The Hon. K.J. MAHER (Leader of the Opposition)


The Hon. K.J. MAHER (Leader of the Opposition) (22:09): I wish to thank all members who have made a contribution over the last two Wednesdays of sitting. It has I think been conducted in a very edifying manner. There has been high emotion, and that quite rightly comes with discussing issues around death. It was noted as part of the committee that it is not something we do well as a society, talk about how life ends and what we go through when life ends, but I think the fact that we can do it respectfully and have differing opinions here says good things about how this chamber operates.

Many of the speeches that have been given are particularly personal and touching, talking about people's life experience and, in fact, how a particular experience with loved ones, parents and others, changed views and influenced the way people see this issue.

One of the most important things is the name of this legislation: voluntary assisted dying. It really is in the name, 'voluntary'. Nothing we decide here, nothing in this bill, will make anyone do anything. It will not force any terminally ill patient to avail themselves of a scheme for assisted dying. It will not force any health practitioner to participate in a scheme if their conscience does not allow them to. However, making a decision against this bill certainly will actively stop people who wish to avail themselves of a voluntary assisted dying scheme in the last months of a terminal illness.

I want to very quickly talk about a few things the Hon. Connie Bonaros and the Hon. Rob Lucas said about when we come to the committee stage on the next Wednesday of sitting, 5 May, particularly in relation to amendments. It would be my view, and I suspect it would be the view of most people in this chamber who support this bill, that an amendment would have to be pretty extraordinary and backed by some significant health advice and expertise to be considered.

As the Hon. Mark Parnell has pointed out, this bill really is a carbon copy of the Victorian bill. The Victorian bill went through a lot of processes. In its formulation it went through a select committee, like we did here, of the Victorian parliament. The fact that the Victorian scheme has now been operating for some 18 months and has had four reports on its operation has given a degree of comfort to some legislators, not just in this chamber but in the other chamber, that there is an Australian context, that this does work and is as safeguarded as it can be.

As other people pointed out—and I thank the Hon. Stephen Wade for his contribution—we are following what can be termed 'the Australian model'. As I said, Victoria has had a scheme operating for 18 months now, Western Australia passed a scheme some time ago that will soon come into operation, and just last week Tasmania passed its voluntary assisted dying laws. It was an election promise of the current Queensland government to consider an early scheme, and I think New South Wales is about to introduce a scheme.

Where once we would have been first in any of the other 16 attempts that have been made over the last quarter of a century or so, we are now midfield, and following what has been a tried and tested formulation of what the health minister loosely, and correctly, terms 'the Australian model' for voluntary assisted dying.

This will be the conclusion of the second reading and, from indications of members, it seems to me that the second reading vote, if I can count properly, will pass with a significant majority. After that we will move into the committee stage. Because there is not a formal way to co-sponsor a bill, I think the Hon. Mark Parnell might make a contribution at clause 1 similar to a second reading sum up in relation to this.

I want to sincerely thank the Hon. Mark Parnell. He has done a lot of work on this over many years. He has described it, at some stage, as being a bit like pass the parcel: it is going to stop somewhere, and this legislation will pass the South Australian parliament. In his view, and in my very strong view, it is not a question of if that happens but a question of when that happens. Hopefully, Mark, it will be this time, but I am severely disappointed that you are cutting and running and not sticking around for the entirety of this bill. However, I look forward to you giving some reflection on this at clause 1 in just a moment.

From there we have indicated that if possible it would be good to wrap up clause 1, but I appreciate comments that others have made to perhaps not cut off the end of clause 1 tonight. There are some reasons for that. It might be beneficial so that the contributions people make on the operation of the scheme in the whole of clause 1, if there are questions that need further answers, then probably in that month we can get very concise answers and it will not take as long when we come back on 5 May. So we can reasonably quickly provide some of the answers to anything that is raised on how the scheme in totality works, and then move through the rest of the committee stage.

Given that it has been a number of months since, I think, 2 December, when this was first introduced into this chamber, there has been ample time for members to reasonably consider, and that has been reflected in the second reading speeches members have given. They have had time to thoroughly look at and consider, research and give their reflections on this piece of legislation. It is difficult to imagine that we would see amendments put on the day or the day before, given the long gestation period we have had for this bill.

As the Hon. Rob Lucas pointed out, they will very likely find even less favour with this chamber if they are put on the day or the day before. It is difficult to see a reason why we would not wrap up on 5 May. It is unusual that we have already had this. This will be the third week of sitting in which we have considered this bill, so I look forward to the passage of this bill and to getting to the third reading vote. At some stage during tonight—and there is a reasonable prospect we may be sitting later on Wednesday 5 May than we often do, but that is the way that many of us understand we occasionally operate in this chamber when it is necessary. I will very quickly address in a brief way a couple of the comments people have made. There were a number of common themes that people raised that are worth touching on, and when we come back on 5 May we can expand briefly further on those if people raise them in a moment at clause 1.

The slippery slope argument has been mentioned a number of times tonight, that in some way it will be irresistible that the scheme will be broadened over time. When the Victorian legislation was being debated, ABC Fact Check had a look at, I think, Paul Keating's comment, which has been referred to tonight. I think Paul's Keating's comment was the claim that further changes will be irresistible and there is that slippery slope.

ABC Fact Check said that that claim does not check out in evidence from around the world. ABC Fact Check pointed out that there had been some changes in Belgium, in the Netherlands further guidelines had been published, but in most jurisdictions where assisted dying has been legalised little has changed regarding what practices are allowed or who can access assisted dying.

