One bill down, one to go in South Australia


by Paul Russell:

The Shadow Disability Minister in SA simply doesn't get it.

In all of the argy-bargy around the on-again-off-again euthanasia debate in South Australia, Shadow Disability Minister, Duncan McFetridge explained to Radio 891 yesterday that he would be putting a new bill, understood to be now called a 'Death with Dignity' Bill into the Parliament, today, the 20th of October.

Mr McFetridge has been a long time supporter of euthanasia, having backed previous attempts and having effectively co-sponsored Steph Key's current bill.

Steph Key has adjourned debate on her Voluntary Euthanasia Bill 2016 to the 1st of December - an optional sitting day which is rarely used. This is an effective admission that her bill will go no further as the numbers in the chamber clearly do not favour such a braod approach.

Mr McFetridge's bill is essentially Steph Key's bill with the inclusion of the amendments tabled by Steph Key at the eleventh hour. It is claimed that the amendments were formed after consultation with some members of parliament who were probably likely to support the principle, but not the model itself. One of the Australian Medical Association's objections was, however, that they were not consulted.

In introducing his bill today, McFetridge said that one does not need to be a QC to understand his bill. Quite so.

Last evening on drive time radio, Mr McFetridge was challenged by the radio announcer: You're the Shadow Minister for Disabilities and Paul Russell is from an organisation called Hope that wants to prevent euthanasia has actually said that some of these changes have come about after disability activists railed yesterday against both the current and the amended bills –what about people from the disability sector who look at this bill and say 'Look I'm worried about it.' (a paraphrasing of what I had said that missed some of the detail)

His answer: "I think Paul really wants to go back to school and learn how to read legislation because certainly with my disability Shadow Minister's hat on I meet the most amazing people in that sector who face challenges every day and I'm doing everything I can to make sure that they get the best out of their lives and this bill specifically excludes people on the fact that they've got a disability - if you've got a terminal illness and a disability, different story--."

Ignoring the invective, had Mr McFetridge attended the briefing session last Tuesday held by some of Australia's most experienced disability activists and advocates, he would have heard a very different story. He would have learned that disability always arises from a medical condition; that many of the disabled people present have conditions that they live with that are indeed terminal; that, ultimately, simply saying in a bill that one cannot access euthanasia merely for a disability does not make it so. Nor does it protect disabled people from ableism and poor attitudes towards such people. (the new bill requires an eligible person to have a terminal illness)

The new bill leans towards assisted suicide in the first instance with euthanasia for those who cannot, for whatever reason, commit suicide. Mmm! People with a disability no doubt! It includes the administration of euthanasia by a 'registered nurse or nurse practitioner' and people ending their lives by assisted suicide can, curiously, 'be assisted by such other persons as he or she thinks fit'.

This is a recipe for elder abuse. No-one else need be present when the person ingests the lethal substance and no-one will ever know precisely what occurred. Did the person ingest the lethal dose voluntarily, were they hoodwinked into taking it or were they forced to take it?

The Financial Services Council is concerned about the possibility of insurance fraud could effectively incentivise the ultimate form of elder abuse for the sake of a policy pay out.

Commentary continues - even in the chamber today - that suggests that this new bill is only for people for whom palliative care and perhaps other options have been exhausted.

McFetridge's bill puts it this way:

"there is no reasonably available medical treatment or palliative care options that would, having regard to both the treatment and any consequences of the treatment, relieve the person's suffering in a manner that is acceptable to the person."

The operative phrase is 'a manner that is acceptable to the person'. This is entirely understandable given that no-one can force people to accept medical interventions - even palliative care. I have known some heroic people who have refused palliative pain amelioration because they had good reason to want to stay fully alert and were willing to accept a level of pain as a trade off. But is does mean, as the clause clearly indicates, that it is not possible to say that people have to try certain procedures before a doctor would say, 'Okay NOW you qualify.'

This is borne out in the data from Belgium where a report in the Journal of Bioethical Inquiry from April 2015 (based on the euthanasia data from 2012-2013) summarised that, "almost 40 percent of the patients who received euthanasia did not see a palliative care specialist nor interacted with a palliative care team." it also observed that only 40% of people were 'visited by a palliative care team' and only 9% 'had a visit from a pallative care specialist'. This confirms observations by people like Professor Theo Boer that euthanasia is, 'on the way to becoming a default mode of dying for cancer patients'.

While, indeed, there may be many people who try some or all reasonably available options, the bill is much broader than that. Once someone has received a diagnosis that they have a terminal illness the only other consideration, in reality, is that they are suffering 'intolerably'as a result of their illness which is entirely subjective, identical in meaning to 'unbearable and hopeless' from Key's bill and, ultimately, cannot be challenged.

Steph Key's bill was ultimately adjourned to a later date; it is for all practical purposes, dead.

Mr McFetridge's bill will resume debate on the 3rd of November. In normal circumstances this would mean that, on that date, there would be one or two speeches followed by a further adjournment - a process that could reasonably be repeated deep into 2017. However, McFetridge said on morning radio today that he will seek 'government time' for the debate which could see his bill argued out to a vote on the 3rd of November.

Whether or not this happens is principally a matter for the Premier. He had said, originally, that he wanted the matter dealt with by Christmas. Whether 'the matter' refers to Steph Key's Bill only, is not known at this stage.