Introduction from Michael
Before I share with you my speech during the recent parliamentary debate, some initial thoughts.
I support the importance of personal freedom and responsibility. However, my objection to this bill follows mistrust I have developed toward the promise made time after time that these type of laws will be completely safe. Creating exceptions to laws of murder, manslaughter and suicide are innately dangerous. Of course I also share the concern of the medical community that euthanasia legislation fundamentally damages the relationship between a patient and his/her doctor.
A key foundation of law in Western civilisation is the prohibition of intentional killing. In the sincere but misdirected attempt to end all suffering, that foundation is being undermined and eroded. And if that occurs, we are left with no foundation and no coherent basis to continue to belief in the fundamental dignity of human life.
I have no problem with medically-sanctioned withdrawal of interventions when life is being artificially extended by medicines and machines. However, this is current medical practice and involves family discussion. If this can be practically improved, I would be open-minded to suggestions. The last thing we want is to not utilise medical and scientific advances which can alleviate suffering.
I’ve noticed that the current debate has left people with the impression that people are not being allowed choices in their treatment. Current systems do give people choice. Medical interventions can be and are withdrawn. Advanced Care Directives (eg forbidding resuscitation) are currently legal, but they are poorly enforced and understood. This is why the Government is separately in the process of making a new law for Advanced Care Directives – which I totally support.
To endorse suicide in some circumstances is to lose all credibility when we promote pro-life messages to depressed young people, the mentally ill and those going through life crises such as family breakdown. My point is that suicide is either sanctioned, or it is not. We cannot have it both ways.
I offer my considered view based on a heightened sense of obligation to ensure that the laws of our state respect individual wishes, respect life and protect those who would be vulnerable to physician assisted suicide laws.
Speech to Parliament Friday 4 December 2020
I commend the tenor of this debate and the content and the perspectives that people have very honestly shared with this House. I wish to add to the debate and bring as much meaning as I am able to in the time that is available, and sharing from a personal perspective; importantly, sharing on behalf of the perspective of the people I represent in my electorate of Bass. I feel very privileged and indeed honoured, that I am one of the 25 people of this House who were elected to make decisions about what we believe is best and right and proper. I note that as is the case with every piece of legislation we debate, there are nearly always – if not always – competing priorities at play that need to be balanced up.
I have formed the view after careful consideration, and looking at the provisions of this particular bill, that it is not a good thing for the people of our state. Despite what it attempts to offer, it is bad law for our older people. It is bad law for our young people. This bill is an affront to our attempts to prevent suicide in Tasmania.
I am very familiar with this subject; more familiar with this subject than I would wish. Having been a school teacher in Tasmanian high schools, I am familiar with the subject of youth suicide. For family reasons I am familiar with this subject, and it has been something that I have been committed to throughout my life – and I know members of this House listening to me will share that journey as well.
We are all reaching for the best way to know how we can reduce the incidence of suicide in our state and in our country. It is a real problem for our state of Tasmania. It is a real issue for our entire nation. It is an issue for every jurisdiction, everywhere in the world.
I fundamentally believe that any life lost to suicide is one too many. I have always said that.
I am not representing the Government when I speak right now, but it is government policy that every life lost to suicide is one too many. It is embedded in Tasmania’s suicide prevention strategies. It is an embedded narrative in our work with young people, and empowering a sense of belief that there is always hope for a better future no matter how dark a time a person may be going through.
When I was a school teacher in 1997, I went to a professional development session conducted then by the Wesley Mission in Tasmania. I forget the name of the foundation but it was empowering teachers, social workers and school psychologists to know how to support people who are going through difficult times. It was a very powerful time in my life, as still a very young person and as a fairly new teacher. What made the greatest impression on me, apart from the statistics and the things that you can do to help, was this statement that ‘people who are considering suicide actually do not want to die, they want the pain to stop’.
