Under this head of power [section
122], the Commonwealth has a general power of legislating for a
Territory. It may do so by means of paramount legislation passed by
the Commonwealth Parliament, or by setting up a Territorial
legislature with its own legislative power, although these will
always be subject to the overriding authority of the Commonwealth
Parliament.(11) </ ul>
In this respect, recognition must be
given to the development of any convention which may affect the
Commonwealth's power to legislate for a self-governing
Territory.(12) </ ul>
The Commonwealth may acquire territories:
- as a result of surrender by a State Parliament - this occurred
when South Australia surrendered the Northern Territory and when
NSW surrendered the ACT (then called the Federal Capital
Territory);
- by the Queen placing the Territory under the Commonwealth's
authority and the Commonwealth accepting the placement - this
occurred in the case of Norfolk Island(13);
- by other means - for example, by cession or transfer.
The ACT, the Northern Territory and Norfolk Island are all
Commonwealth territories. All three have been granted
self-government by the Commonwealth, although self-government
legislation in each case contains certain limitations - for
example, empowering the Governor-General to disallow
legislation(14) or providing that the Territory executive or
legislature cannot exercise power in respect of certain subject
matters.(15)
On 18 September 1996, the Senate Standing Committee for the
Scrutiny of Bills released its Alert Digest No.7 of 1996.
The report expressed concerns about the Euthanasia Laws Bill
overriding the ability of democratically elected legislative
assemblies to enact laws and affecting the residents of territories
in a discriminatory fashion.
Item 1 of Schedule 1 of the Bill amends the
Northern Territory (Self-Government) Act 1978. The
amendment provides that the Territory's Legislative Assembly cannot
make laws that permit euthanasia or mercy killing, or which permit
a person to be assisted to terminate their own life [new
subsection 50A(1)].
New subsection 50A(2) provides exceptions to
this prohibition by allowing the Legislative Assembly to make laws
about:
- the withholding or withdrawal of life-prolonging medical or
surgical treatment - so long as those laws do not permit the
intentional killing of the patient; or
- the provision of palliative care to a dying patient - so long
as those laws do not permit the intentional killing of the
patient.
Item 2 of Schedule 1 provides that the
amendment does not retrospectively invalidate or make unlawful
anything done in accordance with the Rights of the Terminally
Ill Act 1995.
Item 1 of Schedule 2 amends the Australian
Capital Territory (Self-Government) Act 1988 in a similar
fashion to new section 50A of the Northern
Territory (Self-Government) Act 1987.
Item 1 of Schedule 3 amends the Norfolk
Island Act 1979 in a similar fashion.
Definitions
The term 'euthanasia' comes from the Greek words 'eu' and
'thanatos' and literally means an easy death. However, what is
meant by 'euthanasia' is not easy to define.(16) The Bill does not
define 'euthanasia.' Instead, it refers to 'the form of intentional
killing of another called euthanasia (which includes mercy
killing).'
It is arguable whether there is one form of behaviour called
'euthanasia'. This is because views differ concerning which acts
and/or omissions are covered by the term 'euthanasia'. For some,
the withholding or withdrawal of life sustaining medical treatment
is not 'euthanasia' if it is done pursuant to the request of a
competent patient,(17) or if it is done because the treatment is
considered medically futile or burdensome to a competent or
incompetent patient.(18) Similarly, some commentators do not
consider that 'euthanasia' includes the administration of pain
relieving measures in the foreknowledge that they may or will
hasten death. On these views, the defining characteristic of
'euthanasia' is that it involves acting with the specific and
primary intention of causing the patient's death. (19)
For others, the term 'euthanasia' covers a much broader range of
actions and omissions done in order to hasten death or end life.
