Senate debates

Wednesday, 15 August 2018


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

10:53 am

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

At present the constitutional framework of Australia divides legislative responsibilities between the states and the Commonwealth. The states are therefore different to territories. The residents of territories are therefore subject to a different legislative process than the residents of states. Under the United Nations Declaration on the Rights of Indigenous Peoples, article 24.2 states:

Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

We know that Australia's attempt to achieve the realisation of that right, through the Closing The Gap campaign, has been an abysmal failure. First Nations people do not enjoy the same quality of life in this country at every stage of their existence, as shown in the national figures. In the womb, a First Nations child is at higher risk of contracting life-threatening bloodborne diseases. Last year, six First Nations babies died of syphilis. Our children are more likely to be diagnosed with chronic health conditions such as type 2 diabetes. They are at greater risk of contracting meningococcal and rheumatic heart disease. As teenagers, they watch their friends, their cousins and their siblings prematurely end their own lives. These facts are true of the Northern Territory and nationally. In the Kimberley region, where I come from, the suicide rate is the highest in the world.

By what most Australians call middle age, many First Nations people are already living with kidney failure, without sufficient access to dialysis. The burden of disease and disability in First Nations communities is far higher than it is in the general population. First Nations people are more likely to live with a severe or profound disability. They also die younger. On a national basis, First Nations men can expect to live to an average age of 69, while non-First Nations men can expect to live to 80. First Nations women can expect to live to an average age of 73, while non-First Nations women can expect to live to 83.

All governments—state, territory and federal—have failed to enact the necessary action to close the gap. The government is currently undertaking a refresh process, with the Minister for Indigenous Affairs announcing at Garma earlier this month that some two dozen new targets would be added as part of the refresh process. That seems a drastic amount of new targets, and only emphasises how we've failed to address the health issues suffered by First Nations people to date. With so many of our people suffering complex health conditions at an early age, there is a desperate need for culturally appropriate palliative care services in regional and remote areas. A review recently commissioned by the Australian government confirmed that more needs to be done to ensure that First Nations people are receiving palliative care within their communities. Where First Nations people are already overrepresented at every stage of our health system, it is irresponsible to vote in favour of another avenue to death. Paving the way for euthanasia and assisted suicide leaves First Nations people even more vulnerable, when our focus should be on working collectively to create laws that help prolong life and restore their right to enjoy a healthy life.

During the debate on the Voluntary Assisted Dying Bill 2017 in Victoria, former Labor Prime Minister Paul Keating argued:

No matter what justifications are offered for the bill, it constitutes an unacceptable departure in our approach to human existence and the irrevocable sanctity that should govern our understanding of what it means to be human.

…   …   …

It is a mistake for legislators to act on the deeply held emotional concerns of many when that involves crossing a threshold that will affect the entire society in perpetuity.

In Yawuru we have three concepts that guide our experience of life. They shape our ways of knowing and understanding, and are the collective approach to our existence on this earth and, to that extent, any afterlife that may come. They are: mabu ngarrungu(nil), a strong community—the wellbeing of all is paramount; mabu buru, a strong place and a good country—human behaviour and needs must be balanced in their demands and needs of what creation provides; and mabu liyan, a healthy spirit and good feeling. Individual wellbeing and that of our society not only have to be balanced but be at peace with each other within the context of our existence and experience.

This concept of interconnectedness is one that transcends across many First Nations groups. It is grounded in our understanding that human resilience is based on our relationships with each other and our connectedness with the world around us. The quality of life for individuals and for our communities are intertwined, not limited to the wellbeing of an individual. We are fundamentally responsible for honouring our fellow human beings. We are called to carry responsibilities, to exercise duties and to honour those who are in need, who are ill, who are elderly, who are dependent and those of the next generation to value life with love, respect and responsibility. This is true of family members and unknown individuals. Moving away from such principles and values begins to reshape the value of human beings and our civil society, in my view.

We exist not as solitary individuals; we exist within a family, a community, our cultures and ethos, and in the kinship landscape. I'm a great admirer of those who have cared for loved ones and made personal sacrifices to do so. Not everyone is able to do this, I know, and I do not condemn them for the choices that they make. In the broad sense, we are part of a common humanity. If we give one person the right to make that decision—that is, to assist in committing suicide—we as a whole are affected. If we give one family that right, we as a whole are affected. If we give one state or territory that right, we as a country are affected. If we give one nation the right to determine life, our common humanity is affected. I cannot support this legislation.

11:00 am

Photo of Richard ColbeckRichard Colbeck (Tasmania, Liberal Party) Share this | | Hansard source

I rise to make my contribution to the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I acknowledge the contributions made by others in this debate, regardless of their perspective. I understand fully that there are very strongly held views on this matter. I congratulate Senator Dodson on the contribution that he's just made, particularly from the perspective of the First Nations people. It was a quite profound presentation. I think it typifies the issues, particularly for the more disadvantaged in the Australian community. The bill is portrayed simply as returning rights to the territories to enable them to legislate for euthanasia. It's portrayed as being quite simple in that context and therefore, effectively, an issue of territories' rights. But one thing I have learnt in my time in this place is that, when you believe in something, you need to utilise your entire toolkit to ensure, to your best ability, that your beliefs are reflected. The reality is that, in this circumstance, the Commonwealth does retain some oversight with respect to territory law. Therefore, part of the toolkit of this place rests in that context.

I'm not a supporter of assisted dying. I understand that, as I said earlier, there are strongly held views with respect to people who view that as their right, but I can't sanction or support what I see as, effectively, state-sanctioned killing. I don't support the death penalty, so I can't support what's termed assisted suicide or euthanasia legislation. I understand perfectly the difficulties that exist for some people towards their end of life. I think we all understand that, and that's reflected very much in the way that this debate has been conducted. In that sense, I congratulate my colleagues for the sobriety of the debate and also the arguments that they've made in support of their relative perspectives. But, because I don't support assisted dying, assisted suicide, euthanasia, I can't support any legislative measure that might promote that. So I put on the record my opposition to the legislation and say that I will not be supporting this bill.

11:04 am

Photo of Carol BrownCarol Brown (Tasmania, Australian Labor Party, Shadow Minister for Disability and Carers) Share this | | Hansard source

I also rise to speak on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I would like to place on the record my appreciation of the contributions that have been made, regardless of the positions that senators have taken on this bill. The intention of the bill before us is to undo the restrictions brought into effect by Mr Kevin Andrews's private member's bill in 1997. These restrictions limited the ability of the territories to decide for themselves how and when terminally ill people should be allowed to die. Such restrictions removed the democratic rights of territorians. I listened carefully to Senator Colbeck's contribution, and I can understand where he's coming from. But I do disagree that we should use the powers that we have as a federal parliament to take away the right of territorians to decide matters that they would normally be able to decide for themselves. The territories should have the same opportunities that the states have in Australia.

For those who don't support assisted dying, I understand that position. It is a difficult issue for many, and unfortunately there are many in this parliament who have had loved ones who have gone through agonisingly painful deaths. I have myself, and there are many others in this parliament who have witnessed their loved ones passing away in those conditions. It's not easy to see your loved ones passing away, especially when they do so in such pain and with a wish to die with dignity and in the manner they wish to. This is denied of many Australians. It is very hard to then come in here and have a position where we will not allow territorians the same right to debate the issue within their communities and in their parliament and to decide to legislate for it or not. But for a federal parliament to come over the top of the rights of that community, to even have that debate—I don't think we should be supporting that.

I had the opportunity to listen to a couple of contributions made last night on this bill. Both Senator Catryna Bilyk and Senator Claire Moore talked about good palliative care, and I absolutely agree with the content of their statements. Senator Bilyk said:

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.

Senator Moore's contribution went to the very heart of investment in palliative care. I think we do have across-the-board support from senators and members in this place for investing in palliative care, but the action isn't there. There is not enough investment in palliative care, and both those contributions articulated the need for this investment.

But, as I was saying, restrictions that were placed on the territorians not only removed the democratic rights of territorians to create their laws for themselves but overturned properly constituted legislation. They also prevent legislators from having that debate, despite such laws—in the case of the Northern Territory—having already been passed.

