Mr BLACKWOOD — I rise to speak on this piece of legislation, which seeks to make it legal for people to end their life in certain circumstances. I will outline at the outset that I will be opposing the legislation, and I intend to detail my concerns with the bill and why I will be opposing it. At the outset, however, I must explain that I can understand and I have empathy with those who will support this legislation based on compassionate grounds. I believe their position is underpinned by a genuine concern for those who feel they are facing a period of pain and hopelessness that they believe will end in their death.
The position I am taking has been arrived at partly from personal experience, partly from concerns with some aspects of the legislation and largely from my concerns about the potential to undermine the sanctity of human life, something that I believe should always be upheld, protected and nurtured. I witnessed the passing of my beautiful mother, Jean, seven years ago after a battle with bowel cancer. Ten years before Mum died she lost her brother, my uncle, to the same disease. Also, seven years ago my father-in-law, Howard Bloye, a wonderful man, died of old age, and just 12 days ago, on 4 October, we lost our dear dad, Norm, also a victim of old age. In every one of these cases the palliative care they received was fantastic. They were comfortable and not in pain and, thankfully, they died very peacefully. Once again I thank all those who have participated in the care of our family members in each of those circumstances.
In my view, this is a morally sound alternative to the system that would be introduced by this legislation. Indeed the Leader of the Opposition has foreshadowed that if the coalition is elected to government in 2018 it will provide $140 million to increase palliative care services across the state. Ensuring everybody has access to the best palliative care services is a very genuine, effective alternative to voluntary assisted dying.
In considering this legislation we must not just consider the impact on those who may be considering taking up the option of voluntary assisted dying, but we must also have regard to those around them — those involved in the decision and the process both before and after a person has passed. Our doctors, nurses and carers — they are the ones at the front line. There is real concern about the conscientious objection provisions in the bill, and one example of the inadequacy of the bill in this regard has been expressed by Professor Owler, who has said that health services will not be obliged to take part in assisted dying, and yet the bill allows any person to ask any individual practitioner in Victoria to assess them for assisted dying and thereby become their coordinating medical practitioner. A practitioner has only three grounds on which they can refuse — firstly, conscientious objection; secondly, unavailability; and lastly, not being qualified. Therefore any qualified and available practitioner who does not have a personal conscientious objection is obliged to take part in the process, even if they work for and receive the request in a health service that does not wish to take part.
A large number of doctors and nurses have contacted me with concerns about this bill. Professor Jennifer Philip and Dr Jenny Weil provided an open letter from more than 100 palliative care doctors and nurses, and I quote:
As palliative care doctors and nurses we have sat at the bedside of many thousands of people who are dying. We have witnessed the sadness and loss, and at times the suffering of both the people dying and their families and friends.
We are a group of clinicians with considerable experience of this part of life, and feel a responsibility to share our thoughts with the community.
Our message is clear, improving palliative care services is the most effective and equitable way of reducing suffering for dying Victorians.
Additionally, we share three facts:
1. Very few people who we care for when facing death with advanced diseases are interested in euthanasia, in the order of 1–2 per cent.
2. The majority of people who do request euthanasia change their mind when they have access to high-quality palliative care.
3. Access to palliative care in Victoria is currently very patchy, and largely a matter of luck. Access is highly variable and far from equitable. The deciding factors are your diagnosis, your postcode and your doctor. Worse still, our data shows that even for those who are able to access palliative care, they do so too late in their illness trajectory to receive the benefits purported by evidence-based world best practice.
If the voluntary assisted dying bill passes, Victorians will be able to access assisted suicide, yet at the same time many thousands will struggle to access the high-quality palliative care they deserve.
Ready and equitable access to high-quality palliative care is the effective and just response and will benefit all people who are dying in Victoria and their families.
Kylie Draper, the manager of nursing and medical services at Eastern Palliative Care, has also spoken out very strongly in support of her staff. I commend her for courageously acting in the interests of others, and I quote:
I am the manager of nursing and medical services at Eastern Palliative Care and have worked in palliative care for more than 25 years. I supervise and support 56 specialist palliative care nurses across the eastern region of Melbourne.
Specialist palliative care nurses, who will be managing clients accessing VAD and dealing with the consequences of VAD as we work in people's homes, have been barely consulted in relation to this legislation. These nurses were not invited to the initial ministerial panel consultations. Some of them attended a meeting that was run at the Australian Nursing and Midwifery Federation (ANMF) office where they were told what the legislation would look like after all of the other consultations had occurred. This was not a consultation, there was no question time.
