November 16, 2016
The Hon. M.J. ATKINSON ( Croydon ) ( 19:32 ):
My father died the kind of death described by James Joyce in the opening pages of Ulysses. It is a novel about 24 hours in the life of the city in which my father was born and was published the year before he was born, 1922. It was a death in which, for the last 12 hours, I wished every breath would be his last. Yet he wished to recover and to live, and about 24 hours before he died he tried to get out of his bed in the oncology section of the Royal Adelaide Hospital, pull on his trousers and walk onto North Terrace, where, in his rugby playing days, he had been a patron of the Botanic Hotel.
He was, of course, heavily sedated, and I will never know what he felt in those final hours. In the final hour, in what I regard as a miracle, the rostered nurse was from my father's home neighbourhood of Dún Laoghaire. It was he who administered the last dose of morphine, which depressed my father's respiratory system and caused his death swiftly. Should we always 'choose life', as the T-shirts say? Not always. I would not have wanted my friend, Frank Clappis, who was dying of mesothelioma, to go on any longer. Indeed, it would have been merciful if his life had ended days earlier.
As members of parliament, we are influenced in the debate about physician-assisted suicide, or active voluntary euthanasia (AVE), by our experience of death. Not long after my father died I was elected to parliament, and in my first term I served on a two-year select committee on the law and practice relating to death and dying. No-one who gave evidence to the committee argued that we choose life in all circumstances and at any cost. We on this committee called this position, which no-one held, 'vitalism'. Until I heard the member for Schubert's contribution on 20 October, I did not know anyone embraced it.
In my second term in parliament, I served on another long inquiry, this time the Social Development Committee euthanasia reference. In my three years working on euthanasia references, I found the dementia and motor neurone cases most troubling. Who knows whether a person with terminal dementia is suffering in his or her deep, end-stage psychotic state.
I have read the book that Andrew Denton and Go Gentle are circulating, and most of the stories make a strong case for physician-assisted suicide, although one story I read revealed unwittingly that palliative care had not been applied. One current member of the house mentioned, in supporting a previous euthanasia bill, that a loved one had refused pain relief in her illness. Our 1999 Social Development Committee report states:
Many of the survivors of this medical revolution now live with the chronic and degenerative conditions that come with old age...Demands are likely to increase and put greater pressure on the health systems as society ages.
Evidence to our committee was presented that more money is spent by the health system in the last year of a person's life than in all his or her preceding years.
If the bill is passed, especially if the member for Ashford's bill is passed, a future South Australian minister for health would make savings, not that the current minister would welcome savings obtained this way. Those who want AVE say they want personal autonomy in the manner of their death, yet they require the state to create and fund a vocation whose job it will be to terminate life.
The people threatened by the ambitions of the AVE movement are the poor and the lonely and those otherwise vulnerable, those who can be influenced by a society in which AVE is common into thinking that they should end their life because they have become a burden to others. Families are stressed by the older generation living longer than oldies could ever have expected in their childhood, with families of four living generations now common and oldies not dying swiftly of the infections and heart and pulmonary weaknesses common in the first half of the 20th century. The older generation might employ the words of Charles II of England: 'I am sorry, gentlemen, for being such a time a-dying.'
Some conclusions of the Social Development Committee have stood the test of time:
1. The ineffectiveness of palliative care in some situations;
2. The ignorance of the public about what active euthanasia entails, and the prevalence of the misconception that active voluntary euthanasia involves turning off machines or other currently legal practices;
3. The majority of dying patients' pain can be relieved with therapy and drugs, about 10 per cent of patients need more concentrated drug treatment for pain relief, and a small percentage of patients suffer from intractable pain;
4. The potential damage the legalisation of active voluntary euthanasia might have on doctor/patient relationships; and
5. The law envisaged would not just control the practice of active voluntary euthanasia but was likely to confirm and encourage it.
The latter point is grasped by both sides of this debate, and the AVE advocates know that, if they can change the law first, then they can change minds and take the law in the direction they ultimately want it to go.
I do not think that Christianity in its scriptures compels opposition to the bill. There are theologically reasoned exceptions to the commandment, 'Thou shalt not kill.' In more than 30 years of going to churches across all denominations, I cannot recall a homily preached against it. It is a pity then that so many supporters of AVE resort to pre-war Australian sectarianism in debate as though Australians who happen to be Catholics or Orthodox do not have full citizenship and the right to organise and advocate for the position they conscientiously believe. If my opposition to AVE is based on ancient wisdom, it is not that of Jesus of Nazareth but Hippocrates of Kos, who lived some 350 years before.
Although Mr Denton holds that people who pray are merely talking to themselves, as he is entitled to do, just how the member for Newland's organising prayers about the bill is a threat to the integrity of our polity, as Mr Denton told the Adelaide media, is not apparent to me. Mr Denton is redolent of the approach to state-church relations in Warsaw Pact countries. Of course, the media reaction to my saying that will demonstrate the degree to which criticism of a television celebrity is the new blasphemy. The Adelaide media, with one honourable exception—Matt and Dave—refuse to give equal time to the two sides and pretend that there is no secular opposition to the legislation and caricatures opposition to the bill by having only religious opponents of the bill on their programs.
The member for Morphett was wrong when he told the house, 'The bill we have today is the result of months and months of negotiation on behalf of the member for Ashford.' The member for Ashford moved a doctrinaire bill in the house that did not restrict AVE to people with a terminal illness and made the test of suffering wholly subjective and unreviewable by a doctor or anyone else. The Australian Medical Association (South Australia) has put a compelling case about that bill and highlighted the slapdash approach to formulating the bills and consultation on them.
The Attorney-General, hitherto an opponent of AVE, was so concerned by the member for Ashford's bill that he used the resources of his department to draft a series of amendments to it that rendered it capable of being supported by a majority of members. As the member for Ashford's bill slid towards defeat a month ago, the members who rescued the AVE proposal in this parliament were members from my part of the Australian Labor Party, some of whom conscientiously believed in a limited form of euthanasia and others who were opposed to it.
What united us was a belief in procedural fairness and fair play, wholly absent from those who played the sectarian card via the member for Bragg's untruthful one-minute outburst at the end of the debate in October. The member for Morphett's second reading speech was, in my opinion, so lame because he was not familiar with its provisions. It had been drafted on the order of the Attorney General. There were no clause notes.
The bill before us is not what the AVE movement wants. It prefers the bill the member for Ashford moved, and it would much prefer to the member for Ashford's bill the law as it applies in Holland and Belgium, where children can be euthanased, people with mental illnesses can be euthanased, and where the law, such as it is, is routinely ignored by doctors, especially the reporting requirements.
We are faced with a fine judgement. We could oppose all AVE bills on the assumption that, once passed, any restrictions will be removed one by one by civil disobedience and then by legislative amendment, as society becomes accustomed to the state providing death on demand, or we could support the member for Morphett's bill, put it into committee, make further amendments with a view to preventing it going on the trajectory of Holland and Belgium and offer relief to those for whom palliative care is ineffective. It is a very fine judgement.