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Responsibility for Approval of RU486

Speeches in Parliament
Christine Milne 8 Feb 2006

Therapeutic Goods Amendment (Repeal of Ministerial Responsibility for Approval of RU486) Bill 2005Second Reading

Senator MILNE (Tasmania) (7.07 p.m.)-Contrary to much of the advertising and public discussion, the question before the Senate today is not whether pregnancy terminations should continue to be legal in Australia. That is another debate under the jurisdiction of state parliaments. The question before us is: who should have responsibility for approving the use of the chemical abortion drug RU486 in a country in which it is legal in every state and territory to have a termination if the mental or physical health of the woman is at risk? Should responsibility for approving RU486 lie with a single member of parliament, the Minister for Health and Ageing, or should it lie with the Therapeutic Goods Administration?

What does that responsibility involve if you are the person or organisation making that decision? It involves assessing the safety of taking the drug. One has to ask: who is best informed or equipped to determine if a drug is safe for use by humans-a politician who may have no medical training at all, or the organisation specifically set up and trusted to make that decision about every other drug on the market in Australia today? The Therapeutic Goods Administration is accountable at every stage. Can the same be said of one parliamentarian?

I think it is dangerous for politicians to involve themselves in medical decision making. Parliamentarians should set the policy framework, and the medical experts should assess what is safe within that framework. The policy framework has already been determined. Parliamentarians in state parliaments around Australia have determined that termination is legal in Australia today. Therefore, the decisions about how that procedure is performed safely are a matter for medical experts and for women in discussion with their doctors.

If surgical abortion has already been approved by state parliaments, by parliamentarians like ourselves-in other words, if it is legal-why should the alternative option of chemical abortion not be available if it is safe?

To be safe and to comply with state laws, abortions, whether procured medically or surgically, require medical oversight and approval. If a state requires that a woman satisfy physical and mental health tests before qualifying for a surgical abortion, she will be required to satisfy the same tests to have a lawful termination using medical methods. So failing to support this bill will continue to force women into surgical procedures when a chemical option is available. For many women, a drug may be a better option for their physical and mental health than surgical intervention. They may recover their physical and mental health faster if they can access the procedure at an earlier stage and be secure in their own surroundings, supported by those who care for them. How logical is it for politicians to say that it is okay for women to have a surgical termination but not a drug induced one? If you are opposing this bill, that is exactly what you are arguing.

Decisions about the health of Australians need to be made, on the basis of medical evidence, by the experts charged by the government to assess risk-namely, the Therapeutic Goods Administration. This administration assesses and monitors almost 50,000 drugs on which Australians rely for their health. The only drugs in Australia that are not currently permitted to be assessed and monitored by the TGA are those intended for use as an alternative to surgical abortion. This is inappropriate. If we trust the TGA to assess the risks on every other occasion why not on this one? Would you trust the health minister to determine if the latest cancer drugs were safe? Many of these cancer drugs have horrendous side effects. Many of these drugs could cause death if used in wrong or inappropriate ways, yet we say that the TGA has the responsibility to assess the risk and effectiveness of the drugs. We trust it to do that. Would we trust a health minister to do so?

The World Health Organisation placed RU486 on its list of essential medicines in July 2005. Europe has 15 years of experience of this drug, which is widely available internationally-in Sweden, France and Great Britain, for example. It is endorsed as safe and effective not only by the WHO but by the Public Health Association of Australia, the Royal College of Obstetricians and Gynaecologists, the American College of Obstetricians and Gynaecologists, the Australian Medical Association, the American Medical Association, the American Association for the Advancement of Science and the Federation of International Gynaecology and Obstetrics.

Whilst I respect everyone's view on the matter of whether abortion should be legal in Australia, I do not think it is appropriate to confuse that issue with the matter before us. The matter before us is simply: who should decide what medical options are available to give effect to a decision the state parliaments of Australia have made-namely, that termination is legal in Australia? I believe that the Therapeutic Goods Administration-medical experts-should make that decision and not one parliamentarian. I support the bill.

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