When it comes to legislating voluntary euthanasia in Australia, success is rare and short lived.
The Tasmanian Voluntary Assisted Dying bill is the latest such piece of euthanasia legislation to be defeated. It was ultimately voted down, although it was close – 13 to 11 votes.
The outcome was a great disappointment to many: opinion polls consistently indicate majority public support for legalisation of voluntary euthanasia. So, why are our legislators not representing public opinion?
Tasmanian members of parliament were allowed a conscience vote on the bill. All of the Tasmanian Green members of parliament supported the legislation, as did the majority of the Labor members (only three Labor members voted against it).
Notably, all Liberal members voted against the bill. This was also the case with a 2009 Tasmanian bill, Dying with Dignity.
Other Australian jurisdictions have seen the same voting patterns. For example, earlier this year, a similar bill proposing assisted voluntary euthanasia – Rights of the Terminally Ill – was defeated in the NSW Parliament’s upper house by a far greater margin (23-13).
After the defeat, the sponsor of the bill, Cate Faehrmann, expressed her bitter disappointment:
…and with the MPs who I know support reform but chose to abstain or vote against the bill for political reasons. Outrageously, not a single Coalition member voted in favour of the bill. It was hard to believe it was a conscience vote. Clearly pressure was placed on some members to not support my bill.
All other legislative attempts in Australia have also failed, but some have come closer than others.
South Australia looks to be the next state to consider a vote on euthanasia legislation, with the Ending Life with Dignity bill.
If an Australian state – as distinct from a territory – were to pass voluntary euthanasia legislation, there would be no valid constitutional basis for the Commonwealth parliament to override it, as it did to the Northern Territory bill 1996.
Means and ways
Each of the proposals that have been put forward had different specifications.
The recent Tasmanian bill, for instance, provided for voluntary euthanasia, where a doctor is directly involved and assists with the termination of life.
The bill also provided for doctor-assisted suicide, where a physician only provides a prescription and is present while a patient administers the medication.
In contrast, the NSW Rights of the Terminally Ill bill only aimed to make doctor-assisted suicide legal. An exception was made for people who are mentally competent but physically incapable of self-administering, who would require a doctor to actively administer any drugs for them.
Proposals for decriminalising voluntary euthanasia, without making the practice “legal”, have also been put forward.
In the United States, two states – Washington and Oregon – have both successfully enacted assisted-dying legislation. In these instances, the legislation came about as a result of a citizen-initiated referendum process available in those states.
The Netherlands and Belgium have also legalised active voluntary euthanasia. In those countries, the political situation is quite different to Australia. There, multi-party systems have resulted in a more diverse parliamentary mix, that potentially allows for a less politicised process on such issues.
Reconceptualising the debate
It’s difficult to understand why, in the face of strong public support, it’s so difficult to pass voluntary euthanasia legislation in Australia, irrespective of the model or quality of the safeguards.
Efforts to champion the cause have come from both doctors and advocacy groups, some religious.
But these tend to be lonely voices in a debate dominated by a vocal minority. Opposition groups, particularly those of a religious nature, have been very vocal and effective in mobilising.
In reality, it’s not a question of whether we begin to allow euthanasia. Rather, it’s whether we are honest about the fact that it already occurs.
Evidence indicates active voluntary euthanasia already being practised in Australia. But the hidden and unregulated nature of the practice leaves both doctors and patients exposed to risk.
Where the practice is prohibited, there’s greater risk of active termination of life without a patient’s request. This lies in stark contrast to countries such as The Netherlands, where voluntary active euthanasia has been legalised but carefully regulated.
Legislation with appropriate safeguards is essential to promote patient autonomy as well as safety.
As the bill’s author, Tasmanian Premier Lara Giddings noted in the aftermath of the defeat of the bill, achieving major social change is always an incremental process. Eventually though, the overwhelming tide of public support for change must surely be acted upon.