Religious discrimination in Australian health law: hype or reality?

Queensland has passed the Voluntary Assisted Dying Act 2021.

I’m disappointed in Queensland’s Parliament, not for passing assisted dying legislation, but for consciously trampling over the religious beliefs of Catholic and other religious healthcare organisations.

Catholic hospitals are right to be aggrieved.  It’s entirely predictable that church institutions are now considering civil disobedience. (See “Catholic Hospitals’ Revolt on Euthanasia” Weekend Australian 21-22 August 2021, p 4. See also here).

I mean, if you genuinely believe that intentional killing is wrong, you don’t just help it along because a bunch of politicians told you to, do you?

Catholic moral beliefs preclude intentional killing, yet Queensland’s law will force Catholic hospitals to open their doors and to facilitate actions to end the lives of patients in their care, on their premises, by non-credentialed doctors who do not share their moral values.

The passage of assisted dying laws in Victoria (2017), Western Australia (2019), Tasmania (2021), South Australia (2021), and now Queensland illustrates the growing heft of personal autonomy as a secular value in Australian life.

(I call this the “Dombrink thesis”, after American scholar Professor John Dombrink, who demonstrated the resilience of libertarianism, through – and despite – America’s culture wars.  See here, here, and here.)

Recent assisted dying laws follow on the heels of two decades of reform that have greatly liberalised abortion laws in every State and Territory; see eg here, here, and here.

But if personal autonomy means anything, it ought to extend to those who, despite these changes, have a sincere, morally-grounded opposition to killing and assisted suicide.

In my view, co-opting religious health care organisations to facilitate euthanasia is a step too far.

For further detail on what Queensland’s new law will force religious health care facilities to do, see below.


Sharing the love? The importance of singing in church in the middle of a pandemic

Let’s be clear: not all complaints of discrimination or oppression, by churches, in Australia’s largely tolerant democracy, are worthy.

For example, in a Facebook post on 2 July, Pastor Brian Houston of Hillsong fame dismissed Covid delta outbreak restrictions that prohibited singing in church as “religious discrimination…so archaic it’s hard to believe”.

He urged his followers: “Let’s make a stand”.

Judging by their responses, some of Houston’s followers are primed for persecution and reluctant to see themselves as beholden to earthly laws (that is, emergency public health orders).

On 16 June 2021, an outbreak of the insanely infectious delta variant of the Covid virus began in New South Wales.  Daily cases are currently averaging over 1200; see here.

On 20 June, masks became mandatory in “places of public worship, being used for public worship or religious services”, in 7 local government areas.

On 23 June, singing in non-residential premises – including places of worship – was banned. However, a number of exceptions applied, including singing in a performance or rehearsal, singing in educational institutions, singing for the purposes of instruction in singing, or if “the premises are a place of public worship, and the persons singing are members of a choir”.

On 26 June, the exception for choirs was eliminated.

In response to questions raised at a Religious Communities Forum held on 28 June, NSW Health advised forum members by email that the delta outbreak restrictions operating at that time (the Public Health (Covid-19 Temporary Movement and Gathering Restrictions) Order 2021, dated 26 June 2021) did, indeed, prevent singing in places of worship, even if a religious leader was singing to a largely empty church or place of worship as part of a livestream.  Masks must also be worn.

The intent of the restrictions, NSW Health advised, was to prevent transmission between, for example, a singing pastor, and people providing technical assistance during the livestream, given previous evidence of tansmission via singing in a place of worship.

NSW Liberal MP Tanya Davies raised Houston’s concern with Premier Gladys Berejiklian and Health Minister Brad Hazzard.  Hazzard granted an exemption on 3 July, with specified safeguards: see here.

I suspect that quiet diplomacy by Houston would have been equally effective, if the need for religious leaders to sing directly to camera outweighed the importance of protecting others present in the venue from the risk of acquiring the highly infectious delta variant.

I notice one comment on Pastor Houston’s post:

“It’s time people stopped seeing everything as an attack or discrimination. Seriously we are in a pandemic.  Christian leaders should be setting a good example”.

Amen to that. As to which, see here, and here.


Moral arm-twisting in Queensland’s voluntary assisted dying legislation

While some complaints of discrimination by religious leaders are over-blown, I would put Part 6 of Queensland’s Voluntary Assisted Dying Act in a different category.

The new Act respects the right of a health practitioner not to provide information about voluntary assisted dying, nor to participate in the assessment process for lawful access to assisted dying that the legislation makes available (s 84).

