Senate debates

Tuesday, 14 August 2018


Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015; Second Reading

6:52 pm

Photo of Louise PrattLouise Pratt (WA, Australian Labor Party, Shadow Minister for Environment and Water (Senate)) Share this | | Hansard source

When debate was interrupted before question time today, I was reflecting on the experiences of an advocate for euthanasia in Western Australia, Clive Deverall. He had said that he had been discussing the lack of a compassionate law in that state and how it would force people into taking their own lives in a fairly brutal way. Clive, in fact, was one of those people who ultimately took his own life because of a lack of access in the state of Western Australia to laws similar to those that have now been passed in Victoria.

Before we went to question time, I was speaking of the fact that the Victorian state coroner, John Olle, had described the 240 suicides in the state as those ending their suffering due to an irreversible decline of health. He reported to the committee that where people have essentially been forced to euthanise themselves because of a lack of access to gentle dying, those methods of suicide, because of a lack of access to euthanasia and the prospect of a terrible death, were poisoning, hanging and shooting.

People should not have to suffer. Those terminal patients who are suffering with no hope of relief or return should have compassionate options available to them. Stringent legislation that has been written in consultation with experts and that has strong safeguards that protect patients and health practitioners means that patients have those options.

So the question for the chamber today is indeed about choice. It is about a choice of this chamber to free up the jurisdictions of the ACT and the Northern Territory so they can have their own discussions and their own parliamentary debates about making quality and responsible euthanasia mechanisms available in their states.

This is not a replacement for palliative care. We need to make sure in our nation that we have palliative care options so that those with terminal illnesses can make a choice to die in a way that is acceptable to them.

As I've reflected previously in this debate, we already know that Australians widely support voluntary assisted dying. The 2016 ABC Vote Compass poll demonstrated that over 75 per cent of participants supported assisted dying. Support for this kind of legislation is in fact overwhelming. Newspoll polled on three occasions in recent history—in 2007, 2009 and 2012. Between 80 and 85 per cent of those polled supported euthanasia for those experiencing suffering with no chance of a cure.

I note that views in our community will be diverse. They vary according to cultural and linguistic background and religion, and people have every right to hold those views. But we need, in this place, to remember that people should also have the right to make their own choices about the way they die. Our views should not mean that we stand in the way of others who need to be able to make these choices, and that includes this parliament not standing in the way of the ACT and the Northern Territory and not standing in the way of Australians who have these difficult choices to make.

The alternative is for this chamber and this parliament to have to deliberate on our own medical-care-of-the-dying legislation to apply to the Northern Territory and the ACT, because we can't continue, like we did on marriage equality, to allow our nation to have laws that are so out of step with public opinion. We can't refuse to legislate ourselves at the same time as refusing to allow the Northern Territory and the ACT to legislate as territories in their own right. My preference is very much for the ACT and the Northern Territory to have their own self-determination on these questions.

So I call on the Prime Minister to allow a free vote in the lower house on this question, just as we have been allowed a free vote in this chamber. Ultimately, this debate should not be about our control. It is about putting it in the hands of those who are terminally ill and who choose to end their own life course where they desire to. It is also about the choice of the territories in this nation to have their own conversations with their own citizens about these issues.

My own mother changed her GP when she found out her GP's views on end-of-life choices and found that they were more conservative than her own. The prospect of having a doctor not supportive on these very sensitive issues was concerning to her, particularly as she ages. But here, in this place, we have exactly the same kind of concern: we have a parliament which is allowing legislation to stay on the books that is overwhelmingly out of step with the majority view of Australians. That GP is perfectly entitled to her own view and perfectly entitled within her own medical practice to exclude herself from those decisions, but that doctor should not be entitled to make decisions for all patients, any more than this parliament should be in control of all of the life-ending choices of Australians.

This parliament stood in the way of marriage equality for too long, and we should not let people's choice to use assisted dying be the same. In my own state of Western Australia we're currently having this debate. Victoria has had it, yet Canberra and the territories are precluded from even having their own discussions. In the meantime, this parliament simply wants to preclude them from having those discussions, rather than even substantively discussing the question itself and whether we would be prepared to legislate on these questions for the territories. We're stopping the territories and their communities from having this conversation and making their own decisions. This bill is about giving territorians their voice back and about supporting the end-of-life choices of Australians, and I commend the bill to the Senate.

7:01 pm

Photo of Rex PatrickRex Patrick (SA, Centre Alliance) Share this | | Hansard source

I wish to outline my support for the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 introduced by Senator Leyonhjelm. I do so for two reasons. The first reason pertains to the basic concepts of democracy. Next month will mark 22 years since the introduction into this parliament of the Euthanasia Laws Bill in 1996. That private member's bill, introduced by the member for Menzies, Kevin Andrews, was drafted to remove the ability of the Northern Territory, the Australian Capital Territory and, at the time, Norfolk Island to pass legislation relating to euthanasia and assisted suicide. The bill effectively overruled the Rights of the Terminally Ill Act 1995, passed by the Northern Territory Legislative Assembly. That Northern Territory legislation operated from 1 July 1996 and allowed four terminally ill people to die with dignity on their own terms before the federal parliament stepped in.

For the avoidance of doubt, the Andrews bill, as it was known, affirmed the power of the territory parliaments to make laws with respect to the withdrawal or withholding of medical treatment for prolonging the life of a patient, the provision of palliative care and the repeal of sanctions against attempting suicide. However, it also unambiguously closed the door on any legislative regime legalising euthanasia or assisted suicide. Parliament passed the Euthanasia Laws Act on 25 March 1997, rendering the Northern Territory euthanasia legislation void.

More than two decades later, I commend Senator Leyonhjelm for bringing this bill before the Senate. Its passage in the parliament will enable the territories to revisit the issue now that the Victorian parliament has passed the Voluntary Assisted Dying Act 2017. Its passage will effectively put the territories back on an equal footing with the states. I accept that there are differences between states and territories; I don't accept that there should be differences in relation to the rights of the citizens of the territories. If this bill is not passed, it would send a clear message to the territories that they have a less democratic form of government than the states. It would be telling the territories again that their citizens are effectively second-class citizens whose lives are ruled by the federal parliament. It would further erode confidence in one or both of the two major parties by refusing to follow the will of the people and by abandoning the principles of democracy. In that respect, I commend the leaders for ensuring that this will be a conscience vote. It happened in 2013, when the ACT's Marriage Equality (Same Sex) Act was ruled invalid by the High Court after being challenged by the Abbott government. History has shown that the federal government's challenge was out of step with the will of the people.

This brings me to my second reason as to why I will support the bill. It is again time for this parliament to respect the will of the people when it comes to perceived issues of morality. This is the latest in a series of issues that Australian parliaments have had to confront in recent decades, such as laws relating to capital punishment, divorce, women's rights and LGBTIQ rights. I think it's fair to say that much of the opposition to this bill, both in this parliament and in the community, comes from people with views based on religious doctrines about the sanctity of life. I wholeheartedly respect everyone's right to hold those views; however, we do not live in a theocracy, and close to one-third of Australians declared themselves to have no religion in the 2016 census. In a multicultural democracy, in matters of conscience such as this, I am compelled to be guided by the will of the people.

The fact is that the parliaments of the Northern Territory and now Victoria have already supported the tenor of this bill. The facts are that euthanasia is legal in the Netherlands, Belgium, Colombia, Luxembourg, Canada and India, and assisted suicide is legal in Switzerland, Germany, South Korea, Japan and the US states of Washington, Oregon, Colorado, Hawaii, Vermont, Montana, Washington DC and California. And the fact is that Australians wishing to end their lives because of a painful terminal illness must travel to one of those places to have their wishes respected. For these people, their loved ones and all Australians who will one day tread the same path, my conscience is unequivocally clear in supporting this bill. Of course, the federal parliament has a conditional responsibility to ensure that legislation in the territories comes with the right checks and balances. Any ensuing legislation relating to this issue that does not satisfy those conditions is something that this parliament could assess at a later date. However, on the basis of surveys in my home state of South Australia indicating that three in four voters support euthanasia, I must support this bill.

This bill confronts end-of-life issues—how we deal with incurable illness and its intolerable pain and suffering and what choices should be available to people in these circumstances. It will allow terminally ill people to dramatically reduce the amount of time spent in pain and suffering before the inevitable occurs, and that is the most humane thing that we can do for humanity. Thank you.

7:08 pm

Photo of Amanda StokerAmanda Stoker (Queensland, Liberal Party) Share this | | Hansard source

I rise to speak in opposition to the Restoring Territory Rights (Assisted Suicide Legislation) Bill, and I would like to start by telling a story. David Williams was 35, a husband and father of three, with a career as a car service manager, when he began suffering severe back pain. He was eventually diagnosed with a tumour on the spine. David was told that he would be in a wheelchair by 37 and most likely dead by the time he was 40. He had surgery just as his third child was born. Bedridden, in terrible pain and fearful of the distress he was causing his family, David asked his doctor about assisted suicide because he didn't want his family to watch him die. He was eventually admitted to a hospice, but he still thought about ending his life. With good palliative care, his pain was eventually made bearable. He expected the imminent end of his life, but the cancer went into remission. David now believes he was probably depressed by the experience of his illness. In his world prior, he had a good job, a nice house, three lovely children and a happy marriage. Everything was great, and then it all went wrong. He now believes that, under the pressure of severe illness, he felt so depressed and thought that euthanasia was the easy way out. It's a decision, he now states publicly, that he's glad he didn't take.

David's story is not unique. I hear from many people in our community that during times of severe pain, when it seemed like it would never end, they have been in the position of feeling that there was no way out. But, upon the end of that pain or at least upon its management, upon reflection those same people tell me how grateful they are that they did not make a decision to end their life whilst their otherwise sound judgement was clouded by the kind of incredible pain that would make almost any person falter.

This bill and the policy of euthanasia represents a defining moment in who we are as a people. If passed, it is a fundamental change in the way that we approach human existence, the essence of life. It sends a disturbing message that there are some people in our community who are better off dead. The impact of that message goes beyond that which can be mitigated by what are often referred to as 'safeguards to assisted suicide'. It means that when a person becomes dependent because of their age, their illness or their disability, a social pressure will inevitably emerge for that person to, as an act of compassion for their families, end their life, lest they become a burden on others. That culture of dying will permeate our medical and social frameworks leading to a subtle expectation that those who require care should choose not to be resource intensive by volunteering to die.

Respect for human life cannot be dismissed as a mere matter of religion, although I confess that my faith is an important factor in my opposition to euthanasia. It's about our ethic as a civil society; it's about who we are. This bill has been framed in a dual sense as being about both euthanasia and federalism. It is no doubt an effort to cleverly wedge those people who, like me, are enthusiastic proponents of states' rights and the different but also important rights of territories.

I regard this bill as an inappropriate and insufficient opportunity for a proper consideration of the scope of the territories' rights of self-government. If a real debate were designed about the differences between the powers of territory and state governments, or about whether territories wish to seek the status of states then let's have it properly. But that important issue should not be used as a Trojan horse by which to sneak in euthanasia, a dramatic change to our social, medical and institutional values. If I'm forced to choose between my respect for the territories and my respect for life itself, I'll choose life every day of the week.

Often proponents of euthanasia frame this issue as a mere matter of personal freedom, of choice. That argument is attractive, particularly to someone approaching this in a secular way, as many people do. But it's overly simplistic. It fails to take into account the ways in which extreme pain, mental illness, depression and the anguish of facing the unknown trials that lie ahead when in receipt of a negative prognosis can affect an individual's disposition to the point of clouding judgement. In this place, sometimes slippery slope arguments are dismissed as though they're not logical. That's a mistake. The notion of a slippery slope is that one starts with a clear-cut case and, by a sequence of many small choices, one ends up accepting a practice in circumstances where, had they been considered at the outset, they would have been strongly opposed.

If you take the case of Holland, where right-to-die legislation has been in place since 2002, there are more examples than I would like to point to about how corruptible euthanasia is, despite efforts to build protections into the details. It is evidence in practice of the slippery slope we face. Let me give just a few examples of the circumstances in which Holland's regime has facilitated suicides that seem a far cry from the circumstances of terminal illness that are usually conjured in this debate. A 54-year-old woman with a personality and eating disorder was able to end her life, and Holland's health minister is on the public record to say that multiple psychiatric patients have been euthanised. A 47-year-old mother of two teenaged children was euthanised because she found her tinnitus—the ringing in her ears—so unbearable that she wished to die. It's chilling to think that any mother of young children would choose to die, particularly when she wasn't terminally ill. It makes a mockery of the sanctity of human life that this was not a matter of public outcry. In Holland, it is permissible to kill a child on the grounds that it is distressing for a parent to watch that child in pain, whether or not that child might have a prospect of being saved. Still, there is no public outcry.

It says a great deal about the way in which the crossing of this important threshold changes the way that a society values human life. There is, then, not much more ground to be travelled before chronic but non-life threatening illnesses, disabilities or mere age become reasons to end one's life. Here, we can and we must do better. We must invest in palliative care and health care that provide hope and comfort for those who are suffering from pain and fear.

Assisted suicide does not offer real choice or freedom, as some might argue. It doesn't alleviate suffering or address its causes. Some might say that it provides an easy way out of suffering, but the only people I can see that it provides an easy way out for are those politicians who are unwilling to invest in meaningful health and palliative care. We cannot in one breath pour our resources into efforts to stop suicide in our community, particularly among our young people and in the next breath provide state-sanctioned death. We cannot train doctors to heal and then ask them to kill. There is a world of difference between making a natural death more comfortable and giving a right to kill those who, as the proposer of this bill has put it, find their life 'unsatisfactory'.

It's easy to think of this subject in the context of loving families wanting to help a loved one fulfil their desire not to suffer, and that will be true for some families. But it is also the reality that that is not the situation in all families and that there are many vulnerable people in our community who require protection from family members whose personal financial interests, convenience or impatience would see them push to end the life of that vulnerable or dependent person. If the measure of our society is how we treat the vulnerable, then we must not turn away on this occasion.

As former Prime Minister Paul Keating put it:

The issue is not how many people will choose to die under this proposed law. It is how many people may die when otherwise they wouldn't.

He might be from a different political tradition to me, but I am grateful that this is an issue on which we can cross party lines because there is a sanctity to life that goes beyond today, beyond politics and, for those of faith, beyond our understanding. To have the opportunity that is life, we've already more than won the lottery. Our chances of being born are one in 400 trillion, speaking in pure biological terms. What we get as our prize in this lottery is the human experience in all of its complexity—the happiness, the sadness, the victory and the suffering. It all has meaning and it all has value. Even the hardest parts can teach us and those we love new things, can build relationships and can grow our understanding of the meaning of life and our place within it. I, for one, will not put my name to a law that would see us cross the ethical threshold from fostering life to sanctioning death.

7:19 pm

Photo of Lisa SinghLisa Singh (Tasmania, Australian Labor Party) Share this | | Hansard source

I rise in support of the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I'd like to outline at the outset that I also am a supporter of Victoria's dying with dignity legislation. I very much support the democratic principle that people living in the territories should have the same access as people living in states to parliamentary debate and votes on voluntary assisted dying legislation. I say that because, at its heart, this bill is about the right of all Australians, not just those living in the states, to determine the laws which they are governed by. I believe that it's a fundamental tenet of our democracy and that it is undermined when citizens of the same country have differing capacities to participate in political decision-making on the basis of where they live.