The nurses at EPC will conscientiously object to being involved in VAD in any way, yet there is no protection for us. We get called out to clients who need support 24 hours per day — yes, we are on the road when a call comes overnight. We have three nurses on call every night just for the eastern region. Our nurses are the ones who will be dealing with the issues leading up to and after VAD has been enacted. They are the ones providing care before and after the death of people at home. How are we to know that someone is planning to do this? We may have a conscientious objection but will be inadvertently drawn into being involved in the VAD process as we won't abandon our clients before or after death. The promise of the legislation regarding being able to have a conscientious objection therefore is a hollow one.
The media portray VAD as a quiet, beautiful end; the reality is that when family members see the client in distress we will be called. Yes — the draft legislation says we do not have to perform life-saving activities, but we do not want to be involved at all.
Please listen to our nurses who do not feel they are being represented in this debate. Palliative care nurses are the nurses caring for the dying day in and day out and they have many years of experience of what 'normal' dying looks like. They are not being represented by their union in this debate as the union chose a side early on without surveying or consulting the palliative care nurses, who are the ones that care for the dying.
We are happy to care for the client up to the point of them deciding to take the medication and we are happy to care for the family after the death but you are not listening to us or protecting our right to have a conscientious objection to VAD.
Can you not see what the experts are saying? This legislation is not sufficient to protect us or allow us to have a conscientious objection.
In Victoria we have a shortage of palliative care nurses who have the skills required to provide quality end-of-life care. I have had nurses tell me that if this legislation is enacted, they will walk away from palliative care. We cannot afford to lose skilled, compassionate nurses from this important work.
I commend Kylie Draper for being prepared to come forward and tell it as it really is for her nurses and what they may be faced with if this legislation does come to be.
The Catholic bishops of Victoria, the leaders of Christian churches and other religions have also united in publicly expressing their opposition to this legislation. Indeed the Australian Medical Association and the World Medical Association maintain that doctors should not be involved in either assisted suicide or euthanasia.
Sitting suspended 6.30 p.m. until 8.02 p.m.
Resumed (20:01:59) —
As I was saying prior to the dinner break, I was about to quote from a pastoral letter that a Catholic bishop sent to their congregation recently. I quote:
Many proponents of this change in the law are motivated by compassion. While it is never easy to face the end of life of a loved one, assistance in our time of dying is something that we should all want for ourselves and for others. However, this should not involve dispensing and administering medications intended to kill people.
No 'safeguards' can ever guarantee that all deaths provided for under the proposed laws will be completely voluntary. Whether because of carelessness, error, fraud, coercion or even self-perceived pressure, there will always be a risk. Victoria abolished the death penalty because we learnt that in spite of our best efforts, our justice system could never guarantee that an innocent person would not be killed by mistake or by false evidence. Our health system, like our justice system, is not perfect. Mistakes happen. To introduce this law presuming everyone will be safe is naive. We need to consider the safety of those whose ability to speak for themselves is limited by fear, disability, illness or old age.
More care — not euthanasia and assisted suicide
This bill comes at a time when not all Victorians have equal access to the highest standards of care that we can provide. The care of our elderly is failing in some critical ways and elder abuse is a growing, although often hidden, phenomenon. Surely these matters — not assisted suicide — should be the focus of our government's attention.
There is clear evidence that most people who seek assisted suicide do so from fear of what lies ahead — not because they are experiencing unmanageable pain. Anxiety about being a burden influences many people. It will be a tragic injustice if people opt for state-endorsed suicide because access to adequate emotional, psychological, spiritual and physical care is not available. For many people this is the reality.
The Catholic community does so much to care for people through our network of hospices, hospitals, aged-care facilities and other services.
We are grateful to the Catholic community and all people of goodwill who serve the frail, elderly, sick and the dying. We ask everyone to continue to journey with those who are dying: visit them, ensure they have appropriate care, support them, offer appropriate pain relief and, most of all, remain close to them.
We ask Victorians to continue to love and care for those who are sick and suffering rather than abandoning them to euthanasia or assisting them to suicide. Our ability to care says much about the strength of our society.
As Christians we are encouraged to do our very, very best to uphold the values of respect, love and forgiveness. If we succeed, the vulnerable, the disabled, the sick and the elderly in our society will always be safe. As has been said, our ability to care says much about the strength of our society.