Thursday, 11 April 2013

SA Government adopts changes to Advance Care Directives Bill

Lat Tuesday evening the Legislative Council (Upper House) of the South Australian Parliament finalized the debate on the SA government's Advance Care Directives Bill.

We had reported earlier on our concerns that this bill, in its original form, provided some limited possibility of euthanasia by deliberate omission. Concerns on other matters were also raised by medical bodies in South Australia. These matters of concern prompted the new Health Minister, the Hon Jack Snelling MP, to conduct a round of consultations on improving the bill which had already passed in the lower house by this stage (as we noted at the time, with unseemly haste).

Health Minister Jack Snelling MP
The area of Advance Care Directives remains problematic for some and many ethicists have commented, over the years since this idea came to the fore, that they foresaw difficulties with making directives about what care a patient wanted or did not want at a time when their prognosis may not have been entirely clear. Issues have also been raised about whether unforeseen medical events would be wrongfully applied as the trigger for the operation of a directive (for example, a diabetic coma).

This legislation does address these concerns in what we observe to be a positive move. Will it necessarily remove all problems with interpretation of a patient's wishes? I think that unlikely in as much as I don't think any legislation is perfect. However, it is a far better framework than existed in SA previously and does protect patients rights and welfare.

The consultations resulted in the adoption of a series of amendments to the legislation which were tabled by the government and adopted by the chamber. As many members of the upper house observed, the entire process was a credit to the government, the minister and his assistants and also a great credit to the members of the upper house themselves in the way the debate was conducted and the desire by all parties for the best outcome for all South Australians.

Amendments covering the areas of concern raised by HOPE and others were included in the government amendments.

I think that the lesson for us in this exercise is the need for vigilance in every matter relating to end-of-life care. It's not always about sinister motives and subversive agendas; sometimes it is simply the reality that getting legislation right is never easy!

Our thanks go to Minister Snelling, Parliamentary Secretary for Health, Leesa Vlahos MP, to all members of the upper house and to Martyn Evans and Annabel Digance who directed the consultation.

Thanks also to everyone who took the time to contact MPs over this issue. In the final analysis, all initiatives worked together towards this good end. Thank you!

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