If we can realise that and grapple with that concept, our interventions can be so much more powerful because we recognise that the person wants the pain to stop. They do not actually want to end their life. They want the pain to stop. If we can assist them with help, real help, if we can assist them with hope, real hope, then the pain can be addressed in a way that is existentially purposeful for them.
I sincerely thank every Tasmanian, in particular from my community, who has contacted me on this vital issue. This question gets everybody talking, and I do not think that there would be many Tasmanians who do not have an opinion on it.
I acknowledge the many politicians and lobbyists who have variously put forward their points of view, including those who have unsuccessfully put forward private members bills in the past. The debates have always been respectful, but at times perhaps adversarial in points of view that do need to be made. I respect that.
I had a good look at yesterday’s Hansard last night, and I picked up a lot of storytelling, emotion, personal views, personal opinions, and experiences. There was some poetry. I had this great sense that all around this Chamber, my colleagues in this House – Liberal, Labor, Green, Independent – we are all reaching for some way to provide a better future for the people in our charge. And here is the point: these people are in our charge.
We have very often heard stories about Tasmanians who have been through unfair, unjust and painful experiences. When you look at those stories, of course you just to want to do something better. This is our obligation, unchanged by whether this bill passes or not. It remains our objective to deliver time-, regional- and person-relevant specific palliative care to support people so that these stories can be avoided.
I will come to Mr Gaffney’s documented collection of stories, ‘Voluntary Assisted Dying Tasmanian Perspectives’, if time permits. One of the perspectives of a nurse who was able to tell her story in this collection made a very clear point – that the stories of some which have been shared were not good medical practice and were not appropriate medical outcomes. That suffering should not have occurred. Was it a failure of the law? This nurse says, ‘It was a failure of treatment.’.
Are we putting the cart before the horse? What problem are we actually trying to solve here? I have been through all my emails. I have read extensively. I have listened to those with the loud voices. We know who they are. I have spent time with people who are marginalised, and those others who have tried, with very limited success, to give the people on the margins of our community some sort of voice in the media and in opinion pieces.
I recognise that the campaign for this legislation has been quite successful insofar as public opinion, it could be said at a superficial level, is in favour of it.
I put forward the view, with great respect, that most people have no concept of the operation of this proposed bill. None. Most people have no concept of how this bill would operate in practice, nor the attempted so-called safeguards and guarantee provisions that have been drafted. I doubt few people have read the bill; they are trusting us as politicians, as their 25 here, who, as I say, are making decisions in their charge.
I believe that is manifest in the debate, because, again – and I say this with great respect – few, if any, of the contributions in this debate so far have gone anywhere near talking about how the proposed bill will operate, and that is most unusual. Nearly always a second reading speech will deal with the detail of the bill. It will discuss how it would work; it will articulate how a Tasmanian could expect it to work for them, and assurances on how certain concerns are being mitigated and risk-managed.
There have been no descriptions of how the act, if it were passed, would operate. Again, as I say, precious little, if any, discussion during the debate so far has been about how people can be prevented from dying early and inappropriate deaths – not captured with the case studies that are so often made as the arguments for these reforms.
I note in the matter of process that this bill has gone in reverse order. It was introduced in the Legislative Council, ordinarily the House of review, which usually reviews legislation that arises from policy made in this House. Having reversed the order, it now falls to this House not just to consider the bill in principle, but in material fact actually to become the House of review in relation to this matter.
There has been a specific absence of the bill development process that would pass as public consultation, if this were a government bill. Sessions happened, yes, but we do not know what submissions were received because they haven’t been released. We have not seen drafting instructions. We have not seen the policy decisions that were the basis for that drafting.
Some members have asked to see those submissions and receive explanations for the variations in the 21 versions of this bill, but those requests have been denied.
Question and answer sessions for members of the Legislative Council have been recorded and placed on the parliament’s intranet, but members of the public cannot access them, and there is a warning message at the bottom of those intranet pages that they should not be shared or disseminated.