In this country, the states are generally responsible for laws on euthanasia. The Commonwealth has no constitutional authority to legislate in relation to euthanasia other than in the territories. But, under the Commonwealth Euthanasia Laws Act 1997, citizens of the Australian Capital Territory and the Northern Territory are denied the right to debate and enact policies which would authorise voluntary euthanasia. We all know that that came about after the Northern Territory, in 1995, legalised voluntary euthanasia, albeit for just eight months, before the Commonwealth parliament passed what was known as Kevin Andrews's bill, which prevented the ACT and the Northern Territory from legislating on euthanasia; hence the bill that we have here in front of us in the Senate today, which repeals that legislation.

However, I think it is important to note that this bill does not seek to legalise euthanasia in those territories. The legislative assemblies of a territory would still have to legislate to permit euthanasia, and they may, of course, never utilise that capacity. On that point, regardless of our own personal views in this place—and I do recognise that it is a conscience vote—I think that we really must acknowledge that this is an issue on which state and federal parliaments are seen to be lagging behind community sentiment. There's been polling that suggests that some 75 per cent of Australians believe terminally ill patients should be able to legally end their own lives with medical assistance. That shows that a national conversation should not take place while there are jurisdictions that are deprived of the deliberative power to address this issue.

If I look at the parliament of my own home state of Tasmania, for example, Tasmania has had three bills in the last 10 years seeking to legalise voluntary euthanasia. One of them was in 2009. I had the opportunity to participate in that particular bill when I was in the state parliament. I think after that there was one in 2013 which came very close, bar one vote, to being successful and then another in 2016. I understand that currently there is discussion within the Tasmanian parliament about there being another bill presented before too long. I'm looking forward to that because I think there is a real possibility that a Tasmanian piece of legislation could indeed get up.

If we look at other states, Western Australia has just had an inquiry, and it is just about to report. Victoria, of course, has successfully passed euthanasia laws, and I think in 18 months it will be implemented. New South Wales had a bill recently that was only defeated by one vote. That shows you, in a sense, that, slowly but surely, parliaments across the nation—other than those in the territories that don't have that right currently—are actually moving forward with this legislation for dying with dignity, and they're doing that because they're responding to the community sentiment in our nation.

This capacity for choice and for genuine debate only becomes more important as the issues at stake increase in their complexity. In one respect, this bill is about restoring to some Australians the right enjoyed by most other Australians to choose the laws that bind them. In other respects, this bill concerns the enabling of every Australian citizen to participate in nuanced and genuine discussion about how and when they wish to die. Voluntary euthanasia is a complex issue, and I have deep respect for those who have personal experiences and sincerely held beliefs that have led them to a position different from my own; however, I personally support legislative changes that would give the Australian people the right to die with dignity and to free themselves from the appalling suffering that chronic and terminal disease can inflict. It is indisputable that, despite the best efforts of skilled doctors and quality palliative care services, a small number of people have intolerable and unrelievable suffering at the end of their lives and want the choice to end that suffering, even though they will die a short time earlier than perhaps they would have done. The community has every reason to expect that we, as parliamentarians, will respond to that, and that we will respond ethically, compassionately, respectfully and responsibly to their needs; hence there have been so many jurisdictions that have brought these laws to their parliaments.

When a person only faces suffering and has no reasonable prospect of improvement, I believe a humane society should give that person a clear choice: to continue life with the support of well-resourced palliative care or to receive the help of a physician to voluntarily end their suffering with dignity and humanity. Either choice must be genuine, made without external pressure or coercion, and of course subject to strict safeguards to ensure it's not abused. But I say to those senators in this place who are against voluntary assisted dying: I, too, value human life, and it's because of that that I have come to my position of supporting someone's right to end their life if they have unbearable, intolerable suffering and disease. My view has been formed by the experiences of individuals from across Tasmania and Australia who have shared their stories with me, not least when I was a member of the Legal and Constitutional Affairs Legislation Committee's inquiry into the Medical Services (Dying with Dignity) Bill 2014.

Listening to Peter Short during the inquiry was a compelling and illuminating experience. Peter testified whilst suffering from a terminal illness. He highlighted his priorities: saying goodbye on his own terms in his own home with his family at a time of his choosing. Peter valued life intensely but was determined to make the case for every individual having a choice. He said to me: 'I don't want to die, but I want to go out of what has been an incredible life with an incredible family on the best note I possibly can, and I want to die in that way.' Both paths are dignified. What is undignified is not having a choice. He said that no-one suffering unrelievable and intolerable pain should have to carry on living.

While doctors always try to ensure that death occurs with dignity and comfort, this outcome does not always occur, and sometimes it's impossible. That's why Peter felt that voluntary assisted dying was a compassionate and humane approach. In recognising his life and the legacy of his advocacy for dying with dignity legislation, I hope that one day we're able to honour that by actually having that legislation pass across the country. He felt that no-one with unbearable suffering should have to go on if they choose not to. Peter believed that assisted dying legislation is possible in our country without being a threat to vulnerable people, and he wrote that on his blog nearly every day when he was alive. I agree with him. Australia can learn from other international jurisdictions like the Netherlands, Canada and parts of the US how sympathetic euthanasia laws can work. The risks are minimised in a consistent, safe, legal framework where people are able to make fundamental choices about their life if they judge it cannot continue in a dignified manner.

To those who are concerned that legislation of voluntary euthanasia would lead to patients' lives being terminated against their will, I suggest that is more likely to occur when vulnerable people cannot communicate openly about their wishes for fear of the repercussions for their doctors and for their families. People living with terminal illness and chronic disease, and the people who love them, suffer immensely. That suffering should not be compounded by the prospect of a painful and protracted death or by the fear that a wish to die with dignity will have legal ramifications.

Life is precious. We are all reminded of that all too often. We know it is finite. Life is a mixture of the good and the bad, the beautiful and the ugly, and we should embrace that complexity. I believe wholeheartedly that we should make the most of the time we have, taking up all the opportunities and challenges with which we are faced and which together make up the experience of being human. But life is no longer truly life when it's defining characteristic is suffering with no hope of improvement, only the fear that it might get worse. Our capacity to recognise and celebrate the daily challenges inherent in being human is fundamentally abrogated when every experience is coloured by unending pain.

I have voted in favour of a bill, as I said, in the past that would have legalised voluntary euthanasia when I was a member of the Tasmanian parliament along with Senator McKim, who is in this place as well. And, although its focus is different, I support this legislation today for the same reasons that I supported that legislation in the Tasmanian parliament—that is, to enlarge the capacity of Australian people to make choices about the way in which they live their lives.

The laws that bind us and the manner in which we die are two of the most fundamental components of human existence. Along with a more complete citizenship, this bill grants Australians in the Northern Territory and the Australian Capital Territory greater agency over both. I think it is our responsibility, indeed our duty, as senators in this place—as I would hope it is for those in the other place—to recognise that we need to respond ethically, compassionately, respectfully and responsibly to the needs of those people suffering in Australia who want us to give those same legal rights to anyone in Australia who may be in a position where they have no other choice but want to end their life and do it with dignity.

7:33 pm

Photo of Nick McKimNick McKim (Tasmania, Australian Greens) Share this | | Hansard source

I'm happy to rise to support this legislation which will provide the Australian Capital Territory and the Northern Territory with the capacity to regulate a practice which occurs every day in palliative care wards around Australia, which is medical professionals acting out of compassion and humanity to assist people to end their lives. This bill, as many speakers have said, would allow those territories the ability to make laws in relation to voluntary assisted dying. This isn't simply a vote on the issue of whether or not a person has the right in the final stages of life, under certain circumstances, to end their life; it's about the ability of territories to enact their own laws and to respect the autonomy of their people and their parliaments.

It's important to note this is essentially a redrafted bill to get the outcome that we believe, based on poll after poll, the community wants. All Greens MPs will be supporting it. I, along with my colleagues, have a view that, regardless of whether you live in a state or a territory in Australia, you ought to have access to compassionate end-of-life choices and that these choices ought to include a well-funded palliative care system as well as access to voluntary assisted dying. I reject the notion that those two things are incompatible, and those who would seek to present this debate as a choice between a well-funded, well-run palliative care system and access to voluntary assisted dying are trying to present people and this parliament with a false choice.

It's a matter of historical record that the Greens have campaigned and led on the issue of voluntary assisted dying for a long time—from Bob Brown's private member's bill back in 1997 through to Senator Di Natale's bill on the territory rights, which is the basis for the bill that we are now debating. As the previous speaker, Senator Singh, pointed out, there have been opportunities for both her and I to vote in the Tasmanian parliament for voluntary euthanasia. That was firstly in 2009 when I was the sole sponsor of a bill to provide for a voluntary assisted dying framework in Tasmania and, again, in 2013, when I co-sponsored a bill with then Premier Lara Giddings. The first bill, in 2009, was defeated 15 votes to seven in the Tasmanian House of Assembly—and I want to thank Senator Singh for standing up to pressure within the Labor Party at the time and voting for that bill. The second bill was defeated by, as Senator Singh said, a single vote in 2013. That is a matter that is of some regret to me today, as I genuinely believe we had the numbers in the upper house to get that through at the time, and that would have led to Tasmania being the first state to legislate for a voluntary assisted dying framework.

As I said earlier, we currently have both voluntary and involuntary euthanasia or assisted dying occurring on an ad hoc basis in palliative care wards in Australia, and this is a relatively common occurrence. It's important for people to know that this is being done with no formal system of safeguards to protect the rights of patients and, importantly, protect the rights of the medical professionals who, for the best of reasons, based on their compassion and their humanity, are assisting people to die in palliative care wards every day in this country. To those who say in an argument against voluntary assisted dying frameworks, 'What about the vulnerable people who might be exploited or influenced or coerced under the provisions of such a framework?' I say back to them, 'What about the vulnerable people who are being assisted to die in palliative care wards around Australia on a regular basis?' They are being provided with assisted dying with no formal protection and no safeguards and the doctors and medical professionals, who, for the best of reasons—and I absolutely support them in doing this—are conducting those voluntary and involuntary assisted deaths in palliative care wards, are doing so with no legal protection whatsoever.

If people doubt what I'm saying, I refer them to a couple of studies. A 2001 survey entitled, 'The intention to hasten death: a survey of attitudes and practices of surgeons in Australia'—a survey of attitudes and practices of practising surgeons at that time in Australia—by Douglas et al found that 36.2 per cent 'reported that, for the purpose of relieving a patient's suffering, they have given drugs in doses that they perceived to be greater than those required to relieve symptoms with the intention of hastening death'. So, in that survey, over a third of surgeons who were surveyed, admitted giving drugs in doses greater than what they perceived to be necessary to relieve the symptoms of suffering, with the intention of hastening the death of their patients.

There have also been other studies. A landmark study conducted in 1997 by Peter Singer and others found that:

Australian law has not prevented doctors from practising euthanasia or making medical end-of-life decisions explicitly intended to hasten the patient's death without the patient's request.

So it's very clear that this is going on in palliative care wards around the country. I'm not going to name the ward or the hospital, but I'm very happy to place on record that, last year, my father was euthanised at his request in a palliative care ward in Tasmania. I'm really pleased, and I thanked the medical professionals profoundly, from the bottom of my heart, for killing my father, because he wanted it, he was lucid, he was rational and it was the right thing to do, based on compassion and humanity.

But this isn't about my father or anyone else's relative. This is about people who are suffering intolerably. During my work on this issue over many years in Tasmania, I came into contact with many outstanding people. I want to place on the record a letter that one of those people, Mr Robert Cordova, wrote to me. He's dead now, but he was a remarkable man—brave, intelligent and dignified and a gifted communicator, despite the fact that MND had entirely removed his ability to communicate verbally. His life ended not long before the debate on my Dying With Dignity Bill in the Tasmanian parliament in 2009. This is a letter Robert wrote to me before he died. He asked me to read it out in 2009, which I did during the debate, and I'm going to read parts of it out today. It's headed 'Australia supports torture'.

We do not see this headline in any of our daily newspapers, yet I'm being tortured under legislation, mandated and enforced by both state and federal Australian governments—simulated drowning, stress positions, humiliations and other indignities.

I have motor neurone disease, a terminally fatal degeneration of nerves and muscle tissue to which the medical profession has surrendered to its paramount entity, death. Nothing can be done to stop the inevitable advance of MND.

The medical community is complicit with the policymakers of torture in not actively working to permit the resolution of our suffering by our voluntary death, and they continue to support our torture by washing their collective hands of us, to let us suffer through the full disease cycle.

The first torture is the indeterminate death sentence. I do not know how long I am to be held in this Guantanamo, and cannot be told. What I do know is that all my voluntary muscles will continue to degrade until I cannot walk, talk, use my arms or hands, swallow and, finally, unable to breathe, I will expire.

The sentence is a humiliation of any measure of my humanity.

That's what current law has subjected people to.

Whilst many people will mount arguments, quite rightly and understandably, that this is a law reform based on the simple human value of compassion, for me it's about that but more than that. It's actually about self-determination and personal autonomy. I say to people in this chamber that, if they believe in the human right to a dignified and peaceful life that's driven by autonomy and informed choice, then it is the right and consistent thing to do to vote for the rights of Australians to choose a peaceful and self-driven death on their own terms. Dying is one of the most personal things that we will ever do in our life. We have a responsibility to allow people to the greatest degree possible to choose the time and the means of their own death.

The laws that I proposed in Tasmania on two separate occasions were very tightly framed and would only have allowed people to choose to access a voluntary assisted dying framework under very constrained circumstances. But we have to be careful, when we are framing such laws, that we do not create so many hoops that people have to jump through that it becomes too difficult or impossible for them to access the framework.

So, even though this legislation is actually not about creating a framework but is simply creating the right to create a framework, I do want to say that, although I proposed laws which created a very stringent framework, on reflection I would have made those frameworks less stringent and potentially allowed access to those schemes for more people than would have been able to access them should those laws have been passed. That is because I ultimately believe in personal autonomy and self-determination.

For those who want to base their arguments on compassion and humanity—and I believe that, at least in strong part, my support for laws to create voluntary-assisted-dying frameworks is informed by those values—I refer them to people like Robert Cordova. I refer them to other people whose family members have held bowls under their mouths in the last days of their life while they vomited faecal matter into those bowls. I refer them to those horrendous deaths where palliative care, despite all of its advances and all of the beautiful and brilliant people who work in the palliative care sector, simply cannot remediate that suffering and that indignity. I urge people to think about those people, many of whom are no longer with us and some of whom will be suffering through those indignities right now as we debate this, before they determine their votes on this legislation.

7:47 pm

Photo of Barry O'SullivanBarry O'Sullivan (Queensland, National Party) Share this | | Hansard source

I acknowledge the difficult contribution made then by Senator McKim. Can I say that I've had a similar experience, and I may or may not visit that as I make my contribution. Putting aside the fundamental, I suppose, premise of states' rights—which I do put aside in relation to this; I'm not going to submit either way on that—this is a very difficult subject, a very emotive subject, that will test us all as we make a contribution on the question of creating an environment where it's inevitable that territories in our country, in this case, will ultimately deal with assisted suicide legislation.

I've listened to the contributions of quite a number of the speakers during the course of the evening. I am fundamentally opposed to any act or omission on the part of anyone—and I'm talking from a humanity point of view—that contributes to the end of somebody's life. My fundamental position stems from the fact that I don't think humanity has evolved sufficiently to be able to manage this in a proper fashion. I'll touch on some of the examples of that as we go through.

