Seymour DavidDAVID SEYMOUR (Leader—ACT): Thank you Madam Chair. I rise in support of Part 2 and if I may to make a couple of preliminary comments. I'd like to advance a series of amendments to Part 2 which are set out in Supplementary Order Paper 259 in my name which has all of the amendments in a revision-tracked format for ease of reference. I might add that that revision-tracked version has been prepared by the Parliamentary Counsel Office with the assistance of the ministries of justice and health and in consultation with a wide range of external experts—for instance some of the legal counsel responsible for the application in Seales v Attorney-General. A number of other Government departments and experts have been consulted in the preparation of those amendments. So there has been some considerable work that has gone into them and by and large the bill as reported back from select committee remains in spite of all that. But if I can I'd just like to address Part 2 in general and some of those changes in particular. There is a new clause 5A with regard to conscientious objection. Conscientious objection has always been a cornerstone of this bill and the principle that nobody must do anything under this bill that they do not wish to do. What we've done with this amendment is say that it applies to all healthcare professionals who may have a duty under the bill or a duty that arises in any other way in relation to assisted dying and that they cannot be discriminated against on the basis of employment law. That is new clause 5A. Clause 6 describes what must happen if a medical practitioner has a conscientious objection and that is that they must tell the person applying for assisted dying that they have a conscientious objection and that the person must contact Support and Consultation for End of Life in New Zealand or SCENZ a new office established in the Ministry of Health to get a replacement medical practitioner. Some people have tried to portray this as referral. There is no way that it could be portrayed as referral—to give a piece of publicly available information that the person must contact the Ministry of Health for a replacement medical practitioner. Clause 7 is a new clause which makes it clear that a medical practitioner cannot initiate in any way a conversation about assisted dying. They can of course provide information if they're asked but they cannot initiate a conversation that is in substance about assisted dying. I'd say to members that in Victoria it has been ruled by the authorities that that includes any kind of advertising. There are some people who are anxious about the advertising of assisted dying. That has been interpreted in Victoria as being blocked by the requirement not to initiate a conversation. If you breach that you can be subject to disciplinary proceedings by the Health and Disability Commissioner. Clause 8 is the beginning of the process proper for assisted dying. A request is made by a person to either their medical practitioner or a replacement medical practitioner if there's been a conscientious objection and at that stage we go through quite a comprehensive process where the doctor has to talk to the person about their options and their prognosis and has to seek to talk to family members so long as it's not in breach of the person's privacy. They have to talk to other people engaged in the person's care. They have to examine their notes. They have to talk to them at times suitable to the development of their condition. With people with a rapidly advancing condition that might be quite short time increments; with somebody with a longer prognosis that might be quite long time increments but nevertheless there is an extensive process under clause 8 where the person has to have it made very clear that it's their choice. They can say no at every time. It's important for instance that the person must be told about their other options for care. Now of course that's just normal—that's just informed consent—but for those who want to see other options somehow made mandatory or people being made aware of other options we have covered that in clause 8. Clause 9 is that having gone through that process if a person still believes they're somebody who would like to request assisted dying they then have to confirm that request in writing. They must sign a form. The form can be signed by somebody else if they are physically unable. There is provision if a person is physically unable to sign but the person that signs for them must be somebody who has no direct benefit from the person's death or no potential to benefit from the person's death. If the person has confirmed their request in writing then we get to the first opinion. The doctor must examine the person. The doctor must read their notes. The doctor must come to the conclusion that the person is a person eligible for assisted dying according to the criteria set out in Part 1: they must be over 18; they must be a New Zealand citizen or permanent resident; they must have a condition that the doctor judges likely to end their life within six months; they must be a person who is mentally competent and able to make the decision which is also a criteria that we discussed in Part 1 and it's defined there; and they must believe—and this is critical—that in their view their suffering cannot be alleviated in any other way and that becomes important later on. If the doctor comes to that conclusion then they must refer the person's file back to SCENZ who then take a second doctor who in clause 11 goes through the whole process again in clause 11. Clause 12 is the third opinion. If either of the first two doctors in clause 10 or clause 11 reach the conclusion that the person would be eligible for assisted dying were they mentally competent to make the decision but they're not sure then they have to send the person to see a psychiatrist. This is a change from the bill as introduced or reported back from select committee. It was a psychologist or a psychiatrist. We've had some discussions with various people and concluded that because the person has a medical condition it should be a medical expert—that is a psychiatrist. Finally there is a decision. If any of the three medical practitioners involved—either of the doctors or the psychiatrist—do not believe the person is a person eligible for assisted dying then the answer is no. Any of them can veto it. At that point clause 13 sets out how the person must be told and the results of that decision must be reported to the registrar. Throughout this process the registrar who is an officer of the Ministry of Health collects all of the paperwork all of the forms and all of the records of what happens through this assisted dying process. Clause 14 is what happens if the answer is yes—that those two or potentially three medical experts all agree that the person is a person eligible for assisted dying the criteria of which I set out a moment ago. If that is the case then they choose a time and a date and they make provisional arrangements to end their life at a time of their timing and at a time of their choice and on their terms. Finally clause 15 is the making of the provisional arrangements. Clause 16 is very clear and this something new from the bill as reported back from select committee which is that the person can actually choose to defer within a six-month window. I think this is really critical. Evidence from offshore is that there is a palliative effect simply from having the choice. Once people know that they have the choice about how and when they die if they want it then that actually has a huge positive effect on their wellbeing. We've made it that a person once they have that choice can change the date. They can change their mind at any time. They can change the time at any time within a six-month window given that that is supposed to be their prognosis from the two doctors. So what we've got in Part 2 is a process. As you can tell from the really quite a glossing-over sort of summary I've given I've mentioned really a small portion of the detail in this part but I hope I've summarised it well. There's a very rigorous process. There's many checks and balances there's many safeguards and there's many medical experts and a great deal of medical expertise engaged in deciding whether or not a person is somebody who is eligible for assisted dying and of course the definition of that is something that is decided according to the definitions that this committee debated and agreed to in Part 1. So I'll try and keep my contributions brief but I hope that that description of Part 2 and the changes that I'm proposing and asking the committee to agree to suffices to begin this debate. Thank you Madam Chair.