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Appetite for change, but satisfying it requires almighty struggle

21 November 2015 115 views No Comment

Many historians are interested in the progress of social movements, some of which are dubbed inevitable. However, that ducks the question of timing.

Becoming a republic and same-sex marriage are said to be inevitable in Australia. But why have they not happened already?

Despite the defeat in the 1999 referendum, 62 per cent of Australians in 2001 still favoured a republic. In 2012, after the Queen’s Diamond Jubilee, 58 per cent wanted to retain the monarchy. And this week the Australian Republican Movement announced that 51 per cent of Australians — a bare majority — wanted a republic.

Now, about two-thirds of Australians support same-sex marriage (up from 38 per cent in 2004). Two to one is a substantial majority. And in 2011, 75 per cent thought it was inevitable.

Compare these figures with public support for voluntary assisted dying (also known as voluntary euthanasia, dying with dignity or medically assisted dying/suicide).

For the past 20 years, public support in Australia for such a law has run at 75-85 per cent, regardless of political allegiance, religious persuasion, age or gender.

Four out of five people support legislation that gives a person who is suffering unbearably from an incurable illness the choice of asking a doctor for help to end their life quickly and painlessly. That is an overwhelming majority. But there is still no legislation, so even a massive majority of public opinion does not mean inevitability.

Every now and then debate is stimulated, often by a tragic ­personal story of an agonising death. Recently, a panel on the ABC’s Q&A program talked about “facing death. These types of programs can be useful but they are often frustratingly short on time and content.

In this debate, Andrew Denton concisely and cogently put the main arguments in favour of voluntary assisted dying. But there was almost no mention of the opposition of the Catholic and Protestant churches, nor was the position of the Australian Medical Association explained. Some palliative care specialists acknow­ledged they could not help a very small percentage of dying patients but did not draw the conclusion that voluntary assisted dying was complementary, not antagonistic, to palliative care.

More significantly, the panel­lists did not raise the issue of why, on many occasions, politicians have rejected voluntary assisted dying bills.

If this question had been ­mooted, a panellist might have pointed to the elements of a parliamentary process that would make a successful outcome likelier.

Some supporters of voluntary assisted dying think all that is needed is a conscience vote, where in theory politicians are unencumbered by a party line and can vote according to their personal beliefs. If the members of parliament are in any way representative of the 75-85 per cent of those who elect them, there should be no doubt about the result.

But that has not happened. Private member’s bills seeking to introduce legal voluntary assisted dying were considered in NSW and Tasmania in 2013.

Both purported to be conscience votes. The NSW bill lost by 21 to 11 in the upper house and the Tasmanian bill lost by 13 to 11 in the lower house.

Remarkably, not a single conservative politician voted in favour of either bill. A few abstained, but none voted yes. One would have to conclude there were other factors at work besides their personal view (perhaps their religious belief) on whether voluntary assisted dying was a good idea.

It is often instructive to see how a progressive policy has been introduced elsewhere.

In The Netherlands, there were numerous court cases and lengthy public and professional debate for more than 20 years before a ­voluntary euthanasia law was passed in 2002.

Quebec passed its comprehensive Act Respecting End-of-Life Care last year. It not only codifies how terminally ill patients can choose medical aid to die but also strengthens “living wills and enshrines their right to palliative care. But the whole process took four years. It was eventually passed after two years of public consultation, the preparation of a thorough report by a nonpartisan committee and the approval of more than 75 per cent of Quebec’s population. The final free vote, unbound by party lines, was 94 in favour and 22 against.

In my view, any legislative success in an Australian parliament will almost certainly depend on cross-party interest and support, perhaps beginning with a small group of like-minded MPs.

In the NSW parliament, there is such a newly formed cross-party working group on assisted dying, led by Trevor Khan, a National, whose concern about end-of-life choices has been prompted by the extreme suffering his father endured before his death. This could lead to setting up a parliamentary committee — or some other kind of body, such as the Law Reform Commission — that would produce a report to be used to draft a new bill.

There would need to be a lengthy public inquiry, such as is taking place in Victoria, where an upper house committee is looking at end-of-life choices. The committee includes Fiona Patten, the feisty leader of the Australian Sex Party, whose platform includes support for voluntary assisted dying.

In the West the tide of change may be accelerating. Earlier this year, the Canadian Supreme Court unanimously overturned a 20-year-old ban on doctor-­assisted dying. The Canadian Medical Association now “recog­nises that there are rare occasions where patients have such a degree of suffering, even with access to palliative and end-of-life care, that they request medical aid in dying.

It “believes in those cases … that medical aid in dying may be appropriate.

And last month, California Governor Jerry Brown, who noted his personal conflict about making the decision, signed a new law to allow assisted dying.

Although a Catholic and a former Jesuit seminarian, Brown said: “I do not know what I would do if I were dying in ­prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill.

“And I wouldn’t deny that right to others.

Are voluntary assisted dying laws inevitable in Australia?

Maybe so. But they are unlikely to occur quickly or without considerable personal and political struggle.

Ross Fitzgerald is the author of 38 books including his memoir, ‘My Name is Ross: An Alcoholic’s Journey’.

The Weekend Australian, November 21-22, 2015, Inquirer p 24.

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