Euthanasia Bill speech

On September 22, 2010 WA parliamentarians voted against Robin Chapple's Voluntary Euthanasia Bill 2010, a Bill for an Act to provide for the administration of voluntary euthanasia.

11 MPs voted for the Bill and 24 voted against.

Information about the bill and safeguards.

THE PERSON SEEKING TO END THEIR LIFE MUST:

    • Be of sound mind
    • Be at least 21 years of age
    • Have a medically diagnosed terminal illness that will cause their death within 2 years of the date on which their request for euthanasia is made.
    • Be experiencing pain, suffering or debilitation that is considerable and related to the terminal illness.
    • Be a resident of Western Australia, and having been a resident for at least three years prior to the application for euthanasia.

    THE APPLICATION MUST:

    • Be made in writing, in the form set out in the Bill.
    • And be witnessed by 2 independent and unrelated people.

    MEDICAL PRACTITONERS

    • In order for an application to be progressed, it must be referred first to an independent medical practitioner, who becomes known for the Act as the “applicant’s medical practitioner.”
    • The applicant’s medical practitioner must ensure the person is aware of palliative care options and the availability of counselling and other support services before assessing the request.
    • The applicant’s medical practitioner and another independent medical practitioner must then assess the request
    • These independent medical practitioners must ensure the person’s request is not wholly or substantially attributable to a state of clinical depression.
    • These independent medical practitioners must also ensure the person’s request is not wholly or substantially motivated by a desire to cease to be a burden, and that they have made the request voluntarily.
    • The applicant’s medical practitioner and a third, new independent medical practitioner must be present at the time of the administration of euthanasia.

    OTHER SAFEGUARDS

    • A person may revoke their request at any time.
    • A person’s request lapses immediately the applicant’s medical practitioner concludes an applicant has ceased to be of sound mind.
    • Medical practitioners, witnesses and any others involved, provided they comply with the Act, will not incur any criminal or civil liability.
    • A person who does anything required or permitted under the Act, forfeits any direct or indirect financial or other benefit that would otherwise have come to them as a result of the death of the applicant.

For more information and to see a copy of the entire Voluntary Euthanisia Bill 2010, please go to Robin Chapple's website here.

Lynn's speech can be viewed here:

[COUNCIL - Wednesday, 22 September 2010]

HON LYNN MacLAREN (South Metropolitan) [5.50 pm]: I rise to support the bill. I acknowledge the many
people who have been here over the past two days in the public gallery, demonstrating their concerns for both
sides of the debate no doubt. I also express my appreciation to all those who have written so many letters and
emails to us expressing their views and sharing parts of their lives with us to enable us to make wise decisions. I
note that, as was very eloquently put the other night, the opportunity to effect significant policy changes does not
come up very often. I think that this is one of those opportunities, and I thank Hon Robin Chapple for providing
us with the opportunity to be able to look at one of those really serious questions in life and reflect on it and try
to make wise decisions.

In providing my statement of support for this proposed legislation to facilitate voluntary euthanasia in Western Australia, I also want to respond to some of the comments that have been raised over the past two days. Like many members, I have had quite a few letters and quite a few emails that are opposing the idea of euthanasia, onthe grounds that it is apparently “killing” someone. With very few exceptions, I can summarise these emailsbriefly: life is precious, pain and suffering have a purpose, and legal safeguards cannot be relied upon to protectthe vulnerable. That is how I sum up those messages.The letters in support of euthanasia, with very few
exceptions, are detailed explanations of personal experiences that are complex, real-life situations. Many
members may have received this email. I want to read it into Hansard. I sought the permission of Chele
Wickramasinghe to read it in, because I think it illustrates the very complex situation that we are dealing with. It
reads —

Hi Lynn
I am writing to let you know that I am 100% behind a euthanasia bill being passed. I think it’s totally
archaic that people don’t have control of their lives in situations where there is no hope. Anyone
suffering a permanent disabling or terminal illness and/or no quality of life should be able to decide
they have had enough and pick the time and the place for a dignified ending. You’d be in court if you
let animals suffer the way humans are left to suffer. Everyone doesn’t have to make use of it, but
everyone should have the option. It’s time for politicians to make this possible.
I missed seeing my mother before she died of cancer. She lived in Sydney and I was living in
Melbourne with a toddler, so it wasn’t easy for me to just up and travel. If she had had a choice of when
her life should end I could have known when the time was and been there to see her. I never got to say
goodbye and that will haunt me every day of my life until I lose my faculties.

