Speeches

02
Nov

Voluntary Assisted Dying Bill 2017

Speeches

The desire to die with dignity is universal. It is a concept that nobody can argue against. Dying without pain, discomfort or loneliness is an understandable and compelling human desire. The reality, however, is that for many people that desire is not fulfilled. People do die in pain and discomfort and loneliness. People die as a result of misadventure or through violence. As with many aspects of life there is a gulf between the ideal and the reality.

The government's intention with this bill is to bridge that gulf. In the words of the minister's speech:

This bill establishes a safe and compassionate framework to give Victorians who are suffering the ability to choose the timing and manner of their death.

On the face of it this may appeal. The reality, though, is that attempting to use this Parliament or any other to legislate for a utopian outcome is a folly. Many members have drawn on their personal experiences in dealing with this bill, and I am not unsympathetic to them.

I have had three people very close to me die of cancer in the last seven years, with all that that entails. As parliamentarians, though, we need to look beyond our own experiences to what legislation will mean for our society. This debate has often been framed in terms of the right to die, the right for an individual to determine the timing of their death. For somebody who believes in the freedom of the individual, as I do, that is an important consideration. This Parliament in fact recognised that freedom 50 years ago when the Crimes Act was amended to decriminalise suicide. At the same time, though, the Parliament recognised the necessary limitations on that right by making it a serious criminal offence for a person to assist or coerce another person to commit suicide.

Providing the autonomy for an individual to choose death and be aided in achieving that death must be weighed against the broader societal cost. This bill is not merely about a right to die; it is about creating a state-sponsored mechanism to facilitate death. To allow people to choose the manner and timing of their death — to use minister's words — means providing the infrastructure to end a life.

Under this proposed legislation death just becomes another form of treatment available in the health system. It was said in the other place by the Premier:

…this legislation will not introduce assisted dying in Victoria, because assisted dying is already happening in Victoria.

I find that statement disingenuous, though, because it ignores intent. It is true that some current medical interventions such as pain for terminally ill people can have the effect of accelerating death. There is a fundamental difference between medical intervention for pain management and medical intervention with the intention of causing death. The passage of this bill would for the first time legitimise suicide as a medical treatment. This flies in the face of suicide prevention strategies which have been developed over decades and this government's own announcement in July 2016 of its plan to halve the rate of suicide over the next 10 years.

The impact of legitimising assisted suicide as an option in managing terminal illness should not be underestimated. People availing themselves of assisted suicide will be making an irreversible decision at what is probably the lowest point in their lives. The availability of assisted suicide will inevitably lead to pressure, real or perceived, on terminally ill people to choose death. A person who is terminally ill and in need of substantial care is often mindful of not being a burden on their family and friends, or even the doctors and nurses who are caring for them. This is even before any element of sinister intent on the part of relatives. We are just starting to recognise the extent of elder abuse in our community, and I have seen it firsthand in constituent matters in my electorate. The prospect for manipulative relatives to coerce a person into opting for assisted suicide is real. The idea that the bill guards against this through creating an inducement offence is, I believe, absurdly naive.

Access to assisted suicide is predicated on a terminally ill person having a prognosis of 12 months or less to live. These prognoses are notoriously inaccurate. We have all heard of people with terminal illnesses being told that they have a short time remaining only to go on to live for many years. This is not a sound basis for any assisted suicide scheme, if such a concept is possible.

The flaws in this bill are not confined to its impact on vulnerable people and the message it sends about the value of life. The creation of state-sponsored infrastructure to deliver assisted suicide will also have a profound impact on the medical profession. The strength of opposition to this bill from the medical and allied professions has been extraordinary. I cannot recall an occasion where opposition has been so united from the professional colleges, institutions, and service providers. The traditional role of the medical profession has been to treat and heal the sick and through palliative care manage the pain and discomfort of the terminally ill.

Introducing assisted suicide as just another medical intervention available to practitioners forever changes the medical profession. The bill fails to remove the assisted suicide regime from the day-to-day pressures of the health system. If the legislation is passed, over time its use will become more common. Inevitably the pressures of the health system and the relative costs of administering treatment to a terminally ill person versus the cost of administering assisted suicide will become a factor, even if only subconsciously.

My opposition to this bill is grounded in the negative impacts it will have on both terminally ill Victorians and the medical profession. That, however, is not to ignore the technical flaws in the bill. Despite the work of the parliamentary inquiry and the ministerial advisory panel, the bill as drafted has signs of a rushed job. The Orwellian reference to a 'voluntary assisted dying substance' betrays the fact that, even as the Parliament is being asked to endorse the assisted suicide framework, the most basic details, such as the composition of the poison that will be dispensed to end a life, is unknown.

As stated earlier, the Crimes Act 1958 establishes a number of offences relating to assisting suicide, yet with one exception the bill before the house does not resolve those inconsistencies. The bill seeks to amend the Births, Deaths and Marriages Act 1996 to provide that where a person dies as a result of assisted suicide the cause of death is instead falsely recorded on the death certificate as the underlying illness. The perversion of the death certificates, indeed as we have seen with other pieces of legislation relating to birth certificates, undermines the very fundamental basis on which we record the existence of human life.

The government has claimed that the bill provides multiple safeguards to prevent misuse of the assisted suicide regime. At best, these are naive and ignore the realities of subtle and sustained pressure on the vulnerable as well as providing absolutely no guarantee of professional independence in the medical assessment of candidates.

I cannot support legislation where the intentional ending of a life is just another treatment and becomes a social norm. I will oppose this bill at the second reading and, if personal circumstances prevent that, at subsequent stages if it progresses through this Parliament.

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