VOLUNTARY ASSISTED DYING BILL 2017 Second Reading Debate The PRESIDENT: Before I call the Hon. Walt Secord, on behalf of all members I welcome all visitors in the public gallery to the New South Wales Legislative Council. I know they are here to watch the proceedings. A number of rules apply not only to members but also to people in the public gallery who will be listening to the debate. No matter what they think about what is said, they need to listen to the debate quietly. Applause, jeering or any other gestures are not permitted. Visitors are also not to attempt to talk to members in the Chamber. If they have something to say to those who are seated next to them I ask them to do so quietly. There should be no audible conversation. Photographs and filming are not permitted apart from the media photographers who have been authorised to do so. Please follow any instructions by officers of Parliament. No signs or other props are to be utilised during the debate. The Hon. WALT SECORD ( 10:41 ): I contribute to debate on the Voluntary Assisted Dying Bill 2017 which was introduced by the Hon. Trevor Khan, Deputy President and Chairman of Committees and a Nationals member of Parliament. I acknowledge that this bill was developed in conjunction with an informal parliamentary working group comprising a number of members from various parties. This bill, while simple, is historic. It has significant and far-reaching implications and it encapsulates more than the simple slogan of the right to die. Today we are debating laws to regulate medical intervention to end a patient's life and to prescribe drugs with the intention of ending a patient's life. The PRESIDE NT: Order! If members wish to converse they should leave the Chamber. The Hon. WALT SECORD: I know that doctors and nurses, like the whole community, are divided on this issue. Young doctors will tell us that early in their training they quickly realise there are three key prohibitions in medicine: they should not have intimate relationships with their patients; they should not financially benefit beyond what is seen as reasonable compensation for their professional services; and, finally, and most importantly, they should never intentionally kill a patient. I note that there are very different views within the medical profession on euthanasia. On 18 October in Victoria, Australian Medical Association national president Michael Gannon indicated that his views differed from various State and Territory bodies of the Australian Medical Association. However, I note that in New South Wales the NSW Nurses and Midwives Association supports this legislation. Opinion is divided. I have spoken with many doctors and nurses in a private capacity about this matter and I have heard the arguments on both sides. Very few doctors and nurses outside official organisations are comfortable going on the record about their own professional experiences involving euthanasia or end-of-life matters. They flatly refuse to say whether they have informally experienced or been involved in this area. However, nurses and doctors acknowledge that they have always had more power than their patients, particularly in terminal illnesses, and their patients almost always defer to them, their judgement and advice. There is a real power imbalance that should be, and that has to be, acknowledged. The recent select committee on off-protocol prescribing of chemotherapy in New South Wales heard evidence from families, including in-camera evidence, that they accepted without question their doctor's recommendation for treatment. From a personal perspective I do too—that is, until recently. In recent months I found myself pressing specialist doctors about their approaches to my treatment. They were surprised but pleased to respond to my questions on why they were ordering particular tests and not others. Without going into details, I asked one specialist why he had not sought a particular test and he replied that he had ruled out a particular ailment in a previous test. I said to the specialist, "It would have been nice if you had shared that information with me earlier." He nodded, agreed and was slightly embarrassed. Doctors, nurses and other allied health professionals often observe that there HANSARD 16 NOVEMBER 2017 – NSW VOLUNTARY ASSISTED DYING BILL PAGE | 1 is a conflict or paradox in the euthanasia debate. As a society we have the desire for unlimited medical treatment and procedures, especially for the extremely frail and aged, which is almost a desire to master mortality. There is also a movement in some circles towards physician-assisted death. Today we must attempt to navigate and resolve this paradox. I have thought long, hard and often about this law. When it comes to a division I will be voting against the bill. My views have been on the public record for a long time but I again wish to express them clearly. I have said in this Chamber before that at another time in my life and my career I supported the concept of legislation on euthanasia. Years later I now see that I did so without fully considering or understanding why, or the implications of the legislation. Previously I would have supported the concept of ending someone's life if that person thought it was no longer possible to go on. I no longer hold that view; I realise it is much more complex. To this day I have great sympathy for any person for whom voluntary end of life is a real consideration. I have met with proponents who want laws passed and with those opposed to its passage. After those meetings I still believe that the best course forward is to provide better palliative care. The moral worth or measure of a society is how it cares for the vulnerable. By that measure we do not do so well. I have spoken to many doctors, especially those in palliative care, and they believe that much of the suffering of patients with advanced illnesses is entirely preventable or manageable. A look at my parliamentary and public record will show that I have been a strong advocate on this point—that is, supporting palliative care and opposing legalising euthanasia. In June 2012 I gave a lengthy adjournment speech expressing my reservations about euthanasia laws and supporting palliative care. The bill before us today is a legal framework—a legal codification for assisted death. In around 2008 I reached the conclusion that it was not possible to codify this aspect of human desire—that is, the desire to decide the time and manner of a person's death. I acknowledge the strength and perennial nature of that desire. To argue against this bill is not to deny the strong emotional and compassionate desire behind it but rather the capacity of our legal system to codify that desire. I have not yet seen—I do not believe it is possible to develop—adequate legislative safeguards to protect people from the misuse of these laws. I have not seen a legislative model in this area that cannot be exploited or manipulated. I cannot support any gaps for exploitation when the consequences are so final. Furthermore, I agree with former Prime Minister Paul Keating. On 20 October he warned that protections for the most vulnerable of all people—those in the end stages of life—were highly problematic. He said: … the advocates support a bill to authorise termination of life in the name of compassion, while at the same time claiming they can guarantee protection of the vulnerable, the depressed and the poor. No law and no process can achieve that objective. Currently, 14 jurisdictions in the world provide access to assisted dying or voluntary euthanasia. In North America experts for and against euthanasia look to Oregon and Canada. In Europe, they look to Switzerland and the Benelux countries of Belgium and the Netherlands for data, research and legislative frameworks. Humans have always grappled with this issue. In 1906 the Ohio state legislature debated an Act concerning administration of drugs to mortally injured and diseased persons, which tried to legalise euthanasia. After debate it was overwhelmingly rejected. I note in the words of the Hon. Trevor Khan that the bill follows the State of Oregon model of voluntary assisted dying, which requires self-administration. It does not follow the broader European model of voluntary euthanasia like the Netherlands and Belgium. I do not believe it is possible to put in place sufficient safeguards and protections to prevent abuses in this law. This is before we consider the invidious pressures of spiralling medical costs, which will become more pressing in Australia as our population grows due to the rising birth rate, immigration compounded with our longevity, financial burdens on families, emotional burdens on relatives who see a loved one's protracted death as a problem to be fixed rather than a process in life to be accepted, or the process of manipulation due to inheritances—or what some have described as inheritance impatience. HANSARD 16 NOVEMBER 2017 – NSW VOLUNTARY ASSISTED DYING BILL PAGE | 2 I appreciate that my stance today will seem to be in conflict for some compared with my position on many other so-called conscience issues. Members would be aware of my support for a progressive social agenda, which I hope to bring to the area of health policy if I am fortunate enough to be the health Minister in a future State Labor government. I have been on the record for years in support of marriage equality and I am pleased with yesterday's result of the national plebiscite. Several years ago, I was the only New South Wales right-wing Australian Labor Party member to march in the Gay and Lesbian Mardi Gras alongside Rainbow Labor.