Consent To Medical Treatment And Palliative Care (End Of Life Arrangements) – Amendment Bill
24/11/2010
The Hon. K.L. VINCENT (21:12): I rise briefly to make my contribution to this debate. To begin, I would like to thank the Hon. Mark Parnell and Steph Key MP, member for Ashford in the other place, for hosting an information session on the topic of voluntary euthanasia some weeks ago. I would also like to thank the Hon. Dennis Hood and Tom Kenyon MP, member for Newland in the other place, for hosting a similar session here at Parliament House.
I thank the Hon. Mark Parnell for acknowledging my presence at his information session in his closing remarks. If I recall correctly, he referred to me as a new member of the Legislative Council who takes their job very seriously, and if I may flatter myself for a moment, I would say that the Hon. Mr Parnell is indeed correct. I do take this job very seriously and consequently I have not entered into my consideration of this bill lightly, particularly since it is a conscience vote.
I recognise that voluntary euthanasia is a very controversial and emotive topic and one that is often heavily interwoven with religious and spiritual beliefs. I myself am indeed a woman with religious and, moreover, spiritual conviction. In fact, I believe that I have one of the closest possible relationships to God and, if I may, I would like to take the opportunity to thank him for his guidance. He knows that I love him dearly and I believe that no matter what the outcome of this debate, our relationship will not be made weaker.
If the truth be told, I have spent more than one sleepless night—literally—debating this bill in my mind. I know that no matter which way I speak or vote, I will disappoint many people and I would not be surprised if delivering this speech should prove to be remembered as one of the most difficult things I do during my term in this chamber. However, at the very least, I have worked very hard to come to what I believe is the right decision for the citizens of this great state in which we live, and I ask members of the chamber and members of the public, regardless of their own views, to try to respect that.
I speak in support of the Mark Parnell/Steph Key bill for a variety of reasons, which I will now do my best to outline clearly, although it might not be so easy given my emotive state. Although I am not following the party line, so to speak, on voting on this bill as d4d do not have a specific policy regarding voluntary euthanasia, it is known to all in this chamber that our motto is ‘Dignity through choice’. So, to put it simply, I believe that those wanting to end their life for the right reasons should have that choice.
However, I cannot possibly emphasise strongly enough that it must be an informed choice that is ultimately made by the person who is the subject of the VE request. This is fundamental to the concept of voluntary euthanasia. Of course, I am not saying that a person should come to this conclusion in complete isolation. It is only natural that one should consult one’s friends and family regarding issues as intimate and interpersonal as this. But, at the end of the day, it must be the person requesting euthanasia who drives the process.
It is important to note also that a person making a request for voluntary euthanasia must be assessed by at least two doctors: one, the GP they visit when making the original request; and, secondly, a medical practitioner who specialises in the condition which the subject of the request claims is making their life intolerable for them. Both doctors must inform the requesting person of the palliative care options available that may be used as an alternative to ending life. These doctors must also make reasonable inquiries to ensure that the requesting person is not acting under duress, inducement or undue influence, for instance, the belief that they are a burden on their family. These points in the bill give me some comfort as I am acutely aware of some concern in the disability community that people with disabilities may choose to end their life so as to no longer be a burden on their families in terms of their need for personal support.
I note with some relief that, if the doctors involved in the VE request suspect that the person is in fact acting under these external pressures, the person must then be referred to a psychiatrist, who will assess their mental and emotional state to help ensure that they are making the request for the right reasons. I must say, however, that I desperately hope that anyone considering ending their life would be consulting a mental health professional in any case, and encourage them vehemently to do so.
It is important to keep in mind that under this legislation a person must be an adult, that is, over the age of 18 years, and certified as being of sound mind in order to be eligible to make a request for voluntary euthanasia. The request practitioner must also certify that the person who is subject of a request is able to understand the nature and the full implications of that request. This will protect people with intellectual disabilities, for example, those whose disabilities affect them in such a way that they cannot fully understand the nature of voluntary euthanasia. If somebody has the capacity to understand, then in my opinion they should be empowered to make that choice. Again, this bill seeks only to offer voluntary euthanasia as a last resort, available only to those who are able to make a truly informed and self-driven choice, people who are dying or people who believe their lives to be intolerable.
I now move to what is for me the most contentious part of this bill. The Hon. Mr Parnell and Ms Steph Key have made a decision I can only call courageous and gutsy to extend the eligibility for voluntary euthanasia beyond those in the terminal stage of a terminal illness. If this bill should pass, which I admit I do not expect will happen now, it would also make VE available to people with a medical condition which they consider to be mentally, emotionally or physically intolerable. It has been pointed out to me on more than one occasion—although I am already very aware—that under this section of the bill I myself technically could choose to end my life using voluntary euthanasia due to my cerebral palsy. Although I recognise that it may be somewhat emotive and even inappropriate to use my own personal circumstances as an example, I can see that this is in fact true.
