(Private Members Statement, 25 March 2021, Legislative Assembly, NSW Parliament)
As previously announced, I am drafting legislation to give people suffering from a terminal illness access to voluntarily assisted dying, which I hope to present to Parliament in September, following release of a draft in July.
Similar laws have now passed in Victoria, Western Australia, Tasmania and New Zealand. The Queensland Government has committed to reform with a draft bill due in May. A bill is currently progressing through the South Australian parliament. The New South Wales bill will be largely based on the Western Australian model, which improved on the Victorian laws and that it will be informed by the Tasmanian and Queensland processes.
Voluntary assisted dying will be accessible to adults with a terminal illness that will cause death within six months – or 12 months for neurodegenerative conditions – and where suffering cannot be tolerably relieved. A person must have decision making capacity and be acting voluntarily and without coercion.
The person must undergo two independent eligibility assessments by two separate doctors.
There are options to self-administer or for a doctor or nurse to administer the substance. Doctors and nurses must undergo voluntary assisted dying training and will be able to conscientiously object.
Each step of the process must be documented in forms sent to a statutory board which will have oversight, collect data and provide advice to government.
I will add further safeguards, including to legislate appointment of the board by the Attorney General and health minister, and to give the board final authorisation to prescribe the substance – as done in Victoria and included in the Tasmanian and South Australian bills.
The bill will strengthen the definition for decision making capacity and require each doctor to request a report from a psychologist, psychiatrist, or appropriate medical professional to provide this assessment if there is any question over capacity.
Since announcing my intention to introduce legislation, I’ve been contacted by many people near the end of their life and I would like to tell you about Tony, a 55 year old Blue Mountains resident who was diagnosed with aggressive advanced prostate cancer with secondary metastases in his bones in 2017.
Back then he was given a life expectancy of around five years with treatment. Since then, he has undergone intensive therapy including hormone therapy which has had disfiguring side effects to his body, and chemotherapy which has permanently damaged his leg muscles and toe nerves. Fatigue from treatment forced him to give up work.
The cancer has spread with the number of sites and intensity of pain growing. At times the pain has been so unbearable that he has gone to the emergency ward. He also experiences twinges and burning sensations.
Tony said it would give him strength and peace of mind, and help him cope with the pain, discomfort and deteriorating health to know that he has control over his body if the situation gets intolerable.
It is this control at the end of life that people seek. Suicide among people with a terminal illness and poor prognosis is unfortunately common.
In jurisdictions that have legislated voluntary assisted dying laws, not all people who apply for assistance follow through and there is evidence that some feel the option is enough to help cope with suffering.
One area that will come up for debate is access for people in rural and regional areas. It is neither fair nor appropriate to legislate a medical service if it is not accessible to people outside of cities and I am committed to legislating for people across the state.
Sadly, we cannot rely on telehealth to ensure people outside of cities can access voluntary assisted dying as there is legal uncertainty around whether use of audio-visual communication in the process conflicts with Commonwealth laws, which prohibit the use of a carriage service to help someone commit suicide.
It is important to remember that voluntary assisted dying does not compete with palliative care. It is estimated that 10 to 20 percent of end-of-life symptoms cannot be effectively controlled and people continue to experience prolonged and agonising deaths.
The parliament has always dealt voluntary assisted dying bills through a conscience vote, which is appropriate. I acknowledge that there will be a range of views based on members’ personal experiences, faith backgrounds and the communities they represent.
New South Wales is not leading on this reform, as a result our debate, provisions and safeguards will benefit from best practices in other states.
It is my hope that the bill will be cosponsored by as many members of both houses as possible. I am open to the legislation being introduced in either house and scrutinised by an appropriate inquiry process.
I commit to a respectful and open process and will work with members across the political spectrum towards providing hope, options and relief for people facing horrific health news.