Debate stirs over legalised euthanasia as NSW set to consider new bill

Sydney state MP Alex Greenwich is leading the charge to legalise voluntary assisted dying in NSW, as he prepares to submit a bill for parliamentary debate next month.

His campaign joins multiple states considering whether to grant people suffering from severe and incurable diseases access to euthanasia.

Most recently, South Australia joined Victoria, Tasmania and Western Australia in approving a voluntary assisted dying scheme. Queensland is expected to hold a conscience vote later this year.

Over the past two decades NSW has seen three attempts to push legislation forward, the last in 2017 was defeated by a single vote. After a rapid progression led by other jurisdictions, Greenwich said he is hopeful the state parliament has had a change of heart.

“NSW has been a very conservative state and is a state whose parliamentarians like to carefully consider every issue,” he told Aged Care Insite.

“By the time I have the bill ready, it will be informed by every other state’s legislation which will give my colleagues confidence that we have legislation that will be the best in the country."

The NSW bill largely draws from the one seen in Western Australia, which will make assisted dying accessible to those living with a terminal illness who have six months left to live, or twelve months if diagnosed with a neurodegenerative condition.

Public opinion surveys in NSW have shown support for legalising euthanasia, with over 70 per cent in favour. The state’s premier, Gladys Berejiklian, along with campaigners and church bodies, continue to express opposition.

In late 2020, Berejiklian told the press she was “personally uncomfortable” with the subject and would prefer if it wasn’t debated in parliament “given everything else we’re facing”.

Despite resistance, Greenwich contends that the upcoming bill is likely to receive approval across the board. If the law does pass through, it could potentially become legalised by Christmas.

“I know that there is strong support for reform within the National Party, the Labor Party, the crossbench, and there are a number of people on the record of all parties in support,” he said.

“I really want to make sure this is a reform that is owned by the entire parliament, where every member has the ability to have their say."

As more states move to legalise euthanasia, doctors must navigate a risk of persecution due to a commonwealth law which prohibits discussions of suicide over the internet or by phone. Any charges made based on the law rests upon each individual state's interpretation.

Greenwich said that if his bill becomes law, practitioners in NSW should not offer end of life services through telehealth consults due to legal uncertainty.

“It is going to be important that we get the balance right between making sure that there are the necessary safeguards in the legislation and making sure that we don't put in politically charged safeguards which limit access,” he said.

“I’m really keen to work with my colleagues who represent both rural and regional NSW to make sure that those people and their communities are treated equally as people living in my city electorate.”

Concerns have since risen in Victoria over extremely unwell citizens being unable to attend face-to-face consultations due to living with mobility issues or being situated in non-metro areas. A recent study found this was also a significant burden for medical practitioners involved in the scheme.

The government has rejected all calls to amend the commonwealth law, which was first passed in 2005. Greenwich said that if his bill is successful the state is likely to spend 12 to 18 months assessing the needs of practitioners before placing any scheme into effect.

“The government will have a good amount of time to be able to put the legislation into practice and to make sure there is the right support and resources for all healthcare workers involved,” he said.

On July 1st, Western Australia's first legally assisted dying laws came into effect. The bill was approved for legislation in 2019 following weeks of rigorous debate, a decision which was welcomed by Dying with Dignity WA President Stephen Walker.

“All in all, I think it’s well accepted and it’s well known that the great majority are saying, let's get on with it, it's about time,” he said.

A large majority of Western Australians support legal euthanasia, according to surveys taken in 2017. GP Scott Blackwell, chair of the state's VAD implementation leadership team, told the ABC that one to two per cent of the state's population are eligible to access the service.

While campaigners have expressed their support for the new laws, vehement opposition from church groups has persisted.

“The main thing we are concerned about is the position of faith based institutions both in hospitals and aged care providers,” said Walker.

“This is something we are going to be monitoring very closely.”

Some of the largest hospitals and aged care facilities in WA operate under church ownership. Over 2000 private and public hospital beds, and over 6000 residential and home care packages across the state are located incatholic health institutions.

Earlier this month, Perth Archbishop Timothy Costello declared in a pastoral letter that staff working in the state’s catholic health sector will not facilitate or encourage patients and aged care residents to access the scheme.

“We think that while doctors and nurse practitioners absolutely have a choice as to whether they participate or not, that choice should be that of the individual practitioner and not dictated by an employer,” said Walker.

According to Walker, only a minority of doctors and nurses have completed the required training, hampering the early weeks of legally assisted dying in WA.

Walker suggests this issue will be of great concern over the coming months.

“There are also some requirements in WA which are being introduced by the Director General of the Health Department,” he said.

“We are concerned they are providing impediments to medical and nurse practitioners signing up.”

According to the WA Department of Health, medical practitioners and nurses must seek the approval of two professional referees and have practiced twice the minimum hours per registration period.

“We want to see how it plays out to the extent to which they’ll allow doctors and nurse practitioners and the care navigators who help people through this process.”

In NSW, Greenwich is expected to present his legally assisted dying bill to the public by the end of July. He told SMH last week that he hoped the matter will be debated by state parliament during the final sitting period in August.

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