Under this bill a person may choose to end their life due do a disability, and I will admit, of course, that this has been somewhat alarming and, to a certain extent, offensive to me. When I first realised that a person may request VE due to a disability under this bill, I found myself thinking: is my life worth less than average purely because of my disability? Is my life really that difficult and am I really a source of pity? But I had become far too subjective in my thinking.
I have already spoken in this chamber on several occasions about my belief that my disability is a blessing in my life. If I did not have it, I would not be here today. I feel that I have lived many lives, particularly for someone of 22 years of age, and have achieved many dreams, both in spite of and because of my disability, and I am sure that I will go on to achieve many more. Therefore, it goes without saying that I believe that the answer to the question is my life worth less than average due to my disability is a definite no, but I say this speaking only from my own perspective.
I can only ever know what it is like to live with my exact, unique case of my disability and in my body and in my mind. Yes, there are fleeting times in my life when my disability causes me some frustration and even sadness, but I cannot see a future in which this would ever cause me to want to end my life, but that is only my story. Pain and suffering are very subjective things, and though I would do all in my power to help someone with a disability who was considering ending their life because of it to see that there may be other options, at the end of the day I can never live in their skin and it is not up to me to say that their life is either tolerable or intolerable.
Although I have been a supporter of the concept of a well-informed, well-monitored voluntary euthanasia scheme for some years now, I will admit that this section of the bill has made it a lot more difficult for me to come to the decision to support it. I find myself wondering: if I oppose this bill on the grounds that I am fearful that people may choose to end their life due to a disability, am I protecting them or am I, in fact, discriminating against them? Again, I must do all I can to remain objective in my deliberation.
I have been contacted by numerous people who either have disabilities themselves or care for or love someone with a disability and who speak to me of that same fear that some people with disabilities may choose to end their lives using VE due to the negative effects of not having adequate disability supports. For example, living in an inaccessible house. I, of course, appreciate these concerns and put on the record in the strongest possible terms that I believe that this is yet another reason for the government to stop sitting on its hands in terms of efficient and adequate disability service provision.
While some may see this as a reason to oppose the bill, I believe that this bill will not lead to a greater number of people with disabilities banging down the doors of doctors for I believe that the will to live is strong in all of us, as many members have already touched on. We have not seen thousands of people taking up VE in the Netherlands or Oregon. Of course, there may be some individuals who consider their life to be intolerable because they do not have access to services, and I would encourage those people to put the government to notice, to let them know that I am here to stand for them, but, ultimately, it is not up to me to deem their life tolerable or intolerable.
Mr President, I am sure that I do not need to explain to you or anyone in this chamber that it would be a shame, an unspeakable shame on the government and the entire history of this country if people with disabilities were to start expressing an intention to end their lives in order to get the government to sit up and listen. This would yet again perpetuate the idea that this government seems to find it acceptable that people with disabilities have to beg, fight and scrounge for so-called services which the majority of people take for granted as simple human rights.
One has to wonder how many reasons for change the disability community has to present before the government will respond with more than a few crumbs. I put it to the government yet again that immediate action must be taken to improve the lives of people living with disabilities. However, I cannot rightly express how insulting it would be if the government stepped up to the plate simply because it feared people may die and not because it is and always has been a basic human right to access these services.
I do believe in the sanctity of life but, over the past few years, I personally have come to understand that there is perhaps some difference sometimes between a true life and a mere existence. This is again a very subjective and complex belief so I will not go into every detail. Yes, I believe that life is a great gift, as long as it is full of growth and joy and all of the energies that make it so. However, I do not wish to condemn any person to an existence in which all of this energy, so to speak, is gone, unless they wish to hold onto it for their own personal reasons.
I think it is important to mention also that I believe this bill does more than to allow the peace and dignity of the people who want to end their lives using voluntary euthanasia, but also their families. Just the other day I was speaking about voluntary euthanasia with a very dear friend of mine whose mother died of cancer some years ago. He said to me, and I paraphrase, ‘Watching her pass away naturally was awful, but thank God she didn’t ask me to do it because I would have had to.’
Although I have been fortunate enough never to have found myself in this situation, it does resonate with me enormously. If someone I loved dearly were dying or were adamant that they wished to die, for the right reasons, I would not want to let them go under any circumstances. This is only natural. However, physically, emotionally, and perhaps even morally, at some point in time I would have to let them go.
So I personally would rather it be under the circumstances and at the time which they deem appropriate and in accordance with their own wishes. No person should ever have to live with the unimaginable pain and guilt that must come from being asked to end a loved one’s life and, worse still, feeling obligated to act on that request.
As I have already said, it has been a great struggle for me to come to this decision and I feel as though I have outlined my point of view as clearly as I can without becoming emotive—although, clearly, I wrote that part of the speech before I did, in fact, become emotive. To be honest, I feel that I am doing something that is against my beliefs either way I vote today, but I will conclude by saying that if I believe in the human right to a dignified and peaceful life that is driven by autonomy and choice, then I must vote for the rights of South Australians to a peaceful and self-driven dignified death.
