Bill C-407 (Historical)
An Act to amend the Criminal Code (right to die with dignity)
This bill was last introduced in the 38th Parliament, 1st Session, which ended in November 2005.
Francine Lalonde Bloc
Introduced as a private member’s bill. (These don’t often become law.)
Not active, as of June 15, 2005
(This bill did not become law.)
Citizen Advisory Committees
Statements By Members
November 2nd, 2005 / 2:05 p.m.
Gary Carr Halton, ON
Mr. Speaker, I rise in the House today to inform my fellow colleagues of an innovative process that I use to communicate and work directly with my constituents. They are called citizen advisory committees.
We currently have committees on the topics of health care, citizenship and immigration, seniors, rural and agriculture. These groups meet a minimum of four times a year in small groups of 10 in order to exchange real dialogue and debate on issues.
They provide me with advice and feedback on issues and legislation which I in turn take back to the caucus and ministers. In between meetings we share ideas through e-mails, letters and phone calls. This allows an ongoing dialogue and is much more effective in dealing with complex issues.
On October 15, I held an advisory group meeting on Bill C-407, an issue that has become very emotional to many of my constituents. I had the opportunity to listen and take notes on the opinions, concerns and comments of my constituents which I will then discuss with my caucus.
I would like to thank everyone who came out to this meeting and thank all those who have taken the time to volunteer on the advisory committees. Their time, work and comments are very much appreciated.
Statements By Members
October 31st, 2005 / 2:05 p.m.
Bradley Trost Saskatoon—Humboldt, SK
Mr. Speaker, the introduction of Bill C-407 on assisted suicide has once more brought to this House a bill dealing with the precious gift of life.
Many in this House will express their painful choices and divulge a wrestling deep within their souls.
This issue is only difficult if one holds to a material, chance view of the universe, if one holds purely utilitarian values, and if one denies that there is an intrinsic value in human life. It can only be tortuous if one holds that the underlying validation of life is wanton service of self.
For those of us who acknowledge that life has value distinct beyond all else, our choice will be instinctive. Our choice will be the affirmation of the immense value of the most vulnerable of our society, a reiteration that every person is of immeasurable worth.
When a society in any way invalidates the sanctity of life, it throws in its lot with evil incarnate. As members of this House, let us do better. Let us choose life. Life: what a beautiful choice.
Private Members' Business
October 31st, 2005 / 11:40 a.m.
Joe Comartin Windsor—Tecumseh, ON
Mr. Speaker, as the previous member for the Conservative Party did, I rise to speak to this bill as an individual member of the House. The NDP caucus has differing opinions on how to respond to Bill C-407.
My position is to oppose the bill. There is a need for debate on the issue of dying with dignity. The problem is the bill focuses the debate on only one area, an area that should be put off and discussed only as part of the larger debate when conclusions are reached on the issue of assisted suicide and only when that debate takes place and proper services are in place to deal with those people in our society who are unfortunate enough to be faced, at times, with the decision whether to end their lives on their own at a much earlier stage than they might otherwise have to.
The debate has been around assisted suicide. It has been highlighted by the Rodriguez case back in the early 1990s. However, it has been isolated to that area.
I think Windsor has the best hospice in the country. I talked with the director, the volunteers and the medical personnel. With very few exceptions, that entire community has been providing palliative care broadly based across the whole of the city and the county. They have told me that we can build a system that will dramatically reduce anyone having to make this decision. Our medical doctor, who is one of the leading pain control specialists in the country, has said that there are very few cases where medication cannot be used to control pain so it is tolerable and people do not have to make the choice of ending their life prematurely because they cannot end what might be otherwise intolerable pain.
So much of this is very personal to us, although we ultimately as legislators have to think in terms of what our responsibility is to set national policy. I think of a friend of mine. He was our law dean at law school and the president of the university. He ultimately died of Lou Gehrig's disease. I would like to be able to take some credit, although I was not directly involved, but his friends and family, his wife in particular, built a system around him. He struggled but he was determined to live absolutely as long as possible, and he did.
