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Legislative Assembly for the ACT: 1997 Week 2 Hansard (26 February) . . Page.. 438 ..

MR KAINE (continuing):

Mr Speaker, I have a few comments to make about the Bill itself. It requires that a person making a decision to receive euthanasia be of "sound mind". Exactly what does that mean? The Diagnostic and Statistical Manual of Medical Disorders does not mention it; nor does any modern psychiatric textbook or manual use the phrase. Do not just take my word for it. I am referring to an article in the Melbourne University Law Review in 1993 entitled "Medico-legal aspects of the `Right to Die' legislation in Australia". We have other legislation in the ACT at the moment which is causing trouble because of the lack of definition of words used or not used in the medical profession. This is another beauty, is it not? You can imagine the litigation that is likely to go on over those two words "sound mind".

It is questionable whether even a 72-hour cooling-off period after the patient learns that the illness is terminal, followed by a further 24 hours after the statutory preconditions to the grant of a request for help to die are met, is sufficient. Illness is vulnerability at its most intense. The sufferer loses confidence in his or her own body and future. Patients bring the vulnerability of this time to their relationships with medical professionals who hold the knowledge that patients may desperately need. This adds to the dependence which characterises the doctor-patient relationship. In all, it is not a time in the patient's life when a rational decision is always possible. There is scope for mistakes on both sides. I am sure that Mr Moore does not wish mistakes of this kind to happen; but I warn him that, no matter how carefully his Bill is drafted, they can and will happen.

The Bill refers to palliative care and makes it a condition that the patient must be satisfied that palliative care is not satisfactory. The patient must get information from the medical practitioner about the illness, alternative forms of treatment and their consequences, including palliative care, and the consequences of remaining untreated and not receiving palliative care. Can we be confident, Mr Speaker, that even a patient apparently of sound mind, on getting this information, can make the right decision? It is not enough to rely on the Bill's requirements for that.

Medicine is an excruciatingly difficult science, practised by mere mortals who, while they may have access to all manner of modern diagnostic technology, are capable of making mistakes. At the least, the practitioner who provides the information to the patient needs to be a specialist in the disease which the patient is suffering. So too must the practitioner who carries out the obligatory second examination. (Extension of time granted) The Bill imposes an awesome burden on both of those practitioners. What if they disagree? Does this oblige the patient to go shopping for two who do agree, and what if the practitioners are not both familiar with the person? The practitioner may well read case notes, but in such a critical situation is it not essential that the practitioner also know the person whose life is under consideration, or are we considering just the carcass of an animal here?

Summing up, Mr Speaker, I do not believe that it is possible to draft legislation that would adequately protect people in the moment of their greatest vulnerability. The Bill is unnecessary as a matter either of law or of medical practice. The Bill says that, while we abjure capital punishment even for our most heinous criminals, it allows us to kill the depressed, the lonely, the disabled and those in pain. Mr Speaker, I have the most

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