Page 2874 - Week 10 - Wednesday, 14 September 1994
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To take a particular religious view of the process of dying, there is a very strong argument that death should be allowed to take its course and that intensive care clinicians should avoid artificially prolonging the process. Mr Moore's Bill, the Medical Treatment Bill, essentially clarifies the legal situation in relation to withholding treatment. The difficulty at the moment is that a doctor or other medical professional who ceases that interventional treatment is in a very grey legal area. Even though it may be clear that they are acting in accordance with the wishes of the patient, doctors are under an ethical and legal duty to provide treatment. Doctors are constantly being sued by patients or patients' families, alleging negligence in failing to provide appropriate treatment. The doctor who pulls the plug, or turns the machine off, must always worry whether or not at some time in the future their conduct could find them in court.
In essence, what Mr Moore's Bill proposes to do - it is something that the Government had long ago announced its intention to support - is ensure that there is a method by which an individual can make it clear that they do not wish to have intensive interventional treatment and that they wish nature to take its course; that those wishes will be respected; and that medical professionals, health professionals, doctors or nurses who, in good faith, obey those instructions and give effect to the wishes of the individual will not face legal action. The so-called "living will" is a simple form in which an individual can make that election. We do not know how often people will choose to do that; but, certainly, it is something that should be there if a person does want to make that election.
One significant recommendation that came out of that committee process and that is reflected in this Bill is a simple form of written direction, printed as a schedule to the Act, which can easily be circulated. It is the sort of thing that I would anticipate that the Department of Health would have printed and made available in health care facilities here in the ACT. It is a significant step forward, in the sense that it allows the individual's rights to be respected and provides legal protection for medical professionals. No doubt, medical professionals do respect individuals' wishes when they say that they do not want further intensive interventional treatment; but there is always that doubt as to their legal status and there is always that possibility of litigation.
The Government has a range of amendments, which have been circulated and which carry with them a fairly extensive explanatory memorandum. By and large, these relate to fairly technical issues which we seek to tidy up. There is some interrelation between the Bill and the powers of attorney legislation. There are other clarifications and improvements of which I believe the proponent of the Bill generally is supportive. There is one other issue that the Government has addressed, and that relates to the provisions in the Bill which say that there is a right for patients to seek as much pain relief as they want. That is a very sensible concept and one which we support. Indeed, it came out of some very carefully considered work that was done by the committee.
However, we do suggest a qualification to that provision. We say that the right to maximum relief from pain and suffering should be qualified so that it reads "relief from pain and suffering to the maximum extent that is reasonable in the circumstances". At the end of the day, maximum relief from pain and suffering is death. It is clear that the intention of the Assembly in passing this Bill is not to facilitate active euthanasia, in the sense of a massive dose of a pain-killer which would immediately result in the death of
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