Voluntary Assisted Dying Bill 2016

Roger’s Second Reading speech on the Voluntary Assisted Dying Bill

Mr JAENSCH (Braddon) – Madam Speaker, I believe every person here today, every person we represent and every person following this debate wants to relieve the suffering of people who are dying.  We are all going to die.  I believe we can all agree on these couple of starting facts and I think that Dying with Dignity, the AMA, palliative care providers, our churches and our families all agree on these things and they all want this for our people.  We owe it all those people to leave here today with something decided that takes us closer to achieving that for more people more of the time.

There are many things that contribute to a person’s comfort and dignity and sense of control when they are dying and their chances of having what I have learned is called a ‘good death’.  One of those things is early diagnosis of terminal or life-threatening conditions.  Access to good advance care planning that means something, as early as possible, is another and gives people a sense of control over what is going to happen to them.  Quality palliative care in all its forms and stages, again commencing as early as possible, is another, and pain management through medication and other techniques is another.  For example, I have learnt about techniques of delaying or frustrating the formation of pain pathways in the brain that are part of the new evolving science of palliative care.  It is a fascinating field and is changing all the time.

Importantly, another factor that contributes to a person’s chances of experiencing a good death, on top of all these other things, is the character of that person, the skill of their carers, the love of their family, their faith and their values.

Equally, every person is unique.  Every death is different and no treatment is perfect.  There are gaps and deficiencies in every case and every stage of even the very best care and there always will be.  I believe everyone involved in the care of people who are dying would agree, and there are people in Tasmania who are suffering terrible deaths, despite the best that we can do.  It is our responsibility as a parliament and as a society to always try to do more.

I am convinced that a significant proportion of the Tasmanian community that we represent genuinely wants us to examine how, not if, we can offer safe, legal, voluntary assisted dying to address those cases of suffering that are beyond the capabilities of our best pain management to control:  not as an alternative to good palliative care, but because we cannot offer anything better to relieve their suffering.

Importantly, for this debate when we understand this want properly we see that the request for assisted dying comes not because people want to die, but because they want to end their suffering and nothing else we can offer will do it for them.  To me, and I am not a lawyer and you are, this sounds very much like the dilemma faced by the doctor providing pain management with the intent of relieving suffering, but the effect of also hastening death.  No one wants death for the death; they want relief that only death can bring.

Regardless of our personal conscience, our faith or values or what we want for ourselves, as parliamentarians we need to respect that tragic reality and respond to it.  The problem is this bill will not achieve that today for the very practical reason that it will not be passed.  Not enough people will vote for it.  It does not have the numbers.

Ms White – They haven’t been tested yet; it is a bit early to say.

Ms O’Connor – You could actually do something about that if you support it.

Madam SPEAKER – Order.

Mr JAENSCH – Why?  Why will this bill fail?  I believe for the same reasons this bill and versions of it have failed before, and some new reasons.  It is the 2017 version of a bill introduced in 2009 and then again in 2013 and most lately in 2016.

Ms O’Connor – It’s very different from the 2009.

Madam SPEAKER – Order.

Mr JAENSCH – It was sent to a committee in 2009, which the proponents labelled as a cynical exercise.  It has changed over time in its title and its key clauses and it has picked up, sensibly, developments from other places like Quebec as it has gone on.

Ms O’Connor – Canada, most specifically Canada.

Mr JAENSCH – Canada, and Quebec being part of Canada.  It has become a little bit like grandpa’s axe.  It has had two new heads and three new handles, but it is the same axe and despite this it keeps failing to get up.  It is not changing the minds or the votes of people who need to support it.  It has a couple of other worrying features that diminish confidence in it for those who might otherwise be supportive.

One is the issue of drafting errors.  I understand and we are told, and I believe because of the labelling on the thing that it has been to the Office of Parliamentary Counsel, but I am sure the version that we are looking at has not.  There are upwards of 20 errors in this that make this bill hard to read and I am surprised that I am the first person here who has raised this today.  This bill does not refer internally, consistently at all and it is hard work to follow through.  That, to me, says this bill is not polished, not ready, not checked enough and that erodes confidence in this bill for me.

