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Wednesday, 24 November 2010
Senator POLLEY (12:45 PM) —I rise to speak today on my fundamental reasons for why I cannot support euthanasia. Today in the South Australian parliament there is legislation being presented and in my home state if Tasmania it was a little over 12 months ago that there were attempts to legislate there. We know that in recent times there has been a bill come before this place.
This is a very complex issue. It is complicated by a range of interpretations of what is meant by euthanasia; confusing inconsistent laws, which collectively do not provide a conclusion; Australia’s Constitution and the different relationships between states and territories and the Commonwealth; the need for appropriate palliative services to support dying people and their families in their homes, in hospices and even in hospitals; and strongly held beliefs and values of people who support or oppose euthanasia. To me the latter is the key issue in determining how I will vote on this issue. Those values and beliefs are what should define our laws—it should not be the reverse.
To clarify what I am talking about, I suggest that there are a range of issues for consideration: The Australian Human Rights and Equal Opportunity Commission states:
- involuntary euthanasia refers to the termination of life against the will of the person killed;
- non-voluntary euthanasia refers to the termination of life without the consent or opposition of the person killed;
- voluntary euthanasia refers to the termination of life at the request of the person being killed;
- active euthanasia refers to a positive contribution to the acceleration of death;
- passive euthanasia refers to the omission of steps which might otherwise sustain life.
The two issues which are important are that there is an active request of the person to be killed and that there is active intervention to accelerate that death. The first sentence of article 6(1) of the International Covenant on Civil and Political Rights states:
Every human being has the inherent right to life.
I will move on to what I consider the fundamental issue in this debate. On any bill it will be a conscious decision and I believe in what was said at the American Catholic Bishops Conference:
As Catholic leaders and moral teachers, we believe that life is the most basic gift of a loving God—a gift over which we have stewardship but not absolute dominion. Our tradition, declaring a moral obligation to care for our own life and health and to seek such care from others, recognizes that we are not morally obligated to use all available medical procedures in every set of circumstances. But that tradition clearly and strongly affirms that as a responsible steward of life one must never directly intend to cause one’s own death, or the death of an innocent victim, by action or omission ...
We call on Catholics, and on all persons of good will, to reject proposals to legalize euthanasia.
These are not my words but they are ones that I clearly agree with and support. While these are only a few words, to me these words are the essence of the debate—life is sacred and we should not be actively aiming to end any life. I cannot emphasis this enough. To me this is the core of the issue.
The people who would support euthanasia tend to rely upon three common themes: the avoidance of suffering, the right to die and that voluntary euthanasia will not slip into involuntary euthanasia. Laws against euthanasia and assisted suicide are in place to prevent abuse and to protect people from unscrupulous doctors and others. They are not and never have been intended to make anyone suffer. I am reliably advised that nearly all pain can be eliminated and in the rare cases where it can not be eliminated, it can be substantially reduced. This is an area that all governments at a state and a Commonwealth level should be looking at to ensure that the best medicine to reduce pain is available in this country. Adequate pain control should be available to all people. Killing them is not the answer.
The issues associated with dying are much broader than just controlling pain. Care is not just about symptom management but must include counselling, social support, and pastoral care for the dying person and their carers and supporters. A recent article in the Australian newspaper by Margaret O’Connor, President of Palliative Care Australia stated:
In the palliative care settings of hospital, hospice and home the request for assisted suicide is rare.
Palliative care needs to be available to people in their own homes, in hospices and in hospitals, day and night as the need may be and to be provided by a range of health care professionals to cater for all of the needs of the dying and their families. I have spoken in this place before about the importance of palliative care. A palliative care guide states:
Under palliative care, doctors, nurses and other health professionals treat the symptoms and ease the pain of the terminally ill, making them more comfortable and helping them lead a dignified life until death. The goal is not to ‘cure’ the patient, but it’s also not to expressly hasten that person’s death. Dying is a normal part of life.
So, until there are adequate services to support all people who are dying, why are we even considering this option? Until that is the case, how can we know if there is truly a problem? I have no doubt this is the direction that a caring society should head. Admittedly, in a recent study released in the Economist magazine of the palliative care services in 40 countries, palliative care services in Australia rated highly. However, we are not immune from the effects that euthanasia would have on palliative care services.