However, Part 6 co-opts health practitioners and forces them to facilitate that assessment process, irrespective of their personal beliefs about the ethics of killing.

Let’s count the ways.

Firstly, a health practitioner with a conscientious objection must either refer a patient requesting information on assisted dying to an officially approved “navigator service” for assisted dying, or to a health practitioner who is known not to have moral scruples about assisted dying and may be willing to assist (s 84(2)).

Secondly, a “relevant entity” (meaning a health care establishment such as a hospital, hospice or nursing home) must not hinder a person’s access to information about assisted dying.

In order not to do so, the health facility must provide entry to a registered health practitioner, or member or employee of an approved navigator service in order to “provide the requested information to the person about voluntary assisted dying” (ss 90, 156).

Thirdly, the new Act requires a health care facility operated by a church or religious organisation to provide access to an (external) medical practitioner who is willing to act as the patient’s “coordinating medical practitioner” for the purposes of facilitating assessment and taking the various actions required by the legislation in response to the patient’s first, second and final requests for assistance to die (ss 9, 92-93).

If the medical practitioner requested by the patient is unable to attend, the religious health care organisation must facilitate the transfer of the patient to and from a place where the patient can formally request assistance from a medical practitioner who is willing to act as the coordinating medical practitioner (ss 9, 92(3); 93(3)).

Fourthly, the religious health care facility must facilitate the coordinating medical practitioner (or their delegate) to carry out a “first assessment” of the patient’s eligibility for dying assistance under the Act, either by permitting this to occur within the facility, or by facilitating transfer of the person to and from a place where the assessment can take place (ss 9, 19, 94).

The same obligations apply to the second, independent “consulting assessment” that occurs if the coordinating medical practitioner concludes from the first assessment that the patient is eligible for voluntary assisted dying (ss 9-10, 30, 95).

After making a third and final request, and undergoing a final review, an eligible patient may decide to self-administer a voluntary assisted dying drug or, if advised that this is inappropriate, may choose to have the drug administered by the coordinating practitioner (ss 50, 56).

This step triggers a number of authorisations, including the right to prescribe, supply, possess and self-administer, or administer the drug overdose to the patient (ss 52-53).

Again, the legislation requires a religious health care facility to provide access to the coordinating practitioner so that the patient can choose how the drug will be delivered – whether within the facility, or by assisting transfer and travel to a place outside the facility where these decisions can be made (s 96).

The facility must then provide access to the administering practitioner and witnesses to enable assisted dying to take place on the premises, and must not hinder self-administration if the patient has made a self-administration decision (s 97).

These statutory requirements honour the voluntary assisted dying principle that “a person should be supported in making informed decisions about end of life choices” (s 5(f)), and that “access to voluntary assisted dying…should be available regardless of where a person lives in Queensland” (s 5(e)).

Another principle recognised in the legislation is that “a person’s freedom of thought, conscience, religion and belief and enjoyment of their culture should be respected” (s 5(h)).

However, by forcing religious health care facilities to cooperate in processes whose central aim is intentional killing, (I am not here debating the rigour of safeguards) the legislation tramples over well-known and defended moral values that lie at the heart of professional, competent, yet religiously-informed health care.

The bottom line

Like abortion, assisted dying is one of the enduring ethical fault lines in medicine.

Politicians can’t legislate it away.

Part 6 of Queensland’s Act seems hell-bent on making victims of doctors and religious organisations that have long-standing, deeply felt moral objections to intentional killing.

There ought to be room in Australia’s liberal democracy for religious hospitals and hospices to offer their services, including high-quality palliative care, in accordance with long-standing ethical values, without putting euthanasia on the menu.

Patients who request assessment for assisted dying should be transferred to a facility where such actions do not offend long-standing institutional values, as provided in South Australia’s legislation, which recognises a right of conscientious objection for hospitals and other health care establishments (see s 11, although this does not extend to nursing homes).


One response to “Religious discrimination in Australian health law: hype or reality?”

  1. John McCarthy Avatar
    John McCarthy

    Your understanding of MAID laws in Australia is shocking to say the least. There is no assisted dying obligation; only the prevailing will of an individual.

