Respectful Consideration — Statement by President

THE PRESIDENT (Hon Kate Doust) [10.06 am]: Members, just before we move to the Voluntary Assisted Dying Bill 2019, hopefully this will be our last sitting week for the year. I know that it is anticipated that we will be sitting some very long hours. When we commenced this debate, I asked that people pay due respect to the diversity of views in this chamber and I think that has occurred during the length of this debate. In these last few days, I remind members that there are different views about this issue in the chamber and I ask that each of you apply the appropriate level of respect to every other member in the chamber as you work your way through this very significant and complex legislation.


Resumed from 29 November. The Chair of Committees (Hon Simon O’Brien) in the chair; Hon Stephen Dawson (Minister for Environment) in charge of the bill.

Comments and speeches from various members

Clause 81: Notification of death —

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Page 55, lines 6 to 8 — To delete the lines and substitute —

(6) The medical practitioner must state that voluntary assisted dying was the cause of death.

Comments and speeches from various members

Hon ALISON XAMON: I rise to indicate that I will be supporting this amendment. I have been perplexed about why this provision is included in the bill in the first place. We have other causes of death that are recorded. For example, if someone takes their life, the way that person died is recorded on the death certificate, but so is the fact that the person took their own life. That is already there and it happens regardless of whether people are concerned about stigma or perhaps families do not want to have that revealed. This decision is made independently by the coroner. The coroner does this as a matter of record. I think it is really important that we also ensure that these sorts of records are kept. We have our death records so that we have an accurate record of what has happened in people’s lives and how their deaths have occurred. This is also used historically. It strikes me that this provision in the bill is a bit of a disturbing attempt at social engineering to try to hide something that I do not think needs to be hidden. One of the things we keep hearing, and we know, is that a majority of Western Australians support the capacity for people to go gently and to avail themselves of voluntary assisted dying under certain circumstances. As such, I think this provision, if anything, stigmatises something that we keep being told has broad social acceptance. I find it perplexing that if someone is murdered, it is reflected in the death certificate. If someone takes their life, it is reflected in the death certificate. I do not see why this should be treated any differently. I think it is really important that we do not attempt to try to withhold this sort of information from what should be just a standard record.

Comments and speeches from various members

Hon ALISON XAMON: I just want to clarify something. Currently, death certificates are accurate. They often have two components. Firstly, they always describe the physiological cause of death—always. Secondly, if there have been additional circumstances around the death, they are recorded, such as whether it was self-inflicted or was the subject of a homicide. That is the way that death certificates currently operate. There will be an initial assessment by the coroner about what has occurred physiologically, and often after further investigation or even an inquest, a codicil will be put on the death certificate. I know; I have seen them. That is the way that death certificates are written. They are done in that way so that we have a clear and accurate record of the circumstances under which someone has died. If someone were to avail themselves of voluntary assisted dying, as should be their right—I remind members that I am one of the people who are voting for this legislation—that would be included, but it would not be listed as the cause of death as such. The actual underlying physiological issues that led to them requiring voluntary assisted dying would be listed as the cause of death and then the circumstances under which they availed themselves of VAD would be articulated as part of the historical record.

In response to something that the minister said when he spoke about other jurisdictions, the thing I have found the most perplexing is that a specific provision in the bill precludes us from ensuring that the historical record is accurate. This is not about being silent. This is not about looking at whether there is a possibility for the coroner or a medical practitioner to make the decision to include this if they wish to; it specifically precludes it and says that we cannot allow the record to be maintained. I think that is a mistake, because if we accept that voluntary assisted dying is a legitimate avenue to take, there should not be stigma around it. I believe that this is a stigmatising provision. I also suggest that it might be a historical source of comfort to loved ones. For example, if the parent of a toddler died but they were too young to remember the circumstances, and the rest of the family did not want to talk about it, they might have simply a death certificate that describes a rather awful death or they might have a death certificate that describes a terrible underlying illness but that their parent died a peaceful death. I do not think that people are really connecting the fact that it could be a source of comfort for families to know that people have gone gently.

I also want to pick up on this idea that somehow the record of the facts is being expunged to assuage people’s concerns about stigmatising deaths. We do not do that with suicide, and I have already made it clear why I distinguish between VAD and suicide. We do not do that with suicide and we do not do that with homicide, and we know that they can be highly stigmatising deaths. I do not accept the argument that somehow this is an entirely different category that requires us to make sure that we wipe this from history, even though the entire bill in front of us says that it is okay.