I know much has been made of particularly the experience in the Netherlands. Much more analogous to what Victoria, WA and Tasmania have passed are the schemes in the US. ABC Fact Check concluded that there has been no further liberalisation in any of the eight states involved in the US—and this includes Oregon—ABC said during debate on the Victorian laws in 2017, where the system has been operating since 1997.

Another common theme in contributions was about the experience in the Netherlands. A couple of contributions talked about figures and anecdotes from the 1980s and 1990s in the Netherlands but, as the Hon. Dennis Hood correctly pointed out, the Netherlands only had a voluntary assisted dying scheme in 2002. I think it passed the parliament in the Netherlands in 2001 and came into effect on 1 April 2002. Quoting statistics or evidence from the 1980s and 1990s in the Netherlands I am not sure makes a lot of sense, given the scheme did not start until 2002.

There have been quotes from the views of medical organisations around Australia and around the globe on voluntary assisted dying. It is true that the Australian Medical Association has a stance against voluntary assisted dying, even though 30 per cent of members surveyed by the AMA in 2016 favoured the AMA supporting or taking a neutral stance on VAD, and 51 per cent of members in that survey agreed that VAD can form a legitimate part of medical care.

Most other organisations take a neutral stance. Some are supportive, but most others are neutral. The ones that are neutral or supportive include the Australian Medical Students' Association, the Australian Nursing and Midwifery Federation, the Health Consumers' Council, Palliative Care Australia, the Royal Australian College of General Practitioners, the Royal Australian College of Physicians, the Royal Australian and New Zealand College of Psychiatrists and the Pharmacy Guild of Australia. They take a neutral or supporting stance.

There have also been suggestions, as a theme in some of the contributions, of potential misuse or abuse and particularly the potential for coercion in a voluntary assisted dying scheme. I cannot remember the contribution, but one contribution, I think, pointed to the quote from the Chair of the Voluntary Assisted Dying Review Board, Betty King, whom I think those who served on the Joint Committee on End of Life Choices had the opportunity of meeting and talking to when we went to Melbourne to have a look at the Victorian scheme. I think the Hon. Dennis Hood and the Hon. Mark Parnell were both on that fact-finding trip to Melbourne.

Certainly, I think we were impressed with the forthrightness and tenacity of former Supreme Court judge Betty King, whose quote in one of the early reports on the operation of the scheme talked about pressure being placed on terminally ill people to end their lives. About that question of coercion, she said, 'I have not seen—and I have been looking, believe me—I have seen no indication of any type of coercion.' When the honourable Betty King says she has been looking, I do not doubt she has been looking.

I do not have the quote here, but I think it was from the most recent, only weeks ago, report from the Victorian scheme, and again the chair of the review board, former Justice Betty King, talked about the argument that had been put up before the scheme was introduced about the possibility of coercion. It often takes the form of the possibility of children who stand to inherit money from their parents placing pressure on their parents.

Betty King made the comment that the evidence just does not bear that out in Victoria. She talked about the fact that, if anything, it goes the other way, that there is pressure from children put on parents who have decided to avail themselves of voluntary assisted dying when they are at the end stage of a terminal illness and are suffering intolerably. She went on to say that after talking with the doctors and their parents, almost always the children understand their parents' wishes. That issue of coercion has been borne out, not in the way that I think most fear, and that is a coercion or a pressure to avail yourselves of voluntary assisted dying, but in the opposite way; that is the evidence from Victoria.

There have also been suggestions about whether we trust doctors to involve themselves and make these decisions. I absolutely trust doctors to do this. Doctors are involved most days of the week in exceptionally difficult decisions, decisions that deal with life and death. Doctors regularly now make decisions in consultation with their patients, as people mentioned here, that are sometimes termed 'passive assisted dying', the refusal of medical treatment, which as people have noted—I think the health minister and the Minister for Human Services both noted—is regularised in legislation in the Consent to Medical Treatment and Palliative Care Act.

A patient can make the legitimate decision to refuse medical treatment, and a doctor in South Australia is obliged to follow that request from the patient. A patient can refuse that medical treatment to passively assist their dying even though medical treatment may involve saving their life. Doctors make these decisions without the safeguards and the protections that this act now affords.

I trust doctors, and I think most of us here do. We recognise doctors as doing what is in the best interests of their patients. If an argument is made that we cannot have this scheme because we do not trust doctors, then I think we are in a lot of trouble with how the medical profession runs in general.

With those brief remarks, I again thank members for their contribution and look forward to the start of the committee stage in just a moment, should the second reading vote go as members have indicated, and I look forward to members' questions about how the scheme in total might work and then, on the next Wednesday of sitting, on 5 May, delving into those individual clauses, the nuts and bolts of how this scheme works.

We are fortunate that we have the Victorian experience to fall back on in answering a lot of those. This is not, as it has been every other time, a more esoteric and hypothetical debate. There are things that we can now talk about in terms of how the scheme operates, and I look forward to that.

It would be my suggestion that if members have thoughts about amendments, I think it would be a courtesy to everyone in this chamber if they filed them, I would suggest, at least one week before the sitting week. The bill has been before the council since 2 December, and a draft of the bill we now see, which did not change very much, was distributed to members some months before that. I thank members for their contributions. It is time to get this done.