I am pleased that, as we approach this issue again in this House, the Premier has acted to ensure this bill achieves the scrutiny and informed expert examination it absolutely needs, and which, in my opinion, is overdue. I welcome the role the university will play and the panel will bring to this process so that members here can unpick the detail of this legislation, its operation and the so-called safeguards so that debate on it in the new year can be more informed.
I also acknowledge with gratitude that the Liberal Party I belong to has a genuine conscience vote on this matter, which has never had to be the subject of repeated questions of journalists to check again and to check again whether our members have a genuine conscience vote. It has always had that when it comes to matters of life and death, and I am very grateful for that.
I am grateful for the fact that in this debate a great deal of respect has been shown to different perspectives, and I would like to bring some of my own: I am a family man; I am from a big family. I think Ms Houston and I may argue over who has the biggest family, but, for that reason, as I approach this question, now for the third time, I suspect I have more brothers, sisters-in-law, nephews and nieces than most others at least in this place. Like every other member here – and I am grateful for the respect you show as you listen to me – we all love our families. We love them dearly; we want the best for them.
When we make this law, a number of people have written to me, asking me to think about how I would want my end of life to be governed. What choices would I want to be able to have so that the decisions I make today as a 46-year-old are not decisions that relate only to someone still in the prime of life, generally healthy and not looking at end-of-life issues personally and to put myself instead in the shoes of somebody who has walked that journey, who has suffered or died an unacceptably painful or intolerable end-of-life period, or a carer who has walked that journey with them?
When I think about that, I think of myself, but, more importantly, I think of my family. I think about what I would want for my beautiful 95-year-old nanna. I think about what I would want for my parents, because we are not avoiding this issue – it is personal. The decision I make as I exercise my conscience vote is not about Michael Ferguson. It is not about his constituency in Bass: it is about my family and it is about all of the constituency in Bass, including the people who want me to vote for this bill and those who are deeply troubled by it.
I have had the special honour of being with two family members when they died. For those who have experienced that, it is really quite difficult to put into words what it means but above all, whether it was a good death or not a good death, it has always been a great honour to think you can be with a person as they depart this life.
I want to say thank you to Mr Gaffney specifically for this book, because while many of the emails and letters Mr Gaffney published, I have also received – I believe all of us have received a number of them – I actually believe that this captures in quite some significant way the human experience of life and death; the family experience and the trauma people find themselves in when they are reaching for something better.
I was particularly moved by one particular story that I will not relate, just to say as I looked through the pages that I found particularly a person I thought I could absolutely relate with. I have such respect for people who have been ill and have been diagnosed with terminal illness, who are asking themselves the very hardest of questions. For us, assuming everyone in this Chamber is not experiencing any kind of serious diagnosis right now, it is just an honour to hear their stories, and I honour their lives.
I want to honour the lives of people who have passed, who are the subject of advocacy for those who want change. I never want them to think that when perhaps those of us who will not vote for this legislation, I want them to know that we do really honour your mum, your dad, we really do. We do not want to set ourselves in opposition to your desires. We would like you to appreciate, with the kind of respect that we are each trying to offer, that we are also reaching for something better for you.
A significant argument central to the case for change has been about personal choice, made by informed adults who are diagnosed with a serious terminal illness, and who are experiencing or want to avoid intolerable pain and suffering. I have to say I think that that is an appropriate argument to be making. I have heard it on quite a number of occasions from members of this chamber.
I have also noticed that those arguing that point of view have not been able to also introduce the other competing values that have to be considered by responsible law-makers, because we are not making laws for those individual circumstances. We are making a law that will be binding on half a million people. Like upholding life. Like ensuring there are weaknesses in any process when you seek to weaken laws around the taking of one life by a human of another and, of course, in the process of assisting in the suicide of another person.
