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Thursday, 9 February 2006
Page: 29

Senator CHAPMAN (10:39 AM) —The bill before the Senate today, the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, proposes to repeal ministerial responsibility for approval of RU486, a drug used to induce abortion as an alternative to surgical termination of a pregnancy, in favour of the Therapeutic Goods Administration having that responsibility. I oppose the bill. In short, the accountability for decisions involving such a drug is rightly placed with elected parliamentary representatives. I am not convinced of the veracity of the information attesting to the drug’s safety, and as someone concerned about the current level of abortions in this country I cannot countenance a situation where abortion is made more readily available.

Before addressing these issues, I congratulate the Senate Community Affairs Legislation Committee for its work in conducting the inquiry on the bill and the great number of organisations and individuals who made submissions to the inquiry and who wrote to me directly about their views on this matter. I respect all of those who have expressed their view, although I appreciate that I will not please all of them in taking the position that I do on this matter.

The issue of responsibility is central to this bill. Although the bill under consideration has been designed to look to be merely a matter of the mechanics of procedure, I do not see it this way. Rather, it is a serious issue of ethics and social policy, one that cannot be adequately examined without proper regard for questions regarding values and matters of principle that it throws up. It is only right that Australia’s elected representatives in the parliament retain the accountability for decisions involving the use of abortifacient drugs.

In opposing this bill, I am not reflecting negatively on the skill and diligence of the TGA in discharging their responsibilities and duties; it is rather a matter that is too serious to escape the direct scrutiny of and accountability on the part of elected members of parliament. A key feature of this debate has been a continual drawing of attention to the perceived personal beliefs of the current minister for health. Of course, this parliament needs to, in the course of considering this bill, look into the future to a time when the current incumbent no longer holds the position. However, this begs the question: how then would the situation change depending on the potentially different views of people in this position? I believe that, whatever the views and the persuasion of an incumbent minister for health on this particular issue, they should, collectively with their parliamentary colleagues, be held accountable for decisions on this drug.

I do not accept that RU486 should be lined up alongside all other drugs under consideration or for possible consideration by the Therapeutic Good Administration. It is a drug designed to abort a pregnancy, to end the life of a human embryo, not to treat an existing medical condition, to prevent a possible medical condition or to sustain life.

Another question which this parliament must address involves the examination of the responsibilities which correctly fall within the province of the Therapeutic Goods Administration. As argued persuasively by the Catholic Archdiocese of Sydney in their submission to the Senate inquiry, the TGA is charged with the responsibility of assessing therapeutic drugs—those drugs which treat or cure disease. Drugs such as RU486, however, are classified as restricted goods on the grounds that they are intended for use as abortifacients. This is a clear warning sign that Australians who are potential users of RU486 should have the confidence that the drug they are using has been reinforced by responsible parliamentary scrutiny—scrutiny which extends beyond what is normally entered into for merely therapeutic classes of drugs.

Further, while the TGA is charged with assessing the quality, safety and efficacy of pharmaceutical goods for use in Australia, it is not charged with the responsibility of assessing the social and ethical issues related to drugs under its consideration. In my view, the social and ethical issues relating to RU486 are present to a degree that clearly distinguishes and separates them from the general issues under consideration by the Therapeutic Goods Administration. That is why parliamentary scrutiny and, through that, greater public scrutiny are required in this instance.

To the public eye, the TGA is rather an invisible and unaccountable body to be dealing with such a complex, serious and sensitive issue as abortion, which through the passage of my many years in this parliament has remained a highly controversial and emotional issue. In summary on this issue of accountability, hundreds of years of evolution of our Westminster parliamentary system did not remove the divine right of kings to have it replaced by the divine right of experts.

The arguments surrounding the safety of RU486 also demand consideration. The champions of this bill do so under the auspices that, among other things, the availability of RU486 to women will provide a safe and easier method of abortion for women, particularly those in rural and remote areas without ready access to surgical abortion. This might be all right in a situation where a woman administering RU486 does so without a hitch, including being in a position to attend the three medical appointments required to administer the drug. However, the United States Federal Drugs Administration patient information sheet on mifepristone, another name for RU486, which was updated only last year in July 2005, requires serious consideration. It states that some women will need further medical attention, including in some cases admission to an emergency room, and that in up to eight per cent of cases the attempted abortion will be incomplete and will require surgical intervention to end the pregnancy or to stop considerable bleeding.