If someone could create the perfect legislation, create the perfect environment that Senator McKim described, where people in these most extreme circumstances want to end their suffering, where palliative care and medical support can provide that, this would be an even more challenging question. But evidence suggests that we're yet to achieve that. Countries which have introduced assisted suicide legislation—using the term of the 'slippery slope'—have really failed to confine it to the original pure intent, if you like, of what they were endeavouring to do. I think it's important as we consider this that we draw on the position of the medical professionals who we will be asking to take on these very onerous tasks of making decisions from time to time, interpreting legislation, legal instruments and the like as they decide what they may do in a particular case. If we go first of all to the Australian Medical Association, its position is it opposes euthanasia and physician-assisted suicide. The AMA stated:

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

That is a very powerful statement from the body that represents the physicians who we are going to ask to engage, eventually, as the territories make legislation in these assisted suicide events. In fact, of the World Medical Association's 109 members, 107 oppose euthanasia and physician-assisted suicide. In a statement, it says:

Physician-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession.

Without debating the emotive term 'unethical', it begs the question—here we have a world organisation that represents physicians and its position is to oppose legislation of this type.

The Hippocratic oath, written some 2½ thousand years ago, forms part of the ethos that has underpinned medical professionals and practitioners for centuries. It reads:

I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion.

Whilst the two things are completely different—the debates about abortion and euthanasia are completely different—the fact remains that at the very beginning it was suggested that assisting someone to take a life offended the original conventions set out to guide medical practitioners over time.

Like Senator McKim, I've had two personal experiences in this space—one my mother, and the other my wife. In both cases, I was burdened with making decisions that effectively ended their lives. In my mother's case, it was something more simple. She was 90 years of age, had suffered some injuries in a fall, and the physicians indicated quite clearly that she'd entered into a coma and was suffering from heart failure and that they had no prospect of returning my mother to the condition she had been in in the days leading up to that point. I had her medical power of attorney and, consequently, my instruction or guidance to the medical team was that they did not need to do anything to prolong her life. There was nothing involved in that that terminated my mother's life; that ended naturally.

My wife suffered from an aneurysm and, for the course of a day, was in a coma. On all the best advice we had upon which I relied, there was to be no return. My wife potentially could have lived, according to the medical practitioners, for literally years in that state. I accept Senator McKim's advice that events took place, and I don't intend to particularise them or go into the detail of conversations, but clearly during the course of that evening the administration of her medication, perhaps, promoted her departure earlier than nature would have ordered. I've got to tell you that in those circumstances family are in no position to be able to think clearly, and any legislation into the future would need to recognise in detail the fact that family, next of kin and loved ones, at a time when they need to be able to think clearly and make clear decisions, have no capacity to do that. So if we talk about the prospect of involuntary euthanasia—that's to say that the person is in no position themselves to make a contribution to what happens to them—we would need to be extremely careful around the environment that near and dear and loved ones find themselves in as they make that decision.

I'm opposed, and I have been on the record, to all matters of interference with life, knowing all of the case studies around abortions. You would think it strange for a retired detective who spent a lot of time studying serial killers in the United States to be opposed to capital punishment, but I am. Of course, I'm opposed to euthanasia, because there have been so many instances—it's impossible to write a law that is fluid enough and dynamic enough to be able to meet every circumstance we find ourselves in as these decisions are made, whether they are voluntary circumstances where the subject is contributing to the decision or, as was my case, and as it would appear in many cases, the decision is made involuntarily for the subject person.

I'm sure no-one from the chamber has been immune to some of the case studies that have been presented to us from Scandinavian countries. I've had my staff make sure that the case studies they bring to my attention have been well and truly verified; I don't want to rely upon Google searches about the failures of euthanasia or euthanasia policy. In those cases where I am satisfied and they are satisfied that we have applied the appropriate due diligence to use them as examples, some of it is disturbing and challenging. Of course we're at a complete disadvantage here because this chamber will make a decision about ceding the ability to other legislative chambers to create laws in these two territories around euthanasia without knowing any part of the detail of what might be present on their minds as they're exercised with the question.

In this particular case that I'd like to cite there was a young lady who was suffering from mental health problems. She had been diagnosed with post-traumatic stress disorder, and she was 29 years of age. This case has been verified in a documentary. She cited that she was 29 years old and she'd chosen to be voluntary euthanised. She said she'd chosen this because she had a lot of mental health issues and she suffered unbearably and hopelessly. She said, 'Every breath I take is torture.' This young woman was healthy except for the mental health issues and relatively in the prime of her life.

What challenges me, of course, as is true for most of us in this chamber—we've no doubt had experiences of people suffering from mental health disorders and post-traumatic stress disorders and, whilst I don't think they're ever completely cured, I have seen them get through their challenges and find themselves out on the other side, where they've gone on to live a wholesome life in many respects despite the challenges that have confronted them. I don't want to deal with the detail of prospective legislation and trying to guess what the territories might do, but what if we eventually had legislation developed that allowed euthanasia in that circumstance and in another circumstance where the law itself provides that if a child is an infant under three years of age then it's the decision of the parents? They'll make the decision if the child is between three years of age and 12 years of age in one country; I think it's Holland, but don't hold me to that. We've verified that this exists. Then the child can be engaged if they're capable of making a contribution to the decision.

The point I want to make, if nothing else from my contribution is remembered, is that we're about to make decisions here that will make this possible. It's not possible today, but it can be made possible. We have no knowledge of what the framework or the architecture of any legislation may be. I'd hate to think that at some time in the future we will reflect on our decision and indicate that we might have made a different decision had we known what the product of legislation was from the states.

We are all legislators. That's our day job. We look at legislation, we understand how it works and we understand how the moving parts connect and one thing impacts on another. I ask us all to consider: do we believe even we would have the capacity to develop a piece of legislation that was sufficiently dynamic to deal with all the circumstances? Twenty minutes doesn't allow us to cite the dangers around euthanasia. We're talking about, in some cases, instruments that are prepared by people when they are completely sane and are capable of making a contribution, citing circumstances in which they'd like to be euthanised when they might not be able to make a contribution. With the evolution of our lives, it may be that in their own mind, even though they're suffering from a condition that others might judge warrants euthanasia, they're in a place of peace. I've seen this with aged people who are infirm of mind but seem to be perfectly content. They don't seem to be distressed. I had the experience with aged relatives, and I know we all want to see them treated with dignity and die with dignity, but they don't seem to be distressed.

I would never like to see legislation that provided an opportunity for a next of kin or someone who had some power of attorney or medical attorney power with them to be making decisions. I don't want to make the case they could be abused, but indeed they could be. We have such advanced palliative care now that people are treated with great dignity and, in many cases—I suspect most cases, and certainly in my experience, apart from the two I have spoken about, there has been other circumstances—where the palliative care is of such an advanced state that they are not suffering from pain or discomfort. They may not be cognitive and they may not be engaging—they are certainly not walking the dog or eating much more than jelly—but they're not in distress; they are at peace.

I struggle with this question. I don't struggle with where I am—I know where I am—but I struggle with the question when I hear so many strong arguments made by so many people who themselves have had experiences that I haven't had—intelligent people like Senator McKim, whose real-life experiences have led him to want to support the prospect of euthanasia in this country. I'm afraid I can't make that journey. I won't allow myself to make that journey because I fear that there will be so many cases where the application of legislation could be corrupted, where there's human error and where, in certain circumstances, people take advantage of their power—and I talk there about involuntary euthanasia—and I really think that we need to proceed with great caution.

For what it's worth, my contribution is that we should leave the status quo. As a society, I don't think we're ready or advanced enough to create legislation dynamic enough. This will be yours and my only contribution to this question. If this is passed in this place, we'll no longer have carriage of this. We can do a Pontius Pilate and say it's no longer our responsibility, but this is our last chance. I urge colleagues to think very, very carefully. If you are not satisfied that the legislation will be dynamic enough to deal with each of the conditions then we should reject this legislation in this place.

8:06 pm

Photo of Catryna BilykCatryna Bilyk (Tasmania, Australian Labor Party) Share this | | Hansard source

I begin my speech on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 by saying that I agree broadly with the aim of this bill, which is to repeal the Euthanasia Laws Act 1997. While the issue of assisted dying has prompted this bill, I essentially see this debate as being one about equal rights for the residents of the Northern Territory and the ACT. This debate is about whether we take a consistent approach to deciding the powers of the states and the powers of the territories. It's about whether we treat all Australians as equal or we decide to have two classes of Australian citizens—those who can exercise certain powers through their state parliaments and those who can have those powers taken away from them by the federal parliament on a whim. I do have minor concerns about the drafting of the bill, which I'll get to later in my contribution; however, these will not prevent me from supporting it.

To begin my contribution, I think we need to get a couple of definitions clear. Throughout my speech I will refer to assisted dying or medically assisted dying, and it is important to draw a difference between this and voluntary euthanasia and assisted suicide. The Northern Territory act which led to this debate, the Rights of the Terminally Ill Act 1995, only provides for medically assisted dying. It does not permit for voluntary euthanasia, nor does it help to facilitate suicide. Let's get clear the distinction between these terms. Voluntary euthanasia is the practice by which a doctor ends the life of a patient, on their own request, by administering a lethal substance, usually by injection. It is distinguished from assisted dying in that the latter allows the patient to end their own life but with the assistance of a doctor. This usually involves the patient being prescribed or supplied with a lethal substance which the patient then self-administers.

I have a big problem with the term 'assisted suicide', in describing medically assisted or physician assisted dying, being included in the title of this bill. This term stigmatises the practice and, in fact, is often used by opponents of assisted dying for that very reason. Assisted dying and suicide have profound psychological differences. I am aware that, in the United States, many peak medical organisations have policies that specifically oppose the use of the term 'suicide' or 'assisted suicide' to describe the practice of assisting dying. It's not appropriate to draw parallels between the wish to end one's life due to intolerable physical suffering that cannot be relieved by palliative care and someone who ends their life as a result of depression, schizophrenia or another form of mental illness. Suicide is a tragedy—there are no two ways about it—and should be prevented to whatever extent it can. As the American Association of Suicidology points out, suicide is a form of self-harm that results from mental illness such as schizophrenia or severe depression.

There are a number of important differences that distinguish assisted dying and suicide. In suicide, a life is cut short. In assisted dying, a foreseeable death occurs earlier but in an easier way and in accordance with the patient's wishes and values. Suicide stems from psychological pain and despair. Victims of suicide don't want to live because they cannot enjoy life or see that their life may not improve in the future. Patients who seek assisted dying, on the other hand, generally want to live but know that they're ultimately going to die as a result of their illness. A terminally ill patient who is given assistance to die usually experiences stronger bonds with their loved ones and a deeper sense of meaning as their life comes to an end, whereas suicide is usually preceded by isolation, loneliness and a loss of meaning.

Because of these differences, I take issue with the use of the term 'assisted suicide' in the title of this bill. It's simply not appropriate to refer to assisted dying as suicide. Another reason I don't think the title is appropriate is that it implies that the bill is legislating to enable assisted dying when all it's doing is restoring power to the territories to do so. The bill would be more appropriately retitled 'Restoring Territory Rights (Repeal of the Euthanasia Laws Act 1997) Bill'. Similarly, the objects of the bill could be simplified to focus on the central purpose of the bill, which is simply the repeal of the Euthanasia Laws Act. However, I don't intend to move any amendments to address these issues. As concerned as I am about the distraction from the central purpose of the bill, the bill in its current form serves that purpose and so I don't intend to invite debate that may delay the passage of the bill or distract from the issue at hand. Having said that, I'm open to supporting amendments moved by others if they strengthen the focus of the bill.

While I will make a contribution in this speech about assisted dying legislation, I want to express my disappointment at the narrowness of this debate. As the co-convener of Parliamentary Friends of End of Life, I'm deeply disappointed that, as a nation, we don't engage in more holistic discussion about end-of-life issues. We don't talk enough about investing in quality palliative care and encouraging Australians to make advance care plans. It disturbs me somewhat that much of the national discussion around end-of-life issues has focused on the questions of euthanasia and assisted dying, with little attention paid to other important issues around end-of-life care. As a result, governments, both state and federal, have dropped the ball on palliative care. I'm constantly shocked and disgusted at the parlous state of palliative care funding in Australia. There is nowhere near enough being done to educate Australians about the importance of making written advance care plans and discussing end-of-life wishes with their loved ones.

In 2011 the Grattan Institute published a report which found that 70 per cent of Australians would prefer to die at home, surrounded by their loved ones. The number of Australians actually dying at home at that time was a mere 14 per cent, and I understand that it has improved very little since. Ninety per cent of Australians die without an advance care plan, and 75 per cent of Australians have not had the conversation with their family about their end-of-life wishes.

For many years I have been campaigning strongly for investment in, and equal access to, quality palliative care. Some in this place will be aware of the speeches I've delivered calling for funding to be extended for Palliative Care Tasmania to continue its work in professional development and community education about death, dying, grief and bereavement. It's also vital that governments at all levels work with the community sector to promote the importance of making advance care plans and discussing care wishes with loved ones and medical practitioners, something which not nearly enough of us do.

Advocates of quality palliative care are often accused of using it as an excuse not to support euthanasia or assisted dying. The view that palliative care and assisted dying are an either/or proposition is driven by a misunderstanding of what palliative care is. Palliative care and assisted dying are not—I repeat, not—mutually exclusive. Having good palliative care available is not a reason to deny the option of assisted dying. Similarly, providing patients with the option of assisted dying is not a reason to ignore the need to invest in quality palliative care.

Palliative care is a form of care given to people with life-limiting illness, and it's necessary for all patients, regardless of whether they have the option of assistance to end their life. It's a multidisciplinary approach that involves the relief of pain, physical and mental stress, and other symptoms of live-limiting illnesses. I think it's fair to say that the more advanced our understanding and practice of palliative care becomes the better we can be at relieving the pain and suffering of patients with life-limiting illness and improving their quality of life. Quality palliative care can, for some patients, be an alternative to assisted dying and it is an option that they deserve. I'm a firm believer that through advance care planning, together with well-funded and well-coordinated quality palliative care, we can reduce the need for patients to seek assistance to end their own life, but we cannot eliminate it. No matter how good palliative care is, I recognise that some pain and suffering cannot be relieved and we cannot make quality of life acceptable for all patients with life-limiting illness. I accept that there are circumstances where patients with life-limiting illness experience pain and suffering which cannot be relieved through palliative care and ending their life appears to be their only option.

There was a time when I was opposed to assisted dying. However, life experiences, like a lot of people have spoken about tonight, have helped to shift my thinking on this issue. One experience I want to mention quickly had a very profound effect on me. It was earlier this year. I spent about 12 hours a day for a couple of weeks at the bedside of my closest personal friend of 35 years, who had been living for several years with early-onset dementia. In the final two weeks of her life, my friend was in the palliative care suite at the facility she had been transferred to a few weeks before. My friend was given regular pain medication and she lived for two weeks, despite the doctors not expecting her to survive more than a day or two. When she finally died, although I obviously experienced a great sense of grief, I also felt enormously relieved that she was no longer suffering. We had spoken many, many times in that 35-year friendship about what either of us would want done if we had no quality of life left, if we had no hope of recovery or if one of us had a terminal illness. So, for patients with life-limiting illness—those who are able to communicate their wishes and are competent to make a decision—knowing that the option to end their life is available could be a comfort, even if they choose not to use it.

