Legislative reform

Download the editorial (PDF 3.5Mb)

Visit LivingNow

 

Keywords: 

Physician-assisted dying (PAD) | Voluntary euthanasia (VE) | Australia | Religion | Legislative reform | Rhetoric

• Read more about Why assisted dying law reform has taken so long
• Log in or register to post comments

How ironic it was that the very day after I quoted Keating’s slight against his then-hostile Senate, Keating himself, a conservative Catholic, would come out against voluntary assisted dying (VAD) reform.

Hansard record makes compelling reading

But, more importantly, the Hansard record of votes on the Victorian Bill in the lower house make for compelling reading.

Figure 1 shows Victorian voter support for VAD (from ANU Australian Election Study 2016 data) by political preference, and MP votes in support of the Victorian Bill (lower house, 2017).

Figure 1: Victorian electorate support and MP vote support for VAD (lower house, 2017)
Sources: AES 2016; Hansard

It’s quite obvious that Greens MPs (100% v 91%) , Labor MPs (86% v 84%) and minor/independent MPs (67% v 76%) approximately represented the proportion of voter support. (It’s unsurprising that all Greens MPs vote in favour of VAD Bills: it’s Greens policy; while it’s a ‘conscience’ matter for other parties.)

The yawning Coalition chasm

But the yawning chasm of Coalition MPs not representing their own voters (14% v 73%) is even more stark. That’s a gap of nearly sixty percentage points. Surely that would be enough to raise the eyebrow of any conservative voter?

Aside from a handful of Coalition MPs who voted in support of the VAD Bill, it’s clear that there’s generally no real ‘conscience’ vote across the Coalition benches.

The corridors have been buzzing with stories of threats to Coalition promotions and preselections, and threats to preference deals for the state election next year, though of course there’s nothing public and on the record. Just the serene statement that “our members have a conscience vote.” The discrepancy amongst Australian Coalition ranks has been formally uncovered before in university research.

It’s a national story

However, it’s not like this is confined to Victoria. Here’s the same chart (Figure 2) for all state VAD bills across Australia since 2000 which have had a division on the vote — so we know who voted which way.

Figure 2: Australian electorate support and state MP vote support for VAD (all state Bills since 2000)
Sources: AES 2106; Hansards

Again, the largest and most striking gap between voter desire for reform and MPs opposing their voters’ wishes is amongst the Coalition ranks, at a full sixty percentage points short of proper representation.

It’s a similar picture to that published by university researchers in 2008, who found just 17% Coalition voting support in favour of VAD in the federal parliament, too.

As I’ve explained before, the Party leader’s public statements can be ‘persuasive,’ and Mr Matthew Guy, leader of the Victorian Parliamentary Coalition, has made his entrenched opposition to this reform loud and clear.

Inform your own voting

As debate in Victoria’s upper house commences tomorrow, we’ll be watching who’s in favour and who’s against. And we’ll report the voting record to help inform how you cast your own vote at Victoria’s state election in November next year.

In the meantime, here’s the full record of the Victorian Legislative Assembly votes.

Full voting record – Victorian Legislative Assembly 2017 VAD Bill

Ayes	47		Noes	37
Allan, Jacinta	Labor		Angus, Neil	Liberal
Andrews, Daniel	Labor		Battin, Brad	Liberal
Britnell, Roma	Liberal		Blackwood, Gary	Liberal
Bull, Josh	Labor		Blandthorn, Lizzie	Labor
Carroll, Ben	Labor		Bull, Tim	Nationals
Couzens, Chris	Labor		Burgess, Neale	Liberal
D'Ambrosio, Lily	Labor		Carbines, Anthony	Labor
Dimopoulos, Steve	Labor		Clark, Robert	Liberal
Donnellan, Luke	Labor		Crisp, Peter	Nationals
Edbrooke, Paul	Labor		Dixon, Martin	Liberal
Edwards, Maree	Labor		Fyffe, Christine	Liberal
Eren, John	Labor		Gidley, Michael	Liberal
Foley, Foley	Labor		Guy, Matthew	Liberal
Garrett, Jane	Labor		Hodgett, David	Liberal
Graley, Judith	Labor		Kairouz, Marlene	Labor
Green, Danielle	Labor		Katos, Andrew	Liberal
Halfpenny, Bronwyn	Labor		McCurdy, Tim	Nationals
Hennessy, Jill	Labor		McLeish, Cindy	Liberal
Hibbins, Sam	Greens		Merlino, James	Labor
Howard, Geoff	Labor		Northe, Russell	Ind.
Hutchins, Natalie	Labor		O'Brien, Danny	Nationals
Kealy, Emma	Nationals		O'Brien, Michael	Liberal
Kilkenny, Sonya	Labor		Pesutto, John	Liberal
Knight, Sharon	Labor		Richardson, Tim	Labor
Languiller, Telmo	Labor		Riordan, Richard	Liberal
Lim, Hong	Labor		Ryall, Dee	Liberal
McGuire, Frank	Labor		Ryan, Steph	Nationals
Morris, David	Liberal		Smith, Ryan	LIberal
Nardella, Don	Ind.		Smith, Tim	Liberal
Neville, Lisa	Labor		Southwick, David	Liberal
Noonan, Wade	Labor		Suleyman, Natalie	Labor
Pakula, Martin	Labor		Thompson, Murray	Liberal
Pallas, Tim	Labor		Tilley, Bill	Liberal
Paynter, Brian	Liberal		Wakeling, Nick	Liberal
Pearson, Danny	Labor		Walsh, Peter	Nationals
Perera, Jude	Labor		Watt, Graham	Liberal
Sandell, Ellen	Greens		Wells, Kim	Liberal
Scott, Robin	Labor
Sheed, Suzanna	Ind.
Spence, Ros	Labor
Staikos, Nick	Labor
Staley, Louise	Liberal
Thomas, Mary-Anne	Labor
Thomson, Marsha	Labor
Ward, Vicki	Labor
Williams, Gabrielle	Labor
Wynne, Richard	Labor
TOTAL AYES			TOTAL NOES
Labor	38		Labor	6
Greens	2		Greens	0
Liberal	4		Liberal	24
National	1		National	6
Other	2		Other	1
TOTAL	47		TOTAL	37
Abstained	2
Asher, Louise	Liberal
Victoria, Heidi	Liberal
Did not vote	1
Brooks, Colin	(Speaker, Labor)

