Debates of Oct. 31st, 2005
House of Commons Hansard #144 of the 38th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was gateway.
- Question Period
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Private Members' Business
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 addition, as they said in their legislation, the patient must “experience severe physical or mental pain without prospect of relief, but need not be in a terminal phase. All other possible solutions have been exhausted or the patient must have refused all other possible solutions. Euthanasia shall be performed by a qualified medical practitioner. The medical practitioner shall consult at least one other medical practitioner and shall inform the local coroner that euthanasia has been administered“.
Those who have read my bill know that these are precisely the guidelines that I am proposing.
In Oregon, they took another route. It should be noted that this is an American state where citizens voted twice on such legislation. Their act allows any adult suffering from a terminal illness who is a resident of that state and whose diagnosed life expectancy is less than six months to obtain a prescription for drugs to end his or her life. Under my bill, a medical practitioner would be authorized to write such a prescription, under certain conditions. The patient would have to make two oral and one written request for such drugs. Moreover, the patient would have to get the opinion of a second medical practitioner, and the two requests would have to be made at least 15 days apart.
The legislation in Belgium is largely patterned on that of the Netherlands. As for Switzerland, theirs is an interesting approach. Switzerland, like Canada, has decriminalized suicide. However, Canada has decided that aiding a person to commit suicide would carry a sentence of 14 years in prison. By contrast, in Switzerland, unless this is done for venal motives, a person—we are primarily talking about a group called EXIT—can help someone die. It must be clearly established that the decision to die is that of the dying person.
I met a young woman who told me, and this was very touching, that her husband, who was Swiss, had decided to stay in Switzerland when he found out that he had terminal lung cancer. He wanted to make the decision, as a free man, as to when he would die—surrounded by his family. That woman told me he died happy, even though death is not a pleasant thing.
I did not address my bill per se. Members have read it. The principles it puts forward are the ones I covered in my remarks. Obviously, I would like this Parliament to debate it. With all that happened in 1992 and 1993 concerning Sue Rodriguez and with the Senate report, we cannot remain insensitive to the cries of pain and desire for dignity of so many people who are facing death. We could be cowardly, knowing that these people are not likely to stage demonstrations with signs.
In closing, I will read this testimony from the daughter of a friend who died from cancer after suffering great pain and who had agreed to help me prepare and promote this bill.
As it turned out, her dearest wish—to die with members of her family holding her hands—could not be fulfilled. Had the bill drafted and put forward by Ms. Lalonde been passed, our mother would certainly have taken advantage of it when her life was no longer worthy of the name. Perhaps her life would have ended a few hours sooner, but this legislation would have been well worth it, to ensure that her wish was fulfilled and that she could have died peacefully near her loved ones when her life was no longer meaningful.
Who could object to a person being allowed to decide how they will leave their body, to put an end once and for all to relentless pain they are unfairly made to suffer? Having witnessed this unfortunate one-sided fight, I can assure hon. members that she paid too high a price for relief from her suffering. While people may be afraid to suffer and die, they are even more afraid of dying alone and without dignity.
Private Members' Business
The Acting Speaker (Mr. Marcel Proulx)
I would remind hon. members that we cannot refer to the absence from the House of another member.
The hon. member for Brome—Missisquoi has the floor for a question or comment.
Private Members' Business
Denis Paradis Brome—Missisquoi, QC
Mr. Speaker, last Friday I was in my riding office when I received a call from a lady in the hospital who wanted to see me. She said she was no longer able to get around, so I went to her hospital room and spent some 30 minutes with her. This lady is 50 years old and has multiple sclerosis. She can no longer use her limbs, is immobilized, and in great pain. She told me she has to use ice when she goes to bed at night to reduce the pain her body is in. She has been in this state in hospital for over a year. Her mind is perfectly clear, she is a most intelligent woman with whom I had an extraordinary conversation. She is on morphine and the dose is increased from time to time, enough to keep her alive but perhaps not enough to fully do away with her suffering. She says she is still in pain. I saw her in her wheelchair beside the bed, virtually unable to move any more.
