Dr. Edward Mathews:

Our submission is not based on surveys. Obviously, we have discussed this issue with our executive council, which comprises a large group of nurses and midwives who are all practising and talking to their colleagues. The diversity of views is clear from that. We are not trying to ignore, or have we presented, a particular view. We are taking a fairly Jesuitical approach in that there are both ends of the spectrum and in between.

I will deal with the other issues raised by the Senator. I am sorry she did not receive our submission. We identified a requirement for training and support for nurses and midwives around the conducting of difficult conversations and the follow-on for those circumstances. The ubiquity of that or whether they would have to be more focused on different services would depend on what the legislative change was and where provision was made for certain services. I agree with the Senator that there be a requirement for training in those areas.

On the issue of coercion, one of the things that is in the minds of nurses and midwives, as it is in the minds of the public more generally, is the need to avoid coercive circumstances. In particular, and this is clear in the nursing literature and has caused difficulties for service provision and serious moral distress for professionals, there are issues where there has been a failure at the legislative stage to adequately deal with advance healthcare directives and whatever form of assisted decision-making exists. For example, there have been paradoxical situations where there have been particular interventions at particular times which were not expected. From a coercion point of view, that has to be dealt with. There also needs to be other safeguards. I am not sure I can make a contribution on suicidality. It is a matter of professional practice that would have to be engaged with on a case-by-case basis. I am not sure I can offer a particularly helpful reflection on that.