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Advance Care Directives (Review) Amendment Bill

16 November 2023

The Hon. R.A. SIMMS (16:11): I rise to speak on behalf of the Greens on the Advance Care Directives (Review) Amendment Bill. This bill amends the Advance Care Directives Act as a response to some of the concerns that were raised as part of the 2019 Lacey review. The Lacey review, I understand, was established to assess the extent to which the objects of the Advance Care Directives Act 2013 were being achieved.

The report considered legislative amendments and made 29 clear recommendations to improve the implementation of the act. There are now some very sensible amendments to this bill. Digital copies are proposed to be included to bring the act into line with modern practices. Recommendation 5 from the Lacey review included permitting and promoting the use of digital copies of certified advance care directives and the Greens are pleased to see this modernisation of the system and, of course, reduction in the use of paper.

Communities from culturally and linguistically diverse backgrounds will now have clarity around the use of interpreters to prepare advance care directives where English is not their first language. There is also a measure that was recommended in the Lacey review, which found that the use of interpreters under the act is insufficiently regulated and is open to abuse and possible conflicts of interest, both of which undermine the integrity of the act and the possible validity of advance care directives.

The bill also sets out criteria to refer matters to the tribunal and allows for resolutions of disputes by the Public Advocate. On passage of the bill in the other place, we note the insertion of new clauses to amend sections 19 and 36. These two amendments provide additional clarity around people who have advance care directives and present to medical practitioners having self-harmed or attempted suicide.

We have had stakeholders reach out to us in relation to this inclusion in the bill. They have raised concerns about the potential undermining of autonomy on which the Advance Care Directives Act is based. One of the issues they raised is that the right to refuse health care is fundamental to the act. Indeed, I have considered those concerns in contemplating my position on this bill.

On the balance of the information that we have, however, the Greens believe that medical practitioners need clarity around the implications of advance care directives in responding to medical situations as a result of an attempted suicide situation or self-harm. The bill makes it clear that in cases where a health practitioner reasonably suspects that a person has attempted suicide or self-harmed, and that a health professional believes that their health care is necessary to save their life, the provision of the advance care directive is non-binding. The Greens believe in suicide prevention and believe there needs to be investment in programs to ensure that people who have attempted suicide are provided the support they need to prevent future attempts.

We have always been supportive of advance care directives. I think they play an important role in giving people choices around the latter stages of their lives. They also facilitate, I think, important and meaningful discussions within families and within friendship groups around some of those issues. On that basis, the Greens will be supporting the bill.