make a 4-hour round trip to Bendigo for his multiple voluntary assisted dying eligibility assessments, because telehealth was not an option. His pain medication could not remove his discomfort during that drive. His daughter Rebecca has described sitting beside him on that road as he begged her:

Just stop the car, stop the car. I can't handle the motion …

That's what this law does to a dying man in his final months seeking care that is entirely legal.

Consider Tom, a 79-year-old man in Queensland dying of lung disease, who died waiting for his voluntary assisted dying medication to arrive by post, because pharmacists have no legal choice but to mail it. Consider the two rural doctors who, in one documented case, made three trips totalling 8,500 kilometres to assess a single patient—kilometres, time and effort that could have been given to other patients waiting to see a doctor in parts of the country that already have too few trained VAD practitioners. Consider Terry, whose daughter Emma brought a petition to this House on his behalf which I tabled last month. That petition was signed by more than 13,000 Australians and calls for this unnecessary Commonwealth restriction on using telehealth for VAD appointments to be removed. In his final week, simply reaching the bathroom was a huge task for Terry, let alone getting into a car for a medical appointment. Emma said telehealth would have made an enormous difference to her father and would have given him back some agency and dignity in his last days. Instead, this Commonwealth anomaly took that away from him.

These are not fringe cases. The QUT researchers documented this pattern again and again—patients arriving in wheelchairs in their pyjamas, too sore and too exhausted to dress themselves, because they were not allowed to speak to the doctor by phone. These are delays that, in some cases, rob patients of their VAD choice. Despite being approved for VAD, Alan in regional Victoria died without VAD due to long delays in receiving the medication. He died in the circumstances he feared the most. His wife, Zenda, described his death as the most horrific end. This is the problem.

Let me turn to the bill this motion would allow the House to debate and pass. The fix in my bill is deliberately narrow. It inserts a single amendment into subdivision G of the Criminal Code, making clear that lawful voluntary assisted dying, carried out in accordance with the state or territory VAD law, is not suicide for the purposes of the Commonwealth carriage service offences. That is the entire substantive change. This amendment does not touch a single safeguard that exists under state and territory law in relation to VAD. It doesn't mandate telehealth in any case. It does not go anywhere near the act of administration of VAD medication, which state and territory law dictates can only be self-administered or directly practitioner administered.

What this amendment does affect is the earlier assessment process for VAD—the multiple formal requests and independent assessments needed to establish eligibility and voluntariness—and every decision as to whether or not telehealth is clinically appropriate in all of the circumstances for a particular appointment would properly revert to being a decision for the doctor engaged, because doctors and their patients are best placed to decide when telehealth is clinically appropriate, not the police. Doctors already make these decisions in relation to every other area of Australian medicine in accordance with Medical Board of Australia telehealth guidelines.

These guidelines require a doctor to continuously assess the appropriateness of using telehealth for a particular consultation. There is nothing novel about this. Telehealth is already an established practice for serious, complex, life-and-death clinical decisions across Australian medicine, particularly in rural and remote areas, where it's often the only way a patient can reach a specialist at all. My bill does not ask the parliament to invent a new category of medical practice. It asks the parliament to stop treating voluntary assisted dying as the single exception where telehealth cannot be used.

At its national conference a fortnight ago, the government's own party membership resolved to remove federal barriers to end-of-life care, including telehealth, while maintaining appropriate clinical safeguards and resolved that this should be a conscience matter for its members. This is why I am asking this House for one hour not to relitigate whether voluntary assisted dying should exist but to determine whether this ordinary, trusted clinical practice should be treated as a crime.

The Australian Medical Association, the Law Council, VAD regulatory bodies, 20 health organisations and state attorneys-general and health ministers all support this change. Now it is time to determine whether this House also supports that change. We simply want to let this parliament do what people like Brian, like Tom, like Terry and his daughter Emma have been waiting for years for it to do—pass a narrow technical fix so that a dying person can speak to their doctor without turning both of them into criminals. I commend this motion to the House.

Is the motion seconded?

I second the motion to suspend standing orders to reintroduce the bill sponsored by the member for Curtin. The most vulnerable moments in our lives are those in which we enter this world and those in which we leave it. I want to acknowledge here the doctors, nurses, pharmacists and healthcare professionals who provide end-of-life care across this country. I believe that we shouldn't put those professionals at risk because our laws are outdated and misdirected.

Within weeks, every state and territory in Australia will have passed laws legalising voluntary assisted dying. Voluntary assisted dying is not a choice between life and death. All it does is enable terminally ill individuals to take control of their imminent and inevitable death by choosing its manner and its timing.

Suicide is a choice, often made in crisis, between continuing life and not doing so. It is an entirely different circumstance. Australia's leading suicide prevention organisations all agree that the conflation of voluntary assisted dying with suicide is wrong. But a 2005 amendment to the Commonwealth Criminal Code aimed at online material inciting suicide, created more than a decade before VAD was legal anywhere in this country, makes it a federal offence, with penalties of over $300,000, to use a telephone, video conference or email—a carriage service—to discuss lawful VAD services.