This bill is attempting, as I say reaching, to solve the real problems of mental suffering and physical pain, but it is trying to do it with a law. There is no law that can end suffering. There is no law that can take away pain. There is an acknowledgment, I believe, in the pages of this bill that there is some pain and some suffering that will not be eligible. We cannot address it. We cannot find a way. These problems would not be solved – in my view they would be exacerbated – while those with only small voices in this debate will be overlooked and sidelined again.
An honest assessment of where this leads is confronting. The foundation of law in Western civilisation is the prohibition of intentional killing. In the earnest, sincere, but I believe misdirected attempt to end all suffering, that foundation is being undermined and eroded. If that occurs, we are left with no foundation and no coherent basis to continue to believe in the fundamental dignity of human life. Against the basic human instinct, for example, for legal capital punishment which, by the way, as Mr Ellis so remarkably outlined earlier today, is at least as popular in the opinion polls as so-called “voluntary assisted dying”.
This will potentially be replaced with subjective law, and instead become the subject of future private members’ bills to increase eligibility, which will inevitably occur in the name of antidiscrimination. It will occur long after the sense of feeling good about having done this change to the law in the minds of politicians.
As people who have immense power over the way that people in Tasmania live their lives, we have huge responsibility to not blithely go in – as the saying goes, fools rush in. The laws that we make on the basis of the selection of the case studies, including those with sad and tragic outcomes, are in fact binding not on the select few, but on the whole population. Laws of this parliament are supposed to be about protecting those who have no voice.
As a Liberal, we have a set of beliefs, which I think also help. Our platform is called We Believe. One of them was mentioned yesterday, but not the complementary We Believe.
We believe in social justice, in encouraging the strong and protecting the weak, in widening opportunities for education, in the preservation of family life, in good homes owned by the people who live in them.
You will not be surprised to hear me say I extract the greatest value from our We Believe in social justice is really not about the strong at all; it is about protecting the weak. I have often referred to them as the people with small voices, and this is where we must bring it to a strong argument when you consider the central argument about personal choice.
I am a Christian. I would not say I am a very good one, but I find it interesting that faith and religion has been brought into this debate repeatedly, but usually not by those people who call themselves Christians, like myself. In fact, as I have now debated this issue three times in this Chamber. I looked at my record and I rarely, if ever, made reference to my own personal faith. I do not think I need to, because I am quite naturally disposed to arguing this bill and these attempts to change the law on mercy killing and physician-assisted suicide, around the ethical principles that my world view is as a person, of who I am, including as a person of faith.
My own position is rarely, if ever, expressed in terms of my Christian faith. I have not needed to argue my well-articulated position on this matter from a faith argument, or using religious arguments, but it is interesting that this occasionally is said. I was concerned when Mr Gaffney publicly stated to, I believe, the National Secular Lobby of Australia, and I quote –
All groups and individuals have a right to voice their opinion on any issue; however, no religious group should feel as though they should be able to influence policy-making in Australia.
Why has Mr Gaffney singled out the Christian church in Australia, and yet so much has been made by Mr Gaffney, and others, in support of this bill by bringing in groups who call themselves, for example, Christians in Support of VAD, and other select individuals who have been brought into this debate who are public Christians, and who have a different opinion to myself? They are quoted, and yet earlier we were told that no religious group should feel as though they should be able to influence policy-making.
That is just wrong. Any group should be able to influence policy-making in Australia. What else? This is very normal in this country. Unions and community organisations, political parties, sporting clubs, service organisations, lobby groups that spring up for any number of issues – they are all involved in influencing and mobilising public opinion, and ultimately public policy. I mention this as a double standard that is applied at times, and I find that quite odd and actually not defensible.
Madam Speaker, in the time that I have remaining, I want to bring in a few other contributions from people who have though this very carefully.
