Dr. Philip Haig Nitschke:

I thank the Chair and I am very pleased to have a chance to address the committee. It is an important time and an important day because I am asked to comment on the Australian experience and I have some long experience with the situation there. I say it is an important day because today the last state in Australia has reintroduced or brought in legislation rather similar to the one I first became involved in some 25 years ago when the world's first legislation that ever allowed a doctor to provide a lethal injection to a patient came in.

That was in Darwin in the Northern Territory back in 1996. At that time, a heated debate took place within society in Australia about whether or not legislation should come in to allow a doctor to end the life of a patient, legally. I was involved in that struggle. I was a doctor practising the Northern Territory in Darwin then and I supported it but I was one of the very few. That law came in and it became a model which many countries have followed and it is now interesting to see that after 25 years, or a bit more, the last state in Australia is finally catching up.

What happened in the Northern Territory was that the law came in and the opposition was savage. There was opposition from the church, saying it was against the rule of God; opposition from my own profession, saying it destroys the doctor-patient relationship; and opposition from people involved with ethnic communities, saying this is fundamentally racist legislation which set out to and will destroy the lives of the ethnic community, the aboriginal people of the north.

Despite all of that opposition a law did come in. It was conservative legislation, very similar I am sure to the model that Ireland will subsequently introduce, where a person had to be terminally ill. I had to find four doctors - I was one of them so I had to find three others - to certify that this person was terminally ill. They had to be an adult, they had to be living in the Northern Territory and, importantly, they had to be of sound mind and have mental capacity. If all of those things came together, like the alignment of the planets, then that person could get help to die. Four of my terminally ill patients died.

I provided what turned out to be the world's first legal, lethal voluntary injection to four patients. In fact, I did not provide the injection because what I did was build a machine so they could press the button and the machine would deliver the injection. It moved it from what would be considered to be voluntary euthanasia, where I sat there and gave them an injection and they died on the end of my needle, to a situation where it became assisted suicide. They pressed the button. It was clear that it was not a doctor doing it to a moribund patient, but it was a situation where the person knew what they were doing, answered the questions on the laptop and pressed the button. That machine is now in the British Science Museum in London.

The law only lasted eight months. The federal government of Australia, moved on by these pressure groups, overturned the law and Australia went back into the Dark Ages and it has remained there for 20 years until, as we have just heard, Victoria came in some 20 years later.

What were the lessons learned? That is what I am to talk about. There are a number of them and I will summarise them quickly as the time is limited. I would argue that medicalised law, which is what we had in the Northern Territory and what the committee is considering here, is a mistake. If Ireland tries to codify how sick a person has to be to be eligible for assistance it will run into trouble all the time, as we did. I suggest there are better ways to do it. I will give an example. Many of the committee members will know about the situation of Tom Curran with Marie Fleming. I knew Marie; I met her. In a situation where a person may die in two days, two weeks, or two years do not set up situations that are so restrictive that people fall through the cracks and there is legal challenge after legal challenge. There are better ways to do it and I say the better way to do it is to not have a medically-based, what we would call a medicalised, law but have a rights-based law such as we see in one place in the world, Switzerland. I have a lot to do with Switzerland and I strongly urge the committee to consider that as an option, as the right model.

A person must be of sound mind, and they have to do it themselves and have to press the button, but it gets away from that idea of having to go off and ask a panel of doctors, "Am I sick enough to satisfy your criteria of what the level of suffering is?" Those are the main lessons I have learned and I hope Ireland will do something that Europe will be proud of and do something different from the mistake I see in places such as the Netherlands where I now live, which finds itself subjected to challenge after challenge about eligibility.

I will finish on one final point. Do not restrict the method or the means by which a person dies. I strongly urge that it is left open because we see new methods come in and I urge that one does not try to restrict it to drugs, intravenous or oral. The use of gases is very important and we see that happen now. That will provide a better, more peaceful and reliable death for many people.