The people of Australia overwhelmingly support the freedom of terminally ill Australians to decide on this matter. Approximately 75 per cent of Australians polled answered that the terminally ill should be able to legally end their lives with medical assistance. This is a very sensitive subject, and opinions are sincerely and strongly held on this matter. Many feel that Australians deserve the right to choose to die with dignity and that euthanasia is the most effective way of safeguarding this. Others, however, have closely held religious or personal beliefs which mean that they oppose euthanasia. I personally believe that there are, unfortunately, some people living with terminal illness for whom there is no other way to avoid suffering than dying with dignity. That is why voluntary euthanasia laws have been adopted in parts of Europe and the USA and, of course, in the state of Victoria.

Regardless of your position on euthanasia, it is clear that a single private member's bill removed the right for territorians to do so. The legislation was passed over two decades ago. To me, this is a matter of local representation and the right of citizens to elect, at a local level, people who can legislate on territory matters that they are legally able to. As many senators have said in their contributions, just because the federal parliament doesn't like what a state or territory does, that isn't sufficient justification to trample over its right to do it.

Critically, this bill reinstates the rights of territorians. It allows local representatives in the ACT and the NT to legislate for themselves. It goes to the very heart of our federal system. We live under the federal system of government, where state and territory parliaments are ordinarily allowed to debate and legislate these matters for themselves, and this is the system that we seek to uphold in this legislation that we are debating here today.

Recently, the Victorian parliament passed legislation to see voluntary euthanasia legalised. This is a path that the Northern Territory had followed as well, over 20 years ago. But, regardless of their legislative ends, what both the ACT and the NT governments want is the right to decide for themselves. This is something that they have called for—they put a full-page ad in The Australianand it is something that other states are afforded. The right to decide for themselves, through their elected representatives, in these jurisdictions is something that I believe all territorians deserve.

As the architect of Victoria's assisted dying bill, Professor Brian Owler, suggested, discussions should be had at a national, state and territory level in order to ensure that the needs of Australians at all levels are met. As a medical doctor and former head of the Australian Medical Association, Professor Owler is well placed to comment on the needs of the terminally ill. He chaired an independent panel on the matter that provided 66 recommendations to the government on assisted dying.

I believe it is our duty as elected officials to consider the advice of experts on such matters and to respond to the needs of the terminally ill in the light of the recommendations of an expert such as Professor Owler. Now is the time to listen. It is the time to signal a willingness to participate in local grassroots democracy and to allow territorians to decide for themselves whether euthanasia most appropriately meets their needs.

This bill brings together a coalition of parties; it brings together a coalition of viewpoints. The Labor Party is holding a conscience vote on the matter, as indeed is the Liberal Party. I and some of my Labor colleagues would have differing views and opinions as to whether or not voluntary euthanasia should be legislated. But I sincerely believe that, fundamentally, that is not what is being considered here. What is up for consideration is whether or not people living in the ACT and the NT should be allowed to vote for themselves on voluntary euthanasia. This is a question of democratic enfranchisement and it is a matter that has been removed from Territorians for far too long. I am proud to support this bill and to recommend to all senators to vote for this bill, so that we can allow states and territories to have an equal say through their parliaments on whether the terminally ill should have the right to die with dignity.

11:15 am

Photo of Don FarrellDon Farrell (SA, Australian Labor Party, Deputy Leader of the Opposition in the Senate) Share this | | Hansard source

I rise to speak on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I would like to start by recognising that many, if not all, in this place, and those watching will have experienced the suffering and the loss of someone dear to them. It's natural to be saddened by a loved one's suffering and passing, and it's natural to want to help to ease their pain. I think we all understand that it is a very sensitive issue and a very personal one. This debate will no doubt be a difficult and emotional one for many of us. In recognition of that, I hope this will continue to be a debate that is conducted respectfully and with the awareness of the emotions it will no doubt bring for many of us.

This bill does not of itself legalise assisted suicide and euthanasia. But it's very clear from its title, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, and from Senator Leyonhjelm's public comments, that this bill's objective is to pave the way for the legalisation of assisted suicide. That's why it is important that this bill, as it should be, is being treated as a conscience issue. Speaking on the bill today, I'd like to address two main points: firstly, the core issue of the conscience matter, of assisted suicide; secondly, the circumstances that have brought us to this debate today. As I've just outlined, the bill's core objective is to facilitate the legalisation of assisted suicide, so I do not intend to address the issue of territory rights, other than to say this is one of many issues in which the Commonwealth has sought to regulate the territories.

It is, however, the issue at the heart of the bill that I wish to address—assisted suicide. As I mentioned in my opening remarks, the suffering and passing of loved ones is something that most, if not all, of us in this place are likely to have experienced. We're all acutely aware that with life comes death. Obviously it's an extreme emotional experience and it is human nature for our emotions to influence our thoughts on such matters. I'm sure everyone in this place can sympathise with those who have had to witness and deal with loved ones towards the ends of their lives. While I expect much debate on this issue will focus on details, as has been the case with previous debates in state parliaments, my view is that we must not avoid addressing the fundamental realities of assisted suicide.

Paving the way for the legalisation of assisted dying would be an irreversible step over a major ethical threshold. As a society, we should give very serious consideration to the potential impacts of taking such a step—as former Prime Minister Paul Keating described—as abandoning the golden principles. It's also pointed out in typically blunt fashion what is proposed when we talk about euthanasia or assisted dying, which, in his words, would be 'permitting physicians to intentionally kill patients or assisting patients in killing themselves'. Unsurprisingly, whilst there is a range of views within the medical profession, as there is in society in general, the Australian Medical Association has serious concerns. The Australian Medical Association is against the legalisation of euthanasia and assisted suicide. In its position statement on the issue, the AMA says:

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

It's my view that governments, too, should not be involved in interventions that have as their primary intention the ending of a person's life.

The comments of Paul Keating that I referred to earlier come from a piece he wrote following the approval by the Victorian lower house of the Voluntary Assisted Dying Bill 2017. That piece by the former Prime Minister summed up the key issues very succinctly. In that piece, he said:

… the 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. This is the point. If there are doctors prepared to bend the rules now, there will be doctors prepared to bend the rules under the new system.

He goes on to say that his opposition to the Victorian bill was not about religion, and that his concerns were shared by people of any religion and no religion; it is the principles that matter in public life. He says of those principles:

They define the norms and values of a society and in this case the principles concern our view of human life itself. It is a mistake for legislators to act on the deeply held emotional concerns of many when that involves crossing a threshold that will affect the entire society in perpetuity.

This is an emotional issue, but we must not let emotion cloud fact. It's also an issue of conscience, and for some people, that conscience may be informed by their faith. But, at its core, as Paul Keating alluded, it's an issue of principles—the ethics rather than the morals.

This is the point that former South Australian Attorney-General Michael Atkinson also made during a debate on this issue in the South Australian parliament. He said:

If my opposition to AVE is based on ancient wisdom, it is not that of Jesus of Nazareth but Hippocrates of Kos, who lived some 350 years before.

He was of course referring to the Hippocratic oath, that well-known early expression of medical ethics, the principles of which remain of significance today. I'm told that one of the earliest surviving copies of the Hippocratic oath includes the words:

I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.

In Australia, the modern expression of medical ethics is in the Australian Medical Association's code of medical ethics. I would like to read from the section of the code that deals directly with assisted suicide. The AMA's code of ethics says:

It is understandable, though tragic, that some patients in extreme duress—such as those suffering from a terminal, painful, debilitating illness—may come to decide that death is preferable to life. However, permitting physicians to engage in assisted suicide would ultimately cause more harm than good.

Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks.

Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

(a) Should not abandon a patient once it is determined that cure is impossible.

(b) Must respect patient autonomy.

(c) Must provide good communication and emotional support.

(d) Must provide appropriate comfort care and adequate pain control.

The section on euthanasia is similar but goes even further, warning that the practice would be 'difficult or impossible to control, would pose serious societal risks' and could readily be extended to incompetent patients and vulnerable populations.