As someone who was once opposed to assisted dying, I can understand why many people are cautious about it. While some patients with life-limiting illness will have pain and suffering that cannot be relieved through palliative care, depression, family pressure or the feeling of being a burden could also cause a patient to seek to end their life. That's why any legislative proposal to allow voluntary assisted dying must be approached with a great deal of care and caution and include the strictest safeguards. The Northern Territory's Rights of the Terminally Ill Act includes several such safeguards. The decision has to be supported by three medical professionals, including a specialist who confirms that the patient is terminally ill and a psychiatrist who confirms that they are not suffering from treatable depression. Once all the necessary paperwork is complete, the patient has a nine-day cooling off period before the death can proceed. The act also provides that a medical practitioner shall not assist a patient if there are palliative care options available to relieve their pain and suffering to acceptable levels. There are also protections in the act, with associated criminal penalties, against deceptive and improper influence to procure the signing of a certificate.

The four patients who ended their lives under the Rights of the Terminally Ill Act between 1995 and 1997 were all assisted by a device invented by Dr Philip Nitschke. Dr Nitschke's device administered an injection of a lethal drug after the patient answered yes to a series of three questions that appeared on a screen. The questions were:

1. Are you aware that if you go ahead to the last screen and press the "Yes" button, you will be given a lethal dose of medications and die?

2. Are you certain you understand that if you proceed and press the "Yes" button on the next screen that you will die?

3. In 15 seconds you will be given a lethal injection… press "Yes" to proceed.

Ultimately and importantly, the machine gave the choice and the control to the patient over whether to administer the drug.

Should this bill that we're currently debating be passed by both houses and receive royal assent, the Rights of the Terminally Ill Act will again take immediate effect. Some in this place may choose to debate whether the safeguards in the act are sufficient or whether the Northern Territory should be allowed to legislate for assisted dying at all. We could have a similar debate about the law-making power of any of the states, including Victoria, whose parliament recently passed the Voluntary Assisted Dying Act 2017, but we don't have any power to override Victoria's assisted-dying legislation.

We do, however, have the power to override the Northern Territory's or the ACT's. Section 122 of the Constitution grants us this power, and there will be some in this place who will say that we need to make a decision about the circumstances in which that power should be exercised. I say that, while the authors of the Australian Constitution did a pretty good job, we need to recognise that, for better or worse, this 117-year-old document was the product of a series of compromises. These compromises were necessary to bring six independent colonies together to form a nation. It is an imperfect document, but its implementation has been improved over the years by the conventions and practices we have adopted—conventions such as giving the territories the right to self-govern on equal terms with the states.

In 1997, our federal parliament overturned that convention, a convention that had stood for 19 years in the case of the Northern Territory and for nine years in the case of the ACT. If we're honest with ourselves, we should recognise that section 122 of the Constitution gives us the power to create two classes of citizens, those who are free to govern themselves in areas of state responsibilities and those who are not. So let's not be under any illusions. The Euthanasia Laws Act discriminates against territorians, and anyone who chooses to oppose this legislation is voting for this discrimination to continue.

I do not believe it's for me as a senator elected to this place to determine whether the Northern Territory or the ACT should legislate for voluntary assisted dying, just as it's not for me to determine whether Victoria, Tasmania, South Australia, Western Australia, New South Wales or Queensland should. It's not for me to decide whether the safeguards of the Northern Territory's or the ACT's assisted dying legislation are sufficient. I support this bill because I do not see it as fair to treat territorians as second-class citizens and to say to them: 'The states are mature enough to govern themselves, but you need federal oversight.' That is essentially what this parliament did when it passed the Euthanasia Laws Act in 1997.

I'm not going to agree with every bill that the Northern Territory parliament or the ACT parliament passes, but the question we need to ask ourselves today is not one of whether we allow assisted dying in Australia's territories. If state parliaments have the right to decide whether they want to allow assisted dying, why should this right be denied to the parliaments of the territories? The question we need to ask ourselves today with our vote on this bill is: do we believe in self-government for the territories on the same terms as self-government for the states, or do we only support self-government for the territories when we agree with their decisions? I for one don't believe in treating the Northern Territory and ACT residents as second-class citizens, and that's why I will be supporting this bill.

8:23 pm

Photo of James PatersonJames Paterson (Victoria, Liberal Party) Share this | | Hansard source

I'm happy to admit that I had to wrestle with this issue because for me it is one of competing principles. But, after reflection, I have nevertheless come to a firm conclusion. I will be voting no, and I want to briefly outline why.

I am sympathetic to the principles of federalism that underline the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. It would be nice to simply dismiss these considerations on the technicality that the Northern Territory and the ACT are territories and not states and are therefore not entitled to so-called states' rights. But, if we believe in federalism as a matter of principle, as I do, it is not that easy. I don't believe in a federal system of government just because that's what we happened to agree at Federation. I believe in federalism because I believe in decentralisation. I believe in subsidiarity. Local decisions are best made by local people. Too much policy in this nation is dictated in Canberra and imposed around the nation to variable results. It is not states which have rights but people. People should enjoy no fewer rights simply because of where they live in Australia, even though residents of the territories have not yet taken up the option available to them to become a state.

But this isn't only a bill about federalism. It's also a bill about euthanasia and the principle of the individual dignity of every human life. I can't wipe clean from my conscience the ultimate impact of the vote that I will cast on this bill and on this principle. The actions that we will all take on this bill will have consequences that we all must be prepared to accept. I do understand why many Australians want to have the option of doctor assisted suicide at the end of their life. A painful death is a fear widely shared and a painful death is not something I blame people at all for wanting to avoid if possible. If there were some way of guaranteeing that only those who really wanted and needed that option were able to access it, perhaps I would adopt a different view.

Because we are all flawed human beings, I recognise the profound limitations we have as legislators. Despite our best intentions, there are aspects of human behaviour that we can never perfectly regulate, no matter how hard we try. The consequences of getting regulation wrong in most areas of public life are irritation and inefficiency, but when it comes to regulating life and death they are as profound as they can be. I am yet to see a system for regulating euthanasia anywhere in the world, including in my home state of Victoria, that gives me confidence that no person would ever be put to death wrongly. For me, even one wrongful death is one too many. In years to come, I suspect Victorians will regret the decision that our parliament reached late last year. I believe it is inevitable that there will be misdiagnoses, that some people will feel pressure, real or imagined, and that, if we start to normalise state sanctioned taking of life, the criteria will inevitably widen, as they have overseas. I'm worried that the participation and tacit endorsement of the state and the medical profession in this process will compromise both.

Resolving contests of deeply held principles is always the most difficult decision to make. Federalism and protecting the individual dignity of human life are both dear to my heart. If forced to choose, I have to pick the most fundamental. If, in the future, people are wrongfully killed under a euthanasia regime that is in effect permitted by our votes here today, I doubt that the principles of federalism will provide much comfort to our consciences. That's why I will be voting no.

8:28 pm

Photo of Malarndirri McCarthyMalarndirri McCarthy (NT, Australian Labor Party) Share this | | Hansard source

I rise to speak in the very important debate on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. In Yanyuwa and Garrwa, we don't really have a word for euthanasia in our language. In fact, talking to families in the region over many, many years, especially around the time of the 1997 conversation in the Northern Territory parliament around the Rights of the Terminally Ill Act, I found that people in our families didn't know what euthanasia meant. So, when you think of how you explain that in language when we've got over 100 Aboriginal languages in the Northern Territory, there was a great deal of difficulty on that level.

But this bill goes to the heart of the rights of the people of the Northern Territory to make their decisions—to make decisions within the Northern Territory Legislative Assembly, along with the elected reps in the Australian Capital Territory Legislative Assembly. The importance in the Westminster system in this country is the importance of your democratic right to speak and your one vote—your one value—where you elect people to speak on your behalf in these assemblies.

In 2007, I was the member for Arnhem and stood in the Northern Territory parliament to speak on many issues. I was the elected member for Arnhem from 2005 until 2012. But in 2007, when the Commonwealth parliament made a decision to intervene in the lives of the people of the Northern Territory, as a legislator and as someone elected by the people I had never felt so powerless as a parliamentarian. I had never felt so powerless, as a representative of the constituency of Arnhem and the people of the Northern Territory, that I had no voice. I had no say, along with 24 other members of the Northern Territory legislature.

This was because the founding fathers of this country wrote a constitution which, yes, imperfect though it is, has stood the test of time, and included section 112 of the Constitution, which enables this parliament to overrule and to intervene in the lives of the people of the territories. And this still remains an area of debate. This bill reflects on a law that was made by the parliament of the Northern Territory and to consider giving that right back to the Northern Territory in order for the Northern Territory to make its own laws is the right thing to do. I say to the senators in this house: what makes your conscience and what makes your personal experiences any better or any less than the parliamentarians who stand in the Northern Territory assembly and the parliamentarians who stand in the ACT assembly? What gives you the authority—the moral authority, the personal authority—to think that your ability is much better and greater than theirs? This bill goes to the heart of our country's democracy: the right for people to make laws, to make mistakes and to learn from those mistakes. As elected representatives, they're put there by the people who voted them in.

At the time of the debate here in the federal parliament in 1997 about overturning the Northern Territory's euthanasia bill, the Rights of the Terminally Ill Act, much was said about why it is that 25 people could make a decision on such a very big and important issue. Who did they think they were?

Well, I'm going to tell you who they were, because I knew and know every single one of them who stood in the parliament and debated for hours in 1995, through committees across the Territory, and then struggled with the decision of the Commonwealth two years later: the late Maurice Rioli, the member for Arafura; Eric Poole, the member for Araluen; the late Wesley Lanhupuy, the member for Arnhem; Maggie Hickey, the member for Barkly; Loraine Braham, the member for Braitling; Denis Burke, the member for Brennan; Peter Adamson, the member for Casuarina; Marshall Perron, Chief Minister and member for Fannie Bay; Terry McCarthy, the member for Goyder; Richard Lim, the member for Greatorex; Rick Setter, the member for Jingili; Mick Palmer, the member for Karama; Mike Reed, the member for Katherine; Fred Finch, the member for Leanyer; Neil Bell, the member for MacDonnell; Phil Mitchell, the member for Millner; Noel Padgham-Purich, the member for Nelson; Syd Stirling, the member for Nhulunbuy; Steve Hatton, the member for Nightcliff; Barry Coulter, the member for Palmerston; Shane Stone, the member for Port Darwin; Daryl Manzie, the member for Sanderson; and Brian Ede, the member for Stuart.

And this, Senators, was what they struggled with. Mr Perron said:

… a number of members find themselves in a dilemma over the issue before us. Indeed, I find myself among that group. Today, I will damage relationships that I value deeply. My dilemma is whether to rest my case, and not further bruise those relationships, or press ahead and try to achieve a needed reform that will diminish misery and suffering for a very small number of unfortunate citizens …

John Bailey said:

We should amend it to make it the best legislation possible. We should monitor it in the future to ensure that there are no problems or loopholes. We should delay the implementation of the legislation, firstly, until we are convinced that the community is fully aware of its implications and the fears in the community—

have been discussed and properly canvassed.

And then of course we had the Aboriginal members of the parliament. The late Maurice Rioli, the member for Arafura, said:

We heard from Aboriginal people of the Territory that they want no part of this legislation. At Yirrkala, they were saying that, for some of their people, they know when they are going to die and they wish to be at home with their family in their own country, on their own land, listening to and hearing the songs that give meaning, purpose and the strength to endure and to help the life spirit return to its place of origin so that everything will be right with the world.

Then we heard from another Aboriginal member, the member for Arnhem, Mr Lanhupuy, and he stood on his feet and he said:

Mr Speaker, in rising to speak to the private member's bill … I would like not only to address some of the issues that have confronted myself as an individual in the debate, but also to provide information—

information that he had received. And he asked the people to respect his point of view. Mr Lanhupuy voted in favour of the bill, knowing that his Aboriginal constituency may not have supported him. But it was his decision. He went with his conscience. He was very capable, a speaker of many languages. He could stand in that parliament with 24 other members and put his case—as they all did. And then they finally came to the vote on the second reading: ayes, 13; noes, 12. So what makes this Senate and the conscience of the senators here any better than the conscience of those members of the Northern Territory parliament? What makes the senators and the members in the other House so much better, so much more knowledgeable about the decisions for the Northern Territory than those members elected by the people of the Northern Territory?

I personally have great difficulty with euthanasia, but that's not what this bill's about. This bill is about the rights of the people of the Northern Territory to make their own decisions, to make their own mistakes and to create a future and a vision where they know their landscape, they know their languages, they know their history, they know their faults and they know their problems. So when the federal parliament makes decisions to intervene, it has the most dramatic impact on the lives of individuals. I know, because I speak from personal experience as a parliamentarian, as a Yanyuwa Garrwa woman from the Gulf country who's seen and witnessed time after time after time the complete disempowerment of people's abilities and the complete disrespect to enabling others to make the decisions, to stand by their decisions and to follow them through.

I spoke earlier about how in 2007, as the member for Arnhem, it was the most disempowering moment to stand in the Northern Territory Legislative Assembly and have your power removed for no reason, simply because of a constitutional act. But the mental and physical impact that had on people was quite profound. So I call on the senators here: when you think about your vote, your conscience, I ask you to think about the 25 members of that parliament who didn't just rush in to make a decision on such an important piece of legislation without any thought, or consideration, or angst or division amongst themselves. Those 13 ayes and 12 noes were not from one political party; they were members from all sides who walked, who crossed the floor, who checked their consciences, who talked with their families and who travelled the length and breadth of the Territory to get a sense of what the people wanted. Then they went and voted according to their conscience.

I urge all members, all senators, to support this bill. Support the right for the people of the Northern Territory and the people of the ACT to make their decisions, to be empowered, to feel worthy and to feel that, as citizens of this country, their planning, their research and their values matter, and that their dignity as people who can determine their livelihoods matters. We hear in the debate here how the Constitution and the Federation of 1901 brought the states together. There is unfinished business, certainly for the Northern Territory.

I had the honour of being the Minister for Statehood from 2008 to 2012. If anything, the next step for us is to be included as full citizens in this country, because right now we only have half a vote. In any referendum, we are considered as only half a vote. Any decision going forward should be about growing the legislative capability and the democratic rights and processes for the people of the Northern Territory if that is what they choose. Do not diminish their rights any further. Enable them to have this back. Enable them to choose, to decide, to debate, to argue, to agree or to disagree on pieces of legislation that matter for their constituency—just as you and the members in the other house do for your constituency. We in the Northern Territory are no less than any other Australian in that our rights need to be respected. So I urge the Senate and all senators to support this bill.

8:46 pm

Photo of Andrew BartlettAndrew Bartlett (Queensland, Australian Greens) Share this | | Hansard source

I'll say at the outset, to make it clear, that I support the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 and will be voting in favour of it. There's a lot of reference in this debate to this being a conscience vote. I'd like to think we exercise our consciences pretty much all the time in this place in considering our decisions and actions on a whole range of issues. I don't think the issue of euthanasia should somehow be considered in some magic bubble disconnected from all of the other policy issues that we consider, that we vote on and that we promote or oppose. Even though it is labelled as a conscience vote, I will say that it is explicitly Queensland Greens' policy. It's quite explicit, clear-cut and simple that we support the right of people with severe and incurable disease to choose to die with dignity—and I am voting in accordance with that policy.