My sister is in an institution in another state with early onset dementia. I know it’s not what she wants.
She and I both have the Huntington’s disease gene which means that we will both one day be
vegetables. As we both share this gene we have had numerous discussions on the subject of euthanasia.
I know it’s what she would want. Sadly she has been dealt a blow of a double whammy of getting
dementia before the Huntington’s and will be stuck in an institution until she dies who knows when.

She is only 58.

Having the Huntington’s disease gene, although I am perfectly all right now, I know if something else
doesn’t take me beforehand, I will end up a vegetable and unable to take care of myself. There is no
way I want to be alive when I am unable to look after myself and I certainly don’t want to waste my
children’s inheritance by being placed in an institution with no independence to be spoon fed food
which has been specially prepared to prevent me choking and to be washed by the people and all my
dignity taken from me.

I am certainly hoping a choice of euthanasia is available when my time comes. Please make it possible.
Kind regards

It is apparent from my research that should this bill come into effect as a law, it will make a world of difference
to a very small number of people, and for those who oppose the changes it would bring about, there would be no
discernible difference in the life that they lead. Those who oppose euthanasia never have to take up that option.

They might never need to use it, but to deny another human being who has suffered for any length of time the
right to die in peaceful circumstances, I say lacks compassion. Death comes to each of us. It may come like a
thief in the night, or meander like a slow-moving river, slipping underground and then breaking the surface,
rushing over stones on a steep decline. It may peel back the layers of consciousness until nothing but awareness
in itself remains, or it may linger years on end, painfully in sorrow. Death comes to each of us, but we may have
a choice of how to meet it.

Framing my own views on the matter, I reflected, like many other members, on cultural ideologies and my own
personal experiences, and they are very similar to Hon Col Holt’s experiences that he just shared with us. In
looking at cultural ideologies that we are surrounded by, there are some home truths, such as everyone dies.
Religions and philosophical traditions evolve to make meaning of life and to find ways to address the simple
truth that everyone dies. One of the questions being posed in the debate is: what is the quality of life and how
does that affect death? Christians hold a wide range of positions, and we have heard that from many speakers
regarding end-of-life matters, but I felt that to quote from an email received from Reverend Ken Devereaux
would be helpful at this stage, to present one of the views of Christians. Again, I have sought his permission to
include this in Hansard. It reads, according to my notes —

Whilst many Christians take the traditional view of affirming the sanctity of life in such a way that we
can never contemplate allowing someone to deliberately and legally end their own life, I would like to
suggest that the God-given responsibility we have for ourselves and one another can be understood to
give us the scarey freedom and responsibility to consider compassionately providing responsible
mechanisms whereby someone can decide to bring their life to an end in a caring, safe and respectful
manner.

The reverend has quoted Andrew Dutney’s book Playing God: Ethics and Faith from HarperCollins. He wrote
that it made a helpful introduction to a range of Christian positions regarding the sensitive use of decision
making. I would like at this time to reflect upon my own personal experiences and how they relate to this. I am
very well versed in the Christian tradition. Having been baptised and christened in the Episcopal Church, I was
delighted to hear from Hon Philip Gardiner that most members are in favour of this type of legislation. I was a
star pupil at Sunday school at St Christopher’s in Wichita, Kansas. I delivered homilies from the Pope at St
Timothy’s Church in Apple Valley, California. My spiritual education is ongoing, and it has included studies in
other faiths and other practices, including Buddhism. One enduring lesson for me is compassion. Alongside my
mother I cared for my dying father, with the support of home hospice care in his final months, as cancer ravaged
his body and his mind. My father may never have chosen euthanasia for himself, and I would ever defend his
right to make a choice to fight to the last end of his breath. Having been so close to this experience, I, however,
want the right to make this my own choice should I find myself in circumstances in which it is possible.

When Hon Robin Chapple sent us this bill, I did a bit of research and looked around. I met with Chief Minister
Marshall Perron when he visited us in August. I learnt from his experience about how was able to manoeuvre a
bill through a very conservative Parliament because of his very compassionate and rational treatment of a subject
that was affecting all the members there. I really appreciated the fact that Marshall Perron was able to visit us to
offer his wisdom and his experience in our decision making. I know that other members here also took that up.
Because my mother has now relocated to Oregon, it was of particular interest to me as she is now getting a bit
older. I do like to know what is happening in Oregon as far as hospice and palliative care go. As members all
know and will have been advised, Oregon is one of the places that have voluntary euthanasia legislation. It is
also important to know that hospice care in Oregon is rated as one of the best in the United States of America.

