The Queensland Voluntary Assisted Dying Bill goes too far in trampling on the rights of those who want nothing to do with it in the last stages of their own life or in their long term relationships with their patients and residents. This is a new area of law and policy, and we should step carefully being attentive to the rights and sensibilities of everyone. The Queensland Bill does not strike the appropriate balance.
The Queensland Parliament, like the Victorian Parliament four years ago, is committed to legislating for voluntary assisted dying (VAD). The Queensland bill being considered by the one chamber Queensland Parliament this week basically follows the contours of the Victorian legislation. But there are three major new developments proposed in the Queensland bill which are very worrying in this new field of social experimentation.
First, under Victorian law a registered health practitioner is not allowed to initiate the discussion about voluntary assisted dying with a patient or resident to whom they are providing health services or professional care services. If they do, they are guilty of unprofessional conduct within the meaning and for the purposes of the Health Practitioner Regulation National Law. Of course, they can provide all necessary information and opinions once the patient or resident initiates the conversation.
Under the Queensland bill the registered health practitioner is allowed to initiate the discussion. They can even make an unsolicited suggestion of VAD provided they tell the patient about other options, including palliative care. The last thing that aging, sick people need is a cast of evangelising health practitioners prompting them to consider VAD. The Victorian law precludes that; the Queensland bill encourages it.
Second, under Victorian law a doctor is able to buy out of all aspects of VAD simply informing their patients that the doctor has a conscientious objection to being involved in VAD. Back in 2008 when legislating on abortion, the Victorian Parliament conceded that a doctor might have conscientious objections particularly to late term abortions. But the Parliament insisted that the doctor with conscientious objections refer the patient to another doctor prepared to perform the abortion. The rationale was that the patient might otherwise be stranded in an emergency situation.
When it came to legislating for VAD, the Victorian Parliament saw no need to insist that the conscientiously objecting health practitioner provide a referral. There would be other ways to provide the patient or nursing home resident with the time and opportunity to engage someone to assist with VAD. The Victorian Parliament acknowledged that the doctor with conscientious objections to VAD, perhaps even viewing it as assisted suicide, should be left in peace, not having to provide a referral.
The Queensland Parliament is proposing that the provider who views VAD as morally unacceptable must provide the patient with information about another provider ‘who, in the practitioner’s belief, is likely to be able to assist the person with the person’s request’. This extra clause not found in the Victorian law risks trampling unnecessarily on a health provider’s conscience.
Meanwhile, unlike the Victorian law, the Queensland bill specifically states that “a person’s freedom of thought, conscience, religion and belief and enjoyment of their culture should be respected”. Give us a break!
Third, under Victorian law and practice, hospitals and nursing homes can maintain their principled objections to VAD giving notice to all patients and residents that VAD services are not provided on their campuses whether for religious or other reasons. The Queensland bill provides access for consulting VAD practitioners to facilities which do not provide VAD. It provides that all and any steps in the VAD process can take place on these facilities, and it allows the consulting and/or coordinating VAD practitioner, and not the facility’s own admitting clinicians, to decide whether transfer of the patient will occur.
There have been no reported problems in Victoria where Catholic health and aged care services from day one have made it clear:
“Our staff have always had open discussions with patients, residents and families, about their treatment and care at the end of life. That will not change. Each of our services has a system in place that will respond respectfully and compassionately to any questions about ‘VAD’. This includes coordinating transfer of care to other providers if a patient/resident wishes to seek ‘VAD’. We will not impede access to the provision of ‘VAD’ elsewhere.”
The three novel suggestions in the Queensland bill will upset some nursing home residents who would prefer to be left in peace, violate the consciences of some of Queensland’s finest health practitioners, and interfere with the smooth operation of some of Queensland’s finest hospitals and aged care facilities. If any of these suggestions are to be adopted, Queenslanders should first be told what is the specific Victorian problem that each proposal is designed to solve.
This article first appeared in The Australian.