Note: The vote represents 87 of 88 seats. The seat of Northcote was vacant owing to the untimely death of its representative, Fiona Richardson, from cancer.

 

Keywords: 

Assisted dying (AD) | Australia | Victoria | Analysis | Legislative reform | Poll / survey | Statistics

• Read more about Coalition the 'unrepresentative swill' on VAD
• Log in or register to post comments

Major community support for VAD

Take voluntary assisted dying (VAD) for example. Poll after poll demonstrates that the overwhelming majority of Australians want this additional choice for people in extremis at the end of life. The impeccable Australian Election Survey (AES) conducted by Australian National University scholars last year confirmed that 77% of Australians want VAD reform, with 13% undecided and just 10% opposed.

Strong support (43%) is ten times greater than strong opposition (4%), and support is high across the political spectrum: amongst minor/independent (69%), Coalition (77%), Labor (80%) and Greens (87%) voters. Public support has been in the majority for more than four decades.

Political support missing in action

But since the Northern Territory Rights of the Terminally Ill Act in 1996, none of the many VAD Bills before various state parliaments has passed. And the Northern Territory’s Act was torn down by the federal parliament just eight months after coming into effect.

A 2008 university study of federal MP voting opportunities found 100% of Greens, 55% of Labor, and a paltry 17% of Coalition MPs voting in favour of VAD.

New analysis

Now, a new analysis of the ten state VAD Bills since 2000 where final divisions were called, offers further insights. It found 100% of Greens MP voting opportunities were in favour, along with 51% of Labor, 29% of minor party and independent, and a similarly paltry 17% of Coalition MPs. Excluding South Australia, whose parliament has debated the greatest number of VAD Bills, the Coalition support rate was just 9%.

Overall, while state Labor MP votes fell 29% short of Labor voter attitudes, Coalition MP votes fell an astonishing 60% short of Coalition voter attitudes. At the state level, Coalition MPs had the most voting opportunities — nearly half (48%). No wonder passing VAD Bills is challenging.

It begs the question, how is it that our legislative representatives fail to reflect clear public majority views on matters of conscience for so long?

Hidden reasons behind MP opposition

Obviously, lobbying on both sides of the conversation in part informs MPs’ views, but there are several more persuasive factors.

For a start, there’s a “truism” held by many MPs that their vote in favour of a VAD Bill would lose them more votes at a general election than would a vote against the Bill. However, the opposite has been demonstrated in multiple studies.

Further, I’ve shown before that opposition to VAD is largely religious.  A university study has also found that those who are more religious and who are politically engaged tend to hold very conservative views. So while there are religious MPs on both sides of politics, Coalition MPs are naturally more inclined to hold much more conservative views.

But that doesn’t fully explain the massive 60% representation gap on the Coalition side, either.

In good conscience?

A key factor lies in the seemingly reassuring principle of the “conscience vote.” The major parties have announced that their members are accorded a conscience vote (also known as a “free vote”) on the VAD Bill. That simply means that there’s no official published party policy on the matter and party members may vote freely on the basis of their own conscience.

There are two significant issues with this state of affairs.

The first is that the member may refer exclusively to their own conscience. But what if the MP’s conscience is at odds with the electorate’s? For my home state of Victoria, the 2016 AES study found 79% of the community in favour of VAD. There are 88 members of the Victorian parliament lower house, and just 40 members in the upper house. Therefore, it’s possible for as few as just 20 Victorian MPs to vote “no” in order to extinguish the will of 3.2 million Victorians (79% of 4.05 million Victorian voters).