Such commentators might argue that anything done for the purpose of
ending life or hastening death is 'euthanasia.' On this view, the
withdrawal or withholding of life sustaining medical treatment -
pursuant to a competent patient's request(20) or because the
treatment is considered medically futile or burdensome to an
incompetent(21) or competent(22) patient - can be described as
'euthanasia'. Similarly, it can be argued that the administration
of increasing doses of pain killers to a terminally ill patient is
'euthanasia' because it is done for the purpose of hastening the
patient's death as well as relieving his or her pain. In a recent
article, Kuhse and Singer ask 'Is it even possible, or desirable,
to distinguish between the directly intended and foreseen
consequences of the doctor's actions.'(23)
Apart from 'euthanasia', other expressions not defined in the
Bill are 'mercy killing', 'intentional killing', 'palliative care',
'dying patient', 'medical or surgical measures' and 'medical
treatment'. Nor does the Bill explain what is meant by 'medical or
surgical measures meant for prolonging the life of a
patient.' The meaning of all these terms will determine the scope
and effect of the Bill. As none of these terms has a fixed or
self-evident meaning - legally or ethically - the absence of any
definition of the terms in the Bill is problematic.
Does the Bill remove a Territory's power to make laws that
require health care professionals to respect a competent patient's
refusal of life sustaining medical treatment?
A mentioned above, both the Northern Territory and the ACT have
refusal of medical treatment statutes.
The Natural Death Act 1988 (NT) enables life sustaining
medical treatment to be withdrawn or withheld in accordance with
the direction of a competent patient. It makes it clear that a
health care professional who acts in accordance with such a
direction is immune from any criminal or civil liability. The
Medical Treatment Act 1994 (ACT) also enables life
sustaining medical treatment to be withdrawn or withheld either in
accordance with an advance directive of the patient or under an
enduring medical power of attorney.
The Explanatory Memorandum circulated with the Euthanasia Laws
Bill 1996 states that the Bill enables territory legislatures to
make laws about the 'right to refuse medical treatment'(24) but not
so as to permit the 'intentional killing' of the patient.(25)
As the Bill does not define exactly what is meant by
'intentional killing of the patient' it is not clear whether the
Bill leaves intact power of a territory to pass legislation along
the lines of the Natural Death Act 1988 (NT) and/ or the
Medical Treatment Act 1994 (ACT). One commentator
notes:
The legal community seems to be
engaged in a perpetual debate over the meaning and scope of
intention in the criminal law. The centre of the controversy lies
with the relationship between intention and foresight, and in
particular whether foreseen consequences are 'intended'
consequences. The courts have not applied a consistent meaning to
intention ...(26) </ ul>
The refusal of treatment statutes themselves do not clarify the
matter. The Natural Death Act 1988 (NT) provides that the
withdrawal or withholding of life sustaining medical treatment
under that legislation will not be regarded legally as a cause of
the patient's death. However, it does not address the question of
whether a health care professional responsible for such withdrawal
or withholding can be said to have 'intended' the patient's death.
The Medical Treatment Act 1994 (ACT) does not state
whether a health care professional may be said to have caused the
patient's death in these circumstances nor whether he or she may be
said to have intended the death.
There is no case law in Australia dealing directly with the
withdrawal or withholding of life sustaining medical treatment
pursuant to the request of a competent patient. Therefore, the
question of whether this situation can be said to involve the
intentional killing of a patient has not been explored by
Australian courts. English and North American courts, however, have
held that a refusal of life sustaining medical treatment does not
amount to an attempt to commit suicide. They have held that the
refusal merely allows the patient's illness to take its natural
course. This has enabled English and North American courts to
conclude that a health care professional who respects a competent
patient's refusal of life sustaining medical treatment cannot be
criminally liable for assisting a suicide. It is arguable that
Australian courts could take a similar view, and thus conclude that
a health care professional who withdraws or withholds life
sustaining medical treatment does not have an intention to kill.
There is, however, the contrary argument that the withdrawal or
withholding of life sustaining medical treatment does involve such
an intention at law.
It is, therefore, possible that the Bill would remove or limit
the powers of the territories to make laws along the lines of the
Natural Death Act 1988 (NT) and/or the Medical
Treatment Act 1994 (ACT). On this view, the ACT and the
Northern Territory would be prevented from improving their present
statutory regimes by amending or replacing their current
legislation. It could also be argued that the Euthanasia Laws Bill
may invalidate part or all of the refusal of treatment legislation
in both jurisdictions.
