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Legislative Assembly for the ACT: 1996 Week 9 Hansard (28 August) . . Page.. 2663 ..

MR MOORE (continuing):

It is not a black-and-white situation. It is not a situation where either the patient has the complete power to make a decision or the doctor has the complete power. It is about a relationship between the doctor and the patient. This legislation, I believe, has the effect of altering the power relationship to a small degree towards the interests of the patient. It does that by removing the test. At the moment, when a patient asks a doctor for more pain relief, the doctor cannot simply make their decision on the way they perceive the patient's request. They have to keep in mind that there is a test and that they may well be sued for providing more than what their colleagues would consider adequate pain relief. Under those circumstances there are difficulties for the doctor.

It is really important to understand that this legislation in no way compels any medical practitioner to be involved. The legislation provides that, if a medical practitioner receives a request for pain relief and it does not make sense to him or her, the medical practitioner can simply say, "I cannot provide that kind of pain relief, because I believe the risks are too great in the circumstances". That professional management remains. It is, of course, open to the patient to find an alternative medical practitioner who may be prepared to provide a little more pain relief.

One of the interesting developments in pain relief over the last few years is that doses of pain relief that have previously been considered inadequate are now being given in quite a number of cases. When pain management experts came before the Select Committee on Euthanasia - we spoke to them in Melbourne and in South Australia - it was confirmed again and again by different people that, in spite of all the advances in medical treatment and pain care, 10 to 15 per cent of people who are in the terminal phase of illness and in pain care are not able to be treated. A year or so ago one notable pain specialist from the United Kingdom claimed a 100 per cent success rate. When she was questioned closely on that, though, it was revealed that the only way they can get a 100 per cent success rate is by effectively anaesthetising the 10 to 15 per cent of people who for a series of reasons do not seem to respond to our current methods of pain control. The choice between being anaesthetised until death and trying for further pain relief is an issue that belongs with the patient and not with a doctor. The real question this amendment raises is who should decide how much pain is bearable. That decision does not belong entirely with the doctor, as is the case now, or even entirely with the patient. The legislation seeks to alter the power relationship somewhat.

Mr Speaker, I draw attention to the report of the Select Committee on Euthanasia. Paragraph 4.8 on page 9 of that report states:

A copy of the draft bill -

which is completely consistent with what I have just tabled -

was circulated, in confidence, to the following for their considered opinion:

. The President of the ACT Branch of the AMA;

. The Chair of the ACT Nurses Board;

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