If that weren’t enough, the second issue is that the right to ‘conscience’ is granted only in respect of the Bill itself, not on procedural matters about the Bill. It can make a huge difference.

How the parry works

Here’s what happened in 2008 when Victorian Greens MP Colleen Hartland’s VAD Bill was before the Legislative Council. MPs were afforded a conscience vote, and many of them had said they were supportive of VAD in general, but couldn’t support Hartland’s Bill in its current form. (That’s also a common ruse of MPs who in reality oppose the reform in principle but wish to appear ‘open minded’.)

When the final vote on Hartland’s Bill was lost, then Greens MP Greg Barber immediately moved a motion to refer the Bill to a parliamentary committee so that it could be improved to MPs’ satisfaction. Neither Labor nor Coalition parties afforded their members a conscience vote on this procedural matter, instead directing MPs to vote against such motions. The referral, which may have resulted in Victorians having wider end-of-life choices years ago, was cynically buried.

Most voters remain unaware of the shenanigans played in the corridors of power to achieve such results.

Australia’s special political conservatism

They’re not the only shenanigans, though. Another university study comparing federal MP conscience voting patterns in the UK, New Zealand and Australia found Australia to be different, accounting for why the UK and NZ have legalised marriage equality, while Australia hasn’t.

Firstly, the centre-left in Australia has a larger proportion of Catholic members than in the UK and NZ, accounting for some of the shortfall in Labor representation of progressive views.

Secondly, those amongst Coalition ranks, but with more liberal social consciences, had been lashed by Coalition party whips to vote against progressive reform. So while there was a public display of fairness and neutrality, the reality was quite different.

Borne out in state parliaments

These findings are replicated in Australian state parliament votes too, with Coalition MPs rarely if ever voting in favour of progressive social reform. Coalition MP votes on VAD including and since Hartland’s legislative attempt in 2008 are telling: in Victoria 2008 10:5 against, in Tasmania 2009 6:0 against; in Western Australia 2010 19:1 against; in NSW 2013 10:0 against; in South Australia 2016 14:7 against and in Tasmania 2017 13:1 against.

Rather than reflect 77% Coalition voter support for VAD, Coalition MP voting patterns reflect the highly negative stance of party leaders, whipped through the parliamentary party membership. For example, then WA Premier Mr Colin Barnett made it clear he thought assisted dying was “government-sanctioned killing”. Tasmanian coalition leader Mr Will Hodgman said that “protection for [vulnerable] people cannot be guaranteed.” Then-NSW Premier Mr Barry O’Farrell declared himself “strongly opposed”.

Back to Victoria’s Bill under debate

The situation in Victoria is looking somewhat more positive, with Premier Mr Daniel Andrews and many in his Cabinet publicly supporting reform. A lengthy, detailed, professional and well-resourced process has informed the crafting of the Bill.

However, opposition leader and would-be Premier Mr Matthew Guy has stated his resolute opposition to it and that he intends to vote “no”. That would mean he is quite comfortable for his own personal view to extinguish the contrary views also held in good conscience by 34,626 of the 43,831 voters in his own electorate of Bulleen, and 3.20 million of Victoria’s 4.05 million voters. (Electorate numbers as at 10 October 2017.)

An obvious solution

There’s an obvious solution for MPs whose own consciences disallow them from reflecting the overwhelming majority conscience of the electorate.

They could consider abstaining — simply absenting themselves from the chamber during the division. That would keep their own consciences intact while allowing the electorate’s conscience to be reflected.

I’m a constituent of Mr Guy’s. Over a period of months I made six robust attempts to meet with him to discuss these matters, especially the covert whip arrangements and the consideration of abstention. I can be persuasive in obtaining appointments, but my best efforts proved wholly unfruitful.

As I said to Mr Guy’s private assistant after the last failed attempt, voters could be forgiven for believing he’s more interested in meeting allegedly shady characters in fancy Brighton restaurants, than meeting with his own constituents.

Victorians are watching the parliamentary VAD debate. We’re taking notes that will inform our votes at the state election late next year.

Indications are at present there’s a good chance that Victorian MPs won’t be “unrepresentative swill”.

 

Keywords: 

Filibuster | Fudge | Assisted dying (AD) | Australia | Victoria | Analysis | Legislative reform | Statistics

• Read more about Assisted dying - are our political masters "unrepresentative swill"?
• Log in or register to post comments

Mr Russell wrote that in Washington state:

“deaths from lethal drugs prescribed under the Act have nearly quadrupled (376%) from 51 in 2010 to 192 in 2016.”

Now I’ve called Mr Russell out before for misinformation, for example his laughable ‘secret’ opinion poll, promoting a misrepresentation of a Council of Europe determination, complaining at the same time that people will die too early but yet live too long, and spreading despicable misinformation about Dutch neonatal euthanasia.

His latest claim extends his misinformation crown title.

Don’t get me wrong. He cites the correct raw data figures for Washington. But he packages them up handily with FUD (Fear, Uncertainty and Doubt) wrapping, all tied up with the most sinister bow he can muster.