The physicians in Oregon have attributed their act to an increased knowledge in palliative care. More than any
other state in the USA, Oregonians suffering from terminal illness are dying in the comfort and security of their
own home with the aid of hospice care. A study was specifically aimed at doctors’ attitudes about, and
experiences with, end-of-life care since the enactment of the Oregon act, which put in place voluntary euthanasia
laws 10 years ago.

Although voluntary euthanasia is illegal in Australia now, there are other jurisdictions that have
precedents for maintaining some kind of legal structure for voluntary euthanasia, and Oregon is one of those
areas. In the state of Oregon, physician-assisted dying has been in place for 10 years. Every year there is an
annual report to the legislature. This report indicates that it is not a slippery slope with lots more people joining
every year; in fact, only one-third of the people who went through the assistance safeguards and procedures and
received the drugs actually used them in 2009. It is important that the use of euthanasia drugs in Oregon is
reported to the legislature annually; therefore, there is some method of scrutiny of how the system is working. I
note also that the provision for regular reporting is included in this bill.

I will make a couple more comments about the system in Oregon. I believe it was Hon Brian Ellis who raised
concerns about doctors and how they would be impacted on by this legislation. Members may even have seen on
the news tonight before they returned to the chamber that our Minister for Health commented on his own
practices as a physician and the administration of pain-relieving drugs to terminally ill patients. The study in
Oregon that I am referring to was aimed at doctors’ attitudes towards and experiences with end-of-life care since
the enactment of that act. It concluded that rather than the availability of the drugs for physician-assisted dying
diverting attention from efforts to improve care for the dying, Oregon doctors who treated the dying had
endeavoured to improve the ability to treat those patients. A statutory authority, the Pain Management
Commission, was established to administer pain management education programs for licensed healthcare
professionals who treat patients with chronic or terminal pain. Not only is the system improving health care and
palliative care, but also it is working to reduce the number of people who might initially want to access voluntary
euthanasia, because they end up passing away before they use the drugs that they have obtained.

I want to make a couple of points about the Netherlands, which many members have mentioned at various
instances. I believe Hon Robin Chapple will explain the Dutch system in some detail, but I think it is worth
noting that after many years of voluntary euthanasia being in place in the Netherlands, the Parliament and the
citizens of the Netherlands continue to support that system. They still think that it is worthwhile to pursue a
system that provides that kind of assistance.

They have the most transparent reporting of any of the systems that we know, which is why there is so much
evidence about how well the system is or is not working. Only one study in Australia was designed specifically
to replicate the information that is gathered in Holland. The study by the Centre for Human Bioethics at Monash
University was published by The Medical Journal of Australia and found that the incidence of Australian doctors
ending life without the patient’s request was five times higher than in the Netherlands.

I too am a Peter Singer follower. The history of Peter Singer’s thoughts on voluntary euthanasia is chronicled in
various texts. The text I will quote from today partly identifies what we are not looking at, along the lines of Hon
Sally Talbot who very cleverly outlined exactly what we are not doing by passing this bill. Peter Singer breaks
euthanasia into three types: voluntary euthanasia, when a person is cognisant and aware at the time and chooses
this option; involuntary euthanasia, when a person is not cognisant and aware but has at some time indicated he
wishes to die and the action is carried out only to cease suffering; and non-voluntary euthanasia, which is, of
course, an ethically controversial situation when the person is no longer cognisant or aware and cannot make a
choice. Neither of the last two situations is what we are talking about. Quite a few safeguards in the bill protect
us from going anywhere near those two choices.

Finally, I will quote from Peter Singer’s Writings on an Ethical Life, which reprints part of the “Justifying Voluntary Euthanasia Essay from Practical Ethics” and states —It may occasionally be right to prevent people from making choices that are obviously not rationally based and that we can be sure they will later regret. The prohibition of voluntary euthanasia cannot be justified on paternalistic grounds, however, for voluntary euthanasia is an act for which good reasons exist. Voluntary euthanasia occurs only when, to the best of medical knowledge, a person is suffering from an incurable and painful or extremely distressing condition. In these circumstances, one cannot
say that to choose to die quickly is obviously irrational. The strength of the case for voluntary
euthanasia lies in this combination of respect for the preferences, or autonomy, of those who decide for
euthanasia, and in a clear rational basis of the decision itself.

That quote goes some way to addressing the concerns raised by Hon Col Holt. The bill provides legal clarity for
practices that are already occurring. Every year, through the relief of pain and suffering, many people in Western
Australia experience euthanasia and no legal action is taken. This bill provides a framework to protect those
people who practise euthanasia. I draw members’ attention to clause 5, “No obligation”, which means that any
unwilling ancillary staff, such as nurses, which Hon Brian Ellis mentioned, can opt out of any of these actions.
There is an explicit clause stating that anyone who is at all concerned about it can opt out and there is no
compulsion or obligation for that person to be involved.

