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Legislative Assembly for the ACT: 1997 Week 2 Hansard (26 February) . . Page.. 507 ..

MS REILLY (continuing):

One of the issues that have been mentioned is the pressure on older people, on people living in nursing homes. Let us consider those people and the legislation as it stands. Being old is not a terminal illness, necessarily. It is a fact of life that most of us will get old at some stage, and I do not see why we believe that people who are elderly have fewer rights than others. Those who suggest that there will be pressure on people in nursing homes to accept voluntary euthanasia have not visited many nursing homes in recent times. A number of people who are living in nursing homes now would not fit the criteria of this Bill. One of the problems for those working in nursing homes is the number of people with dementia, who do not fit the criteria of this Bill for making a decision to participate in voluntary euthanasia. So you cannot use the old people living in nursing homes as an excuse not to introduce this Bill.

Another consideration is the view that good-quality palliative care will resolve all the issues in relation to people with terminal illnesses. Palliative care is certainly a means by which a number of people manage the situation when they are in the last stages of a terminal illness. In many circumstances, palliative care addresses very well the pain associated with some terminal illnesses, but this is only one part of the dying process. No matter how good the palliative care, no matter how caring the people working there, some pain is not able to be relieved through palliative care.

We will not be able to put in the dollars that will change that situation. It comes back to what I mentioned previously about the changes in medical technology. We are seeing the development of cancers following previous treatment. People have managed to get treatment for the first series of cancer, but the second ones are more painful and result in more difficult deaths. We need to address this issue as a community, and this is one way of doing that. We also need to consider that, when people are in the final stages of a terminal illness, physical pain is not the only issue. We need to consider their mental suffering and listen to what they are saying about their needs. Pain relief may not be the only answer. With some forms of pain relief, there are side effects that create problems. It is not just a matter of saying that if you give certain types of drugs it will be all right.

In relation to palliative care, doctors do recognise that the various drugs that are available cannot always fix the physical pain. There is evidence from doctors that one way of overcoming this is to give patients considerably more of the drugs so that they go into a deep sleep, which often leads to death because of the associated illnesses that develop. Of course, they say that this is not euthanasia. I am not sure of the difference between giving a person the right to make the decision, which is voluntary euthanasia, and a doctor deciding the amount of medication he or she will administer. It still leads to death, but we do not use the word "euthanasia" in that situation. We quite often leave the person suffering for several more days until the other infections that develop take their course. I wonder whether that is a caring way of addressing the situation.

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