I’ve criticised the use of uncontextualized raw data before, and I do so again.

The relevant facts

Washington state legalised assisted dying by ballot in 2008. The following year the law was put into practice, and 2010 was the first full year of its operation.

Here’s the rate of assisted deaths as a proportion of all deaths in Washington state for all the years on record. As you can see, the rate hasn’t even reached one half of one percent of all deaths in 2016.

2009	2010	2011	2012	2013	2014	2015	2016
0.07%	0.11%	0.14%	0.17%	0.23%	0.24%	0.30%	0.35%

 

Never ones to miss out on an opportunity to spread FUD, if it were just one case last year and two this year, assisted dying opponents would be shouting from the rooftops: “Crisis!! 100% increase!!”. But in reality, only a small minority use the law, yet thousands of patients and their families are given comfort by the option being avaialble even if they don't use it. That message was made loud and clear by Oregon Senator Ginny Burdick. Washington's Death With Dignity Act is modelled on Oregon's, and Oregon's Act has been in effect for twenty years.

A Catholic trifecta

Of course in his missive, Mr Russell, like his fellow Catholic whom I’ve also called out for misinformation, Prof. Margaret Somerville, avoids referring to Swiss data. And their fellow Catholic Mr Daniel Mulino, who furnished a minority report to the Victorian Parliament’s recommendations on end of life choices, a report I’ve also called out for stunning misinformation, fudges his numbers about Switzerland, referring to data from 1998 without further context.

Why do these lobbyists avoid or selectively refer to the Swiss situation? Because the actual data is an inconvenient truth to their FUD story-telling.

An inconvenient truth

Switzerland’s assisted dying law came into effect seventy-four years ago, in 1942. If just one person had used the law in 1942, using Mr Mulino’s favourite annual increase figure of 17.5%, that would equate to 110,338 people pursuing an assisted death in Switzerland in 2014.

I say 2014 because that’s the most recent year for which official Swiss Government assisted dying figures are available. And what was the actual figure in 2014? There were 742 cases of assisted dying amongst Swiss residents, and Dignitas reports that it assisted 198 foreign nationals. That’s a total of 940 assisted deaths.

Let’s add another 60 foreign-national assisted death cases from the much smaller Swiss society that provides accompaniment for foreigners. That makes around 1,000 cases in 2014, including all those who came from all over the world. And it’s less than one hundredth of the minimum rate the doomsayers predict by cherry-picking one statistic that suits their argument.

Swiss law has the fewest safeguards

The Swiss assisted dying law has none of the safeguards of the Washington law. By Mr Russell and Co’s reckoning, you’d think that the Swiss (and those who visit) would be dropping off like flies.

By way of further comparison, the doomsayer number of assisted deaths for 2014 (a minimum of 110,338 cases) is substantially greater than the total number of deaths in Switzerland that year: 63,938. It’s an obvious impossibility.

In 2014, the Swiss rate of assisted deaths including all the foreign nationals who came to use its law, was 1.5% of all deaths; and 1.2% for resident-only cases.

And the rate of assisted deaths in Luxembourg in 2014 (legalised in 2009), whose laws are much more liberal than Washington’s though stricter than Switzerland’s, was 0.17% of all deaths. It’s odd how the doomsayers don’t report Luxembourg data, either.

And what are these cases?

These are cases of people in extremis with no realistic prospect of relief or improvement, choosing a peaceful assisted death as a better option than being forced to prolong their torture, according to their own deeply-held beliefs, values and examined consciences.

Mr Russell believes they should be required to endure their torture. There is a point to it, he says: because it joins them “in some mysterious way to the sufferings of Christ”... whether others believe in Christ, or at least Mr Russell’s version of him, or not.

You won't find this degree of candour on his anti-assisted dying website, but you can find it at NewsWeekly, which is run by the National Civic Council (NCC), itself established by Australia's most famous and conservative lay Catholic, B. A. Santamaria. Mr Russell has been President of the NCC South Australian chapter.

It’s not the numbers, it’s the circumstances

To be clear, in no jurisdiction has its legislature enacted access to assisted dying on the basis of a numeric ceiling. They’ve enacted access on the basis of intolerable and unrelievable suffering. And to this day, those are the folks who may be granted access to an assisted death.

Conclusion

Again, Mr Russell (and colleagues) do themselves no favours by conspicuously cherry-picking the data they want to use, and wrapping it up in threatening garb to create FUD amongst politicians.

Wiser heads will prevail in Victoria.

 

Keywords: 

Fearmonger | Filibuster | Fudge | Assisted dying (AD) | Australia | Victoria | Paul Russell | Catholic | Legislative reform | Lobbying: Opponents | Statistics

• Read more about Paul Russell targets Victorian politicians
• Log in or register to post comments

Unhappily, the kind of misinformation that Dr Hodge advances muddies the waters and cruelly stands in the way of legislative action, which most Australians want.

An impeccable national survey conducted by scholars at Australian National University last year found 77% of Australians in favour of assisted dying law reform. Strong support (43%) outweighed strong opposition (4%) by more than ten to one. In the two states whose Parliaments are currently considering reform, NSW and Victoria, support stands at 75% and 79% respectively.
 