I am worried when I look at the bill. Through you, Mr. Speaker, to the member from La Pointe-de-l'Île, this is not only assisted suicide. As we heard from the parliamentary secretary, in some cases this moves over into euthanasia. Speaking as a lawyer, there is no doubt about that in my mind.
What we really need to do is build that system. About a month ago there was a conference in Gatineau. Caregivers in the system said that we had not built that. The government has some responsibility in this regard.
When we look at some of the provision in the Romanow report, it is quite clear that if we had expanded at a more rapid rate our home care system, our hospices, our palliative care, we would have dramatically reduced the need at any time for someone to have to make this decision.
Again I am going to be critical of the government. It was the NDP member from Sackville, Nova Scotia, who pushed for allowing people to take time away from work to care for loved ones. Rather than following his program, the government put very extremely restrictions on it. In fact, the government budgeted huge amounts of money and spent about 10% of it because it was so restricted that so few people could take advantage of it.
However, if the system were a good one, if it were well funded and did not have these restrictions, it would be part of the system that would prevent people from having to make of taking their own lives prematurely.
The member for La Pointe-de-l'Île spoke about the Netherlands and Oregon. I am worried about what has gone on in Oregon, to this extent. At the same time it brought legislation in, Oregon was prioritizing what benefits people could get. So much of what I think has gone on in Oregon is about minimizing the demands that ill people will put on its system. Canada is not about that.
We built the medicare system. We built our health care system on the basis that every Canadian would have access to it, including those who had terminal illnesses. We have failed them up to this point. I am quite convinced, again from my experience in my own community, that we could build a system that would allow every Canadian to die with dignity in their own time, in the natural course of events.
I am worried about the Netherlands. Two or three weeks ago, it introduced new amendments to its legislation that would allow custodians and guardians of children to make decisions. That again is not assisted suicide. That is not even euthanasia. That country has now moved, if it goes ahead with that legislation, to mercy killings. It gets into the Latimer situation that we and our courts faced. We found that we would not go to go down this road.
The ability of Canada to deal with this is quite clear. We have to assess and build a system that will recognize this. We will never allow for mercy killings. We will not allow for euthanasia. If we build that appropriate health care system, we might have those extreme, rare cases where we would allow for assisted suicide, but we are nowhere near that at this point. I leave myself open to be convinced that we have to do this at some point in the future, once that system is fully in place,
The risk we have is sending a message to the country that life is expendable, that we are prepared to say that we do not care enough for people to take care of them. Canada is not about that. Our health care system is not about that. We should never go down that route. That is what we risk if we adopt this bill.
I hear particularly from the Bloc that we should support the bill, that we need the debate and that we should send it to committee at second reading. On a personal level, I cannot do that and I do not believe members of the House should do that. By doing so, we accept in principle that we will allow for both assisted suicide and euthanasia. I am not prepared to cross that line and say to the country that we will start down that road.
I have a little story from Janet Napper, the executive director of the Hospice Association of Ontario. She describes going to a hospice shortly after she started working and talking to an elderly man. He specifically approached her to say that when he came to the hospice, he knew he was dying but he also knew that he would be treated as though he was not dying that he would be treated with respect. That gave him the courage to continue on.
That is the kind of system we have to have in Canada, not this bill.
Private Members' Business
October 31st, 2005 / 11:30 a.m.
Jason Kenney Calgary Southeast, AB
Mr. Speaker, first let me make clear that I rise to address Bill C-407 on my own behalf as a representative of my constituents and not of my party. The Conservative Party will hold a completely free vote on this bill, as it does on all other matters of moral contention. We believe that members of Parliament should vote in a manner consistent with their consciences and/or the views of their constituents on matters such as this.
Bill C-407 seeks to amend the Criminal Code to permit active euthanasia, that is to say, the deliberate and lawful taking of innocent human life. I will start by addressing what I regard as the profound philosophical error at the heart of this bill and will then summarize some of the dangerous unintended consequences which would result from its adoption.
In a word, this legalization of euthanasia would change our social understanding of the human person as a subject with infinite and inherent value into a disposable object which can be eliminated at will. This bill is premised on a radical misunderstanding of the dignity of the human person. It is, in effect, an attack on the inalienable dignity of the human person, which is the foundational premise of liberal democracy and, indeed, of any culture which merits to be considered a civilization.