Advocates of assisted suicide often highlight patient autonomy as a reason. But, in the broader context of the code, that point refers to things like a patient's right to decline medical intervention or to ask that intervention be stopped, even when that decision is expected to lead to his or her death. Indeed, the code makes it very clear that respect for a patient's autonomy does not extend to providing for assisted suicide or euthanasia. It's important to note that the Australian Medical Association's code of medical ethics warns that assisted suicide and euthanasia would be difficult or impossible to control and could be extended to patients for whom these practices are not intended.

In recent days, I've seen reports that question the idea that paving the way for assisted dying would be a slippery slope. But I've also read with concern the comments of Australian bioethics professor Margaret Somerville reported in The Sydney Morning Herald yesterday. The Sydney Morning Herald reports that Professor Somerville, who has spent decades observing euthanasia in Canada, has said that the international experience demonstrated that 'euthanasia was being used as a cheaper alternative to psychiatric and palliative care'. The professor is quoted as saying that it would be a 'societal tragedy if we allow this', and I agree with her. The article goes on to say that, in a paper published in the Journal of Palliative Care, Professor Somerville and nine of her international counterparts argued that voluntary assisted dying has gone beyond the aims of relieving pain and suffering and is now being misused.

What is very concerning is that Professor Somerville says that assurance by the 'proponents of euthanasia that it would not lead to a slippery slope have been proven wrong, with research showing that safeguards are routinely violated.' The professor was quoted in the article as saying:

In one study in Belgium, they surveyed doctors and found that 32 per cent had gone outside of the regulations.

That should ring huge alarm bells for anybody, because it implies that not only have safeguards failed through human error but also that some doctors may be choosing to ignore them. Professor Somerville also says:

… in many cases, pain and suffering were not the primary motivator for an assisted suicide request, with a fear of being a burden on relatives a more common reason in patient surveys.

She has also argued that 'in most cases pain or discomfort could be remedied through proper palliative care'. I'm sure many in this place have personal experience of loved ones who, approaching the end of their lives, have struggled with the idea they may be a burden on their families. This is not a belief that should be encouraged through the provision of legalising assisted dying.

In the course of the broader debate on this issue across the nation, we've heard stories of people whose personal feelings on the issue of assisted dying and euthanasia have changed when they've been approaching their own end of life. A decision to make use of assisted dying made while a person is suffering and at a low point and may believe themselves to be a burden cannot later be undone. Some in favour of assisted dying argue that we can never achieve safeguards in any area of the law that work 100 per cent of the time, but the very obvious difference in this case is that the failure of the safeguards can result in death, a failure that is irreversible. The report I mentioned earlier—that 32 per cent of surveyed doctors in Belgium had gone outside the relevant assisted dying guidelines in that jurisdiction—only adds to these concerns.

Outside of debate on this issue, we've also heard many sad stories of elder abuse. Unfortunately, there are those who would seek to exploit vulnerable people who are terminally ill and suffering. Under the model proposed in Victoria, patients would have to administer the lethal drug themselves. What safeguards can ensure that once those drugs are provided, they will not be misused by others?

I'm not insensitive to the hurt that can be caused by seeing a loved one in pain and suffering, but there is no way to provide adequate safeguards against the extension, misuse or abuse of legalising assisted dying.

It is not acceptable to put people at risk of dying against their wishes, be it through accident or malicious intent, when we can address the problems of pain and suffering through better provisions of palliative care provisions. We know it's common for patients to say that they don't want to be a burden on their families, but we must not legislate in ways that are likely to make the chronically ill, elderly, disabled or dying feel they are burden. It is society's duty to provide appropriate health care to those who need it, not to devalue lives by classifying groups of people as less worthy of living because they meet an arbitrary set of criteria that make them eligible to seek assisted death.

Having made my position on the real objective of this bill clear, I'd like to now talk about how we got to this point. Malcolm Turnbull brought this bill on for debate this week in exchange for Senator Leyonhjelm's support for the re-establishment of the Australian Building Construction Commission. The democratic rights of workers in the building and construction industry were sold out so that this bill could be debated. The Law Council said this about the ABCC bill:

… a number of features of the bill are contrary to rule of law principles and traditional common law rights and privileges.

Dr Nicola McGarrity and Professor George Williams from the faculty of law at the University of New South Wales said:

… the ABC Commissioner's investigatory powers have the potential to severely restrict basic democratic rights such as freedom of speech, freedom of association, the privilege against self-incrimination and the right to silence.

Senator Leyonhjelm says that the Prime Minister gave him a guarantee that Liberals would be given a free vote on the bill and that it would proceed for consideration in the lower house. Former Prime Minister Tony Abbott reckons that deals like this one are wrong and says that Malcolm Turnbull has ignored proper internal process. Mr Abbott told 2GB:

I am a little worried about secret deals and I am a little worried that undertakings might have been made which weren't brought to the party room and the prime minister likes to talk about due process – I am very concerned about lack of due process.

On this, I agree with Mr Abbott. In other words, this bill is tainted.

To sum up, I oppose this bill because, at its heart, it's about facilitating assisted suicide. I oppose assisted suicide because I don't think any safeguards could guarantee the protection of the lives of the vulnerable. I oppose assisted suicide and euthanasia because experts, including the Australian Medical Association, have warned that it will be difficult if not impossible to control and is the wrong way to deal with the issue of pain and suffering. I cannot support something that I believe will ultimately lead to people dying against their wishes. I would like to again quote former Prime Minister Paul Keating, who said on Victoria's assisted dying bill:

Once this bill is passed the expectations of patients and families will change. The culture of dying, despite certain and intense resistance, will gradually permeate into our medical, health, social and institutional arrangements. It stands for everything a truly civil society should stand against.

11:34 am

Photo of Cory BernardiCory Bernardi (SA, Australian Conservatives) Share this | | Hansard source

I rise today with the intention of detailing two important principles that have led me to oppose the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. Senator Farrell quite rightly raises an important third principle, and that is the principle of doing dirty deals in order to achieve particular outcomes. I say 'dirty deals' because I can't think of anything worse than trading off a life-and-death issue in favour of a political outcome against the wishes or knowledge of your own party room. It is, I think, a gross misuse of process. It is deeply disturbing not only that Senator Leyonhjelm maintains that the Prime Minister promised a vote in the House of Representatives—and promised to facilitate that—but also that the Prime Minister himself denies it. If you can't believe a Prime Minister or a senator, it brings this entire process and this parliament into some element of question. I have enormous reservation about how we come to this point, because I believe there are many more important and critical issues that need to be resolved in this country than whether the Northern Territory and the ACT should have the right to legislate for state-sanctioned killing.

That brings me to my first point. The Commonwealth Constitution makes it very clear that the states have certain rights and responsibilities and the Commonwealth has certain rights and responsibilities. One of those responsibilities applies to the territories. We have the right to make laws that affect the territories and will overturn their own laws—that will disallow them, if I can put it like that. Such an event took place in 1997 with the passage of the Andrews bill, which prevented the Northern Territory from having a state-assisted suicide regime. It's a regime, I might remind you, that was endorsed by, I regret to say, a neighbour of mine—when I say 'neighbour', I mean he lived in the neighbourhood that I lived in and I used to see him at the coffee shop, but we didn't mix very much—the disgraced Dr Nitschke, who was quite happily putting to death people who didn't have a terminal illness but just got sick of living. This is the same Dr Nitschke that professes to have a brewery now so he can import lethal gas and sell lethal suicide kits over the internet, or whatever it does. It makes me ill to think of how this callous man, in the name of compassion, likes to exploit the vulnerabilities of people, who perhaps need assistance, and put them to death rather than help them to enjoy life.