I told her we were soon going to be discussing euthanasia in the House. I asked her how we politicians could differentiate between cases where life is truly unbearable, with no hope of cure, and other cases. I would not want to see it apply to a widow of 75 who no longer wants to live because her husband died two years before. That is not its purpose. So I asked her how we would differentiate and she said perhaps to have two criteria: a degenerative disease with no possibility of remission, and unbearable suffering. She said that these both applied to her and she had really no hope left in her life.
This is what I wonder, and what I would ask the hon. member. Are the criteria she proposes sufficient to properly delineate this so that there is no danger of its becoming too broad at some point?
Private Members' Business
Francine Lalonde La Pointe-de-l'Île, QC
Mr. Speaker, I thank the member very much for this example illustrating my bill. He is asking, and rightly so, about safeguards. As a matter of fact, in every country that has adopted a similar policy, those opposed feared that there would not be sufficient safeguards or that this was the start of a slippery slope.
I have already said that my bill seeks neither to decriminalize nor legalize; it is an exemption to the Criminal Code. Some people might say that it is too strict. That is why I am turning this question back to the member. Why have no studies been conducted in Canada to determine how many assisted suicides have taken place under the definitions set out in the 1995 Senate report?
I have spoken to numerous experts who also do not understand the absence of studies. I am completely in favour of this. Will we include, in an amendment to the Criminal Code, the need for such studies? In my opinion, such studies are essential to every provincial health care system.
We are lagging behind. Debates must be held, particularly with medical practitioners. Not all of them will agree to end someone's life or agree to this person's request for help. This is normal. We must ensure they have this freedom. However, the conditions set out in the bill are part of existing legislation. They must be observed and verified by doctors.
In my bill, I indicated that it had to be a medical practitioner or a person assisted by a medical practitioner. Why did I say that? It is very simple: there is a doctor shortage. Having to find a doctor might mean that someone would suffer a painful death because one could not be found in time.
However, when I talk about someone assisted by a medical practitioner, I am proposing that patients be surrounded by a medical team and for their wishes to be respected. Patients may obtain permission for assistance. That way, they know that, if their condition becomes unbearable, they will have assistance. Maybe they will not need it, but at least they can put their minds at rest: they can die peacefully. That is what—
Private Members' Business
The Acting Speaker (Mr. Marcel Proulx)
The hon. Parliamentary Secretary to the Minister of Justice and Attorney General of Canada.
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
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
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
Christiane Gagnon Québec, QC
Mr. Speaker, today's debate on the bill introduced by my colleague from La Pointe-de-l'Île is on an issue that calls for reflection and questions our consciences on moral, religious and ethical levels. Do we have the right to die with dignity? This debate is serious and important. We must approach it calmly and stay true to our convictions, but we must also look at what this debate is really about.
The main purpose of this bill is to define and set the parameters for a person to die with dignity. The bill sets out conditions to allow any person to aid a person close to death or suffering from a debilitating illness, to die with dignity. I want to stress to die “with dignity”. This phrase is extremely important and makes all the difference in what it is we are debating. I will read the summary of the bill:
—to allow any person, under certain conditions, to aid a person close to death or suffering from a debilitating illness to die with dignity if the person has expressed the free and informed wish to die.
These words are extremely important. When one does not look at the wording of the bill, it is possible to wander mistakenly down all sorts of byways and contexts to know where the debate is going. It is very important that this nuance be clarified. Many people believe that this bill gives a blank cheque to decide on someone’s life or death, at any time and under any circumstances. This is not the aim of the debate on this bill, quite the opposite.
First and foremost, the bill is aimed at lucid people who face a painful end to life, who are suffering and who have no hope of ever being able to improve their physical condition. This bill would give such people, who cannot hope for improvement, the freedom to decide under what conditions they too will have a quality death. This experience will take place in circumstances where they are accompanied by medical practitioners. The physicians will have a role to play.
