Shadow Minister for Primary Industries & Water, Shadow Minister for Police & Emergency Services, Shadow Minister for Parks & Wildlife, Shadow Minister for Local Government

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04
Nov

Speech on Euthanasia Legislation

2009

Mr HIDDING (Lyons) - I acknowledge the depth of feeling with which the previous speaker has delivered his contribution. I am not sure if the Speaker should have not checked with the coroner as to whether he should have put much of that material on the Hansard, but that is a matter for him.

The proposition before us today is to consider whether Tasmanian law should be amended to set aside any charge of murder, or versions of it, that could be made against Tasmanian medical practitioners where they have either provided the means or carried out the early termination of the life of a patient - or, as detractors of the euthanasia proposition would put it more baldly, to kill someone. We will not get too many bigger questions than that before us as members of parliament during our careers.

Let us understand clearly what euthanasia is. It is a legal environment which would allow a citizen to take or to assist to take another life. This can take many forms but in the legislation before us the version of euthanasia is known as physician-assisted suicide as a form of voluntary euthanasia. That appears to be the intent of this legislation, even though it could be argued that the life-taking exercise could be carried out by others.

Euthanasia as physician-assisted suicide always requires a deliberate perpetrator other than the sick individual. This legislation is all about protection for that perpetrator against the charges of murder, manslaughter, wrongful death, malpractice, negligence et cetera. The proposition is in short that it is better to be dead than in pain.

We also need to understand what euthanasia is not. It is my view that euthanasia is not, contrary to the lurid claims of the previous speaker, about switching off treatment or life-sustaining devices or foregoing futile treatment or allowing such a person to die peacefully. That is proper and good medical practice and what happens now in Tasmania. Neither can that good practice be termed non-voluntary euthanasia, as the Greens have accused doctors in Tasmania of practising.

Euthanasia also is not doctors treating patients against their wishes. To do so is quite wrong and illegal. The patient's right to refuse all or any treatment is supreme in Tasmania and in Australia. It is also not the use of adequate pharmacological methods of pain relief, which may or may not contribute to a person dying. The principal intent is to manage pain and a secondary effect of that, it could be argued, is to contribute to a shortening of life. That is accepted medical practice around the world, and to give it special status in this debate simply does not have the support of the legal or the medical fraternity.

Euthanasia is also not suicide, which has the same result of course but is clearly a unilateral action where the deceased person chose to take his or her own life without provocation, suggestion or the assistance of others.

Euthanasia laws exist in a number of places around the world. The Netherlands operated for many years in a legal environment where a court finding simply acquitted doctors who carried out euthanasia. Switzerland has very broad laws which go further than physician-assisted suicide. Recently a leading health professional labelled suicide as a marvellous possibility. In Belgium, where they have brought in euthanasia laws, they have distinguished themselves as leading the world in the management of neo-natal babies with problems - you would understand what I mean - and in Washington State, as in neighbouring Oregon, laws came into being as a result of citizen- initiated referenda. I will not reflect too long on Oregon because the previous speaker has been there and clearly has more information than I have about that.

Where has euthanasia been rejected? Throughout the 1980s and 1990s there was a strong push for euthanasia laws throughout most developed countries, resulting in parliamentary inquiries by the House of Lords in the United Kingdom, the Canadian Parliament, the United States and in various parts of Australia. The reports are all good reading and essentially found the same outcome - that a professional legislator would not be able to provide laws to allow for the early death of a patient in extreme circumstances without substantially risking the interest of a huge section of the community which could be labelled weak and vulnerable. I commend these reports to the House as resources which will ensure that we do not have to reinvent the wheel.

In 1998, of course, there was an inquiry done by this House of Assembly. This is back before we reduced the numbers and we had the numbers to hold House of Assembly inquiries. I am the last surviving member in this House who sat on that inquiry. It was almost two years out of my life. It was highly instructive to me, a huge test for me as an individual, as a father and a person in our modern society. There was a lot of diligent work done by all members of the inquiry, meaning some of us went in with fixed ideas and came out the other end with substantially different ideas. There is a raft of findings from that inquiry which, I understand, this latest inquiry spent some time looking at and essentially agreeing with. They found in particular point 12 of the findings, where it said the following:

'The committee recognises that in a small percentage of cases, palliative care is ineffective in relieving all pain. However, whilst regrettable, this is not sufficient cause to legalise voluntary euthanasia.'

That, of course, gets back to the overriding principle of the large group of weak and vulnerable who are placed in substantial danger as a result of this kind of legislation.