I do want to put some other comments on the record. At its core, this legislation, as we've just heard very eloquently from Senator McCarthy, seeks to restore the rights of the parliaments of the ACT and the Northern Territory to consider the issue of euthanasia. If this bill should pass, it's pretty unlikely that the federal parliament will ever again be considering a euthanasia model directly in terms of a national approach. I expect it will proceed to continue to be considered by state and territory parliaments, as they have done a number of times—sometimes in great depth with significant committee inquiries and with very close votes. So, in that sense, by voting in favour of this bill, we are handing over the decision-making power on this issue to the parliaments of the ACT and the Northern Territory, should they choose to consider any proposal for euthanasia laws. The reason that I want to comment on it is that I do think the issues around euthanasia and end-of-life issues more broadly, as Senator Bilyk said, do need to be discussed and considered more, and the language that we use and the issues that arise do need to be taken into account.

It's also been mentioned a couple of times in this debate that there are just four people here who were in this Senate chamber when the Andrews bill, as it is known, was voted on—Senators Abetz, Collins, Carr and Ian Macdonald. I was actually here in this chamber, but I wasn't a senator at the time; I was in the public gallery and I remember it very well—it was packed. I was working at the time for one of the Democrat senators, John Woodley—who was actually the only Democrat to vote in favour of the Andrews bill—and I was heavily involved as a staffer following the Senate committee inquiries and issues that were being considered at that time.

There are a few points I'd like to make. Firstly, a lot has changed in 20 years. The fundamental issues, philosophies and complexities and the personal nature of people's end-of-life experiences will always continue on, long after all of us are gone. The fact that we will all die is one of the few absolutely shared experiences that we all, as humans, have in common. In that sense, I sometimes find the term 'right to die' a bit of a strange one. We're going to die whether we like it or not. The issue is the nature of that death and also the life that people have not just in that final period but throughout their life. Again, I think the issue of euthanasia can't, or shouldn't, be considered in isolation from all of the other things we can do to make people's lives better right through until that final period.

I note and agree with the concern about using the term 'assisted suicide'. Senator Di Natale has an amendment to change that in this bill. We'll be supporting it anyway, regardless of whether that amendment goes through. But I actually think it's a significant matter. The term 'euthanasia' literally means 'good death'. The other terms that people use to describe this seek to reflect that idea of making the final moments of as many people as possible as good an experience as possible. When we think of suicide, in our community, in our cultures, we do not think of it as a good death; we usually think of it as one of the worst deaths. I don't think it's a good thing to equate those terms when we're talking about the issues involved here.

I have always supported the principle of the right of people to access a good death and to choose that. The challenge, of course, is to ensure that principle is applied safely and not misused, and that's always the dilemma. That's why I have sometimes been equivocal in my support for euthanasia laws. But we're not debating the laws here; we're simply debating whether or not to hand that power back to the territories to consider. I will simply say that my views have evolved over time because of the fact that this has been debated and explored a number of times in state parliaments. I will put on the record the consistent leadership role that the Greens have played in pretty much all of those debates and in leading the charge in terms of introducing legislation, through former senator Bob Brown, as early as 1997 to reverse the Andrews bill.

As was mentioned, in Tasmania the euthanasia bill came within one vote of being adopted. In the New South Wales upper house, it was lost by one vote. In the Victorian parliament, as we know, it has now been adopted. So we now have a model to look at and see how it works in practice. Looking at the evidence from many of those parliamentary debates and committee inquiries has really been the tipping point for me. I don't think you can ever design any legislative regime where you can 100 per cent guarantee that a mistake won't be made, but when you see all the evidence about the reality of what happens now—the immense suffering that so many people go through that we know we could prevent—and the fact that, as Senator McKim reflected on and as was detailed quite clearly in the evidence to the Victorian parliamentary committee, it is already happening now in so many ways, in a completely unregulated way, though almost always, I am sure, with good intent. What is happening right now is that people are committing suicide, having horrible deaths and traumatising their family because they have no other alternative. So we will likely see, with good euthanasia laws, a reduction in traumatic suicides of people in extreme, unrelenting pain who see no other way out.

In the Victorian parliamentary inquiry, there were reports that doctors practise—with the best will—unlawful assisted dying, despite its prohibition and despite prospective liability for serious crimes. That is happening without regulation, often without proper support and without transparency and accountability. So, if we want to minimise the chances of putting an end to someone's life inappropriately, we need to put a regulatory regime around it, because it's happening now already to a degree that we don't really know, because it's underground. The best way to minimise the chance of misuse of power is by putting a regulatory framework around it.

I think we need to recognise that, whilst we all support the principle of choice, choice is not always equal, because power situations are not always equal. It is fine for people who are relatively wealthy, have access to good-quality health services, have family supports around them, have trusted medical professionals and are in positions of power and privilege to engage with some of these processes. But it is different if you're a person in poverty, if you have significant mental health issues, if you are a person with a different cultural background or with language differences, or if you are a person with direct experience of the systemic racism that still exists in the delivery of our services. A point that is made by those in the disability advocacy community who raise issues with the euthanasia laws is the very systemic ableism that is built into so many aspects of our society and our health system so deeply that we are often not conscious of it. We need to be aware that ableism, systemic racism, innate discrimination and power differentials will continue to be there under a regulated regime. But the fact is that they exist already under a non-regulated regime, and I think it is far better to be able to at least have a regime where you can monitor what is happening and try to protect those people who have more direct experience with language barriers or with cultural and racial discrimination.

I know from the debate 20 years ago—and this was a point that was raised by one of the opponents of this bill—the fears of the Aboriginal community in the Northern Territory about what it might mean to them. Senator McCarthy reflected in her contribution on the different views there amongst Aboriginal communities in the Territory. Given even the little I know—and I know Senator McCarthy would know far more than I do—about some terrible, terrible experiences that Aboriginal people have had with very direct and blatant racism through the health system, you wouldn't blame them for being fearful of engaging with it. But you don't address that by just saying, 'Well, we won't address these issues.' You address that by addressing and acknowledging the systemic racism.

We have heard from all sides of this debate often about the inherent value of every life, including some of those most opposed to euthanasia because of the inherent value of every life. I want to reiterate the point that, if we want to adopt that principle—and I certainly do—we can do a hell of a lot more to give value to people's lives throughout their lives. I spoke just last night in this place about the very direct evidence that the inadequate funding for maternity services in rural communities in Queensland is almost certainly leading to higher infant mortality in those rural communities compared to those rural communities that do have basic maternity services and midwife services. That's literally right at the very start. That is an uncomfortable fact, but it's true. Babies are missing out on the entire opportunity of life because we're not adequately funding that. We need to do so much more, and I support the campaigns of the Nursing and Midwifery Federation with regard to aged-care ratios and nursing ratios and the Our Turn to Care campaign. We need to do so much more to fund and provide support in aged-care facilities. There is often no magic tipping point when you suddenly become worried. It's a situation that we all know we're going to face at some stage, and people need support at all stages through their life process.

The ironic part—maybe 'ironic' is not the right word—is that, despite the concerns that some raise about all the situations this might apply to, the Victorian model is only for people who are explicitly diagnosed as having a terminal illness with less than 12 months life expectancy left.

There are a whole lot of other people in excruciating, unbelievable suffering, and sometimes mental health fits into that circumstance as well. They are not covered by the laws. They all need support. People are concerned about addressing people. People are concerned folks might make not the best decisions because of their depression or mental health situation. What about more funding for mental health? It is not adequately funded. We all know that. The support services are not there for so many people in the community. What about better funding for housing? What about not forcing people into poverty? Those are all just as much about the inherent value of every life.

That is the context in which euthanasia law regimes operate. They come into play in a circumstance where we have our society governed so much by market based principles, the profit motive and all of the other neoliberal principles that are put on the top, even for not-for-profit providers. So these laws will operate in that context. I certainly believe we all need to continue to attack and eliminate those neoliberal principles, those market-first principles, from anything to do with ensuring basic care for people throughout their life in times of need. And those times of need can happen when you're quite young as well as when you're elderly.

So, in supporting the rights of territories to consider euthanasia legislation and supporting all of the state parliaments to continue to explore these issues—it has been put forward and examined, certainly, in New South Wales, Victoria, South Australia, WA and Tasmania. I'm not sure that it's happened in Queensland yet, but I think I can be quite confident, now there is a Greens MP in the Queensland parliament, that he is keen to progress this issue and have the debate in Queensland as well. We can all learn, not just from the models in Victoria. From the time since that first legislation was passed in the Northern Territory, laws have been in place in Oregon, in the US, for nearly 20 years. We have examples in the Netherlands, in Belgium, in many states in the US and elsewhere in the world that we can now look at to see the best models to draw on. I think we're in a much better place now to be confident that these debates can be informed. But I think they need to be holistic, and that's why I'm keen that the whole issue of euthanasia is not be seen as some separate conscience issue that's disconnected from all of the other policy issues that we deal with in this place.

With that, I would also like to say that there is a real significance in how we talk about these issues and, as part of that, in recognising the challenges in how we deal with some of the issues, like people with dementia and people with severe and sometimes, sadly, untreatable mental health. I've talked about my own circumstances a bit before. I won't do that tonight because of the time, but I will say that some of the strongest people are those who work through those challenges, but there's still not always a cure, and proper support for those people is important. One of the potential flow-on benefits of having a pathway for people, knowing that there are others who can work with them about end-of-life situations and what they see as their future, is having a regulatory regime in place. Your natural tendency when you're in a bad place is to go inwards and isolate, but having a regulatory regime means that you have a pathway you are encouraged to engage with. But those pathways have got to be properly funded. They need to be comprehensive, they need to include palliative care, they need to include aged care, they need to include mental health support and they need to keep listening to the people who are going through the experience so the choice is a genuine one.

9:04 pm

Photo of Murray WattMurray Watt (Queensland, Australian Labor Party) Share this | | Hansard source

I intend to make a fairly short contribution to this debate. I know there are many speakers to come. At the outset, like many other speakers, I want to respect the fact there are very many different views on this important issue and that everyone's contribution in this debate comes from very deeply held beliefs. I do recognise that this is something that good people can disagree about.

I will be supporting the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, and I'll be supporting it on two bases. The first is really the most fundamental when we look at the terms of this bill, and that is the basis of territory rights. I'm not going to be able to put this as eloquently as Senator McCarthy, who made a magnificent speech a short time ago as a representative for one of Australia's two territories, as to why it is important for residents and their elected representatives from our territories to be able to make decisions about these types of issues. It is important, when we strip all of the debate back and look at the terms of this bill, that we see the only purpose of this bill. The only thing that this bill will do is enable the Northern Territory and the ACT, the residents and elected representatives of those two territories, to make their own decisions about this issue.

The fact is that a bill, which has since become known as the Andrews bill, was passed into law some time ago and it removed the power of the two territories to make their own decisions about voluntary assisted dying. It made it very clear that the Commonwealth does have the legal and constitutional power to legislate in this space. I disagree with arguments that have been made, and will continue to be made, that this is not something the Commonwealth should or can be involved in. Section 122 of the Constitution makes very clear that the Commonwealth does have constitutional power to make laws in relation to the territories. And, just as the Commonwealth had the power around 20 years ago to remove the power of the territories to legislate in this area, similarly, tonight, the Commonwealth does have the power to give the two territories that power back.

In researching for this debate, I read that the Andrews bill, which removed this power from the territories, was actually the first time that the Commonwealth had ever legislated to remove powers that had been given to the territories, so I think it's clear that the legislation at the time was the aberration. It was the first time that power had ever been used by the Commonwealth.

The second reason I will be supporting this bill is, if you like, the substantive reason—that is, despite the misgivings that I think many of us have, I do fundamentally support the right of individuals and their families to make their own decisions about how and when they should die. That has got to be one of the most personal decisions that anyone has the opportunity to make, and I don't see that it's my role as a legislator to make that decision for other people by preventing them from having the opportunity to exercise some level of control over the circumstances in which they pass on. I'm sure all of us know many people who have experienced excruciating and prolonged deaths, and any of us who've been in that situation, whether it be with relatives or friends, would want to make sure that people do have an option. This bill can give them the option either to press on and receive palliative care or any other form of care or, if they reach the point where they feel that the time has come, to have the power to end their lives with dignity, without legislators like me taking that decision away from them.

Like all advocates for this bill, I would want to make sure that there are adequate safeguards in place to ensure what would come from this if the territories do decide to enact legislation to facilitate voluntary assisted dying. We all want to make sure there are adequate safeguards around those powers, but I trust the residents and the legislators of the two territories to be able to make those decisions and to put in place the adequate safeguards that all of us would want to see. That was something that people in Victoria and their political representatives were capable of; that's something that people all around the world and their political representatives have been capable of. I have seen nothing in the various political representations and people of the two territories in Australia to make me think that they are not capable of making the same decision.

So, as I said, I will be supporting this bill, both on territory rights grounds and because I do think that this is a very personal decision. It is something that should initially be left to the territories to make decisions for themselves, and then for individuals and their families to make decisions over their own personal circumstances.

9:10 pm

Photo of Jordon Steele-JohnJordon Steele-John (WA, Australian Greens) Share this | | Hansard source

I too will try to keep my remarks brief. I want to recognise three things during my contribution to this debate on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015.

First of all, I want to recognise the fundamental reality that the peoples of the Northern Territory and of the Australian Capital Territory deserve to have their rights and their voices heard. The Andrews Bill, referred to previously by Senator Watt, was, indeed, an aberration. It stripped hundreds of thousands of Australians of their right to have their voices heard in the legislative process and should now be repealed. I would also like to recognise that this is also a question of many of our individual views of the issue of end-of-life choices, and put clearly on the record that I am a firm supporter of a move, whether at the state or federal level, to grant people under certain circumstances the right to make a choice about how they wish to finish their time on this earth.

My contribution to this debate, however, is unique among the contributions that have been made before mine, in as much as I am the first person with a disability to serve in the Australian Senate. For the disability community, and for at least a significant proportion of it, the question of end-of-life choices has a particularly deep significance. I would like, therefore, to add for the reflection of those participating in the debate tonight some critical context which I believe is very important and which helps illuminate some concerns and fears that are held by those in the disability community. These are not reasons, it is my firm belief, to fail to legislate in this area. They are, in fact, reasons to be kept firmly in mind as we, as legislators, put our minds to work in the crafting of the appropriate legislation.

We here in this place must come to terms with the reality that our society is drenched in toxic ableism. Ableism says that to be disabled is to be broken, is to be shameful and is to be a lesser form of human life. This toxic discriminatory idea pervades our society in the same ways, and deforms it in the same ways, as do sexism, misogyny and homophobia. This demeaning and dark angel of the human nature lies behind so many of the disgraceful circumstances to which disabled Australians are subjected daily. When we are forced to work for a dollar an hour, it is ableism that takes our wage. When we are abused and denied justice, it is ableism that silences us. When a disabled child is told that they can't be educated with the rest of their peers because they just hold their peers back, it is ableism which makes them wonder if they are right. It is this poison of our society which lies at the root of many of the fears of the disability community when it comes to the issue of euthanasia. It is far more prevalent in our society than many of us would like to admit, and it contributes a thought process which, to be blunt, expresses itself most clearly in the statement, 'It would be better to be dead than be disabled.'

It is the reality of modern-day Australia that the four million Australians with disabilities are overwhelmingly denied access to the proper supports and services necessary to live a good life. Although the NDIS is doing much good work in the amelioration of these circumstances, there is still so far to go. Violence, abuse and neglect are still endemic. Human rights are still casually denied. It is into this context that some fear that euthanasia enters. How can it be, some suggest, that this legislature, or any legislature, would seek to make it easier for a disabled person to die when there is still so much work to be done to ensure that we can live? Much concern is also created by often used terms such as 'dignity'. Dignity is, in itself, a very subjective idea. I put it to you that I experience things daily which some would consider undignified but which, in fact, have no inherent indignity. It is these things which we must be cognisant of when legislating in this area to ensure that the rights of disabled Australians and all others are protected and safeguarded.