Properly conceived, human dignity is not a subjective sense of one's self worth, nor is it a reflection of one's worth in the eyes of society or the state. Dignity is not an ephemeral quality which ebbs or flows based on one's mood or social consensus or anyone's will. Rather, any coherent understanding of human rights, including the right to self-government, which is the predicate of democracy, is grounded in the inviolable dignity of the human person.
In other words, human dignity, which is the basis of our civilizational belief in the sanctity of human life, is ontological, that is to say, an essential and inseparable characteristic of human personhood, of human existence. To legalize or seek to legitimize the deliberate taking of innocent human life as this bill seeks to do is to commit the gravest offence possible against the human person. In short, it would turn a society such as ours, grounded as it is in this objective existential understanding of human dignity, on its head.
Obviously this truth of the human person is most clearly understood in theistic terms, that is to say that the human person is created in the image and likeness of God, an understanding most notably and beautifully summarized in the preamble of the foundational document of liberal democracy, the Declaration of Independence, which states, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights”, among which is the right to life.
However, this is by by no means a sectarian doctrine limited to the Judeo-Christian tradition. Rather, it is a truth universally understood throughout history by just societies, including our own. Let me cite some of the wide-ranging expressions of this truth that man cannot surrender his own life, nor can one take the life of another innocent human person.
From the 5th century BC until now, western physicians have sworn in the Hippocratic Oath, first, to do no harm and that:
I will not give a drug that is deadly to anyone if asked [for it], nor will I suggest the way--
Thomas Jefferson, one of the fathers of liberal democracy stated presciently:
The care of human life and happiness, and not their destruction, is the first and only [legitimate] object of good government.
The 1948 Declaration of Geneva of the World Medical Association states, “I will maintain the utmost respect for human life from its beginning”.
The Universal Declaration of Human Rights states that everyone's right to life shall be protected by law and no one shall be deprived of his life intentionally.
The Supreme Court of Canada, in its 1992 decision in the Rodriguez case, stated, “Suicide remains an act which is fundamentally contrary to human nature”.
The Select Committee on Medical Ethics of the House of Lords concluded after an exhaustive study of euthanasia that society's prohibition against intentional killing is the cornerstone of law and social relationships, that it protects each one of us equally.
The United States Supreme Court concluded in a case similar to the Rodriguez case “We are confronted with a consistent and almost universal tradition that has long rejected the asserted right, and continues explicitly to reject it today, even for terminally ill, mentally capable adults”.
In our own Parliament the Special Senate Committee on Euthanasia and Assisted Suicide concluded in 1995, “In a pluralistic society, respect for life is a societal value that transcends individual, religious or diverse cultural values”.
We can see the consequences of rejecting this universal understanding of the sanctity of human life in modern history. I am reminded of the words used by Dostoyevsky in The Brothers Karamazov where one of his characters says that without God, anything becomes possible. To paraphrase that, without the sanctity of human life as an inviolable social principle, anything is possible.
That was nowhere more evident than in Nazi Germany in the earlier part of the last century. In the 1930s beginning on the grounds of compassionate treatment of the mentally ill and the severely infirm, euthanasia was unleashed in that country. Passive euthanasia became active euthanasia and active euthanasia became an entire cult of eugenics. We know what kind of horror and human tragedy that resulted in.
We can see the same slippery slope at work in Holland today. Three separate studies have concluded that an estimated 1,000 cases of active euthanasia occur a year without the consent of the patient. According to one study, Dutch doctors have gone from killing the terminally ill who asked for it, to killing the chronically ill who asked for it, to killing the depressed who had no physical illness but who asked for it, to killing newborn babies because they have birth defects even though by definition they cannot ask for it. The slippery slope is a reality in Holland today.
