Mr PALLAS (Treasurer) (17:22:29) — I rise to support the Voluntary Assisted Dying Bill 2017. I support the Voluntary Assisted Dying Bill because I respect life and I respect the right of a cognate individual faced with imminent and certain death and unbearable pain to choose the right to die on their terms rather than to allow the agony and anguish of a death unsolicited. I, like many Victorians, have felt the anguish and the pain that comes from seeing a loved one suffer a painful death. But that is not why I support this bill and it is not something I intend to go into — that is, a personal reflection upon loss. While I acknowledge that personal experience can force politicians to deal with realities or perspectives that they might otherwise not, in my view good public policy should not be limited by our personal experiences.

As politicians we have a duty to consider not just what life thrusts in front of us but to open our eyes and exercise our empathy and our kindness towards all in our community. There are many people’s lives whose experiences I cannot fully fathom, who face injustices, prejudices and sufferings that I have not, but I am not excused from the obligation to do what I can to help. This bill represents an attempt to do just that.

Our humanity, our self-awareness and our understanding of the finite nature of our existence is our defining trait. The inevitability of death should not be a grotesque conclusion, but faced with the inevitability of impending death and unendurable pain no caring society can absolve itself of true compassion — the compassion that respects the afflicted individual’s right to choose the terms of their end. We have a level of self-awareness that is nothing short of what has been described as ‘the universe observing itself’. Our minds are capable of exceptional technical and artistic achievements. Life is the most magnificent fleeting moment in the long sweep of eternity. Every life is both unique and fragile. We live every moment of this exquisite gift that is our lives and we know that only once, but with great certainty, we will die. Death of course is the ultimate full stop. It does not define our lives; it is an end, but it should not consume who we are, how we live and love and what we value, what we achieve or our failings and of course our foibles.

Too often too many Victorians lose their lives in the most grotesque pain, rendering them and their families powerless, helpless and exhausted. This end is so traumatic and debilitating that everything of a life well lived is lost in the flood of pain and despair. The end comes to define a life. The full stop becomes the longest and most lasting memory.

Victoria’s Voluntary Assisted Dying Bill allows people experiencing severe pain and facing the end of life to make an active and informed decision about the timing and manner of their death. The bill implements a number of safeguards and protections. Victoria has learned from other jurisdictions which have legislated for eligible persons to access voluntary assisted dying. The bill incorporates recommendations from the report of the Voluntary Assisted Dying Ministerial Advisory Panel. The eligibility criteria mean the people accessing voluntary assisted dying will be limited. A person must be 18 years or over, an ordinary resident of Victoria and an Australian resident or permanent citizen. In other jurisdictions where there is no requirement to be a resident, people will travel to access voluntary assisted dying, which is known as ‘death tourism’. The resident requirement has been included in the Victorian bill to preclude people travelling to Victoria to access voluntary assisted dying.

The person must be diagnosed with an incurable disease, illness or medical condition that is advanced and progressive. The disease, illness or medical condition is expected to cause death within weeks or months but not longer than 12 months. It causes suffering that cannot be relieved in a manner that is tolerable to the person. These are the people who are dying; their end of life is imminent and they are facing unbearable pain. The bill makes clear that disability alone does not meet the eligibility criteria. Mental illness alone also does not meet the eligibility criteria.

Voluntary assisted dying is not an extension of palliative care. Palliative care services will continue to provide care to a person based on their clinical needs. In other jurisdictions with a voluntary assisted dying scheme 80 to 91 per cent of people who choose to access the scheme are supported by palliative care. The person must have decision-making capacity. A person will be required to make three requests to access voluntary assisted dying over a period of at least 10 days. The requests must be initiated by the person.

This is a voluntary scheme. A person can withdraw from the voluntary assisted dying process at any time. A health practitioner is prohibited from initiating discussion about voluntary assisted dying. A person is not required to participate in voluntary assisting dying if they do not want to. The first request is verbal and triggers an assessment process by two independent medical practitioners. The second request must be in writing and signed by the person and two independent witnesses. The third request is verbal and must be at least 10 days after the first request. It triggers the final review before the medication is prescribed. The person then self-administers the medication at a time of their choosing. In the presence of a witness, a medical practitioner may administer the dose if the person is physically unable to. Conscientious objection by health practitioners is allowed, provided they do not interfere with a person’s access to lawful treatment.

The person must appoint a contact person who is responsible for returning the medication within one month of the person’s death; in 40 per cent of cases in other jurisdictions a person dies prior to self-administering the medication. The Victorian bill provides safeguards against unused medication by requiring the appointment of a contact person.

The bill establishes an independent Voluntary Assisted Dying Review Board to oversee the framework and review every case of assisted dying. The Voluntary Assisted Dying Review Board will have the specialist knowledge required to oversee the framework. The bill provides the Victorian Civil and Administrative Tribunal with jurisdiction to hear disputes about whether a person is an ordinary resident of Victoria or has decision-making capacity. The bill provides for review of the Voluntary Assisted Dying scheme after five years. The review will ensure the bill is updated and subject to further analysis.

We make personal choices about the kind of lives we want to lead, yet we are robbed of the choice about the form of its conclusion. Without this choice we are asking people to suffer beyond what they would choose to suffer. The Legislative Council’s Standing Committee on Legal and Social Issues held an inquiry into end-of-life choices. Evidence from the coroner indicates that one terminally ill Victorian takes their life each week. There are also publicised examples of unsuccessful suicide attempts, often using violent means.

I received many letters from constituents in the lead-up to this bill being debated in Parliament. I refer to correspondence from the Ambulance Employees Australia – Victoria supporting the introduction of the bill. The union represents employees who are regularly called to assist people suffering terminal medical conditions towards the end of their life. A recent online poll of their members showed that about 462 respondents, or 99.34 per cent, were in favour of voluntary assisted dying legislation being introduced in Victoria. It is evident that paramedics’ exposure to the unnecessary and intolerable suffering of their patients has led them to overwhelmingly support this bill.

A world of pain endured by those suffering, no matter how stoically by our loved ones, is not the lasting impression they wish to leave. But all too often these are not choices we can make in our final moments. No-one likes to see their loved ones suffer, particularly when there is the hopelessness of the certainty of that terminal suffering.

Medical practitioners have a hard enough job dealing with palliative care and end stages of life. Sometimes this care works, but sometimes it does not alleviate pain — certainly not adequately. The magnitude of suffering a person endures is really for them ultimately to decide.

Life in all its broad diversity must be embraced and celebrated. Life’s end, and how we as a society exercise our responsibilities to those suffering, says more about us and our values than the stoicism of the afflicted. I once stated in this place that life without hope is mere existence. I believe that a compassionate society will always reinforce the value of that existence, even at life’s end.