Kat THEOPHANOUS: I rise in support of the amendment proposed by the member for Kew, who has worked in very close collaboration with the member for Monbulk to put this forward. In essence, it gives consideration to the risks around allowing broader AHPRA-registered health practitioners to initiate conversations about voluntary assisted dying, as opposed to medical specialists and nurse practitioners, owing to the differentials in experience and setting in which those two cohorts operate.
I want to say at the outset that I am supportive of end-of-life choices and the ability of each individual to make informed decisions about voluntary assisted dying in a way that is not coercive, either overtly or cumulatively. That is a matter of autonomous choice and freedom of will, which I had the opportunity to study extensively from an existential perspective when I completed my honours in philosophy. Indeed, my final thesis was on the topic of free will. It is a principle that I hold very dear and inviolable as an element of our human condition, which is both our blessing and our burden. That is why I am a supporter of VAD as a choice in the circumstances outlined in the bill.
Inherent in that ability to make an autonomous choice about VAD must be the ability to access appropriate information on the availability of VAD, and I am sensitive to the need to expand that access. The current gag clause, as they call it, is problematic in my view. Now, the members have put forward a balanced approach which preserves in the bill the proposed expansion to enable registered medical practitioners and nurse practitioners to initiate discussions about voluntary assisted dying in the context of end-of-life care. That, to me, is appropriate and represents a significant change in the current settings. It means that when those critical conversations are being had between a patient and their medical practitioner and nurse practitioner about diagnosis, about palliative care options and about what happens next, VAD can be included proactively in those discussions.
What this amendment does is prevent this proactive initiation also being expanded to a vast list of other AHPRA-registered practitioners when they are neither trained nor experienced to have such conversations. This includes health practitioners like acupuncturists, dental hygienists, optometrists, podiatrists, pharmacists and herbal medicine dispensers. As the member for Monbulk outlined, many in the medical profession are concerned about this expansion and the risk it poses not just for patients but for potential mental injury to the practitioners themselves.
Like many in this chamber, my community is home to a large, ageing, multicultural population, many with English as a second language and many with cultural norms that elevate the opinion and authority of health practitioners. A single poorly framed or uninformed conversation could leave a person feeling that voluntary assisted dying is the recommended option, that they are a burden on society or that this is the expected pathway.
Without access to diagnostic details and an understanding of disease progression or expertise in diagnosis, even well-meaning practitioners could inadvertently instil fear or despair simply through a lack of skill in these sensitive discussions. Importantly, the amendment preserves the right of these health practitioners to provide information on VAD at the patient’s request and to advise that person that the most appropriate person with whom to discuss voluntary assisted dying or any treatment or palliative care options available is a registered medical practitioner or nurse practitioner.
It is incredibly important to me that strong checks and balances remain in this legislation, particularly against unintended or intended coercion. Equally, it is important to me that patients have access to the information they need to make informed choices. That balance is appropriately struck in this amendment.
