Mr PEDERICK: I first want to make the comment that I think we had a very respectful discussion a fortnight ago in this place. Everyone knows my position on the Voluntary Assisted Dying Bill 2020. At the finish, I will not be supporting it but I will be supporting any amendments that seek to improve the bill along the way, and I appreciate the work done by the deputy leader and the member for Davenport in coming to agreement on those amendments. It shows what can be done in this place.
I do have a couple of concerns on clause 1, the title, and I will raise them separately. I have a concern about unintended consequences because, obviously, with voluntary assisted dying there is no turning back. Deputy leader, do you think there are enough protections in the bill so that we will not have any unintended deaths? That is one concern I have.
Dr CLOSE: I really appreciate the opportunity to answer that question, and it is a very well articulated question. This piece of legislation is amongst the most conservative in the world. It is modelled very closely on the Victorian legislation, which the Premier at the time claimed to be the most conservative. If you think of the continuum of different forms of voluntary assisted dying legislation that exist, Australia is very much cramming in at one end, and that is to say that it is extremely difficult to obtain a permit to have voluntary assisted dying.
Some people will be disappointed by that, but that is very clearly what Australians have an appetite for and what Australian members of parliament and parliaments generally have an appetite for. What does that mean? It means that someone who wishes to have access to voluntary assisted dying has to go through some 70 hurdles that are placed in this legislation in order to be very certain that that is the right and legal thing to allow to happen.
There are criteria that are established that two doctors must say are to be found to be true. One is the very sincere desire by the person to obtain voluntary assisted dying, and that desire cannot be expressed just once but must be expressed in an enduring way over a period of time and through the different stages. The person must also be, sadly, dying. They must have a terminal illness and one that (other than neurodegenerative) will kill them within six months, and for a neurodegenerative disease, will kill them within 12 months.
They cannot have access to it simply because they do not wish to live. They will have access to it because they are dying and they have proven that and had it tested by at least two doctors, the coordinating medical practitioner and the consulting medical practitioner. There are further tests that are required for each stage of the process to ascertain that that eligibility is indeed fulfilled, and that the desire to undertake the process of voluntary assisted dying remains an enduring wish.
In Victoria, where this has been in place for some time now, there has been found to be by the review board no example of what the member might regard as an unwarranted or unintended death. In fact, the only criticism that that board has really found is that it takes a while and it is hard to get and that sometimes, because of the difficulty in obtaining access to a practitioner who is prepared to engage in the process, people have died before they have been able to gain the relief they have sought. That means that they have experienced the kind of suffering they had hoped to avoid and have ended their lives in greater pain and in greater suffering than they had intended.
However, what that means is that we can be assured there is a very serious ring of protection around people so that they are unable to obtain it if they are not fully eligible. The eligibility is, again, that they must be dying within six months, or twelve months for a neurodegenerative disease; that they not only must be capable of saying they desire that but that that be an enduring desire; and also that they must be experiencing suffering they find unbearable to tolerate for which there is no tolerable remedy. I do not know of any legislation around the world that is as tight and as strict as that. So, if ever we are going to do this as a state and as a nation, it is going to be in this form.
I will add the additional reason that we can be more confident that this is the appropriate path, and that is that it is becoming the emerging Australian model, where we have seen, with very minor variations, Victoria, Western Australia, Tasmania and now our upper house consider this legislation, and not at any point weakened safeguards but ensured that they are tight and that people can continue to have confidence in them.
I would for that same reason argue against any additional amendments to add still further tests. We are at a point where it is difficult for someone who is suffering to obtain the relief that they are voluntarily choosing to seek. I believe that any additional barriers put in place to the capacity of doctors, the kind of consideration doctors have to undertake, are moving away from the model and are also creating the kind of barrier that we know will cause suffering to people who are then unable to obtain the relief that they and their loved ones are seeking for them.
Mr PEDERICK: Thank you very much for that fulsome answer. The other point that concerns me is coercion. I know there are some parts of the bill later that talk about coercion and coercive control. I absolutely understand the time lines on the two different terminal illness trajectories—six months or 12 months. The one thing in light of that is that some people can live significantly longer than those forecast time lines. I guess that is something no-one can really forecast, but it is a reality and a lot of people (and, thankfully, I have not had to put up with it) can handle the treatments, whether it be chemotherapy, etc., and some choose not to have that sort of treatment.
It is similar to my first question. I get concerned that some people will believe that they are a burden to society and a burden to their family, even with these regimes of either the six-month forecast time line or the 12-month forecast time line, depending on the illness. My concern is that someone will think, 'Let's just get it over and done with.' They could be a parent, an aunty, an uncle or caregivers, but they do not want them to be burdened, so to speak.
I guess the short version is: do you believe there are enough controls around the potential for coercion? I am sure it is human nature that some people, if they really want to do something, might bluff their way through it. I know this is very serious and that it is not just about bluff; I am not saying that or trying to degrade the conversation. However, people may think, as I have already indicated, that for the greater good they will go out earlier than perhaps they needed to.
Dr CLOSE: I thank the member for Hammond for raising these issues because they are issues raised in the community about this, and it is absolutely right that we should address them in the course of this debate. The two issues you have raised, member for Hammond, are prognosis being inaccurate and the question of whether a person who is dying considers themselves to be a burden and therefore there could be an element of coercion.
To deal with the prognosis to start with, yes, prognosis is not an exact science. I have just consulted with my adviser, Dr Roger Hunt, who is an expert in palliative care, to confirm my understanding. Of course it is not an exact science; it is, however, the job of people dealing with dying, people with terminal illnesses. The experience across the world is that the length of time people are given tends to be optimistic rather than pessimistic.
So, although there will be cases in which someone lives longer than was expected, the likelihood is that the doctor thinks that they will live slightly longer than they end up living, and in any case we are talking about a fairly narrow window of time because the level of experience and expertise that oncologists have in particular, when we are talking about cancer, means that they are pretty good at determining how long and certainly at determining that the person has a terminal illness and is in that last stage of terminal decline.
On the question of the sense in which someone might consider themselves to be a burden and/or experience coercion, the difficulty is that you cannot off your relative through this.
Mr Pederick: No.