My colleague has drawn her inspiration from other jurisdictions. Some countries have already adopted legislation on euthanasia and assisted suicide. In Canada, we know that assisting a suicide carries the penalty of 14 years in prison, in contrast to Switzerland where it is deemed punishable only if it is done for venal or selfish reasons.
I would like to recall the life of Manon Brunelle, who suffers from multiple sclerosis. At age 36, her condition has deteriorated rapidly to the point where she can no longer receive treatment without pain. Her story touched me deeply. I have a daughter who has suffered from this disease since she was 24. Over the past 10 years, her health has not yet deteriorated to that point, but her quality of life is not that of a young girl of her age.
Although there are grounds for hope that the her illness will remain stable, there is no question that this debate has a quite different meaning for me, especially when my own daughter asks me not to leave her alone to her fate if one day she were no longer able to live life fully and there was no medication that could change her fate. I hope that I will never have to take this terrible, wrenching decision. I can understand the terrible anguish that family members experience when they are asked this over and over again, like a long cry of agony.
There are other cases that deserve mention in order to fully understand the issue of the right to die with dignity. There is, for example, the case of Marielle Houle, who was surrounded by her family and whose husband was praised by her family for the attention and the care he gave her. This man is free on parole waiting to find out what charge will be brought against him for having helped his wife to die. He did so, to be sure, under awful circumstances, but things could have been quite different in a legal context. The situation would have been quite different and a great deal of suffering could have been avoided. It is our duty to take part in this debate which is before us today.
It is easy to imagine how distressed people like André Bergeron can be when a member of their family or a spouse keeps asking for an end to be put to their daily suffering. These are conscious people for whom life has lost its meaning because their body no longer responds. For far too long, their body has been a prison.
It takes a lot of love to understand this terrible request. The curtain fell long ago for these people whose life is nothing but physical and mental suffering from terminal or degenerative illness, for which there is no prospect of relief and quality of life.
Sue Rodriguez, the Canadian woman who had amyotrophic lateral sclerosis, fought before her death in the spring of 1994 for a limited amendment to the Criminal Code so that adults freely and repeatedly requesting it could be helped to die with dignity.
A motion on this important issue was put to the House of Commons by a former NDP colleague, Svend Robinson. The motion was rejected by the members. Sue Rodriguez's application was also rejected by the Supreme Court in 1993, by five judges to four. Today, ten years later, the fight must continue to make known the wishes of suffering and lucid people, such as Sue Rodriguez, Manon, Murielle Houle and so many others so their fight may not be in vain.
It is clear today that the responsibility rests with the members of Parliament. Public discussion and debate is needed to express this issue clearly. Discussion must include not only the distress of the persons who are suffering and their fight but the overpowering impotence faced by those who care for their loved ones, for whom life has no more meaning because their bodies have failed them and because they obtain no relief from medication or other palliative care.
Today, we might think that, because science has made progress and helps prolong life and because quality palliative care is available, there is no need to amend the Criminal Code to permit death with dignity.
This is far from the case according to the authors of the April 2004 end-of-life palliative care policy issued by Quebec's health and social services. Page 7 of this document states that the failure of palliative care is one of the most difficult problems experienced at this final stage. Despite the quality approach, care, medication and various treatments, for some people, these drugs prove ineffective. We are talking about some people.
This is not intended for everyone. Those who wish to continue to receive palliative care may do so. I am talking about testimony from individuals who say that they are lucid and clear-minded, and who no longer have the will to live because they are suffering greatly.
Some terminally ill patients suffer unbearably and ask their doctor to end their life. Ending one's life may be, for those who ask, an appropriate end to quality palliative care.
We may question the practices of some doctors who resort to continuous sedation of their patients, using drugs to send them into an artificial coma, sometimes until the patient dies.
I thought long and hard when my colleague asked me to support her bill. Obviously, I have a profound stake in this issue, perhaps because of my daughter's condition. However, this summer I also read Frédéric Veille's book entitled Je vous demande le droit de mourir , and I recommend it to everyone. This book is an heartrending account of the daily life of a young quadriplegic from France, who was the victim of a senseless car accident. I also invite members to watch the film entitled La Mer Intérieure , about Ramon and his long fight to die with dignity.
