Dr. Edward Mathews:

I will come in, if I can, on Senator Ruane's initial remarks on conscientious objection. I will confine myself to them and related issues. The limitations on conscientious objection for the professionals I represent are quite similar to those for the medical profession, in that people are entitled to their objection and then they must refer a person to a competent colleague to further the discussion about an issue. Dr. Neal made a point about the sharing of moral responsibility in these circumstances but that is an established paradigm in this jurisdiction.

Senator Ruane also made the point about a person's right to receive a service. Deputy Troy made the point about potential geographic blocks. There is an element about thinking about how, arising from conscientious objection issues, it would be actualised and the planning of services. Not to draw myself too close to Dr. Chockinov's contributions but if the committee were to go forward on an issue such as this there is something to be said for an established and identified service to ensure we avoid geographical inequity in the delivery of services, if this were the decision that was made.

Another point made by Senator Ruane was on how we police conscientious objection. To ensure people behave in a way that is professionally responsible and accountable we police conscientious objection through multidisciplinary teams. The point was made earlier that the first person an individual is likely to speak to is their general practitioner.

It may be the case that the nursing literature would report that the first person somebody will likely speak to will be a community or palliative care nurse or a nurse in an established residential service. There is an honesty kept within the peer-to-peer group. I will take the burden on our profession. If a nurse declined to speak with or refer somebody, the person would then speak with a physician and it would be policed in that way. The contrary would also be the case.

Regarding the remarks of Senator Ruane, I know she did not deny this and I would not misrepresent her but it is important to maintain conscientious objection. It exists more broadly in a constitutional paradigm and from a religious point of view, but there is also an established recognised constitutional right for a secularly held viewpoint which gives rise to a conscientious objection. That refers to not being forced to live a life and-or participate in matters which are adverse to one's conscience. We accept the limitation of that as an established principle of our ethical codes, which is that we refer persons to a competent colleague.