I would like to quote from a very thoughtful study that was conducted by a special committee in the state of New York regarding euthanasia. It spent several years examining the issue and concluded that the state of New York should not legitimize or legalize euthanasia. That study concluded the following:
Undiagnosed or untreated mental illness. Many individuals who contemplate suicide--including those who are terminally ill--suffer from treatable mental disorders, most commonly depression....If assisted suicide is legalized, many requests based on mental illness are likely to be granted, even though they do not reflect a competent, settled decision to die.
Requests for assisted suicide are also highly correlated with unrelieved pain and other discomfort associated with physical illness. Despite significant advances in palliative care, the pain and discomfort that accompany many physical illnesses are often grossly undertreated in current clinical practice. If assisted suicide is legalized, physicians are likely to grant requests for assisted suicide from patients in pain before all available options to relieve the patient's pain have thoroughly been explored.
The study further said:
If physician-assisted suicide is legalized, many individuals are likely to seek the option because their suffering and fears have not been adequately addressed.
The practices will pose the greatest risks to those who are poor, elderly, isolated, members of a minority group, or who lack access to good medical care.
This will result in the devaluation of the lives of the disabled. This is one reason that most Canadian disability groups are strongly opposed to this legislation.
I believe that compassion properly understood means literally in the root of the word “to suffer with”. To kill is not compassionate. I invite all members of the House to seriously consider the Rubicon that the sponsor of this bill invites us to cross. Once one crosses that Rubicon, one cannot cross back. If we say in our society that innocent human life does not have absolute value, then we will embark on a social experiment the consequences of which I am frightened to contemplate.
Let us take a stand for true compassion. Let us give the resources necessary to provide proper palliative care to those suffering terminal illnesses. Let us not say that killing constitutes compassion. Let us stand true to the value of compassion which defines our country.
Private Members' Business
October 31st, 2005 / 11:25 a.m.
Paul MacKlin Parliamentary Secretary to the Minister of Justice and Attorney General of Canada
Mr. Speaker, I am pleased to speak to Bill C-407, which was introduced in this House on June 15 by the hon. member for La Pointe-de-l'Île.
Bill C-407 raises some very important issues about death and dignity. For many, the proposals in this bill may appear at first blush to be worthy of support. However, it is important to have a solid understanding of what the bill would do, if enacted, in order to decide whether debate on this bill should continue.
Having examined the bill, I am confident in stating my position that Bill C-407 should not be supported. The bill is quite broad in scope. It seeks to create an exception not only to the assisted suicide offence, but also to the offence of murder. As such, Bill C-407 would permit some forms of euthanasia as well as assisted suicide.
It is important to note that the person who aids another person to die does not have to be a doctor. The bill provides that the aider, or the person who assists, must be assisted by a doctor, and it does not state whether the doctor's assistance would be at the time of death.
The bill would not only apply to terminally ill patients, but also to persons who suffer from severe physical or mental pain without any prospect of relief. Theoretically, persons who suffer from depression could request assistance in dying and those who aid them would not be found criminally liable if the conditions of the bill were respected.
Bill C-407 has the potential to permit quite a vast array of situations. However, let us look at the safeguards that are in the bill. The most glaring shortcomings of Bill C-407 which raise considerable concern with respect to protecting physically or mentally vulnerable persons is the marked departure from the existing medical and legal standard for providing a free and informed consent.
The wording in Bill C-407 of “while appearing to be lucid” would introduce into the law what could be characterized as a vague, broad and arbitrary term to justify actions to terminate someone's life. Also, Bill C-407 contains little reporting requirements with only an obligation on the aider, or the person who assists, to provide the coroner with a copy of the diagnosis.
The legal regimes in other jurisdictions that have permissive laws in this area, such as the state of Oregon, the Netherlands and Belgium have extensive reporting provisions in their statutes. These not only provide an oversight mechanism but also enable the collection of valuable data to track the activities and to evaluate the application of this legal regime that is in place.
Another area that is of concern is the amount of consultation that should go into the proposal of a bill of this nature. A key concern with respect to Bill C-407 is that it appears to have been developed without prior consultations with many of the groups that would have a direct interest in the issue. Persons with disabilities and organizations representing them would certainly wish to express their views and concerns as many of them have perceived that the bill touches their circumstances more directly.