I also sense that there is an issue if not of mission creep then of communication between the proponents and their supporters and those who have been lobbying MPs like me.  Over the last several weeks I have received hundreds and hundreds and hundreds of emails, letters, faxes and phone calls from people who are supporting this bill, and others who speak against it.  Many of those supporting are asking me to support it because it is for people at the end of life with terminal illnesses and it will help them.  Even those who follow the same formula for support in their own words, but the same phrasing and the same points are talking about this for reasons that are not reflected in the bill any more.  This has become the biggest challenge for this bill.  It has become the mission of getting voluntary assisted dying up as a principle.  We have reworked the same vehicle for that several times over, to the point where some of the debate has become meaningless.  Those who have championed it – and I take my hat off to them, honestly – have not been able to find yet, over the past three episodes of this evolving bill, a compelling new reason for successive parliaments to see it as something new and to take the arguments on in a new context.

The last time there was a real inquiry into the need and purpose of voluntary assisted dying in Tasmania was 20 years ago.  I believe it is probably time to go back to what we all agree on, what we are trying to achieve and where this bill or elements of it fit, just as they did in Victoria recently and in Canada, which we are trying to emulate.  On this basis I move –

The bill be amended by leaving out all the words after ‘that’ and inserting –

‘That the bill be referred to the House of Assembly Standing Committee on Community Development to inquire into and report upon –

(1)     the provisions of the Voluntary Assisted Dying Bill (No. 73) of 2016;

(2)     other current initiatives aimed at relieving suffering at the end of life including consideration of –

(a)    The House of Assembly Standing Committee on Community Development inquiry into Palliative Care 2017;

(b)    the Victorian inquiry into End of Life Choices 2016;

(c)    the Victorian Voluntary Assisted Dying Bill discussion paper 2017;

(d)    the Australian Medical Association Position Statement on Euthanasia and Physician Assisted Suicide 2016;

(e)    and contemporary approaches in other jurisdictions; and

(f)     relevant Tasmanian legislation.

(3)     other matters incidental thereto.

And that the committee report by 23 November next.

I put this date in because I am advised by the Clerk that an amendment to be valid has to have a reporting date, and 23 November is the last sitting date of this parliament.  This is a last chance with a sitting parliament to report on the work of this inquiry.  However, I am also advised that this committee can report validly out of session and that that option is one that could be explored.

I also undertake that in the event this committee’s work is not complete before the end of this term of parliament, and if I am part of the next parliament, I will move for this committee to be reconvened and for this inquiry to continue in the next term of parliament.

Madam SPEAKER – The member will need to table a copy of that amendment.  While he is doing that, I remind members we are on time allocation and it does not allow for amendments.

Mr JAENSCH – This can be the Tasmanian equivalent of the Victorian and Canadian approaches and, as my colleague Michael Ferguson commented, we are not starting from scratch.  The palliative care inquiry is current and has not yet been responded to.  This gives us the opportunity to do what the proponents of this bill could have done, ideally might have done, earlier in the process to establish the context and connections required for voluntary assisted dying not only to become law but to work as part of our established care system.  None of us would hope to see a voluntary assisted dying service or clinic that operates entirely separately from the rest of the care system that Tasmanians in need of this care would be travelling through.  I cannot imagine someone would go to their GP, be referred to specialists, enter palliative care, do advance care planning, receive specialist treatment, go through pain management and then at some stage need to be trucked off site to a clinic in an alley to access assisted dying at the end of all that.  I believe that for this to work and to become part of our care system it needs to be born in the context of a joint mission as a state to reduce suffering and pain for people who are dying.

I believe that this process can be the circuit breaker this idea needs to give the community, the professions, interest groups and commentators the chance to examine it afresh as part of the mission to relieve suffering for people who are dying; to see where it fits in the continuum of care, not as part of a narrower and more detached focus on getting voluntary assisted dying up in Tasmania.

I admit it is a purely pragmatic approach to this debate.  I think it is the best chance we have of leaving here today with the need and the work that has been invested in this bill recognised and available for Tasmanians to work with and support as part of a broader and more comprehensive approach to end of life care.  I commend the amendment to the House.