Non-religious support is 91%, and it’s high amongst Catholics (74%) and Anglicans (79%) as well. Bishops are jarringly out of step with the views of their flocks. And across the political spectrum, 87% of Greens, 80% of Labor, 77% of Coalition and 69% of minor party voters also want reform.

The electorate’s desires couldn’t be clearer. But politicians — who have little time to fact-check what they’re told — are fed the kind of misinformation Dr Hodge advances.

The false 'non-voluntary euthanasia slippery slope' argument

He quotes details from a medical journal article by Dr José Pereira, a Canadian Catholic physician. Like others who cite this article, Dr Hodge fails to mention that it was thoroughly debunked in a surgical deconstruction by expert scholars. They found Pereira’s claims variously unsupported by any evidence, unsupported by the sources he cited, or false, concluding that the article was “smoke and mirrors.”

Like other Catholics, Dr Hodge relies heavily on a thoroughly debunked journal article by Catholic Canadian doctor, José Pereira.A significant source of smoke, which Dr Hodge fans from this debunked article, is the claim regarding “900 Dutch deaths hastened without explicit request”: that is, non-voluntary euthanasia or NVE. Such figures are cited as ‘proof’ of the hypothetical slippery slope from legalised voluntary euthanasia to NVE.

Other opponents of assisted dying variously put the figure at 500 or 1,000. For the sake of argument, let’s say the 900 figure is equivalent to 1,000. Both the 500 and 1,000 figures, also repeatedly promoted by Catholic ethicist Professor Margaret Somerville and others, have been true. But here’s the thing.

What they don’t mention is that the 1,000 rate is from the 1990s when Dutch assisted dying was conducted under a general regulatory framework. In 2002 the Dutch euthanasia Act came into effect. Amongst the Act's many details was the establishment of a Commission which examines every reported case of assistance.

Since then, the Dutch NVE rate has dropped to 500, and even further. It has stayed low and is now similar to the NVE rate in the United Kingdom, the world’s gold standard for palliative care, and where assisted dying remains illegal.

There was a significant drop in the NVE rate in Belgium, too, after its euthanasia Act came into effect, also in 2002.

It is absolutely unconscionable that yet another Catholic commentator has trotted out the same old lie as though it's true. Dr Hodge is an academic and it is incumbent on him to check the facts before sounding off.By cherry-picking a single figure, opponents argue the opposite of the facts, implying or even directly claiming that NVE rates are caused by or have risen as a result of legalised assisted dying. I’ve comprehensively exposed this nonsense before, yet it comes up repeatedly.

It’s similar to other lines of Catholic argument against assisted dying, like the claim that Dutch elderly supposedly travel to Germany for healthcare because they fear being euthanised by their Dutch doctors — an outrageous falsehood. There’s also the faintly desperate claim that Dr Els Borst, the architect of the Dutch euthanasia Act, later regretted her reform — a fake claim she’s firmly corrected.

Consider too a Catholic bishop’s claim, without reservation and in formal evidence before an official Parliamentary inquiry, that Oregon’s general suicide rate was very low prior to its assisted dying Act but very high afterwards — contrary to the facts. Or a report cherry-picking just half a sentence from a journal paper to claim that a significant proportion of assisted-death patients in Oregon had symptoms of depression, when the other half of the very same sentence clearly stated that none of them had.

As Professors Griffiths, Weyers and Adams wrote in 2008, “imprecision, exaggeration, suggestion and innuendo, misinterpretation and misrepresentation [and worse] took the place of careful analysis.” Sadly, the same still seems true today.

Major Catholic flip-flop on choosing death

Now let’s turn our attention to the core of Dr Hodge’s thesis. His plea for “the vulnerable” leads his argument and is heavily egged throughout the polemical pudding.

A comparison is moot: Australians have the right to refuse any unwanted medical treatment, even if it’s life-saving.

In my home state of Victoria, this right to refuse is enshrined in statute. The statute contains just three ‘safeguards’ for checking a refusal, and those only apply if the refusal is formally documented in writing but not if it’s only oral.

As I’ve explained in detail before, the consequence is that a person can refuse life-saving medical treatment with few if any checks and balances. In theory, just as Dr Hodge argues in regard to assisted dying, the person might feel pressured by greedy relatives, resource-poor doctors or others, to so refuse.

In this case, where is the Catholic call for protections? Where is the moral outrage on behalf of ‘vulnerable patients’? There is none. In fact, the Catholic Church’s call is quite the opposite. In a directive to all Catholic healthcare institutions in the USA, the Conference of Catholic Bishops make the Church’s position abundantly clear. They direct that there is no obligation for patients to use “disproportionate means of preserving life.”

The Catholic church's rhetoric against assisted dying is a major flip-flop when compared to its cosy attitude towards refusal of life-saving medical treatment: both might result in hypothetical pressure to choose death, yet only assisted dying has adequate safeguards.They define disproportionate means as “…those that in the patient’s judgement do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.”