Nonetheless, we know the Northern Territory assisted suicide regime was misused. We know that. We also know that the states have the role and the responsibility to introduce assisted suicide regimes if they want to. We've seen that happen in Victoria. I don't agree with that either, but it is entirely within the remit of the Victorian parliament to make that determination. If you want to change it, you should elect different people. But the territories are not states. If you look at the population of the Northern Territory, it's 200,000 people. It's got a large land mass and it's had a series of relatively dysfunctional governments but, in terms of population, it's not even the size of a number of South-East Queensland councils. It wants states' rights, yet it has none of the responsibilities, or the ability to take responsibility, for some of the processes that go along with that. A case in point is the misuse of the assisted dying legislation that they introduced. Importantly—I'm interested in this—they voted against becoming a state. They actually voted against becoming a state, because they themselves knew that they weren't capable of taking on that responsibility.

In the ACT, it's even worse. If you want to give the ACT states' rights and if you want to empower it to make euthanasia legislation, the ACT is the most left-leaning government, if you can call it that—it's a council administrator—anywhere in the country. If you were to question how it will end up should you empower the ACT with euthanasia legislation or state-assisted dying legislation, look no further than what is happening in some of the most radical regimes around the world. These are the figures from a chap called Paul Russell, another South Australian, who's got the HOPE initiative.

In Belgium, three children have been put to death under euthanasia laws. They were aged 17, 11 and nine. How are those safeguards looking now? Seventy-seven people have been killed because of mental disorders and behaviour. That is the sixth most common reason for doctor-assisted suicide in that country. Think about that for a moment. Once you break the taboo that it's all right to help someone kill themselves, the only question is: what should be the limiting factors? If someone no longer wants to live, who are you to deny their right to kill themselves? It brings into question: why do we have suicide prevention things? Why do we have mental health support services? Why do we talk about the tragedy of farmers who contemplate this final act out of desperation? Supporting legalised, state-sanctioned assisted suicide is to say, 'We no longer value your worth at any level.' Just because someone has a temporary mental health disorder, just because someone is suffering from depression or just because someone feels they no longer want to live is not justification to support them in ending their own life. Quite the contrary: we should be looking to assist them.

What would you say if it were a 17-year-old? Perhaps you'd argue they don't have legal standing, that they're a minor, and so someone else should be able to make that decision for them. What if they're 18? They're an adult. They can go off to war and they can do a whole range of things. If it's okay for an 80-year-old to say, 'I want my doctor to kill me,' why can't an 18-year-old or a 28-year-old or a 38-year-old? That is the important principle here. To all the people who say, 'I've got the right to end my own life when I can,' where are you going to end that? In Belgium, we know a 17-year-old, an 11-year-old and a nine-year-old—all children—have been killed under this. Seventy-seven people have been killed because they had a mental disorder. I'm sure they were making a full and frank decision for themselves and the checks and balances had gone on there! In Belgium, more than half of the suicides occur within just three months of the request being made. They can just go to their doctor and a three-month process takes place for more than half of them. We also know that, in places like the United States where assisted suicide regimes are in place, there's actually been an increase in the number of suicides. Doesn't it fly counter to everything that we profess to value in the human dignity, in the innate worth, of every individual? We're now encouraging them to take their own lives because that's what they feel like doing. It's the ultimate in liberalism or in libertarianism, except it has a profound effect on so many others as well.

The suicide rate in the US, where it's been legal, has increased in the over-65s by 14½ per cent. There is the impact on other people. About a fifth of family members who actually witnessed an assisted suicide in places like Switzerland subsequently formed a post-traumatic stress disorder—another mental health issue, if I can couch it like that, which could be used to justify them ending their own life too. It truly is a slippery slope. It is a ride from which society cannot return, as soon as you start to measure someone's worth by whether they want to live.

Then there's the argument, of course, about pain. People, quite compassionately, understand and argue that, in insufferable pain, they should be able to choose to end their lives to prevent that. Palliative Care Victoria states that, in rare cases where all methods of palliation for pain and other symptoms fail, palliative sedation therapy is available to provide adequate relief from suffering. If we can accept that we can mitigate or limit this insufferable pain, the reality is that the justification used for assisted suicide is not actually about the pain itself but concern about the person in pain becoming a burden. In Oregon in the US, assisted suicide occurs primarily due to a loss of autonomy, for life being less enjoyable than you want it to be—for incontinence, for example, or for feeling like you are a burden on your family, your friends, your caregivers.

In this country we've had a recent debate and discussion about elder abuse, and quite rightly so. We are seeing ads on buses and elsewhere all around the nation, telling older Australians that, if they're being exploited, beaten or otherwise abused, they should call the hotline. The best statistics I could identify were that between 2½ and five per cent of the older demographic may be vulnerable to elder abuse. What more abusive thing can there be than a manipulative family member or person outside of the family but close to the elderly person, applying pressure—you can call it abuse if you like—that they should end their own lives to stop them being a burden, to relieve those around them of the pain and suffering of having to care for a loved one who is no longer able to care for themselves? It's entirely likely that those events and circumstances would occur. Encourage the elder to move on, whether you are a religious person or not, from the earthly cares, the mortality of this world. It's likely it might be a carer at their wit's end who is more likely seeking to be relieved of the burden of care and placing that guilt trip upon the person they care for.

We also know that, in Oregon, half of those who took lethal medicine under their assisted suicide regime cited that they were concerned about being a burden on their family and caregivers. We also know that around 79 per cent of those in Oregon took the lethal dose without a physician present. The question is: who did administer it? Who provided those checks and balances? Nobody really knows if it was self-administered or not. Surely, if someone's had permission and been provided the wherewithal to end their own life, but they do it without a physician being present, they're vulnerable to someone else doing it, perhaps without their knowledge.

Senator Abetz has quite rightly raised this in an earlier speech, and Senator Colbeck described this as state-sanctioned killing. It's a term that is equally as applicable to capital punishment as it is to assisted suicide. For those who say, 'We know this is very popular, because the polls will say it's very popular,' let me tell you that the death penalty is pretty popular in this country too if you ask the polls. If you say, 'Should we implement that?' they'll say yes, but it's still morally wrong. It's still the wrong thing to do. You'd ask yourself, 'What happens if the Northern Territory wanted to introduce the death penalty?' Do we say that's their right to do that, because we should take a hands-off approach to what is good for this country in the longer term or because it's popular?

Populism is not an excuse for doing something, particularly when it's going to have implications that will be felt for generations and, as Senator Farrell quite rightly pointed out, affects the life and death of individuals and affects deeply the lives of those around those individuals.

I note that one assisted suicide proponent, a neurosurgeon named Henry Marsh, said:

Even if a few grannies get bullied into it, isn't that the price worth praying for all the people who could die with dignity?

Let me repeat that:

Even if a few grannies get bullied into it, isn't that the price worth paying for all the people who could die with dignity?

The reality is, if you vote in favour of this, you are justifying that sort of comment. You are justifying the fact that maybe a couple of people will get bullied into killing themselves, because that's the price you're prepared to pay, or you're prepared for others to pay, for the cliche slogan 'to die with dignity'.

I make the point that Nembutal, the drug of choice for many suicide advocates, is the same drug used in executions. It's the same drug that massive concerns have been raised about in those countries that have the death penalty, because the drug can cause not only death but also a huge amount of pain along the way. We know that in 10 per cent of cases in the Netherlands, where this drug was used, it took longer than the expected median of three hours for the person to die after taking this drug. In one case, it took the person seven days to die. We know that people are concerned about the pain inflicted upon executed prisoners in the States because they haven't been adequately anaesthetised before taking the drug. Where state-sanctioned killing is allowed with the death penalty, and where it is the same drug as that advocated by some of the proponents of state-sanctioned suicide in this country, they can't even get it right. But, somehow, we think we're going to make all the difference and the problems that have afflicted the rest of the world, where these regimes have been impacted, are somehow not going to occur here.

I put to the Senate that there are many, many reasons why common sense prevailed on this question in 1997. It must prevail again. If the territories want to self-govern in this way, let them put it to a referendum on them becoming states. I know the Northern Territory rejected it. I can't see any justification for the Australian Capital Territory becoming a state—I can only imagine the 12 senators they would elect to this place. Rights come with responsibilities. It's not a party on the parents' purse strings. They need to stand on their own two feet, if that's what they want to do, but right now we have to help them to their feet. We have to guide them in the manner that our Constitution allows, because we have to do the right thing here. We can't fall for trendy cliches and slogans. We've got to think through the consequences of every single action that we take. These consequences were thought through in 1997 with the Andrews bill. To repeal that bill would be a retrograde step, because there is no evidence whatsoever, anywhere around the world, that a regime like the one that is proposed to be introduced or allowed can function sustainably with the adequate safeguards that everyone assures us would be different in Australia.

