21 years ago, then-Chief Minister of the Northern Territory Marshall Perron delivered a speech to NT Parliament in the closing of debate on the Rights of the Terminally Ill Bill, which he introduced. The Bill was passed in 1996, and the Rights of the Terminally Ill Act became the first voluntary euthanasia law in the world. The Howard Government overturned the Bill a year later, and revoked the right of the territories to pass such a law again.
What is particularly interesting reading this speech today, is that even with two decades and a wealth of worldwide evidence between then and now, so many of the opponent arguments it highlights are still in play.
Here, we take a look at the argument that the right safeguards do not exist.
A smokescreen has been created today by some members who profess to have concerns about the adequacy of safeguards and uncertainty about competence in predicting life expectancy when, in fact, they have a fundamental religious objection to the legislation.
They should not try to fool Territorians into thinking that they have studied the subject closely to see how adequate safeguards might be adopted to make voluntary euthanasia acceptable when even extraordinary measures would not convince them to change their mind. We could amend the bill to restrict voluntary euthanasia to patients who had been assessed by two psychiatrists, two specialists in the disease, two palliative care experts and to require a three-month cooling-off period, the approval of next of kin, three witnesses, self-administration of the drug, that the whole process be videotaped and that it be done with the concurrence of a Supreme Court judge, and they would still not agree to it.
Thorough and consistent research into jurisdictions where these laws exist have shown repeatedly that the safeguards work, and yet opponents still argue today that adequate safeguards don't exist.
The South Australia Death With Dignity Bill 2016, which you can view here, has strong safeguards. These include:
A person must meet each of these criteria to be eligible:
They must be a competent adult
They must be suffering from a terminal medical condition
They must be experiencing suffering as a result of this terminal medical condition, its treatment, or complications caused by the terminal medical condition or its treatment that is intolerable
There must be no reasonably available medical treatment or palliative care options that would, having regard to both the treatment and any consequences of the treatment, relieve their suffering to an extent that is acceptable
Their death has, disregarding any medical treatment that may be administered to prolong their life, become inevitable by reason of the terminal medical condition
They must not have an impaired decision-making capacity in respect of a decision to request voluntary euthanasia
They must have lived in South Australia for no less than 12 months immediately preceding their request for voluntary euthanasia.
A person will not be eligible merely because they are of advanced age, suffering from a disability, or suffering from a mental health condition.
A terminal medical condition is defined in the Bill as an incurable medical condition (not being a mental health condition) that will cause their death, whether directly or as a result of related medical consequences.
'Terminal' is already a legally recognised term in Australia. Australian insurance companies accept a prognosis of less than 12 months to live for the payout of a life insurance policy.
In order to make a request for voluntary euthanasia, a person must take the following steps:
They must complete the relevant parts of a voluntary euthanasia request form
They must be examined by a medical practitioner, who must assess that they meet all criteria, including providing a diagnosis and prognosis, as well as providing information on available treatment and palliative care options
They must be examined by a second and independent medical practitioner, who must also assess that they meet all criteria including providing a diagnosis and prognosis, as well as providing information on available treatment and palliative care options
If either medical practitioner has reason to believe it is necessary, they must be examined and assessed by a psychiatrist to ensure they are of sound mind and not acting under any form of duress, inducement or undue influence (including that due solely to a perception or mistake on the part of the eligible person)
They must present the completed voluntary euthanasia request form to the first medical practitioner
The request for voluntary euthanasia must be witnessed.
The witness must be a competent adult, and must certify that: they witnessed the eligible person present the completed voluntary euthanasia request form to the medical practitioner; the request for voluntary euthanasia appears to genuinely reflect the wishes of the eligible person; the eligible person appeared to understand the nature and implications of the request for voluntary euthanasia; they are of the opinion that the eligible person was not acting under any form of duress, inducement or undue influence (including that due solely to a perception or mistake on the part of the eligible person) in relation to their request for voluntary euthanasia.
The witness may not be: a medical practitioner or psychiatrist who examines or assesses the eligible person; a person who is a direct beneficiary of, or who otherwise has a direct interest in, the estate of the eligible person; an owner or operator of a hospital, hospice, nursing home or other institution for the care of the sick or infirm in which the eligible person resides, or an employee or agent of such a facility.
A person who has made a request for voluntary euthanasia may revoke the request at any time.
Any person – be they a doctor, a nurse, or a witness – may decline to assist in the administration of voluntary euthanasia on any grounds, without risk to their employment or any other form of discrimination.
The first medical practitioner must retain all documents relevant to the request.
A medical practitioner who administers voluntary euthanasia to a person must make a report to the State Coroner within 48 hours after the person's death.
A medical practitioner to whom a request for voluntary euthanasia is made must, as soon as is reasonably practicable after becoming aware that the person who made the request has self-administered voluntary euthanasia, make a report to the State Coroner.
Failure to do so carries a maximum penalty of $5,000.
Other penalties ensuring the safety of this legislation are:
Inducing another to make a request for voluntary euthanasia by dishonesty or undue influence carries a maximum penalty of 10 years imprisonment.
Making a false or misleading statement in, or in relation to, a request for voluntary euthanasia – whether or not that request has since been revoked – carries a maximum penalty of 10 years imprisonment.
If a person is found guilty of inducement or making false or misleading statements in relation to a request for voluntary euthanasia, the court may order that the person forfeits any interest that they might have otherwise have had in the estate of the person who made the request for voluntary euthanasia.
In this Bill, as in all laws currently operating around the world, the safeguards are here, they are robust, and they have been consistently proven to work. Opponents can not continue to blindly argue that they do not exist.
You can read Marshall Perron's full speech here.
The South Australia Death With Dignity Bill 2016 will be debated this week, Wednesday November 16. If you live in South Australia, please contact your MP here and ask them to support the Bill.