Committee Secretary Senate Legal and Constitutional Affairs Committee
PO Box 6100 Parliament House
Canberra ACT 2600
21 August 2014
Submission on the Exposure Draft of the Medical Services
(Dying with Dignity) Bill 2014
The Rationalist Society of Australia Inc. (RSA) supports the main intent of the Medical Services (Dying with Dignity) Bill 2014, with some qualifications described below. Our 10 Point Plan for a Secular Australia includes the principle that Australians ought to have “Guaranteed control over one’s own body, free from religious interference, when facing the end of life”. In practice, we recommend:[list type="bullet"]
- ‘Advance directives’ should be given legal force.
- Physician-assisted suicide, with appropriate safeguards, should be decriminalised.
- Governments should fund non-religious palliative care services.
The Bill addresses the second of these dot points – that “Physician-assisted suicide, with appropriate safeguards, should be decriminalised” – though we suggest some of the safeguards in the Bill are unnecessary and overly restrictive. These include:
- The requirement to have a qualified psychiatrist examine the person and confirm the person is not suffering clinical depression.
The Bill already mandates that the first medical practitioner be satisfied, on reasonable grounds, that the person is of sound mind and that the person’s decision to end their life has been made freely, and has informed the person of counselling and psychiatric services available; and that this first medical opinion be confirmed by a second opinion. To mandate a third professional opinion is excessive and would add complication and stress to the process.
- The requirement to have both medical practitioners present when the Certificate of Request is signed.
In rural or remote areas, this may present a particular impediment to the process because of the relative paucity of medical practitioners. It should be sufficient that two medical practitioners sign the Certificate but that this does not have to be at the same time in the same place.
- The requirement that the first medical practitioner inform the person of the ‘extraordinary measures’ available for keeping the person alive.
This is an unacceptable intrusion into medical professional standards, assuming as it seems to do that medicos cannot and would not make a professional judgement about the treatment options appropriate to the case. It would be likely to add unnecessarily to the mental anxiety of both the person and perhaps through that person, to their family, in coming to a decision.
- The requirement that, if the first medical practitioner has ‘no special qualifications in the field of palliative care’ that another medical practitioner (who may be second medical practitioner) with such qualifications must provide this information.
This requirement will have the effect of providing an effective ‘power of veto’ to palliative care medicos. The palliative care ‘industry’ is dominated by religious organisations, most of which oppose the concept of providing people with the means to choose dying with dignity services, as proposed in this Bill. It is unacceptable to give a power of veto to those likely to oppose the very concept being proposed in the Bill.
Our third dot point above – that “Governments should fund non-religious palliative care services” – is relevant here. In the light of an ageing population, the need for services to support the dying is only going to increase. We support the provision of palliative care services but most of these are religious. The Government should ensure there is a greater number of non-religious palliative care services, so that the increasing number of people facing end of life decisions who are not religious are not burdened with the religious views of those working in palliative care. In addition, there should be a requirement that medical practitioners operating in religious palliative care organisations not impose their personal religious beliefs onto persons who do not share their religious beliefs.
On behalf of the Rationalist Society of Australia Inc.
Dr Meredith Doig President