Mr MARTYN EVANS(10.10 a.m.) —Before commencing my substantive remarks on the Euthanasia Laws Bill, I would like to thank the many constituents and others who took the trouble to write to me or telephone my office about this measure. There can be no doubt that the community is concerned about the implications of the Northern Territory act and I have received more representations on this bill than I have on any other matter which has come before the House. I certainly appreciate the efforts people have made to bring their views on the bill to my attention and I found them very useful in formulating my own response to the complex ethical and moral questions which are raised by this whole debate. The overwhelming majority of the representations I received were in favour of the Andrews bill and against the existing Northern Territory law.

One threshold issue which often comes up in debate is that of whether the Commonwealth parliament should take up this issue at all, given that it has already been determined by the Northern Territory assembly. The reality is that the Commonwealth retains constitutional responsibility for the territories, whether we want it or not. The responsibility is there and we must accept that responsibility—if we have the right, and no-one I know disputes that, then on an issue of this importance, we also have a duty to pick up that right and determine the matter at the national level. The territories are not autonomous states and while they retain their current legal status under the constitution we cannot abrogate our obligation to ensure that the legislation they pass is consistent with the national interest. This is not a power we should exercise lightly, but one could not suggest that legislation which authorises euthanasia is anything other than extraordinary of itself.

This is not the first time that I have personally had to confront the question of euthanasia. I was appointed as a member of the Select Committee into the Law and Practice Relating to Death and Dying in the South Australian parliament in 1990. The committee was formed on a bipartisan basis on the motion of Mrs Jennifer Cashmore MP. The deliberations of the committee, which involved a great deal of public input, were long but productive. I would have to say that it was easily the most effective committee on which I served during my 10 years as a member of the House of Assembly. All members worked well together—sharing a common goal to improve the law and practice relating to palliative care and to ensure that whatever changes were made to the law were undertaken in such a way as to bring the whole community along in the process. We placed a premium on consultation and education—listening and leadership.

The committee resolved to reject the pro-euthanasia stance of a small but very determined and genuine group in the community. We were all of the view that this would be an inappropriate response to the needs of the terminally ill. We decided instead to focus our attention on the issues of patient autonomy and palliative care. The committee made a series of recommendations for reform of the law and practice relating to death and dying which strengthen the autonomy of the patient through the mechanisms of informed consent, the right to refuse treatment and the availability of the option to appoint a medical attorney to represent the interests of the patient when they are unable to exercise their rights in a personal capacity.

We also recommended the reform of the law to remove the burden of possible criminal and civil prosecution from doctors and other professionals who sought to relieve pain and distress through the use of narcotics, which might have the double effect of reducing the patient's life expectancy, or who discontinued the burdensome or futile treatment of a terminally ill patient in accordance with proper standards of palliative care, without negligence and in order to improve the quality of life of the patient—even where this had the unintended consequence of shortening the life of the patient.

This series of mechanisms—strengthening patient autonomy, including the appointment of the medical agents, informed consent, refusal of treatment and placing the priority on palliative care; removing the burden of law on the health professionals where they work to improve the quality of life of the patient through pain control and the relief of distressing symptoms; and ensuring that there was no obligation to maintain burdensome or futile treatments—together with a range of other lesser reforms, which I will not detail at this time, had the effect of refocusing the attention of patients, the health professions and the broader community on high standards of good palliative care rather than on what some see as the alternative of euthanasia.

The critical distinction here is intention. The intention of the doctor who employs pain relief which they know will also have the effect of reducing life expectancy is the paramount consideration. There is every difference between the administration of a drug to relieve pain and the administration of a drug to end life. Our law and ethical principles have always placed great weight on this kind of distinction of intention and while the practical outcome may not be far different in some cases, the nature of our society would be fundamentally different if we did not draw that important distinction based on intention.

During the term of the committee, I had the good fortune to be appointed as health minister in South Australia and, working with my colleagues from both sides of the House on the committee, I was able to ensure that the recommendations of the committee were introduced as a bill into the parliament. The bill was approved by the lower house with an overwhelming majority of the vote, only three members opposed it. However, the bill took many months to pass the Legislative Council, such is always the way with upper houses. The act finally became law in 1994, and substantially in the same form it was originally introduced.

The medical and related health professions, using the technology available in an advanced country such as ours, have made great strides in the treatment of the terminally ill in recent years. Modern methods of palliative care in the hospice setting are able to relieve much of the pain and distress which in the past could accompany some illness in the terminal phase. The concept of dying with dignity though is a very powerful one and is justly to be wished for all of us.

The focus on patient autonomy and palliative care, which is embodied in the South Australian Consent to Medical Treatment and Palliative Care Act which, taken together with the dedicated work of our health professionals, will help make that promise a reality. Palliative care is not perfect but it has improved dramatically and can be further improved if the resources and commitment are there.

It is a matter of great regret therefore that the Commonwealth has recently chosen to broadband the funding for those services and to reduce funding for the states in that area. Society stands to gain significantly from the modest investment we make in palliative care services. I would urge the Commonwealth to think again about this kind of funding cut.

The Northern Territory act does not establish a sound legal or social base for euthanasia. The legislation is legally imperfect and the result of far too little consultation and debate. It did not enjoy a community consensus which is essential for this kind of social reform. The steps that South Australia took were significant enough of themselves to require several years of hard work to ensure that they represented the best law we could make at the time, and the community consensus which underpinned them was a soundly based one.

The act in the Northern Territory was adopted with almost unseemly haste and with the hallmarks of a proposal assembled to meet artificial deadlines. I do not question the bona fides or the goodwill that motivated the proponents of the bill. I accept without question that they acted from the best of motives and in accordance with their personal beliefs. I do not question their integrity but I do question the legislative outcome that this parliament is now invited to set aside.

I oppose euthanasia as a matter of conscience but, in any event, I do not believe that the Northern Territory should have considered this kind of legislation without first establishing a sound base of palliative care backed by innovative and caring legislation, and with the understanding and support of health professionals and the wider community. With all due respect to those involved, I do not believe that this has occurred. Therefore, our duty as a Commonwealth parliament is clear, we should support the bill now before the committee and thereby overturn the Northern Territory act.