This means that a doctor can lawfully care for a dying patient in a clinic but that the same care delivered over the phone, because that patient is unable to travel, is a federal crime. It means that doctors can't call or use telehealth to review symptoms, to adjust doses, just to answer questions. It means that prescriptions can't be emailed or texted to a pharmacy and that, in Queensland, voluntary assisted dying medications have to be posted or hand delivered. It means that dying patients often have to travel hundreds of kilometres to receive the care that they need and deserve—often in distress, often in pain. It means that sometimes they die before they can access the end-of-life care that they want. Demand for VAD is growing, but up to 40 per cent of people who begin the process don't live to complete it.

The member for Curtin's bill makes a simple and single amendment. It excludes conduct lawfully undertaken under a state or territory VAD scheme from the Commonwealth carriage service offence. It doesn't touch existing strict state eligibility criteria or safeguards. Capacity assessment, coercion screening and identity verification remain mandatory in all states and territories. They ensure that all individuals freely and repeatedly choose what they're requesting.

This bill would not make VAD telehealth only. No-one has ever supported that, and statements to the contrary are wilfully misleading. Best practice medical care is always face to face, but this bill permits clinicians simply to exercise the same clinical judgement over the use of telehealth services that they exercise every day in this country for palliative care, for psychiatry and for the termination of pregnancies.

The AMA, the Law Council, the ANMF—more than 20 health organisations, including Palliative Care Australia, support this change. State attorneys-general and patient support groups have called for this action. Two weeks ago, the ALP's national conference entrenched it in the party's platform. And yet it's been reported that cabinet will not permit us to vote on this issue here. I seconded the member for Curtin's private member's bill on this issue in February 2024 and wrote to the Attorney-General at that time, imploring him to act on this. The bill was allowed to lapse without a debate and without a vote. Two years on, with the ALP's platform now aligned with doctors and with dying patients and their families, there is no good reason for delay.

As a doctor, I know this is a very sensitive issue, but, as a doctor, I also know that all Australians deserve the very best practice end-of-life care. This simple bill would enable this. So I urge every member of this House to support the suspension motion to reintroduce this bill, to give it the debate and the vote that we were denied in 2024, to prevent even one more Australian dying in unnecessary pain because this House continues to fail to right a longstanding wrong.

I thank the member for Curtin for bringing this debate on and the way in which she has engaged not just in this House around this debate today but also in the public domain, including in the media and with the government as well, particularly with me. I really appreciate the way in which that's happened. And I thank the member for Kooyong for seconding this.

As both speakers have indicated, this debate today, I think, arises out of the decision of the ALP's national conference a couple of weeks ago—a conference of which I'm proud, because it is a debate held in public. It is telecast. It is open to visitors. It has these often very difficult, deeply held debates, and has for many, many decades, in the public light. As has been indicated, the conference decided a couple of weeks ago, as a matter of policy, that Labor will remove restrictions in Commonwealth law on a carriage service being used in association with state voluntary assisted dying laws, and—as both speakers have indicated—importantly, while maintaining appropriate clinical safeguards. I was there for the debate. It was a very respectful debate. I thank the conference delegates, some of whom had quite different views about this issue, for the way in which that debate was held at our conference. It was deeply respectful there, as in this chamber and right across the community. These issues raise very deeply held views, some of which come from very traumatic personal experiences. I acknowledge that and thank both speakers for the way in which they've approached this debate today.

As with all decisions of the party platform and party conference, as we've said a number of times, the government and the parliamentary party will decide any questions of implementation of our party's platform. Responsibility for the laws that the member for Curtin is seeking to amend sits with the Attorney-General. The current Attorney-General, as the former attorney-general did, has been engaging with her state and territory colleagues about these issues. Responsibility for the second element of the party's decision a couple of weeks ago—the question of appropriate clinical safeguards—rests with me as the health minister. Although it's the second part of the resolution of the conference, it's effectively a precondition, in our view, for consideration of any change to the laws.

Reasonable people might disagree about what an appropriate clinical safeguard for the use of telehealth in relation to voluntary assisted dying might be, but I indicate my view as health minister and as one member of the government that this is a critical question. Telehealth has exploded, as every member of this parliament knows, since COVID. The experience of that, frankly, has been quite mixed. The seconder of this motion indicated that we should simply follow—I hope I'm not verballing the member for Kooyong—a clinical judgement of a doctor about the use of telehealth. Frankly, my experience of telehealth over the last several years, in too many instances, has indicated that, without very strict clinical safeguards, telehealth has not been used appropriately. There is case after case after case about that.

I'm not convinced that the current telehealth arrangements are particularly well suited to VAD right now. They have not been appropriate for a whole range of ways in which new business models have been developed to use telehealth in a way that I don't think is clinically appropriate. Reasonable people will disagree about what the telehealth standards should be. I agree with the member for Kooyong; I don't know that anyone has ever indicated seriously that VAD should be telehealth only. I've never heard anyone reasonably make that judgement. When a carriage service should be used for particular steps in the VAD process is a very important clinical decision as a matter of substance but also as a matter of perception and reputation.

I indicate that that is something we take very seriously. I'm sure all members take it very seriously, even if they might disagree about the finer details on what those clinical safeguards should be. I'm very keen to continue engaging on this with members of the parliament but also with many other members of the community who have deeply held views about this; I acknowledge that. We are not in a position to support this motion today.

I move:

That the debate be adjourned.

The question is that the debate be adjourned.