I am simply asking for the records to be accurate. I am also going to flag that I am one of the people who is inclined to flag a future amendment. I think this is a really important issue for us to keep revisiting. The one thing I want is to make sure that the data that is kept by the Registry of Births, Deaths and Marriages is accurate, and I think that we have an obligation to capture that historically at this time.

Comments and speeches from various members

Hon ALISON XAMON: I want some clarification about some issues that have been raised, and particularly pick up on a point made by Hon Alannah MacTiernan. The first thing I want to say is that I do not like clause 81(6) as it is currently written. I think that needs to come out of the bill in its entirety. Picking up on Hon Michael Mischin’s comments, I believe that the current process used by the coroner in determining the most appropriate information to go on death certificates should be the same for people who avail themselves of voluntary assisted dying as it is for any other form of death. It leads me to a question about the amendment that is also in front of us at the moment. I see that this potentially can be dealt with in two parts. One is that an amendment could be moved to simply take subclause (6) in its entirety out of the bill. To be perfectly honest, I would be satisfied with that as well. The second question is whether we include the words as put forward by Hon Colin Tincknell; that is —

The medical practitioner must state that voluntary assisted dying was the cause of death.

Hon Alannah MacTiernan put forward to this chamber her understanding that if this subclause were to get up, a death certificate would say “Cause of death—voluntary assisted dying” as opposed to what I want to see, which is “Cause of death—cancer”, with the necessary codicil underneath. That would be further information on the record that voluntary assisted dying was also utilised, in the same way that is done with drug overdose, suicide, murder and a whole range of other forms of death when a further explanation about the circumstances of death is required.

I have an important question to ask the minister. It is not about the substance of whether clause 81(6) should be defended and should stay; I am very clear that I think it should go. Does the minister interpret Hon Colin Tincknell’s proposed amendment would have the effect of describing the cause of death as solely being voluntary assisted dying? If that were the case, I would not be supportive of it. Part of the reason we also need to have the physiological descriptor of death, apart from having an accurate record, is so that people can do things like track their family history. These are good reasons to have these things on the record. Can I please ask the minister whether that is how it is being interpreted, as has been suggested by Hon Alannah MacTiernan?

Hon STEPHEN DAWSON: Our reading of it is yes.

Hon ALISON XAMON: In that case, I would like to move an amendment—I am not sure how this will be treated by the chamber; I seek your guidance, Mr Deputy Chair—or maybe foreshadow an amendment, that lines 6 to 8 on page 55 be removed.

The DEPUTY CHAIR: Let me check this: are you proposing that no words would be inserted?

Hon Alison Xamon: That is correct.

Comments and speeches from various members

Hon ALISON XAMON: I just want to make sure that we are really clear, because I feel that we are getting to the point of wrapping up this debate. If members think that “voluntary assisted dying” should never, ever be mentioned on any death certificate and should never become part of the record, they should not support deleting the words and including the provision moved by Hon Colin Tincknell. If members believe that the status quo should be maintained—that is, that the coroner or medical practitioner should have the discretion to deal with the various components on the death certificate—they should vote to delete the lines, and that would effectively take out subclause (6). If members also believe that it is important that voluntary assisted dying be proactively put on the death certificate as a requirement, they should support the inclusion of the words put forward by Hon Colin Tincknell. They are the three choices.

The only concern that I again flag is that I have heard two conflicting views about the provision put forward by Hon Colin Tincknell, one of which is that it will be part of the record. That was certainly the position put forward by Hon Nick Goiran and it was the position that I always understood. The other view is the position put forward by the minister that the wording as articulated by Hon Colin Tincknell would effectively preclude the capacity to have all the other circumstances around somebody’s death incorporated into a death certificate, and the cause of death would simply be voluntary assisted dying, which I obviously would not support. I think this is the last piece of the puzzle that we need clarified in this chamber: whether the words to be inserted by Hon Colin Tincknell’s amendment would have the effect of limiting further the provisions available on a death certificate, which would run counter to my concerns, because that is precisely my concern with subclause (6) as it currently stands.

Comments and speeches from various members


Amendment put and a division taken, the Deputy Chair (Hon Robin Chapple) casting his vote with the noes, with the following result —

Ayes (17)

Noes (18)

Amendment thus negatived.

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Progress reported and leave granted to sit again, pursuant to standing orders.


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