Tasmanian Premier Lara Giddings and Leader of the Tasmanian Greens Nick McKim have released a discussion paper that outlines and seeks comment on a proposed framework for “voluntary assisted dying”. The paper states a bill will be introduced in the Tasmanian Parliament in 2013.
This is only one in a group of attempts to legalise voluntary euthanasia and assisted suicide in recent months with proposed bills announced in South Australia and New South Wales. The topic has also been examined in a background paper that we wrote, which was recently released by the think-tank Australia21.
But the Tasmanian development is perhaps the most noteworthy and may be the first attempt to get over the line since the Northern Territory legislation in 1996. That law was overturned by the federal government in 1997.
It’s significant that the case for reform is led by the premier and the leader of Greens. And it remains so despite the fact that they’ve made it clear they’re acting in their capacity as private members and a conscience vote is expected. That’s because this is a departure from the usual pattern – bills have traditionally been introduced by minor parties or independents.
The involvement of Giddings and McKim makes it difficult for opponents to dismiss the proposals for reform as agitation by the political fringe.
The process of advancing reform is also noteworthy. The discussion paper engages with a body of empirical evidence and scholarship from the major legislative regimes that permit and regulate voluntary euthanasia or assisted suicide. And it includes reports on the topic by the Commission on Assisted Dying in the United Kingdom and Royal Society of Canada.
A focus on safeguards
Having endorsed legalising voluntary assisted dying, the discussion paper focuses on safeguards. The pitch is to those who may support such legislation in principle but have concerns about adequate safeguards. The paper notes this was the position of some members of parliament when the 2009 Dignity with Dying bill was put forward by McKim. That bill was defeated 15 votes to seven (with two MPs absent).
To address these concerns, the discussion paper explicitly outlines the differences between the proposed model and the 2009 bill. It also engages with the arguments and issues about the earlier bill raised in a report by the Tasmanian Parliament’s Joint Standing Committee on Community Development.
The proposed model contains many of the safeguards that are traditionally seen in such legislation. It deals with competence, voluntariness, the informed nature of the decision, patient eligibility criteria, procedural and reporting frameworks and the role of doctors. A few of the proposed model’s features warrant particular mention.
The first is that a patient’s decision to have their life ended will be the subject of prospective, rather than retrospective, review. The written and witnessed request for assistance to die must be forwarded to the independent oversight body during a “cooling off” period. The paper argues this ensures the voluntariness of the request before it can proceed.
This specific requirement is not part of similar legislative regimes overseas. While opponents may question the scrutiny such oversight brings, prospective review does provide scope for intervention before a patient dies in a way that a retrospective review cannot.
Another significant feature is entrenching the requirement for a doctor to present the patient with a final opportunity to rescind their request in the legislation. The paper makes clear that this safeguard is in response to the 2009 Parliamentary Committee, which considered the previous bill to be deficient for not requiring this.
Perhaps this is it
It’s hard to imagine that state and territory governments will be able to resist the forces calling for change on this issue. Persistent and strong public support for legalisation coupled with a better understanding of how such regimes could work means that change – if not now then at some point in the foreseeable future – is inevitable.
A 1998 report by the Tasmanian House of Assembly Community Development Committee into the need for voluntary euthanasia legislation concluded that such “legislation could not adequately provide the necessary safeguards against abuse”. A lot has happened since and we now have over a decade of evidence about how some permissive jurisdictions overseas work.
The confluence of influential political champions and the focus on carefully addressing concerns about safeguards may mean that Tasmania becomes the first Australian jurisdiction (since the Northern Territory in 1996) to legalise voluntary assisted dying.