As far as hospice care or palliative care is concerned, in 1997-98 the report called for strong improvements to palliative care. I do not want to get political about that. It is not the time for that but it could be argued there has not been enough expenditure on palliative care. Be that as it may, there has been substantial expenditure on palliative care. There are now palliative care beds at country hospitals. There was one featured in the news just a week or two ago and I will not reflect on that. There are very good, special palliative care rooms at country hospitals. That grew out of that 1997-98 inquiry that said that palliative care was the answer to the questions that the proposal of euthanasia threw up.

Since then, over that last 10 years, there has been substantial pain management technique improvement. Paradoxically it is the poppies grown in Tasmania, and one strain of poppies - thebaine - which has allowed the production of these sustained, slow-release, pain-management drugs. This means that the heavy opioids do not have to be used as much. Pain management is still a very strong science in its own right, but it became easier to do.

There are a number of entry level questions for legislators when we look at legislation like this. We always ask ourselves, when we see any bill, is this bill safe for all Tasmanians? Flowing from that, do you recognise that the duty of a state is to treat all citizens equally, as expressed in most human rights charters in existence around the world. Therefore, if you can identify some questions over safety for anyone in this legislation, the question for you is: do you believe you can make it safe? It is this question that is the magic question that all the inquiries around the world into euthanasia have not been able to positively resolve. I understand and respect the fact that the previous speaker and presenter of this legislation believes he can make it safe. Do you believe you can make it safe given that so many jurisdictions around the world do not believe they can make it safe?

Mr McKim - It is certainly safer than an unregulated environment -

Mr SPEAKER - Order.

Mr HIDDING - Yes, but -

Mr McKim - which is what we currently have.

Mr HIDDING - That is right, and if you were to accept that proposition then you could certainly go there. But, as I said earlier, the entire medical profession and the entire legal profession and, if you like, the entire ethical profession around Australia, simply does not agree with you.

Mr McKim - That is just not true.

Mr HIDDING - It is true.

Mr McKim - Not the entire legal and medical professional at all. That is just not true.

Mr HIDDING - No, you can always find a doctor or two. But you have to work with the AMA, nursing groups, nursing colleges, medical colleges and the rest of it, as you would if you were pursuing any other issue. I submit that this legislation, while trying very hard to build in safeguards, because of the autonomy it grants to individuals to override all safeguards at every point, simply cannot pass the principal safety test that should apply to all legislation, that it is safe for all Tasmanians. On that basis the bill condemns itself as unsafe and deserves to be rejected as such.

The member for Franklin, Mr McKim, talks of the will of the people and worries why it is that parliaments do not dovetail more easily into the will of the people. That is an argument that can be self-serving because there are many things that he believes in that the great majority of people in Tasmania do not believe in, and that would sink his argument in all of those cases. For all that, I accept that he and others have done polling but, as I will get to shortly, there is this whole question of autonomy. If you ask any walking, talking human being if they want control over their own body their first answer is, 'Yes, of course I do'. Regardless of what question is asked and what answer is given, it is not for us in this place to be driven only by popular demand outside. I have said this before when I was at Agfest and not long after I was elected - and there were a few others in this place who were there at the same time - after the appalling tragedy in Tasmania's history where 30-odd people were killed at Port Arthur, a number of people came up to us at our Liberal stand, and Labor had the same issue, demanding that we bring in capital punishment in Tasmania. 'We should have capital punishment.' 'We should have the death penalty in Tasmania.' Was there ever any question in this House that we would bring that in? No, there was not, but the prevailing thought for at least six months in Tasmania was that capital punishment was a very good thing but we were not driven by the view there.

As we are speaking here as individuals and not connected to any party, I want to address the matter of religion. People write to me and say, 'Could you just put aside your religious beliefs for the sake of the argument?' It is not beyond me to set aside my religious beliefs to test my religious thinking against secular thinking, which I often do. What I perceive in this debate from the people who write to me is that they are saying, 'Put aside your religion because, while we respect the right that you have to your religion, we actually prefer ours, the religion of secular humanism which says that we are autonomous, we can control our own bodies, we should decide on these matters, so just set yours aside and take ours instead'. I choose not to set aside my faith and neither will the huge numbers of Christians in Tasmania, those who still identify with the Christian faith, many of whom would agree with me. There are some Christians who do not agree with me, there is no question about that, but many of them agree with me that there are very few options in legislation such as this. We believe that God provides life and life therefore has a special sanctity and to take it or offer to take it is forbidden.

