Monica Doumit: Diabolical in the detail

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Conscience rights are quashed and loopholes are everywhere in the NSW dying Bill. PHOTO: Sharon McCutcheon/Unsplash

Four years ago NSW politicians voted down a dodgy dying Bill, this one is even worse

Last week, I wrote about the irresponsible timing of the Alex Greenwich euthanasia and assisted suicide bill. I said that with a state in lockdown and many people separated from elderly relatives and loved ones in hospital and aged care, the introduction of a pro-suicide bill is particularly callous.

The extension of pandemic restrictions has meant that NSW Parliament has postponed sittings for the time being and so Mr Greenwich’s deathly plan has been delayed for at least a few weeks while the state grapples with the current crisis. But he will no doubt recommence his campaign once parliament resumes.

While most MPs have not revealed how they will vote on the draft bill they have received, it is worth noting that the Parliament rejected a much stricter euthanasia bill just four years ago. It is curious that Mr Greenwich imagines that he will get more MPs on board with the bill by slashing some of the safeguards that appeared in the most recent attempt to get these laws through parliament.

It would be astonishing if any MP who voted against the 2017 bill was suddenly attracted to Mr Greenwich’s attempt that creates scores of additional loopholes.

There are countless examples of Mr Greenwich’s winding back of provisions that aimed to protect the most vulnerable, but I will mention just a selection of them.

The first is the age limit. In the previous iteration of the euthanasia bill, a person had to be at least 25 years of age to access lethal drugs. Mr Greenwich has dropped this to 18 years.

Then there was the suite of requirements applicable to the two doctors signing off on a patient’s eligibility for death. The 2017 bill made it obligatory that at least one doctor was a specialist in the illness suffered by the patient; this has been removed in Greenwich’s 2021 attempt.

The 2017 bill also required that both doctors actually meet and examine their patient in-person, and sign the documents approving a patient’s request for death in their presence. In Greenwich’s revision, doctors need not ever meet or physically examine their patient, and can sign a death warrant via Zoom.

The 2017 bill made it essential that the two doctors agreeing to a patient’s death were independent of each other, to remove the risk that medical colleagues could influence each other. Greenwich’s 2021 bill has removed this guarantee of impartiality.

Monica Doumit: Appalling timing in push for death law

Greenwich’s bill also removes the rights of doctors to refuse to have anything to do with killing their patients. The 2017 bill allowed both a doctor and a health facility to opt out of any part of the euthanasia process. The 2021 bill requires doctors to provide patients with information about where they can access euthanasia and requires even faith-based aged care facilities to allow every part of the euthanasia process to occur on their premises.
It’s not only the choices given to doctors that are being removed. The Greenwich bill also removes the choices for care given to patients themselves.

The 2017 bill rejected by NSW Parliament required that a patient be examined by a qualified psychologist or psychiatrist after they made a request for euthanasia or assisted suicide. The 2021 Greenwich bill removes this mandatory examination of the patient by a mental health expert; instead, they are only referred if the euthanasia doctor thinks they should be.

The 2017 bill also made it obligatory that a patient be offered a referral to a palliative care specialist, with the patient able to accept or refuse that referral. The Greenwich bill removes the requirement that this choice be offered to a patient.

There’s also a watering down of safeguards in relation to a patient’s request for death. In the 2017 version of this bill, a patient who was incapable of physically signing a request for euthanasia or who needed an interpreter needed to have their request for death filmed; a protection against a doctor or an interpreter deliberately, negligently or recklessly misreading a patient’s end-of-life decision. Mr Greenwich has scrapped this layer of security, allowing a patient to even request death by way of non-specified ‘gestures’ that are not recorded anywhere.

nurse adjust patient's IV needle.
The removal of safeguards for the sick and vulnerable elderly in Mr Greenwich’s latest iteration of dying laws is shocking. PHOTO: Freepick

Mr Greenwich has also watered-down other compliance mechanisms. Under the 2017 bill, a person would only be protected from prosecution if they acted lawfully under the bill. Mr Greenwich is seeking to additionally protect those who think they are acting lawfully, irrespective of whether they are or not.

The 2017 bill made every death reportable to the coroner. The 2021 Greenwich bill removes the mandatory coronial oversight. The 2017 bill required that the Voluntary Assisted Dying Review Board would include the State Coroner or their nominee, representatives from the Medical Board of Australia, the Australian Medical Association or the Royal Australasian College of Physicians, the Royal Australian and New Zealand College of Psychiatrists or the Australian Clinical Psychology Association Limited, Palliative Care NSW and others.

The Greenwich no-oversight bill doesn’t require that any medical expert be on the review board; it only mandates the presence of an experienced lawyer.

I could go on and on, but you get the point. The removal of safeguards for the sick and vulnerable elderly in Mr Greenwich’s latest iteration of these deadly laws is as confronting as it is egregious.

It would be astonishing if any MP who voted against the 2017 bill was suddenly attracted to Mr Greenwich’s attempt that creates scores of additional loopholes. Indeed, those who voted in favour of the 2017 bill should also be wary of this one. They would be doing their constituents and the rest of the state an extreme disservice if they just voted in favour of it on ideological grounds, with no regard given to the diabolical in the detail.

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