I ask all parliamentarians to discuss this important issue with their constituents—
Private Members' Business
The Acting Speaker (Mr. Marcel Proulx)
I am sorry to interrupt the hon. member, but we are resuming debate. The hon. member for Halton.
Private Members' Business
Gary Carr Halton, ON
Mr. Speaker, I understand that I have only a couple of minutes to speak, but I will fully utilize the time. I will be voting against this piece of legislation.
Like many members of the House, I believe, I have received a lot of mail, emails and phone calls on this issue. The next time I speak to the bill I hope to go through some of that information.
I have also set up citizens advisory committees in a couple of areas, on seniors and on health care. We had a meeting of the citizens advisory committees about two Saturdays ago. I want to thank everybody who came out to that meeting. Some people were in favour of this bill, but the vast majority was opposed.
There were people there like Joanne Matters from Halton Pro Life, who said, as was recorded in the Milton Canadian Champion , “there is no such thing as an assisted suicide bill with safeguards. It is always about killing another human”. She went on to say that we “can't legalize a little bit of killing for those who ask to be killed. Eventually it will include those who don't ask. History speaks for itself”.
I also received information from many people right across my riding. I received a nice letter from the Reverend Charlie Jordan, a pastor at Mary Mother of God Parish in Oakville. He sent a letter saying that he is totally opposed to the changes proposed in the bill. He goes on to say that human life is too important to permit such a course of action. Instead, he says, we should be providing every help we can to prevent pain.
I also have received numerous letters on this issue from the Knights of Columbus, as I am sure all members have. Thomas Pepper sent one. Most of the letters were very similar. The feeling is that it is wrong to take someone's life and that such a change in law would be open to abuse. In an age when we hear a lot about elder abuse, this would not be an acceptable path to take.
I will continue my remarks next time, but I did want to get it on the record that I will be voting against the bill. I hope to elaborate on my reasons at the next opportunity.
Private Members' Business
The Acting Speaker (Mr. Marcel Proulx)
The time provided for the consideration of private members' business has now expired, and the order is dropped to the bottom of the order of precedence on the order paper.
Pacific Gateway Act
Jean Lapierre Minister of Transport
moved that Bill C-68, An Act to support development of Canada's Pacific Gateway, be read the second time and referred to a committee.
Mr. Speaker, I am very proud to stand in the House today to begin debate on Bill C-68, an act to support the development of Canada's Pacific gateway.
This legislation reflects the commitment of this government, working in partnership with its provincial counterparts and industry stakeholders, to best position Canada so it can prosper in a 21st century economy, an economy that is changing rapidly.
International in its outlook but domestic at its core, the Pacific gateway reaches beyond British Columbia. It is a pan-western initiative with benefits for all Canadians.
The legislation that this government has introduced articulates just how this vision will be put into action. It does this in two ways.
First, the bill sets out new policy frameworks for further development of Canada's Pacific gateway and commits the federal government to a clearly defined strategy.
Second, it establishes a new governance foundation through the creation of Canada's Pacific gateway council, to build consensus among a wide range of public and private stakeholders and to advise decision makers on priorities for developing the Pacific gateway.
I will speak to both aspects of the legislation, but I think it is equally important to provide the context for the introduction of this legislation.
As the most trade dependent nation among G-7 countries, Canada depends on international commerce for its prosperity. Today, the dynamics of global trade are driven by rapid, seamless and secure movements of goods and people around the world through global supply chains.
Much of the activity surrounding supply chains and changing trade patterns is concentrated in key geographic locations or gateways. These gateways are linked to each other and to major markets by corridors. The efficient functioning of trade related gateways and corridors is central to the prosperity of trading nations like Canada.
The rise of emerging markets such as India and China makes it a national priority to ensure that we maximize the effectiveness of our Pacific gateway and ensure that we are taking maximum advantage of it. That requires a new integrated approach to a wide range of interconnected issues, including, but going well beyond, transportation infrastructure.
