November 16, 2016
The Hon. J.J. SNELLING ( Playford—Minister for Health, Minister for the Arts, Minister for Health Industries) (21:04):
Some years ago a friend of mine died quite suddenly. He was in his 60s. He was an only child whose mother had died some time earlier, and he left behind his father, who was aged in his 90s and from whom he had been estranged for many years. However, late in his life there had been a reconciliation between father and son. As he was without any other family, my family and other friends of this person adopted Robert, which was his name, as an honorary grandfather, and Robert survived my friend by two or three years.
Robert was an avowed supporter of voluntary euthanasia, and in fact had told his neighbours in the units where he lived that he had pills and that, should the time come, he would take those pills and see himself off. When he made an advanced care directive, he made it clear that should euthanasia be legalised in South Australia his express wish was that he be euthanased. He was in and out of hospital. He was very elderly and he deteriorated quickly after his son died.
The last time he went into hospital, he went into the Royal Adelaide Hospital, a scan was done which showed that his whole body was riddled with cancer and he was very close to death. He was very frightened at that stage and, much to my surprise, when the doctor spoke to him about a treatment regime, instead of saying that he wanted to go, that he did not want any treatment, he was adamant that he wanted absolutely everything thrown at him to try to keep him going. I was shocked that this gentleman, who had been such a passionate supporter of euthanasia and had made it so clear that he did not want anything, in this moment, when confronted with the reality of his mortality, wanted everything thrown at him.
Over the next few days, as we worked through the issues together, he decided that it was not going to be pleasant for an elderly gentleman in his 90s to be subjected to radio and chemotherapy. He came round to the view that palliative care was what was best going to suit him. He died a very beautiful death. I do not agree with the Deputy Leader of the Opposition that all deaths are horrible, ugly, traumatic things. He died, I would say, a beautiful death, looked after beautifully by the palliative care team at Modbury Hospital. In fact, watching this team look after Robert made me immensely proud to be Minister for Health.
The reason I tell this story is that the person nearing death goes through a range of emotions and at any one time they could have completely contradictory thoughts about what they may or may not want done to them. My concern about this legislation is that it is not hard to imagine someone in the depths of despair, knowing that their end is very near, opting for euthanasia. Whatever safeguards there may be, it is not hard to imagine people in those circumstances—indeed, those members who joined me for a briefing by Palliative Care SA know that they said that when people request euthanasia, or request assistance in dying, overwhelmingly it is not because of uncontrollable pain, it is because of other issues: despair, loneliness, all of those sorts of things which the dying person has to confront.
Dr Peter Allcroft, a respiratory physician who looks after patients at the Repat hospital with motor neurone disease (and anyone who is familiar with it will know what a terrible condition that is), described how he cares for his patients who are at the end stage of motor neurone disease, where they are unable to breathe for themselves. They have a PAP machine, basically a respirator, which assists them with breathing. He explained the process he goes through with motor neurone disease patients who have had enough and who do not want to continue to be provided with artificial assistance in breathing.
He said this is a long process. This is not a decision that is taken lightly, but the process he goes through once he is convinced, as the treating doctor who has built a relationship with the patient over many years, is that he sedates the patient, the respirator or PAP machine is turned off and the patient quickly succumbs.
The process he goes through in assisting his patients with motor neurone disease is a long way from what is proposed by the member for Morphett in his legislation where there is no requirement for the patient to have a relationship with a doctor who signs off on this. It is not scaremongering to suggest that there will be doctors who will be prepared to sign off on these requests, and they will be the go-to doctors for euthanasia.
They are not doctors who are going to have a relationship with the patients who are requesting euthanasia, and they are not going to be in a position to make a decision about the state of mind and where the dying person is in the process and whether this really is the decision. It is a very different process proposed by the member for Morphett to that that Dr Allcroft goes through with his patients at the end stage of motor neurone disease, and that is what seriously concerns me about this bill. I also want to say something about palliative care because, without doubt, there are South Australians who die in pain, but the reason why they die in pain is not because of failings in palliative care.
They die in pain because, for a number of reasons, good palliative care is not made available to them. To the extent as health minister I have not fixed that, that is to my great shame. It is partly availability but, to a large extent, it is also knowledge of our doctors and their knowledge of what is available through palliative care and the extent to which palliative care can alleviate suffering. Too many of our doctors are just not aware of what can be done for the dying person to alleviate suffering, and they do not refer palliative care when they should.
Doctors are human beings like the rest of us. They are not necessarily aware of the full suite of services that are available to their patients. To suggest that, when you already have a situation where so many of our doctors are not aware of what palliative care is available to patients, those same doctors, with their limited knowledge, can just the same sign off on a euthanasia request would be a grave mistake. You have these doctors who already have limited knowledge about what is available, and to expect these same doctors to be signing off on cases of euthanasia I think would be incredibly detrimental to good quality health care in our state.
Finally, I understand that many members of this house are attracted to euthanasia on the basis of personal autonomy: essentially, someone should be able to do with their own body what they wish. There are some rights that are what we call inalienable; that is, even if you want to give them up, as a state, we do not allow you to give them up.
An example of that is slavery. We do not give people the right to sell themselves into slavery. Why don't we? Because to do so would be to compromise the rights of everyone else in the community, and the same goes with the right to life. We do not allow people to expect another person to take away their life because it would compromise the rights of all those people in our community.
It is not scaremongering to anticipate a situation where an elderly person near death, feeling like he or she is a burden to their family, requests euthanasia. Even in the most loving and caring of families, it is not unusual for the dying and suffering person to feel themselves to be a burden or to feel, however wrongly, that they are whittling away the inheritance of their children. It is not scaremongering to suggest that, under the member for Morphett's bill, those people are inevitably going to request euthanasia.