11:53 am

Photo of Nigel ScullionNigel Scullion (NT, Country Liberal Party, Minister for Indigenous Affairs) Share this | | Hansard source

Wow, what a debate this has been. It's been a very, very interesting debate with lots of passion and lots of people who have welded ideologies. I have a great deal of respect for all of the views that have been put in this place. We should remind ourselves what this place is about. We call this the 'states house'. A long time ago we had Queensland, Western Australia, South Australia and Tasmania and 12 senators were provided as part of the founding fathers' decision in our Constitution to ensure that the states were dealt with equally—that no one state should be discriminated against. I'm actually from a state called the Northern Territory. I don't have statehood per se, but I'm here. On this whole notion of this debate being about ensuring that the states are treated equally, I have to say that I've been a little disappointed that many senators seem to have missed the point. I'll try to bring them back to that point. Fundamentally, it shouldn't matter where you live, in what jurisdiction, this place is a place that ensures that you are treated equally.

We're talking now about restoration. In fact, the legislation is called the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. In 1995 the Rights of the Terminally Ill Act was voted for in the Northern Territory parliament, a parliament that was properly constituted and democratically elected, in exactly the same way as in every other jurisdiction—in exactly the same way as Western Australia, Queensland, Tasmania and the Australian Capital Territory; their parliaments are constituted in very much the same way. There was a proper debate that went on and there were committees of inquiry. As you would imagine, it was highly controversial. It hadn't happened in Australia before. There was a lot of focus on the process. On 25 May, the Northern Territory Legislative Assembly voted 15 for and 10 against. The act didn't enter into force until 1 July 1996, and, in the period of time in which it was in force, four people accessed the Rights of the Terminally Ill Act to assist their passing.

For all of that to have happened, you have to look at the legitimacy of how that came about. It came about because of the Northern Territory (Self-Government) Act, which was passed on 22 June 1978. The Territorians were then able to 'make laws for the peace, order and good government of the Territory' where the laws related to any matter not controlled by the Commonwealth. That's not inconsistent with other jurisdictions; it's completely the same as the other states, exactly the same. The sorts of things that these laws dealt with were schools, hospitals, utilities, public transport, forests, police, prisons, community services, roads and rail—all of the things that would be dealt with by a state or territory jurisdiction. Nothing too controversial there. We all accept that's exactly as it should be. When the self-government act came out, we all felt equal. We weren't mendicants to the South Australian government or like some backyard nobody could afford. We were a jurisdiction unto ourselves. We had the capacity to raise funds and to do the same things as every state and territory did.

We always understood, as Territorians, that there were some matters that were proscribed as 'matters controlled by the Commonwealth'. Same-sex marriage, for example, has come up. The Australian Capital Territory tried to raise same-sex marriage, but the Constitution said, 'Look, the High Court has struck it down.' Eventually the Commonwealth said, 'Well, it is our responsibility,' and this place recently passed laws on same-sex marriage, which the states and territories had thus far been prevented from doing constitutionally and by the courts. We respected that.

But one thing I want to say about the debate today and over the last few days is that it's been a bit of a Clayton's debate, because we all know that this isn't within the ambit of the Commonwealth government. This is not a matter in the Constitution that we can deal with. We know, in fact, that it's been dealt with by state jurisdictions and will be dealt with by other jurisdictions from time to time—most recently, the legislation was passed in Victoria; legislation was recently defeated in New South Wales—as appropriate. That's entirely a matter for those jurisdictions. But, unlike those jurisdictions, the Northern Territory was a function of the Kevin Andrews bill, the Euthanasia Laws Act 1997. That bill effectively said: the self-government of all territories—there was no mischief in the ACT; no-one was trying to pass laws about euthanasia in the ACT, but we'll throw them in anyway, to make some sort of consistency—will be revoked so as to prevent them from passing laws on euthanasia. They are quite entitled, as jurisdictions, to pass laws on euthanasia. But, because we as a territory are slightly different, we could pass a private member's bill that would not have stood a chance in hell of getting up in New South Wales or Victoria—or of overturning any of those—and no attempt has been made to control those jurisdictions because of their rights under the Constitution. That bill passed through this place on the 27 March 1997 with a vote of 38 noes versus 33 ayes. So 38 people said, 'No, we want to deal with the matter of euthanasia in the Northern Territory.' I understand that, at that stage, it was a reality and it was an opportunity for people whose fundamental beliefs about euthanasia were probably more impacted than those of the Northern Territory.

But euthanasia is not a matter for us, and that's why I have indicated that, despite plenty of passion and plenty of smarts around this place, it's a bit of a Clayton's debate. I can tell you right now there would be a different sense in this place if we were debating euthanasia as a national piece of legislation. The place would be full of media, there would be people running around, and the back rooms would be full of people, ringing and cajoling. But it hasn't been like that because we know it's not going to change anything about euthanasia nationally—we are not doing anything federally—and it's not within our ambit constitutionally.

I heard there's broad agreement that restoring territory rights legislation is really not going to be impacted. So the Rights of the Terminally Ill Act is not going to be impacted if we pass this legislation. Some legal opinion submitted to the Senate Standing Committees on Legal and Constitutional Affairs inquiry into the Rights of the Terminally Ill (Euthanasia Laws Repeal) Bill 2008 said:

However, there is significant judicial and academic opinion which suggests that laws made by territory legislatures are not merely suspended or dormant for the duration of any inconsistent Commonwealth law and then enter back into force upon its removal …

The authors concluded:

… there are strong grounds for suggesting that item 2 of Schedule 1 is insufficient to revive the Rights of the Terminally Ill Act 1995 (NT). The rights of individuals and interests at stake are too important to allow uncertainty on this score.

Another submission raised concerns that an attempt to revive the bill would:

… provide the basis for an argument that the [NT RTI] Act would be invested with a Federal character that it did not possess prior to the commencement of the Euthanasia Laws Act 1997 (Cth) or would not possess following the mere repeal of that Act. There is a real danger of the Act becoming entrenched and thus leaving the Assembly powerless to amend or repeal it …

In a sense, because it had this Commonwealth flavour.

Professor George Williams of the Gilbert and Tobin Centre told the committee:

… instead of the Northern Territory law being revived, the Legislative Assembly there and in the other territories would be able to pass a new law, should they so wish—

and they should be allowed to do so—

I think that is appropriate given the principles of democracy involved, given the time that has elapsed and also given the constitutional issues [rather] than to attempt to revive something that may not be possible to do and it would certainly be inappropriate to leave practitioners and others in a situation where they may be unclear as to the legality of their actions.

All subsequent federal bills to restore territory powers including the current bill have made it clear they do not attempt to revive the Rights of the Terminally Ill Act.

What remains for us if this is not a matter within the ambit of the Commonwealth or the Senate to decide on? It's not about euthanasia. I haven't talked about my issues with euthanasia and I shouldn't because it is not my right to do so; it is the right of states and territories to deal with that matter, and that is clear in the Constitution. So what remains? This debate is clearly not about euthanasia. The only issue remaining is the territories' rights to make laws that are not controlled by the Commonwealth in the Constitution.

It's been quite a disturbing process. Spatially, by dint of history, if you happen to live here in the Australian Capital Territory or you happen to live in the glorious Northern Territory, you are now a different class of citizen. You don't have the same rights to decide what you want as does every other jurisdiction. In this place, in the Senate, to choose to ignore that fundamental, I find very difficult to swallow.

I've heard so much about equality in this place: 'We're all equal in this place, and we've really got to look after equality.' But this is an opportunity to right the wrong of 27 March 1997, where every person who lived in the Australian Capital Territory and the Northern Territory became a different class of Australian. Are we equal? Well, sort of. We're equal unless the Commonwealth decides that we are not.

