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RU486 - who decides?

Speeches in Parliament
Rachel Siewert 8 Feb 2006

In rising to address the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I would like to clarify what exactly is the question that we senators are being asked to address and ultimately decide on tomorrow. Before I do that, I would like to congratulate the proponents of this bill on having the guts to put it up in the face of a lot of opposition from what I believe is a minority-but a noisy minority-in the community. In doing so, I am mindful that there has been extensive media coverage, public debate and constituent lobbying, much of which I believe has been tangential to the question, if not misleading.

The question we are being asked today and tomorrow to make a decision on is whether the Minister for Health and Ageing is the most appropriate person to decide if the drug RU486 and other abortifacients should be made available in this country or if their availability should be determined by the Therapeutic Goods Administration in the same manner as every other drug in this country. This clear question is being clouded by the same turbulent and emotive debate which has for many years surrounded the issue of abortion.

I fully agree that abortion is a very difficult and sensitive subject, but it is one which has been subject to considerable public debate. The fact is that abortion is legal in Australia, but what is before us is not that debate. The opponents of this bill are using it as an excuse to reopen and sidetrack this debate. The issue in question is who should decide if a pharmaceutical drug will be allowed into this country. When you think about it, it could potentially be the start of a slippery slope if today this parliament decides that the health minister should continue deciding about this type of drug. What other types of drugs do we think the health minister should decide about?

The TGA has a very specific purpose. It is infinitely more qualified than any health minister will ever be to assess the medical appropriateness of drugs for listing in this country and is free from any accusations of real or potential political influence. If there are significant health implications of taking medications then these should be subject to a rigorous scientific assessment that takes into account and balances the full weight of the medical evidence of the benefits, the risks and the unknowns. The ethical question of whether abortion should be available in Australia has already been decided and is not up for debate today. Abortion is currently safely available in Australia, with the regulation of provision varying from state to state. To paraphrase Prime Minister John Howard-not something I do regularly-the vote slated for February 2006 is about whether a single member of parliament or the Therapeutic Goods Administration, the TGA, should decide on the safety of the drug.

I think it is particularly important to separate politics from medical decision making. Decisions about the health of Australians need to be made on the basis of medical evidence presented by the experts to those charged by our government with the risk assessment role: the TGA. As has already been discussed by previous speakers on this bill, pharmaceuticals such as RU486 intended for use by women as abortifacients are the only drugs the TGA does not have the authority to evaluate and regulate. Yet, since its establishment in 1989, the TGA has fulfilled its responsibility to both assess and monitor the almost 50,000 other drugs on which Australians rely for their health. Why is this one class of drug considered to be so bad?

I do not think the opponents of this bill and the proponents of the opposition of this bill are really serious about their argument of safety. If they are talking about safety, why do they not argue for similar bans on tranquillisers, mood elevators, Valium, Prozac or many other drugs? Many of these have some very serious questionable social and medical consequences, and arguably have many more side effects, adverse consequences and may even lead to deaths. This issue is about the use of abortifacients.

RU486 is a drug that is recommended by the World Health Organisation, particularly in developing countries. It is a drug that provides an alternative to a surgical procedure for the termination of a pregnancy and therefore gives women more choices. This debate is about women's health and their choices in a country where termination of pregnancy is already frequently performed. It is particularly important for women living in remote and regional communities.

Termination of pregnancy does occur in Australia, and the best health outcomes are where there is ready access to high-quality services in early pregnancy. RU486 should be one of the options in this setting. The family planning debate has been conducted for a long time in the public domain. The issue now appears to be whether individuals should have choice in this sphere of activity or whether the government has a duty to regulate it. I support the idea that contraceptive use by men or women is a personal decision and support the right of women to choose whether or not to have children.

Even if you disagree, and support the notion that family planning is an area for regulation, there is still the issue of whether or not abortifacient drugs may be preferable to surgical abortion, which is already legal in this country. Again I state that we are not being asked to debate this issue; we are being asked to debate whether the health minister should make this decision or whether it should be made by the TGA. Some of the opponents of this argument refuse to understand or acknowledge the basic facts of this debate, and that saddens me greatly. This debate is about whether the TGA should be making the decision on this drug-whether they should be making a medical decision based on facts. I, with the other Green members of the Senate, support this bill.

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