Voluntary Assisted Dying - a First Nations perspective
Posted in Pat's Opinion Pieces | October 05, 2019
Date: 5 October 2019
Publication: The Australian
Western Australia is currently considering a piece of legislation that may be the most consequential set of laws passed by its 40th Parliament: a bill that radically changes our understanding of life, death and suffering; a bill that legalises an individual choice to die or voluntary assisted suicide. I have serious concerns about this bill, and believe if passed into laws will be the source of confusion and contain potentially unintended consequences. Because of communication and medical protocols that are not clear, and concerns over the principle ‘free prior and informed consent’, Aboriginal people will yet again be at the mercy of the professionals who are authorised to prescribe and administer the lethal drugs if you indicate a willingness to end your misery in this life.
These are no ordinary times, and with the Western Australian Parliament at a crossroads, I feel compelled as a Senator for Western Australia to provide my perspective on this important issue – a First Nations perspective but coming from different foundations from those that may be based one way or another on Christocentric belief systems.
It is important to note that until recent times, First Nations affairs have largely been the province of state jurisdictions. The 1967 referendum and resulting constitutional changes have not necessarily translated to Commonwealth Government’s exclusive control of Aboriginal affairs. This is most evident in health policy, where the ideological development of Commonwealth-driven Aboriginal self-determination has been in tension with state-controlled mainstream service delivery. To put it simply, the right of First Nations peoples to manage their health, their way, has mainly been championed by Federal Governments, not necessarily State Governments. The evident lack of public commentary on Aboriginal self-determination surrounding this bill concerns me, because it fails to recognise Aboriginal ideas on civil society or other concerns with its quality. Aboriginal peoples’ unique conception of life and death, their holistic understanding of health, and their fundamentally collectivist nature is part of their concept of civil society. These are matters only gradually being understood by health professionals in the field, or through sustained research. For the more than 100,000 First Nations peoples in Western Australia, this is important – and they have a right to be fully informed and heard. The Western civil society has had an alleged need for this change to the sanctity of life. This sanctity of life understanding has much resonance with our perspectives and First Nations have respected it. Now, with little education or explanation we are confused as to why a change is necessary.
The United Nations Declaration on the Rights of Indigenous Peoples, article 24.2 states:
Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realisation of this right.
First Nations need not look far to see that Australia has totally failed in its duty of care to respect this fundamental right. Repeated Closing the Gap speeches tabled to Parliament and traumatic coronial inquires with numbing regularity remind us that at every stage of life, First Nations peoples do not enjoy a quality of life afforded by the most basic instruments of human rights. This indictment should not simply exist abstractly in key-note speeches or academic literature. It should offend us daily, and it must inform any conversation or deliberation about an individual choice to end life in Western Australia.
First Australians live shorter lives. Their babies are more likely to die of preventable diseases. They watch their friends, cousins and siblings prematurely end their own lives. They have had their hearts broken too often when there is a ‘death in custody’ because of misjudgement, prejudice or ignorance as their culture faces power and authority. One simply cannot bear witness to this reality – where First Nations are overrepresented at every stage of our health and criminal justice systems - and put forward another avenue to death. As representatives and legislators, surely, we must be focusing our attention to enacting laws that help prolong life and restore the right to enjoy a healthy life. Our endeavours should be directed to enabling all citizens to access the highest quality of health care. It’s about priorities, values and care. The duty of care we saddle those administering and prescribing this system is an onerous one and morally cannot be conveniently shoved off to Government legal drafters.
The Northern Territory experience in the 1990s suggests that the mere presence of this legislation may be a barrier to First Nations peoples receiving healthcare. Fears and suspicions of ‘whitefella’ medicine will only increase, and the capacity to ascertain informed consent will be difficult.
Supporters of this bill – most with good intentions and compassion for loved ones – build their case on an individualist rights agenda. Such a perspective emphasises the rights of an individual and ignores the wider influence of such decisions on those around them – families, friends and communities. Individual choice is an important component of this but it should not be the only significant factor because other humans are going to be required to live with the consequences of their part in ending the life of another. In an increasingly atomised world, we are finding it harder than ever to understand the interconnectedness of our social structures and the political choices that hold them together.
First Nations have always been about survival and balance. Death is about returning your body to your place in the land and your spirit to the sky. Your Rai (embryonic essence) may return as part of a newborn member of your people. So, life and death are interwoven with Country, Community and Creation. It is simply not just about the individual leaving this world. It is about being intrinsically interwoven with the dynamic of nature and the powers that sustain it.
Collectivist conceptions of civil society are common features of First Nations. This can be seen in notions of ‘health’ - the National Aboriginal Community-Controlled Health Organisation defines Aboriginal Health:
“…means not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole Community in which each individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their Community.
It is a whole of life view and includes the cyclical concept of life-death-life.”
Clearly, the quality of life for individuals and communities are intertwined and we are fundamentally responsible for honouring our fellow human beings – those in need, those who are ill and those who are elderly and frail. Others may have a different perspective and that has to be respected, but so does our view. We come from different cultures and societies so civil society has to accommodate this.
There are significant deficiencies in this bill and the process that has led to it. Consultations with First Nations have not been conducted well; stakeholder submissions were not made to an exposure draft of the bill; and too many assurances depend on the 18-month implementation phase. On paper, the bill allows for clinicians to initiate a discussion about voluntary assisted dying – a measure specifically opposed by the Aboriginal Health Council of Western Australia – and clinicians who may discuss it by phone, email or telehealth may fall foul of the Commonwealth Criminal Code. For a bill that reimagines our approach to human existence, it is important that proper consideration is given to details and it is not rammed through Parliament with late night sittings. There are many lives to be affected including the individual who makes a choice to end life.
I have not taken the decision to express my views lightly. I acknowledge the burden of sacrifice carers often have to carry, the all-encompassing pain of suffering, and the natural human desire to alleviate it. I admire the dignity with which many have cared for their loved ones to their end. I do not condemn anyone for the choices they make. However, I also believe in the dignity and sanctity of the individual and the importance of not allowing a state to make such a conclusive decision on our common humanity – the power to assist someone in taking their own life.
I urge all Western Australian Parliamentarians to consider the importance of the decision before them. This cannot be business as usual.
Senator Patrick Dodson
Senator for Western Australia