The bill would also impact on the medical profession, doctors, nurses, or others who provide medical services. Surely they would wish to be consulted well in advance of specific proposals being brought before Parliament. The manner in which coroners investigate and classify whether a death is natural, suicidal, accidental, homicidal, or undetermined would also be impacted by Bill C-407. These are just a few of the key groups that would be directly impacted.
Average Canadians should be invited to share their points of view and their concerns on these issues, because these are moral issues and therefore very personal.
Some may suggest that the issue has already been studied extensively, particularly by the Senate Special Committee on Euthanasia and Assisted Suicide in the mid-1990s and that now is the time to move forward on the issue.
Although some Canadians would favour a change in this area of the law, what remains unknown and is critical to this debate is whether their opinions are based on a good level of awareness of the issues, the law and the ramifications. Again, even if there is an appetite for change, we need to know what Canadians would consider being appropriate in terms of a legal regime before moving ahead with specific proposals as we have here.
In this regard, Bill C-407 is, I suggest, being introduced prematurely. It is also quite realistically too broad in scope as I described earlier.
Private Members' Business
October 31st, 2005 / 11 a.m.
Francine Lalonde La Pointe-de-l'Île, QC
moved that Bill C-407, An Act to amend the Criminal Code (right to die with dignity), be read the second time and referred to a committee.
Mr. Speaker, I have come to the conclusion that the Parliament of Canada and its members cannot pussyfoot around any longer and expect the courts or government to make the necessary changes to the Criminal Code to recognize the right to die with dignity for the people of Quebec and Canada.
Any lucid person facing a very difficult and painful end of life, which they consider degrading, an unfitting end to the life they have led, inconsistent with their condition as a free person, has to be able to decide how they wish to die, including if they want to be aided in that objective. This does not mean that all lives do not deserve to be lived; quite the contrary.
The experience of doctors who look after individuals who have been allowed to be helped to die in countries that have passed legislation in this regard is enlightening. One might infer that, knowing that they will be able to get help to die with dignity when they reach the point where their life has definitely become unbearable, it will be easier for people to live fully a painful end of life or a life of extreme limitations because they feel imprisoned in their bodies. As Félix Leclerc reminded us, death is full of life.
This is a societal debate. A few years ago, some countries legislated on euthanasia and assisted suicide. From the outset, I want to emphasize that, in Canada, we have definitions of euthanasia provided in the report from the Senate of Canada which differ from the definition in Europe. In Canada, it is understood that euthanasia, which is the act of putting an end to the suffering of a person, may be either voluntary, that is at the person's request; non-voluntary, if it is not known whether the person wishes to die or not; or involuntary, which would mean against the person's will. Should we not agree immediately that a person's life ought to be interrupted at that person's request, under specific conditions and with safeguards in place?
So, the Netherlands, Oregon in the United States and Belgium have similar legislation. Switzerland, like Canada, does not consider suicide a crime. Assisted suicide, which carries a 14-year prison sentence in Canada, is an offence in Switzerland only if it is done for corrupt or selfish reasons. Death must unequivocally be the result of suicide. That is where, in 2004, Manon Brunelle, former assistant producer with Télé-Québec, obtained assistance ending her life from a volunteer organization called EXIT. She wanted to televise her death in order to promote the right to die with dignity and with help, under certain conditions.
More recently, in July 2005 in Quebec, there was the tragic case of Marielle Houle, in the late stages of a degenerative disease. Her loving husband, André Bergeron, had to leave his job to take care of her full time. He finally gave in to Marielle's repeated requests to die, but the circumstances were tragic. Now, he is out on bail, waiting to see what charges he will face. Her death illustrates the distress felt by many helpers, without financial resources, sufficient knowledge or any firm support to which they are entitled from the public system. The slippery slope must be considered from this angle too.
The Denys Arcand film The Barbarian Invasions brilliantly portrayed one reality when there is a desire to die with dignity: having money and knowing the right people can make up for the lack of legislation for everyone. Former Justice Claire L'Heureux-Dubé wrote, “Let's stop being hypocrites. Hospitals are practising euthanasia. They call it a protocol”. The lucky ones have always had a friend who was a doctor or a nurse who knew how to secretly get hold of what they needed when they could not stand it any longer.