Members have spoken about the importance of whether the public supports this legislation. It is important to me
and that is one of the reasons I am supporting the bill. A study on euthanasia by Newspoll shows that 85 per cent
of Western Australians are in favour of euthanasia laws and that 92 per cent support it nationally.

I seek leave to table that document.

Because I am always curious about how statistics are used and the important thing is
what question was asked, not only how many people were asked, I will read the question asked by Newspoll —
The next question is of a sensitive nature but your honest answers are important to us. Thinking now
about voluntary euthanasia. If a hopelessly ill patient, experiencing unrelievable suffering, with
absolutely no chance of recovering asks for a lethal dose, should a doctor be allowed to provide a lethal
dose, or not?

As we know, the answers to that question were overwhelmingly in the affirmative.

The bill will put in place a system with very sound safeguards. To make a request for the administration of
euthanasia, a person must be a competent adult over 21 years of age and he must have been resident in Australia
for three consecutive years. We talked about the state of mind of the patient. If a patient’s motivation is driven
by depression or anxiety, they are not eligible to seek voluntary euthanasia through this bill. An applicant must
be fully assessed by two different medical practitioners on two separate occasions with 14 days in between. Hon
Michael Mischin indicated that there was no cooling-off period. I suggest that that may have been erroneous.
There is that 14-day period between one medical practitioner examining a person and a second medical
practitioner examining the person. In other jurisdictions that can be as short as nine days. I think 14 days is a
good solution.

Hon Robin Chapple: Can I just correct you? Two medical doctors assess you, then there is 14 days and you are
assessed again.

Hon LYNN MacLAREN: That is even better. In either case, there is a 14-day cooling-off period in between
medical assessments.
Another reason I am supporting this bill is that the importance of palliative care remains, even with this bill. I
note that many people who wrote to me to oppose the bill were strong advocates of a well-resourced palliative
care system. I entirely support this. In fact, under this bill the applicant must be fully informed of all medical
options, including palliative care. Palliative care will meet the needs of many more dying patients than voluntary
euthanasia. There are, however, a number of degenerative illnesses that condemn an individual to a traumatic,
humiliating death in which nothing can be done to relieve the suffering. It is for this group that voluntary
euthanasia advocates compassionate law reform.

We also argue that the possibility of taking control in the late stages of a terminal illness will provide great
comfort to the elderly as well as to the people with illnesses that are technically terminal but only fatal after very
long periods. They will know well in advance that they have the capacity to take control if they need to, even
though, statistically, we know from places with lawful voluntary euthanasia that the vast majority of those who
would consider asking for voluntary euthanasia will end up dying without needing it. That is why I illustrated the
evidence that we have from Oregon. Despite the best palliative care in the world, we know that 25 per cent of
late-stage cancer patients experience moderate to severe suffering. Other diseases can cause equal or even more
profound suffering. Palliative Care Australia, the Australian and New Zealand Society of Palliative Medicine
and the Australian Medical Association have all acknowledged that not all of their patients can be helped.

Palliative care has strengthened in the jurisdictions in which voluntary euthanasia laws are in place. I note that
situation particularly in Oregon, in the Netherlands and other jurisdictions. Let us not forget that due to the
experience in the Netherlands, the neighbouring countries of Luxembourg and Belgium have also embraced laws
of this nature.

The rights of people who do not choose to take up the option of voluntary euthanasia are still supported by this
bill. I point again to clause 5 “No obligation” which states —

No person may be compelled to do or omit to do anything …

We have provided safeguards for those who may want to take up the path. It does not affect those who choose
not to take up the path. It is just an option for those few people who may wish to take it. It will be their own
choice. I, myself, have noted that, at any time, a person can withdraw his or her request and say, “No; I have
changed my mind; I want to keep going.”

Several speakers have listed what the bill does not do among the reasons they would oppose the legislation. In
fact, some have gone to1 great length to describe what the bill does not do. For me, that is not a reason to oppose
the bill. Let us look at what the bill does; let us look at what we can do. For those very few who would be
eligible and those who would choose to go down this path, we can provide a stable and supportive structure to
take that step. I agree with Hon Sue Ellery; she was the one who said, “How I die is just as important as how I
live. It is right and proper that the state does not stand in my way. It is not right for the state to turn a blind eye
and put family members at risk.” We are obligated to provide some protection. I cannot, in good conscience,
deny people a right to face death on their own terms should they choose to; therefore, I support this bill.