I must state clearly, for the record, the anger that I feel when these legitimate concerns are taken advantage of by certain unscrupulous religious organisations seeking to abuse them for their own purposes. I sit here as a disabled person who is a passionate advocate of this reform. These are not reasons why we should not move forward in this area. These are not people whose fears and concerns should be played on, nor should they be immediately dismissed. It is clear we must move in this area. The pain, suffering and fear, which is a daily feature of those struggling with this most difficult of decisions, demands action of us. But we must also move cautiously in consultation, with open ears, to ensure that that which we create does no harm and robs none of their rights. I thank the chamber for its time.

9:19 pm

Photo of Zed SeseljaZed Seselja (ACT, Liberal Party, Assistant Minister for Science, Jobs and Innovation) Share this | | Hansard source

In considering this bill, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, we first have to define exactly what it is we are debating. Some have suggested we, particularly those of us representing territories, should put aside our views about the rights and wrongs of assisted suicide and simply debate the merits of territory rights. I reject this view for a number of reasons.

When the Andrews bill was debated in 1997, a conscience vote was granted by both major parties because it was recognised that this was an issue of such profound importance and, where there are such strong convictions, the vote should not be determined by the parties but by the individual senator or member. If it were an issue of territory rights, no doubt each of the parties would have a party position, because, on other occasions when territory rights have been considered in this place, a conscience vote has not been not granted. For instance, in 2001, this chamber voted to overturn Northern Territory laws on mandatory sentencing. I note that not only was this a party lines vote but the Labor Party, including the Territory Labor senator, and the Greens voted as a bloc specifically to overturn a law that a democratically elected parliament had enacted. As Lindsay Tanner stated in 1997 when debating the legislation that this bill seeks to overturn: where would territory rights advocates be if this were not about euthanasia but about capital punishment? He went on to say he suspected that there would be some who would be only too happy, too ready, to join in overruling the Northern Territory parliament should it decide to reintroduce capital punishment.

In correspondence I have had with people in Canberra, views have, of course, been mixed, though there is a tendency to support or oppose this bill, depending on which side of the assisted suicide debate one finds oneself on. Many of the people who support this legislation would be very happy to see Commonwealth intervention if the tables were turned and it was a different piece of legislation that was being debated. While parts of the media seek to suggest that Canberrans are of one mind in wanting more autonomy for the Territory parliament, I don't have people banging down my door asking that 13 individuals in the ACT assembly be given unfettered power. In fact, the more than 50 per cent of Canberrans who voted for a party not in government often feel completely disenfranchised by the way their government completely ignores their wishes. While I know less about the Northern Territory, I do know that, when given the opportunity to have less Commonwealth intervention in their affairs by becoming a state, Territorians voted in 1998 to remain a territory. This vote occurred after the Commonwealth had used its territories power to overrule the Northern Territory's assisted suicide legislation.

This brings me to the issue of assisted suicide. I oppose assisted suicide. I have no doubt that, if this bill passes the parliament, we will see assisted suicide in the ACT at least; therefore, I cannot support the bill. It's impossible, of course, not to be moved by the plight of terminally ill Australians who are suffering. There is no doubt that not enough is being done to ensure proper pain relief and palliative care is available to more Australians, and I'll come back to this later in my contribution. The question we have to ask as legislators is: will crossing this ethical threshold lead to better or worse outcomes for Australians, particularly our most vulnerable—the sick, the elderly, the disabled, the depressed and the lonely? Experience overseas suggests it will not. Former Prime Minister Paul Keating got to the heart of the matter last year in relation to the Victorian laws, saying:

What matters is that under Victorian law there will be people whose lives we honour and those we believe are better off dead.

He goes on to say:

… 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.

Does anyone really believe that laws passed by 13 Labor and Greens members of the ACT assembly, with no house of review, would be anything but an even more extreme version of the Victorian law with fewer safeguards? In fact, the sponsor of this bill, Senator Leyonhjelm, suggests that is exactly what he is hoping a territory legislature will deliver. In the Australian Financial Review, Senator Leyonhjelm recently wrote that, while the Victorian legislation was, in his words, 'a step in the right direction', he lamented the fact that the law only allows for euthanasia for the terminally ill. No doubt Senator Leyonhjelm is confidently hoping that the ACT assembly or the Northern Territory legislature will deliver a no-holds-barred version of assisted suicide. It's a legitimate fear. Supporters of this bill are very clearly leaving open that possibility, and I think it's clear that, if this bill passes, assisted suicide will be legal in the ACT before long.

One of the government's fundamental duties is to ensure that its laws protect the most vulnerable in society. As Lindsay Tanner stated, back when debating the law that is being sought to be repealed here:

… there is a very different question at stake here; that is, not whether in some individual circumstances there is something morally wrong, but whether the state should legalise and indeed can safely legalise such practices.

The reality is that the state cannot safely do so. Last week, we saw shocking reports that a nine-year-old and an 11-year-old became the youngest ever to be euthanised under Belgian law. Many who favour assisted suicide would say, 'That would never happen here.' To quote Paul Keating again:

… once termination of life is authorised the threshold is crossed. From that point it is much easier to liberalise the conditions governing the law. And liberalised they will be.

He continues:

The experience of overseas jurisdictions suggests the pressures for further liberalisation are irresistible.

So what is the experience overseas? Well, in Belgium, kids are now being killed by doctors with the authority of the state. That jurisdiction brought in assisted suicide in 2002 with apparently strict parameters that only those in constant and unbearable physical or mental suffering which could not be alleviated would be able to make requests for assisted suicide. In a relatively short time, this has expanded so that, in 2015, 15 per cent of cases did not involve people who were terminally ill and included those with depression—and now even children.

In Oregon in 2016, 19 years after the introduction of assisted suicide, nearly half of the people killed under the scheme cited concerns about being a burden to family, friends and caregivers as a reason for it, compared to just over a third who cited inadequate pain management as their reason.

Professor Margaret Somerville writes in The Guardian:

In the Netherlands, euthanasia is no longer restricted to competent adults with unbearable suffering able to provide informed consent. It's now available to children, newborn babies with serious disabilities, and people with dementia and mental illness, such as depression, without physical illness. There are movements to legalise access to inflicted death for people "over 70 and tired of life" or who feel they have a "completed life". Likewise, after just over a year of legalised euthanasia in Quebec, there are calls for it to be extended to "euthanasia on demand", that is, that there should be no requirements for access by a competent person.

So it's difficult to see how the logic pointed to by Paul Keating about further liberalisation, which is being played out everywhere that assisted suicide is allowed, would not apply in Australia's territories.

Victoria's Labor Deputy Premier, James Merlino, pointed to studies that have shown that, in jurisdictions which have legalised assisted suicide, the rate of unassisted suicide also rises. With all we do as a government and a society to discourage suicide, particularly by our young people, what message will we send if we open the door for state-sanctioned suicide? How much does legislation such as this undermine the amazing efforts of so many to discourage suicide in our society? And, of course, we've seen the example of high-profile assisted-suicide campaigner Philip Nitschke, who in 2014 advised a 45-year-old man, who was not terminally ill, on acquiring and subsequently taking life-ending drugs. Nitschke said:

If a 45-year-old comes to a rational decision to end his life … they should be supported.

Palliative care has come a long way. However, governments need to invest more in it. Of course, assisted suicide is much cheaper than palliative care, which provides a perverse incentive. Professor Ian Haines, a medical oncologist, tells of his support for euthanasia due to the traumatic passing of his aunt in 1969 in the absence of quality palliative care. However, now his views have changed. He says:

The advances in the skills, availability and knowledge in palliative care since those days have been phenomenal.

He goes on to say:

I have received many euthanasia requests from patients and families over my 34 years in full-time oncology practice, some very passionate, but I have invariably found that they quickly disappear as reassurance and adequate medication doses provide the comfort that is desired …

The reality is that palliative care, properly resourced and administered, provides a whole-of-community response to a patient and has the capacity to nurture people towards a dignified death.

According to an open letter to the Victorian parliament published by a number of palliative care professionals:

Current Australian data indicates that no more than 2 in every 100 Palliative Care patients would be in moderate or severe pain at the end of life. In these unusual cases where when all other methods of palliation for pain and other symptoms is inadequate, and if the patient agrees, palliative sedation therapy is available to provide adequate relief of suffering.

They further note:

It would be unethical for any state jurisdiction in Australia to move to legalise for assisted suicide or euthanasia whilst many ill, aged and disabled Australians cannot yet access the support that they need. Such a move would not enhance choice, but instead reduce choice around the care and support for those in real need.

How could it be any other way? How can people truly be exercising personal autonomy and choice when they are not being offered the best choices available?

In the ACT, where this bill would have its effect, there is no question that palliative care resourcing from the ACT Labor government has not been up to scratch. Dr Michael Chapman, Canberra Hospital's director of palliative medicine, says:

Our pressing priority to provide end-of-life choices in the ACT requires people to have real access to quality palliative care which is currently not always the case for many and not always the case when we need it. People often receive too little or too late or no services at all.

Dr Chapman's evidence to the inquiry into end-of-life choices in the ACT confirmed that there are just four full-time equivalent palliative medicine specialists operating in the territory—half the number required for the size of the population. And, given that the territory treats many patients from the surrounding regions, this number again falls short. The Hon. John Watkins, the chair of the board of Canberra's Calvary Hospital, also notes:

… rather than weakening current protections we should instead be talking about how we best support the dignity and personal needs of those reaching the end of their life in addition to their families and make sure that care is available and accessible to all.

It is significant to note also that the 2016 review of the National Palliative Care Strategy found that there remain significant barriers to access to palliative care services for a number of people within the population, particularly for the Aboriginal and Torres Strait Islander peoples and:

… there is work to be done in developing culturally specific activities to address the needs of Aboriginal and Torres Strait Islander peoples to help improve access for those who need it.

The report noted that Aboriginal and Torres Strait Islander Australians have not accessed palliative care services to the same extent as the general Australian population.

One of the most consistent arguments for legalising assisted suicide is about personal autonomy. However, overseas experience shows that personal autonomy is progressively eroded, with the most vulnerable feeling a burden on others or feeling pressured to do the 'selfless' thing and end their lives. One of the more horrible examples of this was reported in the Washington Times in October 2016. Stephanie Packer, a mother of four children, with a terminal illness, was denied coverage from her insurance company for chemotherapy treatment but was offered coverage for assisted suicide. Mrs Packer had initially been told that the insurance company would cover the cost of switching to a different chemotherapy drug, but the insurance company changed its position after the passage of the assisted suicide laws. This was a situation where a law about choosing to die ended up impacting on someone's ability to make a different choice. How's that for personal autonomy? How much easier will it be for governments to pay for euthanasia rather than treatment if these types of laws are passed?

Indeed, in Canada, with the introduction of assisted suicide in 2016, a report into the cost analysis of medical assistance in dying in Canada found:

… medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5 to $14.8 million in direct costs associated with its implementation.

The report states:

... as death approaches, health care costs increase dramatically in the final months. Patients who choose medical assistance in dying may forego this resource-intensive period.

The report states that, as death approaches, healthcare costs increase dramatically in the final months. Patients who choose medical assistance in dying may forego this resource-intensive period.

In my contribution, I've spoken a lot about the huge risks inherent in legalising assisted suicide, but don't just take my word for it. We debate many issues in this chamber, and how many times do people on all sides talk about the need to listen to the experts on questions of public policy? Let's listen to the experts. Let's listen to the Australian Medical Association, whose former president Dr Michael Gannon pointed out:

It has long been recognised that doctors who are closest to providing end-of-life care are those most likely to be opposed to physician-assisted suicide.

Let's listen to the World Medical Association, who said:

Physicians-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession …

and vulnerable people will be placed at risk of abuse. As I've already mentioned, the chair of the board that oversees Canberra's Calvary Hospital, the former Labor deputy premier of New South Wales, John Watkins, has written a letter that I'm sure every senator will have received. He states: 'Central to Calvary's mission over the past 130 years has been to care for the most vulnerable in our community, and we believe that encouraging laws to terminate life will disproportionately affect vulnerable groups in our society who deserve our care.'

Once again, let's be clear. This is not fundamentally about territory rights; it is about human rights. The passage of this bill will inevitably lead to assisted suicide in the ACT, almost certainly with minimal safeguards, as supported by the bill's sponsor. I will stand up for the human rights of Canberrans not to be pressured to end their lives. I will stand up for proper investment in palliative care. I will stand up for the old, the disabled, the sick and the lonely, for whom the passage of assisted suicide laws would see their lives considered less worthy. I will therefore vote against this bill.

9:36 pm

Photo of David SmithDavid Smith (ACT, Australian Labor Party) Share this | | Hansard source

Firstly, I wish to acknowledge the role of my predecessor, Senator Gallagher, in this debate. Also, I'd like to acknowledge at the outset the many individuals who've written to me about the bill. In the time I've been in this place, I've received more correspondence on this subject than anything else. I've received equally impassioned pleas supporting and opposing this bill. My decision to support the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015 will disappoint some of my constituents, including some close friends, while pleasing others. It's my view that this bill should be supported.

At its essence, this bill is about whether citizens living in the territories should have the same right, through their local legislatures, as citizens in the states to make their own laws. In my view, there can be no doubt the answer to that question is yes. This year is the 30th anniversary of the passage of the Australian Capital Territory (Self-Government) Act 1988 and, indeed, the 40th anniversary of the passage of the Northern Territory (Self-Government) Act 1978. The first election that I voted in was for the first ACT Legislative Assembly in 1989. The grant of self-government to Australia's two populous territories recognised that the people of the territories deserve the same democratic rights as people living in the states. As the then Minister for the Arts and Territories, the Hon. Clyde Holding, put it in introducing the Australian Capital Territory (Self Government) Bill:

The Australian Capital Territory (Self Government) Bill 1988 now before the House will establish the A.C.T. as a body politic, with the legislative and executive powers and responsibilities of the States and the Northern Territory. This Bill represents the most significant transfer of power, on a population basis, since Papua New Guinea became independent. It will allow 270,000 people the same democratic rights and social responsibilities as their fellow Australians.

The A.C.T. and the City of Canberra have well and truly come of age. Canberra is the nation's capital. It is the home of many of the symbols of our nationhood—the National Gallery, the High Court, the National Library and of course this magnificent building—the home of the nation's Parliament. But, and this is often overlooked, it is also home for 270,000 people.

270,000 people live in the Australian Capital Territory. They go about the day-to-day business of their lives, working at their jobs, paying their taxes, making decisions about which schools their children will go to, which doctor or hospital will care for them when they are ill—just like every other Australian. However, unlike every other person in this country—where 'a fair go' is the creed by which we live—they cannot elect a member of their own community to their own government. They have no say in the decisions which affect their everyday lives. What an extraordinary admission in a country so committed to democratic ideals, and why? Are these people somehow different from other Australians? Are they second-class citizens in some way? Do they not understand, or have opinions on, the issues that confront them daily? Can they not be trusted with their own destiny? The answer to all these questions is very simple—the only difference between these people and the rest of Australia is that they live in the Australian Capital Territory!

All that is as true today as it was in 1988, except that there are now over 400,000 people living in the ACT.