If the Bill did have an adverse impact on the refusal of
treatment legislation in the Northern Territory and the ACT,
patients would not thereby lose all their legal rights to refuse
life sustaining medical treatment. The common law rules enabling
competent adult patients to refuse medical treatment in general,
and life sustaining medical treatment in particular, would continue
to exist. It is important to note, however, that the refusal of
medical treatment statutes were enacted in the Northern Territory
and the ACT (and in South Australia and Victoria) partly because of
inadequate awareness in the general community and amongst the
medical profession of the common law rights of patients in this
area. The enactment of these statutes has given patients greater
certainty that their wishes about medical treatment will be
respected. It has also given health care professionals greater
certainty that they will have immunity from legal or professional
disciplinary action if they comply with the relevant statutory
regime.
Does the Bill remove a Territory's power to clarify whether the
double effect protects health care professionals from liability for
administering pain relief that hastens death?
As discussed above, it is not clear whether in Australia a
health care professional may lawfully administer pain relief that
hastens the death of a terminally ill patient. English case law
establishes that a doctor will be immune from criminal liability if
his or her primary intention in these circumstances can be
characterised as an intention to relieve pain, rather than an
intention to hasten death.(27) In Australia, however, a health care
professional may be exposed to criminal liability for murder for
administering life-shortening pain relief to a terminally ill
patient in these circumstances - on the basis either that the
professional 'intends' the death of the patient(28) or that he or
she acts knowing that death is likely to result.
The law on this matter in both the Northern Territory and the
ACT therefore requires clarification. As stated earlier, South
Australia is the only Australian jurisdiction that has enacted
clarifying legislation.(29) It can be argued that the Bill would
remove the power of the Territory Parliaments to enact legislation
similar to the South Australian statute. This claim rests on the
Bill's failure to define 'intentional killing', and on the argument
that Australian criminal law might characterise a death hastened by
pain relieving measures as involving whatever is encompassed in
'intentional killing.'
The Bill seems to try to avoid this result by creating a
palliative care exception - allowing the territories to enact laws
relating to 'medical treatment in the provision of palliative care
to a dying patient.' The Bill does not define 'medical treatment'
or 'palliative care' or 'dying patient', however, so the scope of
this exception is unclear. Moreover the Bill attaches a proviso to
this exception stating that such medical treatment must not permit
the 'intentional killing of the patient'. Thus, if the initial
argument succeeds - ie that the Bill's reference to 'intentional
killing' may encompass a hastening of death caused by pain
relieving measures - the 'palliative care' exception in the Bill
does not preserve the Territories power to make laws on this
matter.
Does the Bill remove a Territory's power to make passive
non-voluntary euthanasia laws?
The withdrawal or withholding of life sustaining medical
treatment from an incompetent patient is described by some as
passive non-voluntary euthanasia. A patient is not competent if he
or she lacks legal capacity. Those without legal capacity include
people who have never been competent to consent to or refuse
medical treatment, such as young children and adults with severe
intellectual disabilities. They also include people who were
competent but are no longer so due to accident, illness or old
age.
At common law in Australia, it appears that life sustaining
medical treatment can be withdrawn from an incompetent patient in
certain limited circumstances.(30)
The Bill seems to remove the territories' power to enact laws
allowing passive non-voluntary euthanasia to the extent that it can
be characterised as involving 'intentional killing.' This would
prevent the territories from enacting a statutory regime to
clarify, regulate and/or modify the common law position.
Passive involuntary euthanasia
Passive involuntary euthanasia might be described as the
withdrawing or withholding of medical treatment from a competent
patient, without that patient's consent, in order to end the
patient's life or hasten death.
It should be noted that at common law a health care professional
is under no obligation to provide any form of medical treatment
simply because the patient requests that treatment. A health care
professional will not be forced to provide treatment 'which in the
bona fide clinical judgment of the practitioner concerned is
contraindicated as not being in the best interests of the
patient.'(31)
The Bill seems to remove the territories' power to enact laws
allowing passive involuntary euthanasia, to the extent that it can
be characterised as involving 'intentional killing.' This would
prevent the territories from enacting a statutory regime to
clarify, regulate and/or modify the common law position.
