Victoria - extension even before the bill is written

Anyone looking at the experience in Canada since euthanasia and assisted suicide laws came into force last year, should be struck by the moves to extend the law so soon after they had been passed. After all, when you look to Belgium and Holland and even Oregon USA, the moves to expand their laws and/or the application of their laws has taken some time to develop.

There are many reasons why the European and Oregon situations have taken time to see the various incremental legal and effective interpretational changes gather momentum. In Belgium and Holland the statutes were written in very broad terms relating to unbearable and irretrievable suffering. While the understanding at the time of their debates focussed on euthanasia as a 'last resort' option for people in the last stages of a terminal illness, the wording never restricted application in that way.

In the last five years and more there has been a continual pushing at the edges of the community understanding of the breadth of the law. Euthanasia for tinnitus, for blindness, for psychological suffering, for the accrual of minor complaints associated with old age, for fear of entering a nursing home - all unthinkable in the beginning. Add to that the 2013 statute amendment to include children in Belgium and the current discussion in Holland in respect to assisted suicide for people over 70 years of age who are simply 'tired of life', and one can legitimately wonder where it will all stop.

As Dutch journalist, Gerbert van Loenen once observed:

Making euthanasia and physician-assisted suicide legal started a development we did not foresee. The old limit 'thou shalt not kill' was abandoned, a new limit is yet to be found.

Canada seems bent on catching up with the Benelux countries at some pace.

In Victoria, Australia, there also seems to be something of a rush.

A Ministerial Advisory Panel charged with the role of consulting about how to make assisted suicide safe, is due to provide an interim report to Premier Daniel Andrews any day now. The final report is due in July and legislation is slated for the second half of this year.

The Panel's reference was the Legal and Social Issues Committee of the Victorian Parliament report in the matter of the 'Inquiry into End of Life Choices' that was finalised in mid-2016.

Recommendation 49 of that report called upon the Victorian Parliament to legislate assisted suicide for people, "suffering from a serious and incurable condition which is causing enduring and unbearable suffering" and that these persons must be "at the end of life (final weeks or months of life)".

So, not necessarily but most likely a terminal illness but still only for those at the very end or, as the Dutch talked about: a 'last resort' option.

Politically this makes sense. The game, if I can call it that, is to gain 50% plus one support in the two chambers of parliament. The logic is, of course, that it is the first hurdle that is the hardest. Better to get something on the statute books rather than risking yet another loss from trying for too much.

In September last year, Victorian Health Minister, Jill Hennessy warned pro-euthanasia advocates not to be too greedy:

Politicians need to ask themselves: is it about being pure or is it about saying 'let's get the best result we can'?

This warning did not stop Victorian euthanasia supporter, Dr Rodney Syme from entering the debate immediately arguing for an expansion of eligibility to include "neurological failure, such as multiple sclerosis, motor neurone disease and Parkinson's disease, who have progressive diseases, and those with profound stroke or high quadriplegia who have a static condition, may have an ill-defined trajectory to death, and while suffering unbearably, may be discriminated against by narrow legislation." It is precisely the same sort of argument that could (and will) be made for a later amendment if Syme does not get his way. Think about that.

Indeed, everyone knows that later extension is a possibility via an amendment bill. Euthanasia for children was originally considered for the first Belgian debate. Trudo Lemmens relates that, 'children were explicitly excluded from the ambit of the original law because "it was deemed so controversial that including it may have threatened approval of the Euthanasia Bill."'

Back in Victoria, there have been a few 'leaks' about the possible direction the Panel's report might take. One article pointed to a plan not to provide effective conscience protections for doctors.

Today we are told that the Panel will recommend a prognisis-based qualifier:

But the advisory panel wants to extend the timeline and the government is believed to be considering three options: 24 months, 12 months or six months.

It is mere speculation on my part, but it would seem that this kind of qualifier might be a compromise position between the Parliamentary Inquiry's recommendation and the agitation of the likes of Syme. Either way, it is much broader than the original "at the end of life (final weeks or months of life)".

This leaves many questions unanswered: Does this call into question the judgement of the members of the Parliamentary Committee? Is it now considered that the Victorian public are open to this kind of extension where those who submitted to the Parliamentary Inquiry were clearly not? Will the members of the Parliamentary Committee rebuke the Panel for their extension?

Lack of answers aside, the idea of incremental extension is now out in the open for all to see. No Victorian MP can ignore it. They now need to question, not whether the model presented satisfies their judgement on a set of limits, but that their vote in support of any framework will most certainly provide precursory endorsement and impetus to later extension.

Dutch Health Minister, Edith Schippers, speaking enthusiastically about euthanasia recently, confirmed: "One thing is certain: on euthanasia and assisted suicide, we will never be finished."

The Panel's interim report is likely to be made public in the next few weeks.