The self-government act established the ACT Legislative Assembly, with the power to make laws 'for the peace, order and good government of the Territory', an expression similar to that to be found in any of the state constitutions. There were exceptions to the powers of the Legislative Assembly but these reflected, for the most part, either limitations that the Constitution itself placed on the states or matters that the states had agreed should be dealt with by the Commonwealth. For example, the Legislative Assembly was not to have the power to make laws with respect to the raising or maintaining of any naval, military or air force, or with respect to the coining of money. Similarly, the act excluded the power to make laws with respect to the classification of materials for the purposes of censorship, which was already the subject of a national scheme under which classification was the responsibility of the Commonwealth. In each case, common sense dictated that these matters should be solely in the domain of the Parliament of Australia. In effect, the ACT was not being placed in a position any different to that of the states.

That leaves two further original exceptions: the acquisition of property other than on just terms, and the provision by the Australian Federal Police of police services in relation to the Territory. The first of these was based on a limitation imposed on the parliament by the Constitution, while the second reflected the fact that the AFP are under the direction of the Commonwealth minister and policing services in the ACT are the subject of an agreement between the Commonwealth and the Territory. That bill was passed with bipartisan support. While there was some discussion around the detail, the record is clear that, across the political spectrum, there was agreement that the lawmaking powers of the ACT Legislative Assembly should be equivalent to those of a state parliament. This remained the case until the passage of the Euthanasia Laws Act 1997, which removed from the ACT Legislative Assembly and the Northern Territory Legislative Assembly the power to make laws with respect to euthanasia or voluntary assisted dying. In doing so, that act introduced discrimination in that it remained completely open to any state parliament to pass such laws, as indeed the Victorian parliament has recently done.

The bill currently before us would, in effect, restore the constitutional position that existed from the time self-government was introduced into each of the territories until the passage of the Euthanasia Laws Act. This bill does no more than repeal the provisions that were inserted into the Australian Capital Territory (Self-Government Act) 1988 and the Northern Territory (Self-Government Act) 1978 by the Euthanasia Laws Act. This bill would not make euthanasia legal in the territories. It would not bring the Northern Territory's Rights of the Terminally Ill Act 1995, which was invalidated by the Euthanasia Laws Act, back into law. It would be a matter for each of the territories to decide whether, and in what form, any laws should be passed in this area, just as it is and has always been for each of the states.

Of course, there are some who may object that the ACT and the Northern Territory are not states and that their legislatures should not have the same powers as state parliaments. Of course, it is true that self-government exists only because of acts of this parliament, not by way of constitutional right, and it is within the powers of this parliament to amend the self-government acts if it sees fit.

However, parliament, having made its decision on the general principle that self-government ought to be granted to the people of the ACT and Northern Territory, would be wrong to pick and choose matters for which we would deny citizens in the territories the right to govern themselves. Some of us may be unhappy with the decisions made by the people of a territory. But, if we support the principle of self-determination, we accept their decisions and do not seek to substitute our own any more than we would where the same decision is made by the parliament of a state. Former Senator Humphries said in 2006 when he crossed the floor to oppose the Howard government's disallowance of the ACT Civil Unions Act, 'We may not agree with the ACT's legislative choices, but we have an obligation to respect them when they are democratically made'.

The ACT government made it clear it would not rush through legalisation of euthanasia if this bill was passed and is yet to actively consider legalisation. The Select Committee on End of Life Choices in the ACT is currently conducting an inquiry into end-of-life choices in the ACT and is considering the many submissions that it has received. I acknowledge that the legalisation of euthanasia, or voluntary assisted dying, is an issue that provokes strong passions with firmly held opinions from opposing points of view. That's understandable, since the issues relate to matters of life and death, and pain and suffering, and because we have a critical role to ensure we protect the vulnerable.

My own personal view is not in support of the legalisation of euthanasia. For me, the risk of exploitation of the vulnerable is too great. However, I know the legislative assembly's select committee will give proper consideration to this matter. I have encouraged people who have contacted me to make sure they make a submission to the inquiry so their opinions are heard. Just as passing this bill will not lead automatically to the legalisation of the euthanasia in Australia, rejecting this bill will not prevent euthanasia from being legalised. It is a risk but it is a responsibility that lies with the ACT Legislative Assembly.

As I said, the states have and have always had the power to pass laws for voluntary assisted dying. The parliament of Victoria passed its Voluntary Assisted Dying Act last year. In other states, they have considered similar legislation. With all its gravity, this is not something that should be restricted from consideration by the ACT and Northern Territory legislative assemblies.

9:47 pm

Photo of Jim MolanJim Molan (NSW, Liberal Party) Share this | | Hansard source

My contribution to this debate will be short, because many have spoken on this bill before me. They have spoken over a considerable time and much has been said. Neither aspect of this bill, territories rights or assisted suicide, are new. Both have been debated extensively, and it's my view that our debate here is not going to change the minds of our colleagues in the Senate, but is more about explaining to constituents why we will vote one way or the other. This is very important, despite the way that this bill has arrived in this place, because it considers a basic life-and-death situation. Because of the importance of what we are debating today, I consulted the medical community, including Dr Ian Haines—referred to by Senator Seselja—some in the psychiatric community and friends and family. Like so many of my colleagues and those of my age, I've experienced the death of my parents and my father-in-law. I've spoken to those who actually have a parent suffering terminal disease. I've been influenced by the writings of Professor David Kissane and Senator Seselja, who gave such a comprehensive speech only two speakers ago. As well, I've read as widely as I possibly can, as time permits, on the subject, and consulted, through its website, an organisation close to my heart, the Ethics Centre in Sydney.

To begin, I would like to address a number of background issues. The first concerns the Dutch example, which exemplifies the risk of what might be called 'normalisation'. In the Netherlands, there is an increased number of people being euthanised, with approximately 7,000 cases in 2017, up from 4,188 in 2012. There are real concerns around doctors overreaching in their mandate and euthanising people who're not able to consent or do not reach the required standards of consent. Recently, Dutch authorities have begun investigating four cases for improper euthanising, raising further concerns about the actions of doctors.

As well, there are risks of pressure on older Australians, including elements of elder abuse. There are already serious concerns around elder abuse in our society. The Australian Institute of Family Studies estimates that between two and 10 per cent of older Australians experience elder abuse in any given year, and the prevalence of neglect is possibly higher. Furthermore, the most common form of abuse is financial abuse where sons and daughters may attempt to inappropriately or illegally use or exploit the funds of their parents or grandparents. Euthanasia risks a further level of this type of abuse, as an older Australian who is in a financial abuse situation could potentially be euthanised in order for the abuser to achieve financial gain.

An important issue is the undermining of trust in doctors. Patients asking doctors to assist in suicide creates a contradiction for medical practitioners. In society, doctors exist as caregivers, with the idea of supporting or helping people. We go to the doctor because we trust in their training and in their aim to help us. It calls into question the integrity of doctors treating patients at a time when we are trying to increase faith in our medical system in the face of disinformation from other sources. We want our doctors to look after us and not to create any question around the chance of doctors doing harm.

There is a serious risk of exploitation of the system as well. There is also the chance that a determined individual may exploit any potential euthanasia system in order to end life when there are significant options to seek and receive treatment for illnesses. Mental health treatment has improved drastically over the last two decades, yet there is still so much more to be done. The risk is that those with mental illnesses will not be treated, and instead seek end-of-life treatment rather than the support and care that is becoming available in society. Such is the case of Aurelia Brouwers, a 29-year-old Dutch woman who took her own life with doctors' support in January. She had a number of mental illnesses, yet was allowed to take her own life with the support of physicians.

Finally, there is a major case that the standard of palliative care does need to be increased in some areas of this nation, because what is now possible with palliative care is that death can come with dignity. If that dignity is not present leading up to the time of death, there may be the case for upgrading the level of palliative care by governments in particular regions. Some members of the medical community who I consulted have told me that, given the standard of palliative care available in many places, they can guarantee that a patient can die with dignity. Other reports are that no more than two in every 100 palliative care patients would be in moderate or severe pain at the end of their life, which can be addressed through palliative sedation.

Many speakers say that this is not the area in which the Commonwealth should get involved and that the two territories should be given the right, like states, to make provisions for euthanasia. The populations of the ACT and the Northern Territory have both rejected statehood in the past, and, when they are states, they will certainly enjoy state rights. I wonder if it is the people of these states demanding these rights or the usual activists. In conclusion, I will vote against the private senator's bill, the order of the day today, titled Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, commonly known as the euthanasia bill, in its second reading debate.

9:54 pm

Photo of Claire MooreClaire Moore (Queensland, Australian Labor Party, Shadow Minister for Women) Share this | | Hansard source

Many senators have put on record that many people have contacted them with concerns about this piece of legislation, the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. Importantly, the thing that upsets me most is there is so much confusion in the community about exactly what this bill before us will cover. That actually upsets me greatly because we know that our community must have a genuine understanding about what is being discussed in this place, particularly when they are so concerned about an issue that they have taken the time to contact their parliamentarians.

The bill itself is very short and it's very clear. It has very straightforward objectives—four things:

The objects of this Act are:

  (a) to reduce Commonwealth interference with the laws of the Australian Capital Territory and the Northern Territory; and

  (b) to facilitate competitive federalism in law-making; and—

and I know that particular quote is straight from Senator Leyonhjelm—

  (c) to recognise the right of the Australian Capital Territory and the Northern Territory to legislate for assisted suicide within their jurisdictions; and

  (d) to repeal the Euthanasia Laws Act 1997 the enactment of which was inimical to the objects stated in paragraphs (a) to (c).

When I've responded to people who've contacted me with an understanding that this is what this bill refers to, they are often quite disappointed because they have very strong views about the issue of euthanasia. They are either strongly supportive and want it to happen or they are deeply opposed and they do not want to have euthanasia in our community under any circumstances.

But that is not what the debate is about in our parliament tonight. It's actually about what those objectives say. It's ensuring that the citizens of the Australian Capital Territory and the Northern Territory have the right to expect their elected representatives to have the power to develop, debate and legislate on the issue of euthanasia if that is on their program. The reason we need this piece of legislation goes back to 1995, when the then parliament of the Northern Territory actually passed a piece of legislation which was incredibly innovative at the time and caused great discussion because it was the first time any jurisdiction in Australia had actually passed such a piece of legislation. It was called the Rights of the Terminally Ill Act 1995. It came into effect on 1 July 1996, and people remember that there was great interest. This was as a result of a very open and very longstanding debate. The core issues of that debate remain largely unchanged now, over 20 years later.

Read what was actually debated in the Northern Territory in 1995 and then here in this parliament in June 1996 with the bill introduced by Mr Kevin Andrews under the title Euthanasia Laws Bill 1996 to override that piece of legislation which was enacted in the Northern Territory. When you read the passionate debates from the Northern Territory and, later, in this place, you will understand that the issues at play are very similar to those which we've heard in many contributions on this piece of legislation this evening. People care very strongly about the issues of euthanasia. That's why the introduction of the bill by Mr Andrews was the first time that the federal parliament actually did intrude, take over and, absolutely, as said by Senator Leyonhjelm in introducing the bill, interfere with the laws of the Australian Capital Territory and the Northern Territory. After many, many hours of deep debate, that piece of legislation, the Euthanasia Laws Bill 1996, was passed in both the House of Representatives and the Senate, which effectively overrode the only existing piece of legislation about euthanasia in our nation.

Now, over 25 years later, we have a piece of legislation here which is seeking to allow people in the two territories to have the same rights as people who live in our states on this particular issue. What happened here in that debate over 20 years ago is that the laws were changed. An element was placed into the self-governance laws for both the Northern Territory and the ACT which explicitly precluded them from having the right to debate issues around euthanasia.

So what we have before us is the opportunity, as parliamentarians, to weigh up whether it's time to ensure that there is equal opportunity around all of our country so that elected representatives can look at this incredibly sensitive, incredibly important and incredibly contested issue of euthanasia. One thing we know is that these debates will continue. Since the bill was introduced in the Northern Territory—it had been enacted for only a number of months and then it was overridden by our national parliament—there have been many debates amongst all states except my own—Queensland—which is considering having a discussion in its parliament.

I believe that there have been over 32 attempts at reform of the legislation around euthanasia since 1995. Nothing we do here tonight will stop the desire for people in our nation to debate euthanasia. I think it's important that not only the people who have been writing to us with their concerns understand but, importantly, that parliamentarians understand what is before us. This is not a debate around euthanasia, although many people have expressed their views and their concerns about it. That is their right but that's not what is before the parliament for consideration.

One point made was that the parliamentarians in 1996, when they were given the opportunities to debate the Northern Territory rules, were allowed to have open debate both in the House of Representatives and in the Senate. There was no attempt to stop the debate. In fact, it was actively encouraged. And, after a full debate in the House of Representatives, the bill came to the Senate and again was referred to a committee. There was major input from the community—over 1,000 submissions I believe—and then the opportunity was given to the Senate to actually pass the legislation.

Whatever we do in this debate in the Senate around the bill, I really hope that it will be given a firm opportunity in the other place to allow the process of democracy to continue so we won't again just have a private member's bill brought forward, causes a great deal of concern and discussion and then goes nowhere. People have invested a lot in this debate. They have considered their positions and shared them with everybody in this place. So it is important that there is an opportunity for the bill—in whatever form it takes, with whatever amendments—to be fully considered in the House of Representatives, so that the people who have been engaged in this debate, the people who have taken the time to express their opinions to their parliamentarians, will know that their parliament, the federal parliament, actually looked at the legislation.

We in the federal parliament do not have the authority to debate euthanasia; it is not within our purview. In fact, as we know, the only reason we have it before us now is because the parliament overrode territory legislation; otherwise, it would not be part of the federal responsibility. We have heard many people express their views and that is important. But where this fits in the overall debate is not an issue that can be controlled or determined in most cases in every state in Australia. It cannot be determined by the federal government getting involved.

Now, after all this time, we have one state that has legislated for their own particular purposes, Victoria, to have a form of euthanasia. They call it something different because the definitions change but nonetheless there is now a state that has gone through the process at the state level of debating and developing the legislation and then legislating. In this parliament we have no ability to interfere in what happened in that process. We can only do that with territories. And that is something that is really important for people to understand and that is the intent of the legislation before us.

I put on record and I have been on record many times saying this: I strongly support the ability of people to make informed choices where they have the opportunity to do so. And when we hear the arguments that are raging around this place about whether euthanasia is in fact something that should be supported or not, and you read the debates that happened in 1995, 1996 and more than 30 times since then, there won't be much difference. People will have strongly held beliefs. They'll quote similar exercises that have happened elsewhere; they'll quote things that have happened overseas. That will be part of the debate. We can have that, but people in the territories at this stage cannot.

I want to address one more element. This is something that truly infuriates me, and I want to put it on the record. It is the confected debate, which was had in 1995 and 1996 and in all the times it has been debated in the states and again in this place today, that puts up some kind of false contest between discussions around euthanasia and discussions around palliative care. I have worked in the area of palliative care and end-of-life care for more than 30 years. I have been involved in various organisations where we actually value, support and celebrate the amazing abilities of people across professional backgrounds who have worked to develop a very positive range of palliative care situations in our nation. When you read the discussions in 1996 in this place, there were many promises made at that time saying, 'We will make sure there will be strong palliative care available for all Australians, so there won't be any need for any other options to be put before communities when thinking of end of life.' We have failed dismally in that space—not because people do not have the skills, but because having strong, accessible palliative care to serve the needs for everyone who needs it has never been effectively resourced at either the federal level or any state level. That argument has been put in the debate tonight, and it will be put again. I know that every time there is a debate around euthanasia, it will come up.