Abortion
Questions have been raised about whether the Euthanasia Laws
Bill could impact on the capacity of a territory to enact laws that
decriminalise or legalise abortion. Laws that criminalise abortion
provide that it involves behaviour performed with the intention of
unlawfully procuring a miscarriage. It is, therefore, extremely
unlikely that abortion is encompassed by the expressions
'euthanasia' or 'mercy killing.' At common law a foetus is not
considered to have a legal personality and cannot be a victim of
homicide regardless of its gestation age unless it is born
alive.(32)
Mercy Killing
Mercy killing(33) has been defined by one writer as 'an
intentional killing which is prima facie murder but which is
carried out for compassionate motives, often by a member of the
family or a friend of the victim.'(34)
'Mercy killing' is not defined in the Euthanasia Laws Bill 1996.
Its inclusion arguably extends the ambit of the legislation beyond
the doctor-patient context to the actions of friends or family of
victims who may or may not be suffering from a terminal
illness.
A study of mercy killing cases dealt with by the Australian
criminal justice system found that many perpetrators were treated
leniently - through the exercise of prosecutorial discretion,
acquittal, findings of guilt on a lesser charge, lenient
sentencing, favourable parole determinations or executive clemency.
(35) Reform of the law relating to mercy killing is sometimes
raised and has included suggestions for the creation of a separate
offence of mercy killing with a lesser penalty than for murder or
continuing to treat mercy killing as murder but allowing the courts
a sentencing discretion to reduce or set aside penalties.(36)
The Euthanasia Laws Bill prohibits a territory from making laws
which 'permit or have the effect of permitting (whether subject to
conditions or not) the form of intentional killing of another
called euthanasia (which includes mercy killing).'(37) Does the
Euthanasia Laws Bill prevent a territory legislature from reforming
the law in relation to mercy killing? Could such reform, depending
of course on its nature, be regarded as having the effect of
permitting mercy killing?
- See Northern Territory. Legislative Assembly. Select Committee
on Euthanasia, The Right of the Individual or the Common Good?
Volume One. Report of the Inquiry by the Select Committee on
Euthanasia, Darwin, May 1995.
- Ibid, p.x.
- Cica, N Euthanasia - the Australian Law in an International
Context. Part 2: Active Voluntary Euthanasia, Research Paper
No.4 1996-97, Parliamentary Research Service, Department of the
Parliamentary Library, Canberra, 1996.
- Ibid, p.v.
- Otlowski, M Active Voluntary Euthanasia. A Timely
Reappraisal, University of Tasmania Law School Occasional
Paper 1, 1992.
- See, for example, 'Commonwealth may veto Territory's euthanasia
laws,' Financial Review, 28 June 1996.
- 'First death under NT mercy law,' The Age [Melbourne],
26 September 1996, p.1.
- See, for example, section 22 of the Medical Treatment Act
1994 (ACT).
- R v. (Bodkin) Adams [1957] Crim LR 365; Airedale
NHST v. Bland [1993] AC 789.
- Cica, op.cit, Active Voluntary Euthanasia. Otlowski,
op.cit, pp.19-20 writes:
Under existing criminal law principles for murder, liability
will be established for acts which cause death if they are
performed with an intention to cause death or in the
knowledge that death will result. Provided the necessary
mens rea and actus reus can be established, the
doctor's motive or the fact that the patient consented to the
administration of pain relieving drugs would be irrelevant
to the issue of liability. ...
Notwithstanding the clear application of criminal law
principles, it is widely assumed that doctors are not
acting unlawfully if they administer pain relieving drugs which
hasten the death of a patient, provided that the doctor's intention
was to alleviate pain and not to bring about the patient's
death.
- Lumb, RD & Moens, GA The Constitution of the
Commonwealth of Australia. Annotated, 5th ed, Butterworths,
Sydney, 1995.
- Ibid.
- Norfolk Island was the first external territory acquired by the
Commonwealth. It became a territory of Australia after the Queen
placed the Island under the Commonwealth's authority and the
Commonwealth enacted the Norfolk Island Act 1913.
- See, for example, section 35(2), Australian Capital
Territory (Self-Government) Act 1988 (Cwlth).