    One need only to look at some of the Schengen countries (i.e.,Switzerland, Belgium, Netherlands) to look at models for how assisted dying should be done. If not for countries like Switzerland, we would not have had a proxy example of how assisted dying could be used. What I want from you is to do some research into this yourself before waddling away on slippery slopes of how this supposed zeitgeist is going to start happening. Let me start by schooling you a bit so you may also understand what assisted dying really is:

    In a nutshell, assisted dying — as supposed to euthanasia – is merely a last resort option which should be requested willingly from a mature party, amidst their own research and will. Age, maturity and tenacity, are both monitored by a medical model, which will be the sole decision factor to determine intent. In the world today, we don’t see this currently. What we do see is this pauper-bashing and man-handling of the suicidal to the point where they are thrown into psychiatric wards against their will, fed off to hospitals, and resuscitated with lasting brain damage — all because their will is not respected by 2nd party do-gooders. There is simply no option for people who fear for their end (whether it be terminal or non-terminal) and this poses a great problem: some people are indeed trapped in situations where the certainty of more pain is known. Think of those in advanced stages of Alzheimer’s disease – or, God forbid lyme disease or cancer — where the progressive effects could mean unavoidable trauma. Without the voice for assisted dying there cannot exist any model to help these people should they feel they spare themselves to bigger torture. In other words, there is no safety net should things get really out of hand. To reference David Foster Wallace the fire becomes too much and someone has no way of getting out of a burning building, all thanks to pro-life theocracies.

    Being the main culmination of problems, the religious right mistakes assisted dying for euthanasia which is NOT the same thing. The former proposes a model where an individual routinely requests with a 3rd party giving a substance which the party then uses to end their lives with. Media outlets keep getting this wrong ad nauseum: It is not the same as a party willingly forcing another party to die as they claim it to be. In straw-manning these models, it does not display the truth about assisted dying. Instead it mis-references that there are numerous safeguards in addressing problem areas; for one, assisted dying comes with a laborious safety-net; euthanasia does not.

    What we are witnessing in the beauty of Constitutions (finally) opening up to become more liberal is allowing people to have the option of wanting to die, should they decide so wholeheartedly. Difficult as it may be, the very fact that the Constitutions are opening up shows their intent for respecting freedom of speech, that which we as a nation were robbed of and can now restore to some merit.

    You strike me as the type of hypocrite who will take your animal to a vet to get it euthanised, but ostensibly vote to corner another life form from getting the same luxury. A logic I can’t amass.

    What you people miss is the very rhetoric of assisted dying vs. euthanasia. You make it out to be some sort of zeitgeist or World War Z scenario in which Doctors willingly put people out of their misery.

    Empirical evidence shows clearly how assisted dying is being monitored in some Schengen countries: the public in neither of these groups have the concerns as notoriously referenced by pro-life (AKA forced-living groups). The problem is strictly controlled/monitored with enough safeguards so to prevent what you claim might otherwise happen; that people will die before their time. In fact, nowhere else do we witness such safety nets in regards to medical monitoring. Principally because we have no time limit to how long we ought to monitor someone — that is, no Doctor gets pushed into helping by having a directive time-limit. As such there is plenty of time for any oversight to make a final judgment and, with this, hope to the requester that they can always opt-out should they change their mind. Our Medical Doctors are well-trusted Professionals who otherwise make life-and-death decisions such as which pills we should take and what we get to eat for breakfast and so forth. Perhaps they can also be trusted in practicing good judgment on whether someone portrayed the correct motive? Indeed, what we persistently witness is that the time taken to process an assisted dying application gives enough time for someone to change their mind, and not at the expense of criminalising their intent as what Governments currently do in other countries. This is the beauty of assisted dying in Switzerland not least because it works and provides an excellent model in which very few cases of unprecedented suicides happen. This craze you are talking about is not evident in Switzerland for a very good reason as outlined above.

    By forcing assisted suicide to hide in its shadow, your group is simply compounding the problem of ostracising individuals who made a determined decision. This is falling into the trap of solving a puzzle with a bigger puzzle when it simply would be appropriate to find a median step instead. To me, it is obvious in the model of human rights to allow anyone autonomy over their body but sadly it isn’t the case as evident with your group. What we are asking is for your groups and Governments to stay put; that we can speak and take up our own crosses. We don’t need to be daddy’s by benefactors. In the least we want to be heard and respected and unless this cannot happen, we will have to step up the ante.

    This prevents a bottleneck (the very thing you pro-lifers keep creating) by vetting a discussion going between the individual and the government. One that does not get scrutinised as with the current laws where the public are thrown into jails just for being suicidal, which is absurd seeing that we have moved away from criminalising suicide in the first place — a model which your group venerates.

    Why should I, a free person, keep living because your worldview tells me to? Please give me a good answer.

    Liked by 1 person

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