The Federal Drugs Administration also notes that it knows of four women in the United States who died from sepsis, described as a severe illness caused by infection of the bloodstream, after medical abortion using mifepristone, marketed as Mifeprex. There have been ten known deaths in the United States and in Europe. One might say that this mortality rate is relatively low when compared with the mortality rate involved with other drugs and what is considered to be a generally accepted standard and a small price for Australians to pay for access to RU486. I disagree: four lives lost is four too many when they are avoidable. We should put no price on the loss of a human life. Furthermore, as I said earlier with regard to occasional unfortunate side effects of other drugs, at least their purpose is to sustain, not destroy life.

Furthermore, the United States Food and Drug Administration have noted over 800 adverse reactions to RU486 since the drug was approved for use in 2000. Such reactions are listed in the Senate committee’s report to include heavy and often prolonged bleeding, including the need for blood transfusions; incomplete abortions necessitating surgical intervention; moderate or severe physical pain; and considerable mental anguish. The Food and Drug Administration further estimate that only 10 per cent of cases of adverse reactions are actually reported. This brings the true number of adverse reactions to an alarmingly high rate.

It is clear that a woman taking RU486 requires close monitoring and for emergency room back-up to be readily available to deal with cases where RU486 leaves an abortion incomplete or where a woman suffers serious further health problems, including haemorrhage and infections possibly leading to unintended side effects such as sterility. We can never be sure that unforseen circumstances will not intervene to prevent a well intending patient from obtaining this medical support or women who live a significant distance from appropriate medical support being able to travel the distance in time. This point has been well made by my colleague Senator Alan Eggleston, who practised as a general practitioner and obstetrician for over 20 years in Port Hedland in Western Australia and experienced the challenges of rural medicine first hand.

In Australia, regulation of abortion is currently a matter for state and territory governments. I appreciate this and also that there is not a widespread push for a change in the current arrangements; however, in my opposition to this bill and in my long-held position as someone who is pro-life, it is important to address what I consider to be an alarmingly high rate of abortion in Australia today. Indeed, official government figures put it at between 80,000 and 100,000 per year.

Recently released research conducted by independent market research providers on behalf of the Australasian Federation of Right to Life Associations found that 51 per cent of Australians oppose abortion performed for financial or social reasons and 53 per cent oppose Medicare funding in these circumstances. Critically for this debate, 79 per cent of Australians believe abortion can harm the physical or mental health of a woman; 96 per cent believe a woman should receive free independent counselling before having an abortion; and 86 per cent believe there should be a cooling-off period of several days between making an appointment and having an abortion.

This demonstrates that, while currently there may not be an appetite from the majority of the Australian public to change a woman’s right to obtain abortion, there is certainly some appetite for changing the processes governing abortion. It also demonstrates that the majority of the Australian public hold concerns for the wellbeing of Australian women obtaining abortions. That is why I commend particularly recommendation 1 of the Senate committee’s report and I emphasise from that recommendation the need for counselling that is independent and does justice to the grave nature of a decision involving the possible termination of a growing foetus.

With this in mind, the issue of relinquishing ministerial responsibility for RU486 is relevant to our responsibility as parliamentarians. It is our responsibility to address Australians’ concerns about the staggering number of abortions performed each year in this country. Just ask this question: will approval of RU486 increase or decrease the number of abortions performed each year? I suggest the logical argument is that the former is more likely to be the case. Also, it is foolhardy for elected representatives to ignore the widely documented adverse psychological effects often associated with abortion. As Dr Stephen Grocott and Dr Dianne Grocott, consultant psychiatrists, noted in their submission to the Senate inquiry:

Many researchers have documented increased rates of depression, suicidal behaviour, substance abuse and relationship dysfunction that have variously been labelled ... “post-abortion syndrome (PAS)”.

…         …         …

There is a great need for public recognition of the psychological consequences of abortion so individuals can be correctly diagnosed and treated.

Given our focus on mental health in this country at the moment, it would be neglectful for us to ignore the many public calls for due consideration of the psychological impact of abortion. This only adds another level of seriousness to the issue.

In closing, I reiterate my opposition to this bill. For the reasons I have outlined, the case in favour of repealing ministerial responsibility for this drug is not a convincing one and, as elected parliamentarians, I believe that it is our responsibility to have decisions on such gravely serious social and ethical issues retained appropriately within the aegis of this parliament.