So, under two identical hypothetical possibilities of inappropriate persuasion to choose death, Dr Hodge’s argument bristles against an assisted dying reform containing — as he acknowledges — no fewer than 68 safeguards, while his Church argues that patients may refuse life-saving medical treatment if the patient feels it’s “hopeless,” entails “excessive burden” or imposes “excessive expense” on others, with hardly any, or no statutory safeguards at all.

The incoherence, and repetition of misinformation, is indefensible. Civil debate on such an important matter deserves better.

 

Keywords: 

Fearmonger | Fudge | Fiction | Faith | Assisted dying (AD) | Australia | New South Wales | Victoria | Catholic | Legislative reform | Lobbying: Opponents | Rhetoric: Slippery slope | Rhetoric: The 'vulnerable'

• Read more about Yet more Catholic misinformation - Fairfax media
• Log in or register to post comments

Similar to the Victorian Parliamentary inquiry in 2015/16, the move is a strong step forward in assessing current practice and recommending improvements to both legislative and regulatory oversight of end-of-life for Australians in the west.

The Joint Committee is comprised of eight members, four from the Legislative Assembly (Reece Whitby, Labor, Baldivis; Amber-Jade Sanderson, Labor, Morley; Simon Millman, Labor, Mount Lawley; John McGrath, Liberal, South Perth) and four from the Legislative Council (Robin Chapple, Greens, Mining and Pastoral; Nick Goiran, Liberal, South Metropolitan; Colin Holt, Nationals, South West; Sally Talbot, Labor, South West).

Its terms of reference are:

That the Committee inquire into and report on the need for laws in Western Australia to allow citizens to make informed decisions regarding their own end of life choices and, in particular, the Committee should—

1. assess the practices currently being utilised within the medical community to assist a person to exercise their preferences for the way they want to manage their end of life when experiencing chronic and/or terminal illnesses, including the role of palliative care;
2. review the current framework of legislation, proposed legislation and other relevant reports and materials in other Australian States and Territories and overseas jurisdictions;
3. consider what type of legislative change may be required, including an examination of any federal laws that may impact such legislation; and
4. examine the role of Advanced Health Directives, Enduring Power of Attorney and Enduring Power of Guardianship laws and the implications for individuals covered by these instruments in any proposed legislation.

 
The Committee will soon meet for the first time to elect a Chair and Deputy Chair. It will have up to twelve months to report back to both Houses.

 

 

Keywords: 

Western Australia | Legislative reform

• Read more about WA Parliament commissions end-of-life choices inquiry
• 1 comment
• Log in or register to post comments

I have no quarrel with individuals of faith regarding their own private beliefs. However, the bishops’ attempt at public “leadership” through the advertisement is deserving of redress for its multiple fallacies.

The ‘abandonment’ fallacy

The bishops claimed that assisted dying “represents the abandonment of those who are in greatest need of our care and support”. On the contrary: to ignore the deeply-held beliefs and rigorously-tested wishes of people at the end of life is to abandon their values and critical faculties in favour of the bishops’ own religious dogma.

The ‘competition’ fallacy

The bishops demand there should be more funding for healthcare rather than assisted dying, fallaciously pitting one option against the other. The Victorian government is indeed increasing funding for palliative care. It’s also aiming to provide lawful assisted dying for when even the best palliative care can’t help – which Palliative Care Australia has acknowledged – giving lie to the faux competition.

The evidential fallacy

Contrary to the bishops’ false presumption that legalised assisted dying will decrease trust in “the treatment and quality of care” from doctors, scientific studies into attitude change show that more people trust doctors when assisted dying is legal. Patients can then talk openly about options, even if they decide against assisted death. The bishops have abandoned facts in favour of religious assumptions.

The equivalence fallacy

The bishops refer to assisted dying as “government endorsed suicide”. They fallaciously equate a reasoned, tested and accompanied decision for a peaceful assisted death in the face of a terminal illness, with the impulsive, violent, isolated and regrettable suicide of individuals (many of whom have mental health and substance abuse issues) who are failing to cope with problems that can be addressed.

However, while the latter are choosing between life and death, the terminally ill are choosing not between life and death, but between two different ways of dying, according to their own beliefs and conscience. Rigorous 2016 research from Australian National University shows that the vast majority (79%) of Victorians support assisted dying choice for the terminally ill (with just 8% opposed), clearly distinguishing it from general suicide.

Shame on the bishops for disrespectfully equating the two.

The inconsistency fallacy

They also argue that assisted dying ought to remain prohibited because within healthcare, “mistakes happen and the vulnerable are exploited,” and “that in spite of our best efforts, our justice system could never guarantee” no one would die by mistake or false evidence. However, as I’ve pointed out before, an identical hypothetical problem exists under the refusal of life-saving medical treatment, a statutory right that Victorians have enjoyed for nearly 30 years. The statute has only three “safeguard” requirements, yet even those only apply if the refusal is formally documented, but not if it’s verbal.