This is not a debate about euthanasia. Clearly, it should not be a debate about euthanasia, although I acknowledge and respect those people with strongly held views on those matters. This is only about state rights. I'm not sure why the people who enjoy living in a state don't trust me and don't trust territorians to democratically elect people who will make decisions in the same way as everybody else does in Victoria and New South Wales, Tasmania, Western Australia or Queensland—in exactly the same way. But we can't be trusted! People have said, 'Oh, look, the Northern Territory didn't become a state when it wanted to become a state.' Let me tell you: we had a constitutional referendum about statehood, and it failed because people didn't understand what we were about to get.

But can you imagine, even if it had passed, people coming into this place and saying, 'Thanks very much, and where are our extra 10 senators?' What a bloody joke that would be, because this place, I can tell you, after what I've heard over the last few days, is not a place of equity. It's not a place that respects everybody who lives in this country. For those people who are voting this down, I genuinely respect their views on the fundamentals of euthanasia, but that is a Clayton's debate. That is a Trojan Horse that just doesn't cut it.

There's an opportunity today to put right something that went wrong on 27 March 1997. Territorians for 19 years were okay. Territorians for 19 years were okay to get on with their own business because it was consistent with some of the views of people in the Commonwealth government. But, on the day it wasn't, they sent a clear signal—and to the ACT, who hadn't had the temerity to introduce legislation of their own. Even they would be caught up because it would somehow be consistent. What a lot of rubbish!

Nobody in this debate needs to be anything but absolutely clear about what this is about. This is about entrenching two types of citizens in this country, one who comes from a territory and the other who comes from the Commonwealth. And I can tell you that introducing 20 new senators in this place is not going to happen in my bloody lifetime. So the notion of, 'Oh, why don't you just become states, and then you'll be the same as us,' is complete garbage. There were those glorious 19 years when we were treated as equals around this country. There's an opportunity today to ensure that we are returned just simply to being equals. Territorians aren't asking for any more than that. We are simply asking in this place, in this house, to be treated as equals.

12:08 pm

Photo of Helen PolleyHelen Polley (Tasmania, Australian Labor Party, Shadow Assistant Minister to the Leader (Tasmania)) Share this | | Hansard source

I rise to speak on the Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. It may be argued that the only question being asked of us within this bill is whether the federal parliament should permit the territories to legislate in this space. However, I believe that this is a misguided view and that it is not the only question being asked of us here. The broader purpose of this bill is to allow the territories the legal right to legislate for euthanasia and assisted suicide. But firstly I want to address that question briefly.

Under the Constitution, territories have a different status to states. Territories are not provided the same rights and responsibilities. Our founders did this for a reason. The Australian parliament is provided the right under the Constitution to make laws for the territories. We need to have a broader discussion about the rights of territories in comparison to states and their place in our federation.

The law dictates that government must protect all individuals and govern in the interest of all Australians, and the previous speaker said we have no right to have this debate. Well I believe, even though we can't legislate for assisted suicide and euthanasia, we do have a right, as Commonwealth senators and as members in the other place, to put on record our views in relation to the issue. We exist as a parliament to provide for good government and to protect the most vulnerable at all cost.

Let's not forget why this bill is here, being debated right now. The answer is because Malcolm Turnbull, the Prime Minister, is willing to horse trade on such legislation. This is legislation that is so important to those who support the rights of the territories and to those of us who are ensuring that we put on record our view in relation to assisted suicide. But he is prepared to horse trade on this sort of legislation to ensure he stays Prime Minister of this country—although Senator Leyonhjelm, who is the one that the deal was made with, has said the Prime Minister has reneged on that commitment.

The question for this parliament and the broader community is: should we be giving doctors, or anyone else for that matter, the right in law to end the life of another person? And if we do, how do these laws affect society over time? The issue of voluntary euthanasia affects the entire community, and our emotions through lived experiences with our own loved ones often hamper the ability for reasoned debate on this issue, which is why this subject deserves the time of this place for a considered and lengthy debate. The issue of voluntary euthanasia and assisted suicide is one of the most emotional, challenging issues that politicians, whether it's at a Commonwealth level or at a state or territory level, will have to deal with.

Social regulatory policy, which acts to make a considered change in the way we view life and death, deserves the most serious of considerations, and should not merely be rushed through under the guise of territory rights. Legislation that allows a third party to end or to assist in the ending of another person's life is, without question, the most difficult space to legislate. For the state to codify in law circumstances to authorise the ending of a human life may be viewed as an impossibility because of the inability to ensure it's not abused. Let's be clear here: this is not a legislative space that allows for individual freedom or autonomy; it is actually outsourcing individual freedom to the state and a third party.

This is my major concern: I don't believe that it can be safely legislated. And once we legislate in this space and we end the lives of people within the community, it will erode the value and importance we place on life. We enter this place to make assessments and form judgements about our respective states, territories and fellow Australians. We must take that responsibility with the honour and humility it deserves. We must be acutely aware of the fact that our decisions are not binding for all time, and can be amended. Such proposed legislation in this space will never be able to guarantee that a human life will not be prematurely ended due to abuse or flaws within such a legislative framework, or the social, cultural and medical ramifications of such laws as time moves on. This reason alone should ensure that no such legislation should exist in any state or territory. No legislative framework can account for every individual and unique circumstance, and no amount of safeguards can take into account all variables in a person's life or particular circumstances.

Unfortunately, the Victorian parliament has been successful in this space and has legislated for this reform, and that's been referred to by many speakers in this debate. But that legislation will not take effect until May 2019. I would have thought that we need to take the time to see how that legislation is enacted, and whether or not the safeguards that are being proposed by those who supported that legislation will stand the test of time. As the former Prime Minister Paul Keating said during that debate in Victoria, 'No law and no process can achieve that objective.' We know that legislation gets amended all the time and we know there are social changes within the community, so I don't think you can use the fact that the Victorian bill has not been implemented as justification for supporting this bill.

It should be noted that, although divergent views exist on this issue within the medical profession, the Australian Medical Association believes that doctors should not be involved in interventions that have as their primary intention the ending of a person's life. Withholding and withdrawing treatment is ethically distinct from physician assisted suicide or euthanasia. We hear in this place on so many debates that we should be adhering to the experts' advice. Well, I don't think there are any experts that are more informed when it comes to assisted suicide and euthanasia than doctors. When the AMA is opposed to it—on the grounds they have articulated—then I think we should be adhering to that advice.

I do sympathise with anyone who is suffering with terminal or life-limiting illness or people who live with permanent pain. I do not question your right to argue for voluntary euthanasia, nor do I question your ordeal or your suffering. I cannot possibly understand your individual circumstances. However, my own lived experience—without such legislation—is that pressure can be put on older members of our community when entering the acute health system such that they feel that maybe they shouldn't be asking for a second opinion. I've had that life experience with my own mother. I know what it's like when you're told: 'There's nothing more we can do for you. We don't believe that surgery is going to give you quality of life.' My mother was able to demand that she have a second opinion. That second opinion was still that the chances of surgery were limited, but that surgeon was in fact prepared to proceed with the surgery that she needed. We were fortunate at that time, because my mother had her faculties; she was strong and opinionated. The surgery did take place and my mother had an additional 3½ years to enjoy her life, her grandchildren and her great-grandchildren. With the overseas experience, as I will talk about further, there is not always that option for people.

We've heard many of my colleagues talk about palliative care—and that there should not be a choice between palliative care and end of life, or assisted suicide. The reality is that we have the power in this place—and governments have failed over too many years—to adequately resource palliative care so that people have the support that they need, whether that's in their own home, in an aged-care home or in acute care. What we need to do is not just talk about the need for greater resources; we collectively need to ensure that the government of the day and future governments resource palliative care, because that in itself can assist with ensuring that people have the end of life that they want, with their loved ones. My concern is that legalising voluntary euthanasia and, effectively, allowing the state to legislate to end human life is a fundamentally flawed answer and not an adequate answer in a society where human life should be viewed as paramount. As I said, palliative care needs to be available to people in their homes, in hospices and in aged-care facilities.