It is not a real contest. There must be fully resourced, accessible palliative care services in our community for everyone who needs it. I think that's something on which we can all agree. But, please, don't use that as an argument that there should not be any further discussion around euthanasia. In terms of where we go in this debate, we must make sure we understand that there are a range of needs, a range of issues that should be considered. But for today's debate, it's exactly what we have on the record. I put this on the record: it is about Commonwealth interference with the laws of the Australian Capital Territory and the Northern Territory, and to recognise the right of the Australian Capital Territory and the Northern Territory to legislate for assisted suicide within their jurisdictions.

One other element in this bill is this: Senator Leyonhjelm has put in, as one of the core objects, to repeal the Euthanasia Laws Act 1997, the enactment of which was inimical to the objects stated in paragraphs (a) to (c). This bill seeks to make sure that act is repealed and that it will no longer have the ability to colour the debate on this very important issue for states and territories in Australia.

10:08 pm

Photo of David BushbyDavid Bushby (Tasmania, Liberal Party) Share this | | Hansard source

I rise to put on the record my intention to vote against Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. The issue of assisted suicide, or euthanasia, is a very complex and challenging one. Over the years, I have listened closely to the arguments put in support and run them through the prism of my core belief in the sanctity of human life. My subsequent conclusion is that none of these arguments are powerful enough or cogent enough to warrant my voting to support legislation that will lead to state sanctioned deliberate ending of a human life by another person. Rather, my conclusion regarding those arguments is that, if more is needed in terms of compassion or to assist the maintenance of dignity for those living in the latter stages of a terminal disease, then this need should be met through increased investment in palliative care and assistance for those who need additional care.

Experience in jurisdictions where euthanasia has been legal for some time is very concerning. What has occurred includes the ability to euthanase children, with decisions being made by parents and not the individual whose life is being terminated; instances of people choosing to have another person end their life because of concerns about a genetic disorder that will likely lead to issues later in life; and the reality of family members making decisions to end the life of relatives for motives less worthy than ending their suffering and pain. All of these and more are real and happening.

The inevitable conclusion I draw, observing the actual experience of assisted suicide in these jurisdictions, is that the value of human life is devalued by its application, no matter how noble the intentions may have been in setting up the legislation. Put simply, allowing assisted suicide, even with the tightest possible restrictions up-front, comes with risks and consequences I deem unacceptable. The concerns that this bill are intended to address are, in my view, better addressed through other means such as palliative care.

The other issue here relates to the territories' ability to legislate on matters without interference from this parliament. This has been canvassed eloquently by many others in this place who are opposed to this bill during this debate, and I acknowledge their contributions, particularly Senator Seselja, who is here with me, Senator Stoker and Senator Abetz, who I had the opportunity to listen to and who, amongst others, covered the issue very well. Needless to say, our Constitution specifically makes provision for federal government oversight of territory law, extending to legislation of the assemblies created for them. This constitutional position is very different to that set out for the states, and deliberately so. Accordingly, I am content that this parliament is acting appropriately in considering this matter in this place and, when the time comes to make a decision, I will be voting no.

10:11 pm

Photo of Penny WongPenny Wong (SA, Australian Labor Party, Leader of the Opposition in the Senate) Share this | | Hansard source

The legislation we are debating here this evening, the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, seeks to overturn an act of the federal parliament which denies the people of the Northern Territory and the ACT the same rights as their fellow Australians living in the six states, and that is the right to elect representatives who make laws on their behalf concerning the rights of terminally ill people. Of course, that was an entitlement taken away from them in 1997 when this parliament, at the urging of then Prime Minister John Howard, passed the Andrews bill to overturn the Northern Territory's Rights of the Terminally Act 1995. At that time, the Northern Territory legislation was unique in allowing a doctor to accede to a request from a terminally ill, competent adult patient for assistance in ending the patient's life if specified conditions were satisfied.

The ongoing effect of this legislation is to create two classes of Australian citizens: those who live in states, who have the right to elect representatives to make decisions on issues such as euthanasia, and those who live in the territories, who do not. In November of last year, the Victorian parliament voted to legalise a framework of safeguards to permit assisted dying. Those who live in the ACT and the Northern Territory are denied by a specific act of this parliament the right for their legislators to grapple with these issues. I do not believe that is neither logical nor supportable.

I also want to briefly comment about the political context surrounding this debate—that is, the deal between the Prime Minister and Senator Leyonhjelm to bring this issue on for debate in return for Senator Leyonhjelm's support for the restoration of the ABCC. Mr Turnbull now makes clear that he does not intend to honour that deal, by denying this bill a hearing in the House should it pass. I have to say that this does raise serious questions about how much trust senators and, in fact, the Australian people should place in a man who is prepared to say one thing to get a vote and do another once he no longer needs that vote. Whatever your views on the ABCC or the bill we are debating here tonight, I invite senators to think long and hard about the next time you are offered a deal in return for your vote.

However, returning to the bill before the chamber, whilst the principle that the bill seeks to restore is territory rights, it is of course naive, and would be so, to ignore the issue around which this bill revolves, which is the right of terminally ill people to seek assistance to end their lives. There was much talk in this place, both in 1997 and this year, and in fact just a few moments ago, about the intrinsic value of life. Everyone in this chamber has a fundamental respect for human life, and I understand why any proposal that would in any way assist people to shorten their lives might appear on the surface to defy this basic respect for human life. Life is precious, but let us remember whose life it is we are talking about. We are speaking of a person in the terminal stages of an illness who is seeking the right to determine how they can bring an end to their suffering with dignity and free from pain. I would argue it is precisely our respect for human life, for the person whose life it is and for the fact of their living through a terminal illness that causes us to consider whether that person's life would be better, or at least more tolerable, if they were able to control the pathway to its inevitable end.

We are living in an age where it is possible, in some circumstances, to extend life but not necessarily the quality of life and to ensure that life continues but only at the cost of pain and the forfeit of personal dignity. That is why, after careful consideration of the ethical and moral issues involved, I have come to the view that respect for life must be balanced against the respect for the right of any individual facing certain death and their remaining days filled with pain, suffering, fear and the loss of personal dignity to take control of their life and make a choice about the quality of its ending. In doing so, I cast no judgement on those who hold a different position, because I also come to this position with questions and some reservations about checks and balances.

Of course, we need to ensure that this right of which I speak is not subject to abuse. I am clearly not alone. When the Andrews bill, which we are seeking to repeal, was examined by a Senate committee in 1996 and 1997, it received over 12½ thousand written submissions—the largest number ever received by a Senate committee during the course of inquiry at that time. An important point which should be noted, and to which Senator Moore adverted, is that this parliament doesn't have the legal capacity to legislate for assisted dying. Any Australian legislature which sought to pursue such legislation should—and, I have no doubt, would—consider thoroughly and deeply the constraints and safeguards that would be required.

In closing, whatever my questions or concerns about this issue, I have come to the view that, just as people have a right to control the way they manage their living, so too they have a right to control the way they manage their dying. For that reason, I support the legislation.

10:16 pm

Photo of Peter GeorgiouPeter Georgiou (WA, Pauline Hanson's One Nation Party) Share this | | Hansard source

I've never felt so conflicted over a piece of legislation as I do over the one that is before us right now. I have always supported the right for the territories to choose their laws around euthanasia. Part of me understands why there are many advocates for assisted suicide legislation. I only have to think back to the pain and suffering my late fiancee went through 15 years ago, fighting a rare form of cancer. She had been battling the disease for a few years when it came to the point where every breath she took was a struggle. In 2003 she took her last breath and found her peace. Witnessing this was by far the most gut-wrenching and devastating experience of my life. There were many times when we all wanted the pain, suffering, trauma and heartache to end. However, we still hoped she would beat this deadly disease. Cancer is a horrid disease. There are no winners, and the amount of pain and hurt it causes is immeasurable.

Fifteen years on, I have had plenty of time to reflect on this experience, but the reality is I'm still torn about the issue of assisted suicide. Who are we to deny someone's dying wish? Since meeting a group of doctors this week who are firmly against euthanasia, more questions have been raised, forcing me to question my stance on the issue. What are the safeguards that come with this legislation? Where is the safety net to ensure people who are just lonely or depressed don't get captured in this vacuum of assisted suicide? Is this the answer to our problem? Is this the solution? Don't we have any other options?

When we look a bit more closely, palliative care is something that seems to have been forgotten; it seems to have fallen off the radar. During my deliberation on this complex issue, I was stunned to learn that, of the 49 recommendations made in Victoria's inquiry into end-of-life choices, 30 related to the improvement of palliative care funding and access. Only one recommendation related to the introduction of assisted suicide, which, as we all know, Victoria has legalised. I believe investing in palliative care is an area of focus that the state, territory and federal governments must home in on. The dedication by nurses, doctors and carers in this area is phenomenal, and it is refreshing to note that Australian palliative care services are ranked amongst the best in the world.

What I fear about this proposed legislation is that it may capture people who aren't necessarily on their death bed but are in fact lonely and isolated, have no family or feel they are a burden on society and as a result are depressed and feel that the only option they have left is to end their life.

I feel we could do more in the palliative care space. If the stats are right, there are only two palliative medicine specialists for every 100,000 people living in the ACT or the Northern Territory, and that is some cause for major concern. I believe serious investment in palliative care is necessary to help patients live in a more comfortable space as they approach the end of their life. I'm not just talking about a comfortable bed or a pillow or turning up the pump on the morphine; I'm talking about a holistic approach. I believe it's important to sort out our palliative care system properly to ensure we have done all we can before we look at facilitating assisted suicide. Such legislation, in my view, is a last resort.

My fear is: if the territories are granted the power to make their own laws, what safety measures are in place to capture only those that they are intended to serve? After looking closely at the current legalised model in Victoria, I am not convinced it goes far enough to fill these gaps. Therefore, admittedly with a heavy heart, I declare that I will not be supporting this legislation.

10:21 pm

Photo of Jonathon DuniamJonathon Duniam (Tasmania, Liberal Party) Share this | | Hansard source

I rise to make but a very brief contribution on the debate the Senate is currently considering. Of course, this is a very important issue for many people right across the country, people who have very different views and opposing views. It is something that evokes a great deal of emotion. Some of the contributions today and tonight have highlighted a lot of that, including Senator Georgiou's contribution just then about his own personal experience, which I very much appreciate him sharing with the chamber.

I myself won't be supporting the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I think it is important at the outset to note that this bill doesn't actually deal with the issue of assisted suicide, euthanasia, or voluntary assisted dying—it's known by many different names in a number of different jurisdictions. It's not about formulating how the territories should legislate, what the laws would look like, what sorts of policies would be in place and, most importantly, as a number of contributions have outlined, what sorts of safeguards would be in place. It's not about that. It's about granting the right to two jurisdictions in our federation to make laws with regard to this particular issue—two jurisdictions which, by virtue of the constitutional make-up of our nation, don't currently have that right. They are different to states; they are territories. That is just the nature of territories versus states.

In my mind, I am concerned that this bill is about, in effect, writing a blank cheque for two jurisdictions to go and legislate something that we have no oversight over, no recourse to consider and no input on. I think it's important to divide the two issues up. It is also important, I believe, to note that the two jurisdictions we're talking about, the ACT and the Northern Territory, both have unicameral parliaments. The chambers that will be debating these very important and sensitive issues don't have a second chamber to check off exactly what they're debating. I think many of us can point to many examples over time where single-chamber parliaments have passed legislation which is less than satisfactory. Where there's no recourse, there's no involvement and there's no capacity for this parliament to be involved in the policymaking, I am just concerned that here, by passing this bill, we'd be looking at something like a blank cheque.

It is also important to point out that we're focusing on one issue here. There's the broader issue around powers and rights to be conferred on the territories that they don't currently have. It's a singular issue. There are a number of areas where the territories don't have the rights of states and, if we're serious about issues like constitutional reform, perhaps a broader conversation should be had. But I don't think the piecemeal approach of picking a certain issue and dealing with that and then dealing with another is the way to do that. And, as I understand it, if this bill were to pass, then what would happen in the Northern Territory, for instance, is that the laws that were in place before the Andrews bill came into effect would be automatically reinstated—that is: tomorrow, those laws would be in place and euthanasia could be undertaken on individuals under those laws that are over 20 years old, with all their loopholes and with all the dangers and risks that we don't know about. We just don't know what risks to the public that would present.

So, as I say, we're presented with a bill, which, in my view, means we are writing a blank cheque for two jurisdictions who haven't tabled what they intend to do. There is the situation whereby previous legislation is re-enacted by virtue of the passage of this bill. There are risks to the community, and I don't think it's right for this parliament to support that. I won't be supporting it. I'm not a supporter of euthanasia generally, so I won't be supporting the bill.

10:25 pm

Photo of Patrick DodsonPatrick Dodson (WA, Australian Labor Party, Shadow Minister for Indigenous Affairs and Aboriginal and Torres Strait Islanders (Senate)) Share this | | Hansard source

I rise to speak on the private senators' bill, the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I will not be supporting the bill, because of the potential unintended consequences for the territories, for First Nations people and for our society as a whole. I understand that the Northern Territory government has called on senators to support this bill and to restore territories' rights to make euthanasia laws. The press advertisement argues:

With other states around Australia now passing laws on voluntary assisted dying, the fact that the Australian territories can't even consider their own legislation is unjust.

It reads as a call for the Territory to have the same rights and authorities as other jurisdictions within our Federation. The question of statehood for the Territory arises. We need to take a step back from the emotive question of euthanasia and look at the Territory's rights and issues. The Territory is not a state. If there is a call to change that, it should be dealt with as a separate issue. While we have no specific bill before us from the Northern Territory Legislative Assembly or from the ACT, I consider that the issue is indirectly about assisted suicide legislation.

The bill amends the Australian Capital Territory (Self-Government) Act 1988 and the Northern Territory (Self-Government) Act 1978 to remove the prohibition on legislating voluntary euthanasia, and it repeals the Euthanasia Laws Act 1997. The federal government will still be able to override the Northern Territory legislation even if this bill is passed. If it were not the case, the federal government would legislate to change the self-government act to allow that to happen or to grant statehood to the Northern Territory and the ACT. What we have is a private members' bill that was brought into the Senate without any knowledge of any safeguards or constraints which may need to be included in future assisted suicide legislation. It should not be done in such a way as to make changes to the territories' rights pivotal on the larger question of 'To be or not to be?' while avoiding the question in front of us: what is statehood for the Northern Territory and the ACT; what would be the benefit and what would be the implications for our Federation?

If the Northern Territory wants to have the argument about its ultimate authority over legislation that impacts on Territorians, that is an important conversation, and one this Senate should be addressing. We have seen what has happened when the Commonwealth parliament uses its power under section 122 of the Australian Constitution to enact its own legislation to override the Northern Territory act, and even to override the federal Racial Discrimination Act. But we should not be asked to frame a discussion on territory rights within such an emotive questions for human beings as the right to life or the right to death. In my view, this twists the discussion and creates unnecessary division within the parliament.

Each successive Northern Territory government has failed to recognise the rights of First Nations peoples within the Constitution. Any proposed legislation to change assisted suicide legislation must occur in consultation with First Nations health services and communities. It is the First Nations people who are at higher risk of being in a situation where assisted dying may take place.

Senate adjourned at 22:30