There is another concern: the risk to the disadvantaged. I spoke last week in this place about elder abuse and how elder abuse can include involuntary euthanasia and the threat to our disadvantaged. We need to recognise that euthanasia is likely to be practised with the same social inequity and prejudice that affects the delivery of services throughout our society, including health care. Those who are most vulnerable—the poor, minorities, the less educated and the less empowered—will continue their disadvantage. This is not to say that doctors are more prejudiced or influenced by race, class et cetera—only that they are not exempt from these either.
There is no right to die. Suicide, while a very unfortunate event, is not illegal, but that is not what is being asked for. What is being asked for is that another person be involved in killing the person making that request and that there be no repercussions for the assisting person. Assisted suicide is a halfway house and a stop on the way to other forms of direct euthanasia—for example, for incompetent patients by advance directives or suicide in the elderly. So too is voluntary euthanasia a halfway house to involuntary and non-voluntary euthanasia. If terminating life is a benefit, the reasoning goes, why should euthanasia be limited only to those who can give consent? Why then would we need to ask for consent?
I could talk about a whole range of issues about euthanasia and my own personal experiences with my mother a little over two years ago. She has cancer. She was already in very ill health, and she was confronted with having to have emergency surgery. The first doctor suggested to the family that it was not worthwhile and her chances were very slim. We sought a second opinion, and we were very fortunate, because the second doctor said, ‘If your mother wants to try then I think the hospital should perform the surgery.’ Of course, as a family we were most grateful for that, because we have been fortunate enough to have our mother with us for a further two years. My concern is: with the constant pressure on our health system into the future, if we had voluntary euthanasia, would my mother and our family have been given that opportunity to even attempt the emergency surgery? My mother was 82 at the time and, as I said, in ill health. Now, of course, she is bedridden and is undertaking palliative care. Yes, she is in extreme pain, but she is having palliative care. I believe that she is getting the best possible care available, and we are most grateful to those people who are caring for her. So, when people criticise me for my belief in not supporting voluntary euthanasia, I am not just speaking for my constituency back in Tasmania or for the people who send me the hundreds of emails I get on a weekly basis from around the country; I am talking about firsthand experience with the dilemma that our health system can sometimes confront us with.
You only need to look at two examples cited by Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition Canada and chair of the Euthanasia Prevention Coalition International, who recently visited Tasmania to brief Tasmanian MPs and other interested parties. The most recent report from the government of the Netherlands indicated that in the five years between 2000 and 2005 there were 550 people euthanased without consent or request. When you have a poorly developed palliative care system, it is not surprising that Dutch doctors have been reported as saying, ‘Why should I worry about palliative care when I have euthanasia?’ Another study, published on 17 May 2010 in the Canadian Medical Association Journal, stated that 32 per cent of all euthanasia deaths in the Flanders region in Belgium are ‘without request or consent’.
There has been significant pressure on healthcare providers to contain costs. In my home state of Tasmania, the Minister for Health recently announced a reduction in funding for palliative care services in the north of the state. At the same time the Attorney General has foreshadowed, along with her Greens ministerial colleague, the introduction yet again of euthanasia legislation. A coincidence? I do not think that is how people necessarily all see it in Tasmania.
However, much more worrying is the recent Standard and Poor’s report Global aging 2010: an irreversible truth, reported in the Launceston Examiner on 13 October this year. I quote:
Age-related spending on health, pensions, and aged care is estimated to rise to 14.4 per cent of gross domestic product (GDP) in 2050 … Without further reforms to address these mounting spending pressures, net general Government debt could increase to 71 per cent of GDP over the period …
The article goes on to say:
The global report forecast that Government debt associated with age-related spending could reach … 300 per cent of GDP in … 40 years in advanced economies if fresh measures were not introduced to address the issue.
Meanwhile we have many in the health professions concerned about the ethical implications for their practice and effects on the doctor-patient relationship.
Before I conclude, I would like to summarise. I cannot support the introduction of euthanasia, as I outlined from the very beginning. It is inherently wrong, and this is inescapable. The legislation—any legislation—cannot protect individuals. You cannot prevent the legal slippage, and despite the very clear warnings there is already evidence of this occurring. Combine this with the fears concerning future health funding and the many other practical issues. Finally, I say to those in the chamber and those that are listening to this broadcast that those of us who do not support euthanasia do understand what pain is about and that people want to ensure that their family members are well cared for and without pain. But I truly do not believe that assisted suicide or voluntary euthanasia is the way forward. Life is very precious. I am somebody who can speak from practical personal experience. When you have the opportunity to choose between life and death, it is a very natural thing to choose life, and we should do all we can to instil that value in our society.