In my own home state, in northern Tasmania, we have been fighting for a standalone hospice to assist people with their end-of-life issues so they have the support they need. My colleagues from my home state have not supported that view; they didn't put pressure on the former Labor government to fund such a hospice. So I would like people, instead of just giving the words and talking, to actually walk the walk and ensure that a hospice for northern Tasmania is going to be funded by a future state government.

Quite frankly, until we have adequate services to support all people who are dying, why are we even considering this option? Bioethics professor Margaret Somerville, who has observed voluntary euthanasia in Canada for decades, argues that euthanasia is being used as a cheaper alternative to psychiatric and palliative care. Public policy is not infallible, but often public policy and law changes are in fact flawed. A law that would allow voluntary euthanasia is fraught with potential for abuse and medical malpractice. It's better that voluntary euthanasia does not become law, because if one person's life is extinguished, prematurely and wrongly, then the state would be responsible for the killing of that human life. Such laws, as a matter of public policy, are not worth the risk to people's lives.

When considering the necessity and practically of new laws, it's best to look at overseas jurisdictions that have already introduced similar laws and see what has happened with those laws and how they have changed. One may argue that such legislation in those jurisdictions is operating effectively if individuals are being granted their wish to end their life on their terms. However, I argue that the legislation which has been instituted in other jurisdictions is flawed because human life has been extinguished prematurely and without the consent of the person. Effectively, in many jurisdictions the state is killing people where voluntary euthanasia laws have been established.

Belgium and the Netherlands have legislated euthanasia and we have seen the decline from the initial legislation that was introduced there. The Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey study demonstrated that 32 per cent of euthanasia deaths recorded in the Flanders region of Belgium occurred without explicit consent. The research found that this was occurring because the groups were vulnerable and because there had been a change in the way that citizens and the medical profession viewed end-of-life measures since the inception of voluntary euthanasia laws. Many of the people who were euthanised were either terminally ill or suffering from dementia or other neurological diseases. Euthanasia in Belgium and the Netherlands is being used to end life prematurely when in fact voluntary euthanasia is supposed to control the way and conditions in which a person wishes to end their life.

Switzerland has also passed voluntary euthanasia laws. The Swiss statistics office reported that there were 965 reported assisted suicide deaths in 2015, up from 742 in 2014 and 86 in 2000. The number of assisted suicide deaths in Switzerland nursing homes via the Exit suicide clinic increased from 10 in 2007 to 92 in 2015. They reported that the Swiss association for ethics in medicine found this trend alarming and stated, 'To end lives in this way gives the practice of assisted suicide an institutional seal of approval.' In August 2015 a healthy, depressed British woman died by assisted suicide the Switzerland. In 2014 a Swiss assisted suicide study found that 16 per cent of people who died at Swiss assisted suicide clinics had no underlying illness. In May 2014 the Exit suicide clinic extended assisted suicide to healthy elderly people who lived with physical or psychological pain. In the last two years 77 people suffering from mental health issues and 173 people who had no physical suffering, but who suffered from addiction and loneliness, were euthanised.

The definition of an illness is expanding, with the Netherlands now considering euthanasia for people who are satisfied with their time on earth and have completed their life. The Netherlands legislated for euthanasia in 2001, and now the age of eligibility for euthanasia is 12 years of age. In 2015, Belgium extended the right of voluntary euthanasia to children. In September 2016, a 17-year-old was euthanised and recently it was revealed that two children, aged nine and 11, were euthanised. We must realise that, once someone is diagnosed with depression, they are not in the correct state of mind to make a life-and-death decision. For most people suffering from a terminal illness, depression is likely. If such a bill were to pass in the territories or any state in Australia, there is no reason why the experience of Belgium, the Netherlands and Switzerland would not be replicated. Over time, legislation will be amended, and there is no reason at all that we wouldn't consider that what's happened internationally wouldn't happen in Australia.

I often say that greed and self-interest are almost as certain as the sun rising in the east. The potential for the abuse of voluntary euthanasia laws is stark and is a major concern to any state which is considering legalising voluntary euthanasia. This is not about religion. The concerns I have are shared with agnostics and atheists. This issue is about the ethics of civilisation and the importance of a person's life. We need to balance individual rights with what is in the public interest. It's not in the public interest to provide doctors carte blanche on what constitutes a worthwhile life. Any change to the Hippocratic Oath places a dangerous amount of power in the hands of a third party, taking away individual rights. Where voluntary euthanasia has become law, choice is an illusion and the laws are open to abuse. People have come forth with stories of elder abuse and coercion by family members, doctors and nurses. Some of these stories are about death by lethal injection or assisted suicide. We've all heard the stories about people with disabilities whose quality of life was deemed unworthy by doctors. Voluntary euthanasia and assisted suicide at a state or federal level is not the correct legislative action for a government to take in the care of the terminally ill and the most vulnerable people in our communities.

I admire the contributions to the debate by both sides, whether they support euthanasia or not. This is the place where we should have the opportunity to voice our concerns. My concern is ensuring that we are protective of those who are most vulnerable in our communities and that we continue to value the sanctity of the life of every Australian.

12:28 pm

Photo of Tim StorerTim Storer (SA, Independent) Share this | | Hansard source

I welcome the opportunity to speak in the chamber and indicate my support for Senator Leyonhjelm's private member's bill, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I support the ability of the territories to control their own legislative agenda. Their elected representatives should be fully answerable to their voters for the decisions they take. I would be disappointed if the Turnbull government did not allow this bill, should it be carried in the Senate, to be debated in the House of Representatives. I see here a fundamental question that the Senate is being asked to address: the ability of the Commonwealth to override the legislative will of the ACT and the Northern Territory on the specific question of assisted dying. This bill, if passed, would give the territories the same legislative rights as the states, specifically on assisted dying, overturning a 20-year-old federal law which prevented the territories from legalising assisted dying. This bill, simply put, provides the territories with the opportunity to introduce and debate assisted dying legislation, should they wish to do so. It is important to note that it does not enable the Northern Territory to reinstate the original assisted dying legislation, which gave rise to the decision of the parliament of the Commonwealth to overturn that law. This is a matter of the democratic right of the territories and the people in them. It's a states' right matter, as passionately discussed by Senator Scullion earlier today. Voters in the ACT and the Northern Territory should have the same right as voters in South Australia and the other states to vote for or oppose politicians who pledge to legalise assisted dying.

Other senators here have discussed the question of assisted dying itself. I shall not do so. I simply want to deal with the legislation before me. Should I be asked to consider legislation on assisted dying itself, I would apply myself to considering, deeply, the details of what is being proposed and especially the safeguards contained in the measure. But that is not the case right now.

That said, I have noted the processes that have occurred in other jurisdictions when legislators have been asked to consider bills. The legislation passed by the Victorian parliament at the end of last year, for example, followed a 10-month crossbench parliamentary inquiry set up after that state's legislative council agreed on such an approach in 2015. The relevant committee tabled its final report a year later. The government released its response six months after that. A ministerial advisory panel was then established and its 66 recommendations, informed by the work of the parliamentary inquiry, were completed a further six months later, in the middle of last year. Those recommendations were the building blocks for the legislation itself, which came into law at the end of last year, but not before an exhaustive debate in both houses of the Victorian parliament. As we have heard, the legislation will not be in effect until June 2019. So the reports and the decisions taken in Victoria have taken more than two, nearly three, years. From the outside, this appears to have been a thoughtful and measured way of gathering all the evidence for and against before any parliament makes a decision on a matter of such importance. Therefore, discussion of palliative care and related public policies with regard to assisted dying is admirable but is not being considered here today. Similarly, the discussion of the Victorian legislation and the findings from other jurisdictions, based on their legislation, is also not being considered here today. Again, this is a matter of the democratic rights of the territories to have the same rights as voters in South Australia and other states to vote for or oppose politicians who pledge to legalise assisted dying. Therefore, I will be supporting the legislation before the Senate today, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, on that basis.

