Page 3509 - Week 12 - Wednesday, 12 October 1994
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We are mandating a form of informed consent, which is a rather rare, positive thing to do. The Government supported the original intent of the legislation, and we supported Mr Moore's amendment, which actually takes it a bit further and requires that that informed consent be more comprehensive; but we do not support saying, "And you must by legislative mandate get a second medical opinion to go with that first informed consent medical opinion". Certainly, when the Community Law Reform Committee moves into legislation for informed consent, I would be most surprised if we ended up with a legislative model that required second opinions in every case.
MR STEVENSON (11.35): The amendment proposed by Mr Humphries is a safeguard. In my estimation, there should be no real objection to it. Mr Connolly said that it is really about not trusting the doctor, but it does not have to be. It can simply be held that it is a good idea to have a second opinion as a requirement. Mr Connolly would certainly not say that there are some cases where it might be wise not to trust the doctor, even if it was one in a thousand. From both viewpoints it is a safeguard, and a logical one, and one wonders why it would not be agreed to.
MR MOORE (11.36): I think it is important for us to try to perceive the practical situation. A doctor is dealing with somebody who is trying to determine whether or not they are going to request that a life support system be removed. Such a person ought to be informed. A patient-doctor relationship is usually established over a long time. This amendment would force the medical practitioner to say, "I cannot tell you about the consequences. I am going to have to ask somebody else to do it". Alternatively, he would have to say, "I am going to tell you, but somebody else has to do it as well". That would undermine the relationship between the patient and the health professional who has the primary care of that person. Patients are becoming more and more conscious of their right to ask for a second opinion. It is becoming more and more common. I believe that to mandate it in this Bill is pointless and harmful.
MR HUMPHRIES (11.37): Madam Speaker, I find it hard to see how it could possibly be harmful, but may I correct a couple of misapprehensions? First of all, Mr Connolly is not correct in saying that I am suggesting that there be a second doctor. I said that a second health professional should be involved. It could be one of the other people referred to in the Bill. That person could give this counselling to patients. It could be a nurse.
Secondly, I am not suggesting, as Mr Moore indicated, that the primary health carer, the primary doctor, cannot give advice to his patient about the way in which a particular course of action might turn out. Of course he can. But he has to get a second opinion on that matter. Why is a second opinion needed in this matter? It is obviously a matter in which very often life and death will be involved. It is a matter of extreme seriousness. We are talking about withdrawing treatment from a person. This might lead - from the way this is designed, I suspect that it quite often will - to death. It is entirely reasonable, in those circumstances, it seems to me, to offer some additional protections.
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