This is the challenge and the national priority that the Government of Canada is addressing through Canada's Pacific gateway strategy.
The emergence of China as a global trading partner is realigning patterns of trade and investment internationally, shifting global supply chains and framing the pursuit of competitiveness and prosperity around the globe.
China is currently Canada's fourth largest export market. According to International Trade Canada, our exports to China grew by 90%, from $3.5 billion to $6.7 billion, between 1995 and 2004. During the same period, Canada's imports from China grew by more than 400%, from $4.6 billion to $24.1 billion. And China's recent dramatic growth is expected to continue. While it is currently the world's seventh largest economy, it is predicted to be the second largest by 2020, and the largest by 2041.
While Canada-China trade is likely to remain modest compared to the overall value of Canada's trade with the United States trade for some time to come, our strategic interests clearly require new efforts to position Canada strongly in the Asia-Pacific context.
The rapid rise of China as a trading power directs particular attention to both the challenges and opportunities associated with Canada's Pacific orientation. Indeed, Canada is uniquely positioned to take advantage of emerging opportunities in China and other Asia-Pacific countries, including India and Korea. The Pacific gateway also benefits considerably from a population base that enjoys strong cultural connections with the economies of the Asia-Pacific region, through its heritage, family ties, businesses and investments.
The proximity of Canada's west coast ports to Asian markets offers a one to two day sailing time advantage over all others in the western hemisphere. Canadian rail operators offer among the most affordable freight rates in North America, and our trucking sector is also highly competitive and efficient, both in Canada and in transborder markets.
In addition to the B.C. Lower Mainland ports, significant volumes of container traffic through the new terminal being developed by the Port of Prince Rupert will add considerably to the Pacific gateway picture. Clearly, a strong foundation exists on which to further develop Canada's Pacific gateway as the crossroads between North America and Asia.
I would like to turn now to the gateway itself. Canada's Pacific gateway is a multimodal network of transportation infrastructure focused on trade. It is comprised of interconnected public and privately owned assets including ports, railways and road systems.
Changing trade patterns associated with emerging markets are expected to result in significant growth in trade through this gateway. By 2020 container cargo coming through the ports in British Columbia is projected by the B.C. government to increase by up to 300%, from 1.8 million containers to between 5 and 7 million containers. The value of the trade is projected to reach $75 billion by 2020, up from the current $35 billion.
This will contribute $10.5 billion annually to the Canadian economy, including $3.5 billion in B.C. The trade increases are projected to result in a 178% growth in direct jobs by 2020, from 18,000 to more than 50,000. As we can see, we are talking about trade, more business and more jobs for Canadians.
If we are going to move ahead, we have to understand some of the challenges we face. Despite our potential, Canada's advantages are being jeopardized by freight congestion in the B.C. lower mainland and by points farther east, and concerns exist about capacity to handle projected trade growth. At the same time, Canada is facing an aggressive competition in attracting and retaining a portion of the growing Asian trade.
Other countries and regions are investing in infrastructure and related initiatives to position themselves to seize trade opportunities. For example, the U.S. government recently approved the $286.5 billion over five years safe, accountable, flexible and efficient transportation equity act: a legacy for users. It includes significant investment in the transportation system to improve trade flow.
Recent trade flow increases have strained existing transportation infrastructure capacity on the west coast. In addition, the rail network is also being challenged to meet rising demand. Port backlogs have resulted in some diversion to other ports. This is causing some shippers to be concerned about the future reliability of west coast ports, road and rail services and infrastructure.
In addition to infrastructure capacity, gateway performance is also affected directly by a range of factors, for example: labour market issues including skills shortages in critical fields such as long haul trucking; operating practices in the supply chain; increasing pressures in border management where continued efficiency and greater security must be delivered in the context of rising volumes; and regulatory and economic policies at all levels of government; and municipal land use policies and practices.