12:33 pm

Photo of James McGrathJames McGrath (Queensland, Liberal National Party, Assistant Minister to the Prime Minister) Share this | | Hansard source

Life must trump all. All in this chamber have come to this debate on different paths. All have family and friends who have fought for life and who have shifted from life to come what may. This bill, Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015, will allow a territory government to introduce a government sanctioned right to death or right to kill. Those most at risk will be now at risk of a sometimes morally nebulous society. I oppose this bill. I oppose euthanasia.

This bill socialises death, not as a last resort, but as a means for society to avoid the dignity of life, often when life is drawing to a close. This is a bill that effectively places the dignity of death ahead of the dignity of life as a means for society to allow, indeed promote, the state-sanctioned killing of the old, the infirm, the unwanted, the dying, the depressed and the forgotten. No human being has the moral authority to decide when another should die.

We are inherently fallible. We make mistakes. We commit monstrous acts in anger. We become overtaken by greed. We oppose the death penalty because we know it is wrong and will always be wrong. To take another human being's life in revenge, even for the most heinous of acts, is wrong. And yet we can somehow rationalise the killing of the sick and the elderly. The fact that such rationalisation is possible says enough about the inescapable weakness of human beings and our inherent unsuitability to make decisions so serious and irreversible as whether someone should live or die.

As a society, we should be asking not how to make it legal for people to be killed but how to build upon the dignity of life for all, dignity for life when it is at its hardest. I will not and cannot support this bill. Life must trump all.

12:35 pm

Photo of Deborah O'NeillDeborah O'Neill (NSW, Australian Labor Party, Shadow Assistant Minister for Innovation) Share this | | Hansard source

I rise to speak today to make a contribution to the debate on the bill introduced by Senator Leyonhjelm to this Senate chamber as a private member's bill entitled Restoring Territory Rights (Assisted Suicide Legislation) Bill 2015. I acknowledge the grief, the loss and the personal truth of every recount by senators sharing their life experiences of losing someone that they love. I respect the diversity of views that have been put respectfully on the record in the course of this debate. I have my own history, as others do, of grief and loss, and it's a lens that colours what I feel about this issue. But we're called on in this place to combine that journey of the heart with the intellectual endeavour to interrogate the legislation that comes before us, and I will endeavour to do that in my contribution.

I know that there have been many earnest contributions to this debate that, no doubt with good intent, call on us to avert our eyes from the substantive issue at the heart of this bill. Many will say, and indeed have said, that this bill is just about legislative rights of the territories. But that is only one small element of this bill. The greater, substantive, part deserves consideration. Let me say clearly that history will show that this bill is about giving territories of this nation the green light to go ahead with enacting legislation that will make it legal for physicians to terminate the lives of their patients and to assist patients to take their own lives.

I think a review of the contributions of those who will support the bill will show that, as much as they declare it is not so, they do indeed know that enabling state-sanctioned suicide in the ACT and the NT is in fact exactly what they're seeking to achieve today. The legislation that passed this parliament in the form of the Euthanasia Laws Act 1997 was about euthanasia. This bill, no matter what political magic dust may be thrown over it, is about euthanasia. But it does use the new lexicon of 'assisted suicide'. Let us also be clear that, despite its complexity, this matter of life and death will be determined by unicameral parliaments, where there is no house of review.

Senator Dodson last night made a very important contribution about the nature of the territories and the rejection of statehood by the Northern Territory. He also made important remarks about the particular vulnerability of First Nations people, who make up so much of the population of that territory.

Last year in the context of the Victorian state debate, 105 of Australia's 148 palliative medicine specialists—that's 70 per cent of the profession—wrote an open letter in which they stated that euthanasia advocates actively and deliberately undermine confidence in palliative care. At the time the vote passed the Victorian parliament, Victoria had the lowest rate of palliative medicine specialists per capita in the country. That is, in my view, instructive. It reveals that the one state that has delivered legislation to allow assisted suicide is the least well served in terms of expert palliation advice and access.

Much has been made of the pain of death in the course of this debate. I do not doubt for a moment that senators have authentically revealed their own perceptions of witnessing that pain in their own personal encounters with the death of a loved one. Indeed, I recall one day in the course of my father's dying when palliation failed him as an aggressive brain tumour progressed. He was very much in pain, and we were very much distressed. Seeing that sort of thing makes you question everything. But his palliation was adjusted, and he continued his farewell to us with very little pain over the following weeks. He reached his 49th birthday not long before he passed. That was 30 years ago. There's no doubt amongst palliation specialists that there has been a marked improvement over that time in the field of palliation. I acknowledge the powerful contributions of many senators that call attention to the need for an increase in the level of resources and the enablement of ever-improving palliation practices, including quality mental health and psychological supports that ameliorate the challenges of the journey to death.

In response to many claims about pain management made in the course of this debate, I want to make a few remarks about claims that pain management is the most pressing reason for advancing to legal assisted suicide. Just how significant is pain as a factor in the decision-making of those who actively seek assisted suicide in jurisdictions where it is currently enabled? In the Oregon public health report of 2016, of the 1,127 patients in that state who had died from ingesting a lethal dose of medication, the data revealed, somewhat surprisingly, that neither pain nor fear of pain was the main reason cited by those who sought assisted suicide. It was, in fact, some 296 of those 1,127 people—or 26.3 per cent—who indicated that pain control or concern about pain control was a factor for them.

To be fair, let me put on the record that the most often cited reason for assisted suicide in the Oregon study, at 91 per cent, was the steady loss of autonomy. Being less able to engage in activities making life enjoyable was a reason cited by 89.7 per cent. For 77 per cent, it was the loss of dignity that motivated their assisted suicide. Loss of control of bodily functions, such as incontinence and vomiting, was the reason cited by 46.8 per cent. It's important to note that the two reasons most cited by people who died by assisted suicide in Oregon reveal that it was their feelings about their lives, and their concerns about others' views of their lives, that prompted them to take action. That worries me.

Let me speak to the statistic that is of greatest concern to me—that is, the fact that, of the 1,127 people who chose assisted suicide as reported in the study in Oregon, 42.2 per cent indicated that their reason for seeking assisted suicide was concern about being a physical or emotional burden on family, friends or caregivers. It's here that I want to put on the record my recollection of attending a public meeting in the lead-up to the 2001 federal election. Labor's leader, Kim Beazley, and our candidate for the seat of Robertson, Trish Moran, arrived at Kincumber High School. It was a well-attended meeting. Many residents from the local retirement villages that surround it were in attendance. I do believe that most of the audience that evening were in favour of assisted suicide, and that was pretty clear to Mr Beazley as he was addressing them.

When he was asked the question, Mr Beazley spoke about his experience of taking evidence in hearings—and I point out that the Senate is not going to have the opportunity to do that. A young brother and sister came to the inquiry that he was part of and insisted that assisted suicide should be enabled because their mother was a perfect example of someone who was spending her children's inheritance on her health care, and they should have access to it. Mr Beazley rightly pointed out that people who want assisted suicide—people who have argued passionately for it here in this chamber—do not have a motivation of that kind at all. But those motivations do exist in our community, and we are wise to heed them as we make law for the country. We make it for all people, and we have to cover those who have malintent. Mr Beazley finished by saying, 'I don't know what kind of a mother you had but there's very little my mother wouldn't have done or given up in order to give me a better life.' I've never forgotten that.

That brings me to the very real threat of assisted suicide legislation advancing at a time in this nation when recent reports are urging us, as legislators, to give serious consideration to developing legislation, social leadership and agencies to curb increasing elder abuse—undue influence of one family member over another. Similarly, fears of the exploitation of the disabled were well articulated by Senator Steele-John last night in his contribution. I note Senator Steele-John indicated his support for the legislation, but he quite powerfully described the reality of living with disability, about which he perhaps has the greatest insight of all in this chamber. As he put it, four million Australians with disabilities are denied adequate access to the services they need and want, and violent abuse and neglect is still endemic. It is in this context, some fear, that euthanasia enters.

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

The debate is interrupted. Senator O'Neill, you will be in continuation.