- See, for example, section 23(1) Australian Capital
Territory (Self-Government) Act 1988; regulation 4(2) Northern
Territory (Self-Government) Regulations, sections 49 & 50
Northern Territory (Self-Government) Act 1978.
- Thompson, P 'The law and active euthanasia: whose life is it
anyway?' Journal of Law and Medicine, 2(3), February 1995,
pp. 233-46.
- Recall that the common law throughout Australia requires health
care professionals to respect a competent refusal of life
sustaining medical treatment: see above.
- Recall that the common law permits this.
- See, for example, Tobin, B 'Foreward,' in B Tobin (ed)
Euthanasia. Proceedings of s Seminar Held at the Metcalfe
Auditorium, State Library of New South Wales, 7 November 1994;
Pollard, B 'Euthanasia,' Medical Journal of Australia,
1987, vol.146, p.179.
- Sometimes called passive voluntary euthanasia.
- Sometimes called passive non-voluntary euthanasia.
- If this occurs without patient's consent, it is sometimes
called passive involuntary euthanasia.
- Kuhse, H & Singer, P 'Active voluntary euthanasia, morality
and the law,' Journal of Law and Medicine, 3(2) November
1995, pp.129-35 at p.133.
- Explanatory Memorandum, Euthanasia Laws Bill 1996, p.3.
- Ibid.
- Bronitt, S 'Defending Giorgianni - Part One: The fault required
for complicity,' Criminal Law Journal, 17(4) August 1993,
pp.242-63 at p.248.
- R v. (Bodkin) Adams [1957] Crim LR 365; R v.
Cox (1992) BMLR 38.
- Bronitt, op.cit; & Otlowski, op.cit.
- Consent to Medical Treatment and Palliative Care Act
1995 (SA).
- See Airedale NHS Trust v. Bland [1993] AC 789; Re
B (A Minor) (Wardship: Medical Treatment) [1981] WLR 1421;
Re C (A Minor) (Wardship: Medical Treatment) [1989] 2 All
ER 782; Re J (A Minor) (Wardship: Medical Treatment)
[1990] All ER 930; Re Superintendent of Family and Child
Services and Dawson (1983) 145 DLR (3d) 610.
- Re J (A Minor) (Wardship: Medical Treatment) [1992] 3
All ER 614; See also R v. Cambridge District HA, ex parte
B [1995] 2 All ER 129.
- Cica, N 'The inadequacies of Australian abortion law,'
Australian Journal of Family Law, 5(1), March 1991,
pp.37-68. For recent Australian decisions confirming that a foetus
cannot be a victim of homicide unless it is born alive, see
Attorney-General's Reference No.3 of 1994; Crown v.
Martin, Western Australia, unreported, 4 April 1996.
- Under Australian criminal law, the motive of a person who has
killed another is irrelevant, as are the circumstances of the
victim or the victim's desire to die. Such a person may be guilty
of murder or assisting a suicide.
- Otlowski, M 'Mercy killing cases in the Australian criminal
justice system,' Criminal Law Journal, 17(1), February
1993, pp.10-39 at p.10.
- Ibid. Otlowski examined 19 mercy killing cases dealt with by
the Australian criminal justice system over a period of 30
years.
- Ibid.
- For example, new section 50A(1), Euthanasia Laws Bill
1996.
Jennifer Norberry Ph. 06 277 2476
Natasha Cica
15 October 1996
Bills Digest Service
Parliamentary Research Service
This Digest does not have any official legal status. Other
sources should be consulted to determine whether the Bill has been
enacted and, if so, whether the subsequent Act reflects further
amendments.
PRS staff are available to discuss the paper's contents
with Senators and Members and their staff but not with members of
the public.
ISSN 1323-9031
© Commonwealth of Australia 1996
Except to the extent of the uses permitted under the
Copyright Act 1968, no part of this publication may be
reproduced or transmitted in any form or by any means, including
information storage and retrieval systems, without the prior
written consent of the Parliamentary Library, other than by Members
of the Australian Parliament in the course of their official
duties.
Published by the Department of the Parliamentary Library,
1996.
This page was prepared by the Parliamentary Library,
Commonwealth of Australia
Last updated: 18 October 1996
Back to top