A still broader set of issues, reaching far beyond infrastructure, will determine how well Canada takes advantage of the Pacific gateway. These include: trade promotion, sectoral cooperation, and standards harmonization and innovation in the Asia-Pacific context. Concerted efforts in these and other fields are required to ensure that the Pacific gateway's contribution to Canada's prosperity is as great as possible.
It has become increasingly apparent that all of the issues affecting the gateway are interconnected. And that is what Canada's Pacific gateway strategy is all about. The strategy has been developed to address the interconnected issues in an integrated way, accelerating the development of the Pacific gateway and its benefits for British Columbia, the other western provinces and the entire country.
The strategy includes capacity investments to improve the performance of the gateway, including infrastructure and connected issues such as border security and labour market issues. The strategy also includes measures that will contribute to how well Canadian businesses take advantage of the Pacific gateway, through building deeper links with the countries in the Asia Pacific region. And federal commitments carry both near-term and long-term benefits.
Canada's Pacific gateway strategy consists of three key components.
First, there is the Pacific Gateway Act, which includes a policy declaration and a new advisory body to address the interconnected issues related to gateway development
Second, there is a package of immediate investments, as announced on October 21, 2005, in Vancouver.
Finally, there are additional funds for further strategic investments over the longer term, including in response to the recommendations of Canada's Pacific Gateway Council.
I would like to talk now a little about the Pacific gateway act. First, the act's policy declaration commits the federal government to the Pacific gateway strategy and defines its essential elements. They are: support for the further development of a world-class multimodal network of strategic transportation links and transfer points of national significance that is competitive, efficient, safe, secure and environmentally sound; the advancement of an integrated and cohesive set of measures in areas that affect gateway performance and areas that allow Canada to take full advantage of the opportunities it provides; and, the promotion of strategic partnerships and collaboration among governments and stakeholders, including through the creation of Canada's Pacific gateway council.
The job of the council would be to advise decision makers on the full range of transportation and other issues that affect the effectiveness of Canada's Pacific gateway and how well the Canadian economy takes advantage of it. The council would be mandated to work with existing networks of stakeholders active in Canada's relations with Asia-Pacific countries, such as the Asia Pacific Foundation of Canada, and in gateway issues, such as the Greater Vancouver Gateway Council.
The second part of the strategy consists of specific measures that have been identified which would immediately advance the fuller development of the Pacific gateway.
These measures would be implemented with the participation, where appropriate, of provinces, municipalities and other stakeholders and, in the case of infrastructure initiatives, would include cost sharing requirements. The measures are a total of up to $125 million to address key capacity and congestion concerns in the B.C. lower mainland and points further east including: up to $90 million for the Pitt River Bridge and Mary Hill Interchange in the B.C. lower mainland; up to $30 million for road-rail grade separations in the rail corridor extending from Mission to Deltaport; up to $3 million for North Portal, Saskatchewan road-rail grade separation; and, up to $2 million for intelligent transportation system deployment.
The Government of Canada has also committed to contribute to the environmental assessment of the proposed South Fraser Perimeter Road. While the federal government is not committing to fund the project at this time, it will support necessary environmental work and will continue working with the province of British Columbia.
Up to $20 million would be allocated to the Canada Border Services Agency to support expected increases in traveller and container volumes, courier shipments, air freight, commercial trucking and clearing of goods. Priority would also be placed on increasing border management capacity at marine ports, airports and land border crossings to ensure the flow of lawful people and goods while ensuring public safety and security is not compromised.
Finally, up to $10 million would go toward developing deeper links with the Asia-Pacific region through Canadian involvement in international and regional standards development and harmonization activities aimed at the Chinese and other emerging markets. This would facilitate market access for Canadian products and services in these markets and support two-way trade.
An additional $400 million has been identified for future strategic investments, including those in response to recommendations of Canada's Pacific gateway council addressing the range of interconnected issues that affect the full development of the gateway. The future initiatives could include: strategic transportation infrastructure investments; deeper links with Asia-Pacific; labour market initiatives; and investment aimed at ensuring secure and efficient borders at key entry points for the Pacific gateway by addressing the operational demands resulting from increases in trade, visits, immigration and the evolving security environment.
