Access to palliative care is so poor in regional and remote NSW that voluntary assisted dying can't truly be voluntary, a NSW parliamentary inquiry has heard.
"If a lot of the argument for assisted dying is about choice, there has to be an alternative," Australian Catholic University policy director Michael Casey said on Monday.
In a submission to the parliamentary inquiry considering a draft law to allow voluntary assisted dying in NSW, Mr Casey included research that identified a dire shortage of palliative care professionals outside the state's cities.
While the submission acknowledged limitations in the data, it said that in six of the seven years to 2020 no palliative care doctors resided in remote NSW areas such as Bourke.
Only in two of those years did any palliative care doctor live in outer regional areas like Narrabri.
Over the same period the number of palliative care nurses increased significantly in inner regional and outer regional areas, but for all bar one of those years remote parts of the state again had none.
While general practitioners can also provide palliative care, Mr Casey argued the research showed improving access to, and quality of, palliative care is the next logical step for NSW.
"It seems like a big jump to go straight to assisted dying when ... there's a long way to go in making sure that everyone who needs high quality palliative care has access to it," he said.
However committee member Trevor Khan objected to the argument, saying the bill is designed for people whose suffering cannot be relieved by palliative care.
"Does that mean that for those patients ... the answer for them, at the present time by you, is 'well, you're just going to have to grin and bear it'?"
Mr Casey is among 20 witnesses appearing before the inquiry at a packed hearing on Monday.
The committee also heard from retired priest and academic John Fleming, who compared legalising voluntary assisted dying to legalising the slave trade.
"No one may sell themselves into slavery even if they want to," he said.
"In the same way, until now, we have prohibited the homicide of innocent persons even when they want to kill themselves."
The committee is racing to consider the bill and report back to the Legislative Council before parliament resumes next year.
It mustered a 52 to 32 majority in the lower house after a mammoth four days of debate.
If passed, the draft law would make NSW the last Australian state to allow the terminally ill to choose to end their lives.