I was greatly moved by the recent opinion piece by Professor Ray Lowenthal, AO, and Associate Professor Marion Harris, published in the Mercury. I know Professor Lowenthal and his great work in the Holman Clinic. He is a very respected oncologist in this state who has had a lot more experience, I suspect, than nearly all of us, except perhaps Ms Dow, who I understand from her nursing background – but even with a great palliative care background, no-one could beat Ray Lowenthal. Well, he and Associate Professor Marion Harris say –
In life principles matter. Autonomy is an important principle. But even more important than autonomy is the principle that all human life deserves respect and protection.
So while VAD means voluntary assisted dying, making it sound like a kind act, this is a euphemism that obscures its truth. The American Medical Association maintains that the term physician assisted suicide and euthanasia is the most accurate term for this practice. In this, doctors assist patients to suicide by prescribing lethal substances (physician assisted suicide) or directly administering them (euthanasia).
Australian data shows that physical symptoms such as pain are rarely severe at the end of life despite frequent media reports to the contrary. If specialist palliative care services are available and the patient agrees to use them severe physical symptoms are rare. Only doctors skilled in palliation should be managing complex cases. Stories of past or recent bad deaths are because expert care was unavailable or was rejected.
They go on to say that –
PAS/E (physician assisted suicide/euthanasia) requests are mainly driven by phycological and social suffering. People have lost their sense of self. They can’t do activities that give life meaning and they feel a burden. If concerns are addressed then often some sense of dignity can be restored. Most oncologists in long careers have seldom if ever received requests for PAS/E.
Assisting a patient to suicide is never an appropriate solution to any human problem. It’s wrong to validate the person’s concern that their life is hopeless. PAS/E’s proponents are motivated by compassion but are misguided. Some demand choice and control. Often this is due to exposure to past perceive bad deaths. These concerns are baseless in 2020.
PAS/E is not just about the individual and his autonomy. Doctors, governments and society are all involved. The common good needs to be considered and the vulnerable need protection.
It is impossible to create a system that permits suicide for some but that with ‘robust’ safeguards can guarantee the protection of the vulnerable. PAS/E of course also sends the wrong message to people contemplating suicide and undermines suicide prevention efforts.
Coronial data about suicides of those physically ill have been misrepresented. There is no evidence that most of these wanted PAS/E. Most of these have had undiagnosed and untreated depression with suicidality and its associated high mortality. Most of these did not want PAS/E and many would not have qualified for it. Legal PAS/E won’t prevent these deaths.
So PAS/E is not needed and can’t be safely provided. Our lower house politicians need to step forward and safe the day. In recent years 50 physician assisted suicide/euthanasia bills Australia-wide have been rejected and this bill needs to be the 51st.
As I conclude, I want to again say thank you to Ms Courtney for having the courage of her convictions to move this bill. I do not agree with my friend and colleague on this matter but I deeply respect the way she has conducted herself and I appreciate the sense of mutual respect that we share publicly and privately on this matter.
I am not able to support this bill, not because on this occasion I have agonised over this particular bill. I think the bill is deeply flawed. I have pages I could turn to that raise huge concerns around eligibility and the ability of the potential commission to be able to overturn the usual eligibility rules. I have major concerns about a person with a chronic illness which left untreated with conventional treatment could be easily classified as life-ending within six month, diseases like diabetes and cystic fibrosis apart from the usual like cancer, the big C.
I have major concerns around the very flexible way in which people who should be able to live a healthy supported life can potentially fall into the seductive trap we are laying for ourselves while trying altruistically to provide a better future for people who suffer intolerable pain.
I accept as a politician that while I will not be supporting this particular bill, we have a common duty to do far better with palliative care in this state. I have to say that we are guilty of this. We have failed to take account of inquiries of this parliament dating back I think to 2008 that were calling for advance care directives to be legislated in Tasmania and no government has done it yet.
I acknowledge my good friend the Attorney-General is preparing that bill and I look forward it finally coming forward. If you will permit me, Madam Speaker, I again thank those who have spoken and I look forward to further contributions as well.