Canada's Pacific gateway strategy is an important part of the Government of Canada's efforts to enhance our long-term prosperity. It is consistent with other major policy directions including those that support sustainable development, the New Deal for Cities and Communities and well-established directions in transportation policy.
The gateway approach is about acting strategically to take advantage of the convergence of opportunities related to geography, transportation and international commerce. It is also about addressing the connections among a wide range of issues that impact the effectiveness of a gateway or corridor including, but going well beyond transportation.
The Pacific gateway is a first because the people of western Canada have done their job over the past 10 years or so. I have committed to develop a national policy framework on strategic gateways and trade corridors that will guide future measures to tailor the gateway approach to other regions. These measures will not be identical to the Pacific gateway strategy, rather they will be tailored to the circumstances and opportunities in the region concerned. The gateway approach also depends on partnership and collaboration not only across modes of transportation, but also across jurisdictions, and across public and private sectors.
We all have reason to be pleased today with this bill, which will finally allow us to develop the extraordinary potential our geography has to offer. Whether in southern Ontario, on the St. Lawrence River, or in the Halifax area, we could develop other corridors, other gateways to promote the development of international trade.
British Columbia has been a leader in this field. It has done its homework. We will now use its experience and support it. We will do the same for western Canada. Based on this experience it is clear that there will be more bills of this kind in order to maximize on the full potential of international trade.
Pacific Gateway Act
Rick Casson Lethbridge, AB
Mr. Speaker, my first question for the minister concerns the composition of the board. Would the minister comment on the fairness of appointing two members from B.C. and only one member from each of the prairie provinces?
My second question concerns the expectation of a possible increase in container traffic of manufactured value added goods and grain coming off the Prairies. People are saying that the bulk shipping of grain might be a thing of the past because the customer will want to have trace back to where the product came from, right to the actual farmer's field. In order to do that a container would have to be used and properly handled.
Some of the numbers that we have been given on the potential increase in container traffic is huge. I do not see the point of setting up an advisory council with a mandate over a number of years when it looks as though it may be six years before it reaches a conclusion. Would the minister comment on what the time line is on some action here?
We need capacity and that capacity has to begin immediately. It is now past due. If we take another length of time to rehash the things, which we already know and which the minister already knows from other sectors that have advised him, why do we need to go through this process to add another length of time when we should actually be putting some money in the ground?
Pacific Gateway Act
Jean Lapierre Outremont, QC
Mr. Speaker, the reason two members from B.C. would be appointed to the board and only one from each of the other provinces is that most of the work will be done in B.C. When we talk about congestion, about work being done at the port or about road infrastructure, it obviously will be done in B.C. and those members would have the experience. The Greater Vancouver Gateway Council has been working on this for the last 10 years. We are building on its experience. Provincial Ministers of Transport are happy that they will each have one representative on the board.
This, obviously, is B.C. inspired, and it will be custom designed by western Canada, but it will be for the good of all of Canada. We thought that local representation responded to the needs of the provinces. I have had the support of the four provincial ministers in that regard since the bulk of the work will be in B.C. We also wanted to build on the experience.
The member is right when he says that demand will be huge but I do not see the council preventing us from doing our job. The council would be there to help us prioritize what we should do first. For example, I know we will need to change some of the laws if we want to get truck drivers because there is a shortage of truck drivers in the country. The council would help us establish priorities and probably push us more than anything else.
I do not want a council that prevents us from doing our work. We do need local and regional consultation. The board would be pretty helpful. However, in the meantime we have authorized $190 million of work. An envelope of $400 million will be available, not for the council to decide but for the council to make recommendations, and this is only a down payment.
The demand will be huge, which is why we will have people from CN, CP and others involved on the council. We not only need their input, we need to be prepared to enjoy all the benefits of this great opportunity. We need to ensure our infrastructure is in place. I hope the council will help, not delay any project.