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Legislative Assembly for the ACT: 1997 Week 11 Hansard (5 November) . . Page.. 3675 ..

MR WHITECROSS (continuing):

considered in the past and which I have voted for in the past. I think those Bills were good pieces of legislation, and I was happy to vote for them. I was disappointed that a majority of people in this Assembly were not willing to vote for them, but that legislation provided safeguards to ensure that people requesting the administration of drugs which were likely to cause death had appropriate safeguards to ensure that everyone after the event could be confident that their intention was properly carried out. This approach seems to me to not have any of those same safeguards, although it could possibly be used in the same way.

Mr Speaker, subsection (2) of section 23, which is the section that we are amending, provides that in deciding on a level of pain relief the doctor should take account of what the patient says about their level of pain. If our concern is to ensure that the doctor appropriately manages the patient's pain, then I think subsection 23(2) provides for the necessary impetus to ensure that the doctor appropriately takes account of the amount of pain that the patient is suffering from. What we are talking about here goes beyond that. What we are talking about here is removing words designed to suggest a reasonableness test on the part of the medical practitioner as to the amount of pain relief that is required. I suspect that deleting these words makes no difference; but, if it does make a difference, I think the difference is an undesirable one. For that reason, I will be voting against the clauses.

MR MOORE (5.30): I think it is worth responding to the concerns that Mr Whitecross raises, specifically with reference to section 23. I will try to do them both. Clause 7 actually refers to section 23 and section 4, the objectives of the Act; but it is the same argument. When Mr Connolly moved the amendment to add this, the argument was that we needed a test of reasonableness. When you add a test, you change the dynamics between the medical practitioner and the patient. Adding the test means that the medical practitioner no longer takes into account the patient's concerns alone. He or she takes into account the patient's concern about the issue, on the one hand; but they also have to take into account the concern that you can now bring a court in to test this reasonableness and to test whether that was an adequate amount of pain relief.

The example that I gave earlier when I introduced this Bill was that a patient who had been perhaps opiate dependent, perhaps a methadone patient, perhaps even somebody who regularly used a drug like panadeine forte, could well have a higher tolerance to morphine than would normally be expected. Certainly, it would be so for somebody who was heroin dependent. It may be possible, as I gave the example, that the doctor has to take that into account. There is no question about that. The doctor might also, though, be caught up in the situation, with somebody who is heroin dependent, that they are effectively sworn to secrecy because that person does not want anybody to ever know they were heroin dependent. Therefore, they are in a situation where the reasonable test puts them in an awkward position; but that is an extreme example. By putting an extra test in place, it means that the medical practitioner is not dealing with just the pain that the patient is suffering but is dealing with a series of other issues about how a court and his peers might see it.

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