Further, the United States Conference of Catholic Bishops directs that patients may refuse treatment if it imposes “excessive expense on the family or community,” yet makes no mention of the hypothetical “vulnerability” of the patient to be persuaded so, nor directs any requirements to assess the veracity of the refusal.

In stark contrast, the Victorian proposal for assisted dying legislation contains more than 60 safeguards and oversights.

The bishops are at risk of ridicule for such a gargantuan flip-flop: supporting the refusal of life-saving treatment with little or no oversight, while vocally opposing assisted dying legislation that mandates an armada of protections.

The not-so-hidden agenda

The bishops’ methods are rather unsubtle – hoping that these arguments, erroneous but carefully crafted to avoid any religious connotations, will be accepted as non-religious. Yet religion is writ large across their plea: as signatories to the letter they are all clerics employed directly and centrally in the promotion of their religions.

The authority fallacy

They might also rely on their religious status to convey gravity and authority to their pleas. Yet as people paid to do a job, like anyone else, their titles grant them no special privileges in lecturing Victorians about how they should die in the face of a terminal illness.

According to the 2016 census, just 23% of Victorians identified as Catholic, 9% as Anglican, 0.5% as Lutheran, and the other bishops’ signatory denominations so small as to not appear separately in the government’s statistics. Combined, the bishops’ faiths represent around 33% of the Victorian population, while 32% of Victorians identify with no faith at all. Surely the bishops are not arguing that they’re speaking for these other Victorians, too?

But the bishops don’t represent the views of their own flocks, either. According to the 2016 ANU study, 89% of non-religious Victorians support assisted dying law reform, as do 78% of Victorian Catholics and Anglicans. Indeed, opposition to assisted dying exists mostly among those who attend religious services once a week or more often – that is, those who are frequently exposed institutional religious messages of opposition – yet who comprise just 12% of Australians and 11% of Victorians.

Minding their own flocks

Australians are abandoning religion in droves. For example, when Freier ascended to the top job of Anglican Primate of Australia in 2006, some 19% of Australians identified as Anglican (2006 census). A decade later under his leadership, the 2016 census showed a drop of about a third to just 13%, and in Victoria, his home territory, to just 9%.

Hart’s Catholic church has experienced a drop in affiliation too, and it’s likely to continue and accelerate as Australians react with shock and disgust to the extent of child sexual abuse that the royal commission has exposed from under his organisation’s “pastoral umbrella”.

In conclusion, rather than bishops lecturing the government and Victorians with fallacious and faintly desperate arguments about the choices they shouldn’t have at the end of life, attending to their own flocks may be more useful Christian leadership.

May their God go with them in that endeavour.

 

This article was originally published in The Guardian.

 

Keywords: 

Fearmonger | Fudge | Faith | Assisted dying (AD) | Australia | Victoria | Religion | Catholic | Legislative reform | Lobbying: Opponents | Rhetoric: Palliative care can always help | Rhetoric: Slippery slope | Rhetoric: Suicide | Rhetoric: The 'vulnerable'

• Read more about Seven fallacies in Victorian bishops' arguments against assisted dying
• Log in or register to post comments

The Ministerial Advisory Panel on voluntary assisted dying today handed down its final report to the Government.

The Panel was comprised of seven subject experts, with Professor Brian Owler as Chair and Professor Margaret O'Connor as Deputy Chair.

It consulted extensively across Victoria, taking hundreds of submissions and appearances from relevant stakeholders, and reviewing legislation from other jurisdictions in which one form or other of assisted dying is permitted.

Today, it formally handed its report, comprising over 250 pages, to the Government.

The Panel has developed what is arguably the world's most detailed and carefully laid out principles to inform legislation, and are a credit to its efforts and professionalism.

Key aspects of the recommendations for voluntary assisted dying are:

• The person must be 18 years or over; and
• Be ordinarily resident in Victoria and an Australian citizen or permanent resident; and
• Have decision-making capacity in relation to voluntary assisted dying; and
• Be diagnosed with an incurable disease, illness or medical condition that:
  • is advanced, progressive and will cause death; and
  • is expected to cause death within 12 months; and
  • is causing suffering that cannot be relieved in a manner the person deems tolerable; and
• Doctors and other healthcare workers are not permitted to raise assisted dying — only to respond to formal patient requests.
• The person must make three formal requests, the second of which must be written and witnessed by two independent people.
• The person must make the request themselves. Nobody else is authorised to make the request, and the request cannot be made via an advance care directive.
• Ordinarily, the minimum timeframe between first request and opportunity to take the medication is ten days.
• The person must maintain decisional capacity at all three requests.
• Two doctors must reach independent assessments that the person qualifies.
• Only doctors who have completed specialist training for voluntary assisted dying may participate.
• Any healthcare worker may decline to participate for any reason, without penalty.
• A prescription dispensed for the purpose of voluntary assisted dying must be kept in a locked box and any unused portion returned to the pharmacy after death.
• The person must self-administer the medication; except if the person is unable to, a doctor may administer. An independent witness is required if the doctor administers.
• Establishment of an authority to receive assisted dying reports, to assess reports, and to refer unacceptable cases to disciplinary or prosecutorial authorities.
• For Parliament to review summary reports; twice in the first two years and annually thereafter; a formal review at five years.
   