In Canada, above all, it was the extraordinary fight by Sue Rodriguez, from British Colombia, to amend the Criminal Code that brought the debate on assisted suicide to the forefront.
She had Lou Gehrig's disease and in 1992 she sought permission from the Supreme Court for doctor assisted suicide, since she was physically unable to take her own life.
In 1993, five justices to four ruled against Sue Rodriguez's request. I will read an excerpt from Justice Peter Cory's dissenting opinion:
The life of an individual must include dying. Dying is the final act in the drama of life. If death is an integral part of life, which I believe it to be, then death should be protected as a right under section 7 of the Constitution. The right to die with dignity should be as well protected as is any other aspect of the right to life.
Since Sue Rodriguez's request was denied—five to four—by the Supreme Court in 1993, and despite the hope raised by the statements made by then Minister of Justice, Alan Rock, during consideration of the motion put forward by the hon. member Svend Robinson, which was rejected by the House of Commons, the federal government has done nothing.
Now, it is up to Parliament and the hon. members to act, since there are far too many people at death's door who are suffering and do not deserve to nor want to. This is not a religious issue. The religious convictions of some must not become law for others. We are here to create laws for the common good and out of respect for rights.
Some people's response might be “Yes, but there must be universally accessible palliative care”. I agree, but palliative care and the right to die with dignity are not mutually exclusive, but complementary. Moreover, the end-of-life palliative care policy adopted by the Government of Quebec in 2004 states in its introduction that the failure of palliative therapies constitutes one of the most difficult end-of-life problems. Even with a quality palliative approach, medication and other therapies may not have the desired effect on the patient, on his or her physical and mental suffering. This is along the same lines as what is on the web concerning the Netherlands' legislation. It states that there are, unfortunately, cases where care, no matter how good, does not stop certain terminally ill patients who are experiencing unbearable suffering from demanding that their physician put an end to their lives. In such cases, interrupting the patient's life through euthanasia at his or her request may be the appropriate conclusion to palliative care.
Moreover, the introduction to the Quebec policy also refers to the fact that certain physicians may make use of what is called continuous sedation, which consists of a comatose state artificially induced by drugs. If prolonged until death ensues, continuous sedation poses ethical problems, particularly because there is a risk of its being confused with euthanasia although not labelled as such. The fact that there are no guidelines for this practice is a cause of concern for a number of those involved in palliative care.
In 2003, a Quebec medical journal, L'Actualité médicale , contained an article on “Euthanasia: conspiracy of silence”. Some of the physicians interviewed said they would never want to die the way some of their patients had. That is what some said, but others, like Dr. Pierre Marois, spoke of hypocrisy and the conspiracy of silence, because euthanasia on demand is being practised in Quebec. He described it as an open secret, and felt objective studies were urgently needed in order to cast light on the clandestine practice.
I know that my bill is being faulted for having no safeguards. It is an exception to the Criminal Code. If the conditions contained in the bill are not met, then the code continues to apply.
I have a question. I wish the Minister of Justice were here. How is it that in both Quebec and Canada—they will tell you so in English Canada—there is evidence that euthanasia is being practised?
How can it go on without rules? How many cases of euthanasia are there in Canada of the first, second or third kind? Nobody knows. Studies should at least be done. My bill is being criticized for not providing for any, but it simply provides for an exception to the Criminal Code.
There is strong support in Quebec and Canada for euthanasia, the right to die with dignity and assisted suicide. Saturday's La Presse cited 71% support for euthanasia.
Since 1993, the last time the Supreme Court rejected this matter, countries such as the Netherlands and Belgium have established legislation. They parallelled legislation that I drew on heavily in my bill. These two countries have experience. The Netherlands has more than does Belgium, because, since 1995, medical guidelines have allowed physicians wishing to assist patients who are terminally ill or suffering from a degenerative disease without risk of legal action.
These guidelines have therefore led to broad experience, and the Netherlands established a law in 2001 drawing on the medical guidelines and requiring physicians to ensure that an individual was indeed free and informed and wishing to die. In addi