THE majority of NSW lower house MPs voted to give terminally ill people the right to choose to end their lives on Thursday (November 25).
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Bathurst MP and Deputy Premier Paul Toole voted against the bill.
MPs sat late into the night on Thursday and continued their debate on Friday, the final sitting day for NSW parliament for the year, in a bid to send the bill to the upper house by year's end.
The Voluntary Assisted Dying Bill has passed by 52 votes to 32 in the third reading vote in the NSW Legislative assembly on Friday afternoon.
Mr Toole spoke on his decision in parliament saying that these types of conscience debates can be challenging for many members of Parliament as they go beyond the standard party or geographical lines and focus on what is the right and proper thing to do according to our own values.
"Like others in this place, I have sought viewpoints from people within my electorate. I respect the opinions presented by both sides of the debate. I have read every letter and survey that has been returned to my office," he said.
"I have heard from constituents who are suffering from terminal illnesses and those who have watched an elderly relative unable to walk to the bathroom and unable to eat for weeks, until their body shuts down.
"Another constituent writes of the need to have choice about their circumstances in both life and death, especially when there is no cure and only pain.
"In regional area many of us are accustomed to treating sick and injured animals, whether they be native, domestic or livestock. Tough decisions have to be made to euthanise animals. We have often heard it said that while we can offer this respite for animals, we take a different approach to human suffering. It is a view that resonates among many.
"One couple wrote to me saying, "Horses and cows have more rights than humans." The bill we are debating seeks to address some of these concerns."
Mr Toole said that most people come to this debate guided by their own personal circumstances and beliefs and whatever decision they reach, none of those views are wrong.
"I am the first to acknowledge that no matter how any of us vote on this bill there will be always be people who fundamentally oppose it one way or the other. I respect and acknowledge all those views," he said.
"If this debate was simple laws would have been introduced years ago. It is often pointed out that New South Wales is the last remaining State to legislate for voluntary assisted dying. That is hardly a barometer.
"Every State and Territory has taken a different approach. There is an argument that it might be preferable to have adopted a uniform national law to reduce the risk of doctorshopping or borderhopping in a bid to utilise laws in another State."
Mr Toole said Victoria passed its voluntary euthanasia laws in 2017, and they took effect from June 2019.
"In the following 18 month period, whilst almost 700 people sought a first assessment, only 276 people ultimately administered medication," he said.
"Advocates of voluntary assisted dying are already saying the Victorian laws still make it too difficult to access programs. As many as 30 per cent of people who legally qualify for and seek access to the medication die before they get it.
"It should be noted that the Victorian law requires either the coordinating or consulting practitioner to be a specialist. Anyone who has had to make an appointment to see a specialist knows how difficult that can be, especially in regional areas."
The bill brought to parliament sought to address that situation by allowing general practitioners with a minimum of 10 years experience to take on that role.
"Two years on there are already calls in Victoria to amend those laws and that raises the question: in seeking to legislate for voluntary assisted dying do we unduly complicate a system that already quietly enables people to slip away at the end? That includes important and informed decisions already made on a daily basis such as turning off ventilators or withdrawing food or drink," Mr Toole said.
"Members in this place have raised the importance of improved funding for palliative care.
"There is no doubt we can always do more in that area, but equally there will always be circumstances where no matter what level of palliative care is rendered there will be many patients for whom suffering has become too much."
Mr Toole highlighted that another constituent said that, "some people are beyond the help of palliative care."
"The question then arises: Is there any pain-free manner of dying? We cannot pretend that every death, even if assisted, will be a painless passing. No law can remove pain or suffering - if only our laws could.
"Death is painful for so many, whether it be physical, mental or emotional. It will impact on people in so many different ways. The manner of death will not change, but the choice on how to manage it may well change."
Mr Toole said ultimately the debate and the vote came down to the legislation before him.
"As legislators we must focus on the proposed bill and that is different from the generic concept of voluntary assisted dying. There is broad support for the concept."
Independent MP Alex Greenwich has been spearheading the push.
"I'm grateful for the strong support for reform from my colleagues, finally our parliament is reflecting the will of the people of NSW," Mr Greenwich said.
"I thank the opponents of reform for the orderly and respectful way they have continued to act throughout this debate."
The upper house is holding an inquiry to the bill throughout December and will report back before the first sitting day of 2022.
Dying with Dignity NSW said they are relieved that the NSW Voluntary Assisted Dying Bill 2021 has passed the final vote in the Lower House.
"We congratulate members of the Legislative Assembly who have acted in good faith and respectfully worked their way through what has been a challenging and emotional debate," Dying with Dignity president Penny Hackett said.
"After five decades of campaigning for this law reform, our supporters can see a light at the end of the tunnel and can now picture a time, in the not too distant future, when terminally ill people in NSW will have the same compassionate, end-of-life choices as other Australians."
Health Minister Brad Hazzard was among the MPs to speak in favour of the bill on Friday.
The veteran MP had not supported euthanasia for the first 29 years of his three-decade career in parliament, but he said this bill was different.
Mr Hazzard became emotional as he recalled holding his mother's hand and asking her to squeeze it if she wanted palliative care, knowing that death might come more quickly if she did.
His mother squeezed his hand. She died the next day.
Mr Hazzard said that voluntary assisted dying does not "remove the importance of the value of palliative care".
"What it does do is give choice to those who are approaching the end of their life, to those who might suffer (what) none of us would want family members or friends or anyone to suffer, to enable that person to control their own passing."
He also said he couldn't withhold a right from NSW residents that Australians in all other states have.
If the historic reform secures majority support in the upper house next year, it will make NSW the final state in Australia to embrace voluntary assisted dying.
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