In total, the recommendations include no fewer than 68 safeguards, designed to strike, uniquely for Victoria, an appropriate balance between access to the law, and protection of dying persons.

The Government will respond to the Final Report shortly, and it is anticipated that legislation will be introduced into the Victorian Parliament in August or early September.

A full copy of the Final Report can be obtained here.

-----

Safeguards proposed for Victoria's voluntary assisted dying framework

Access

1. Voluntary
2. Limited to 18 years and over
3. Residency requirement [Victorian resident and Australian citizen or permanent resident]
4. Limited to those with decision-making capacity
5. Must be diagnosed with condition that meets restrictive set of criteria [advanced, progressive and will cause death]
6. End of life is clearly defined [death expected within weeks or months, not more than 12 months]
7. End of life condition combined with requirement for suffering
8. All of the eligibility criteria must be met
9. Mental illness alone does not satisfy the eligibility criteria
10. Disability alone does not satisfy the eligibility criteria

Request

11. Must be initiated by the person themselves
12. No substitute decision makers allowed
13. Cannot be included as part of an advance directive
14. Health practitioner prohibited from raising voluntary assisted dying
15. Person must make three separate requests
16. Must have written request [witnessed in the presence of a medical practitioner]
17. Two independent witnesses to request [exclusions for family members, beneficiaries, paid providers]
18. Specified time must elapse between requests [first and third requests must be at least 10 days apart with exception when death imminent]
19. Additional time required to elapse between steps of completing process [second assessment and third request must be at least one day apart
20. Must use independent accredited interpreter [if an interpreter is required]
21. No obligation to proceed, may withdraw at any time

Assessment

22. Eligibility and voluntariness assessed by medical practitioners
23. Must be two separate and independent assessments by medical practitioners
24. Assessing medical practitioners must have high level of training/experience
25. Assessing medical practitioners must have undertaken prescribed training [to identify capacity and abuse issues]
26. Requirement to properly inform person of diagnosis, prognosis and treatment options, palliative care, etc, [by both assessing medical practitioners]
27. Referral for further independent assessment if there is doubt about decision-making capacity
28. Coordinating medical practitioner must confirm in writing that they are satisfied that all of the requirements have been met

Medication management

29. Person required to appoint contact person who will return medication if unused
30. Medical practitioner must obtain a permit to prescribe the medication to the person
31. Medication must be labelled for use, safe handling, storage and disposal
32. Pharmacist also required to inform the person about administration and obligations
33. Medication must be stored in a locked box

Administration

34. Medication must be self-administered [except in exceptional circumstances]
35. If physical incapacity, medical practitioner may administer
36. Additional certification required if administered by medical practitioner
37. Witness present if medical practitioner administers

Practitioner protections

38. Health practitioner may conscientiously object to participating
39. Explicit protection for health practitioners who are present at time of person self-administering
40. Explicit protection for health practitioners acting in good faith without negligence within the legislation
41. Mandatory notification by any health practitioner if another health practitioner acting outside legislation
42. Voluntary notification by a member of the public of a health practitioner acting outside legislation

Mandatory reporting

43. Reporting forms set out in legislation
44. Reporting mandated at a range of points and from a range of participants to support accuracy
45. First assessment reported [to Board]
46. Second assessment reported [to Board]
47. Final certification for authorisation reported [to Board, incorporates written declaration and contact person nomination]
48. Additional form reported [to Board] if medication administered by medical practitioner
49. Prescription authorisation reported by DHHS [to Board]
50. Dispensing of medication reported [to Board]
51. Return of unused medication to pharmacist reported [to Board]
52. Death notification data reported [to BDM and collected by Board]

Offences

53. New offence to induce a person, through dishonesty or undue influence, to request voluntary assisted dying
54. New offence to induce a person, through dishonesty or undue influence, to self-administer the lethal dose of medication
55. New offence to falsify records related to voluntary assisted dying
56. New offence of failing to report on voluntary assisted dying
57. Existing criminal offences for the crimes of murder and aiding and abetting suicide continue to apply to those who act outside the legislation

Oversight

58. Guiding principles included in legislation
59. Board is an independent statutory body
60. Board functions described in legislation
61. Board reviews compliance
62. Board reviews all cases of [and each attempt to access] voluntary assisted dying
63. Board has referral powers for breaches
64. Board also has quality assurance and improvement functions
65. Board has expanded multidisciplinary membership
66. Board reports to publicly [to Parliament every six months for first two years, thereafter annually
67. Five year review of the legislation
68. Guidelines to be developed for supporting implementation

 

Keywords: 

Assisted dying (AD) | Australia | Victoria | Legislative reform

• Read more about Assisted dying Bill introduced into the Victorian Parliament
• Log in or register to post comments