Let us look at some of the key concepts now of the argument of euthanasia. The central one is this issue of autonomy for all versus the obligated citizen. Autonomy is a seductive proposition where every human being should be able to have charge of his or her own destiny from a day-to-day point of view. The opposite is very unattractive, where the State would seek to overly control matters of physical treatment and that is clearly not attractive to anyone. All legislators, however, understand that where a person seeks to manage their own affairs to a point where they want to take their own life then it is the duty of the State to prevent that, even the planning for it. We spend millions on suicide prevention programs around Tasmania to do just that.

At this point I could quote from the Bible but I choose to quote from a secular source. I would recommend to the House the writings of Ann Manne, an Australian writer and social commentator who has written widely on feminism, motherhood, child care and family policy. She is widely published in Australia. On the question of autonomy of individuals in Australian society she has written of our current society as having two very different moral values - autonomy and obligation.

Mr SPEAKER - The member has 15 minutes, so I -

Mr HIDDING - Mr Speaker, I had indicated I was going a little longer, and we have others to speak. We will manage it all within the time frame.

She describes it like this:

'The clash between the idea of a sovereign, autonomous self, which is expressive of the individual's rights to freedom, choice and self-determination, versus an ideal of an obligated self, which emphasises interdependence, connectedness and limits to freedom where actions are constrained by the consequences for others.'

So that is where we are in this House today, and that is where people who grapple with this euthanasia issue find themselves on one or two, or with a foot on each of those moral positions, trying to figure out which stone to stand on.

Sanctity of life of course is a well-argued proposition, and so is the slippery slope, and while the previous speaker said that there is evidence that there is no possibility of a slippery slope occurring in Oregon, it certainly exists in all other jurisdictions where there is current discussion where advanced Alzheimer's may well be now seen as a disease whereby euthanasia can be indicated. That was something that five years ago was unheard of, and of course now is up for discussion. I also understand that some of those debates have taken place in Oregon, but I have not been there like the previous speaker has, so I am not going to take him on on those matters.

There are also issues about the use or misuse of the word 'dignity'. The proposition is that if somebody takes your life or assists you to take your life, that is somehow dignified. There are many Tasmanians and Australians who believe there is something inherently undignified about that indeed. There was a survey of physicians done in Oregon - I received that just this morning from someone - which was interesting. These physicians gave the reasons for people wanting to end their lives who did end their lives: loss of autonomy, 89 per cent; loss of activity or the ability to do things was 86 per cent, so obviously they ticked a few boxes; loss of dignity was a big one - so dignity is a key word in this whole debate, clearly - and loss of bodily functions, was 58 per cent, which is very high; and not wanting to be a burden on the family was 39 per cent. It is very worrying that those last two matters that should be easily managed are such key matters.

During that 1997-98 debate the telling point was when a leading bioethicist was asked by a Greens member, coincidentally - a very good member, Di Hollister - 'What would you have me say to my educated, articulate and organised friends who want to arrange for themselves assisted suicide at the end of their lives?' This bioethicist said, 'I would ask them to have a care for those less educated, less articulate, less organised and the vulnerable in society who will be put at risk as a result of us having to change the laws for those friends.'

Mr McKim - There's no evidence to back that up at all.

Mr HIDDING - When that whole concept was teased out, the world changed as far as that inquiry took place.

In summary, Mr Speaker, and for the record, I am truncating my contribution substantially as others will be around this House, and that is another unfortunate thing that has come about because a debate like this deserves substantial time.

Mr McKim - Hear, hear.

Mr HIDDING - But given the other debate and discussions -

Mr McKim - I've done the best I could.

Mr HIDDING - Yes, indeed. We tried to build in another week of sitting.

In summary, I believe the moral basis for this bill is bad. It seeks to set aside the charge of murder, the most heinous criminal act in our society. Therefore it is likely to be the most serious bill we will ever have in our political lives. Euthanasia has been discredited as unnecessary by most of the free world's parliaments. This bill has no strong demonstrated public need. It is being pushed by people who are afraid of the dying process, who I believe should take more time to understand the palliative care options and to understand how committed palliative care doctors are in alleviating pain and how angry they get when they hear of these sustained pain situations with a small number of patients. They tell me they firmly believe that it is completely unnecessary and it is bad management if that is taking place.

This latest euthanasia proposal is no different from all the others. It proposes special rules for the educated, articulate and in control individual and sets aside the inherent threats to the less educated, less articulate, and less in control persons in our community who can only be described as in a weak and vulnerable position as a result of their sickness. I call on members of the House to reject this bill.