Debates of April 20th, 2010

Michael Savage Dartmouth—Cole Harbour, NS

Mr. Speaker, I am pleased to have the opportunity to speak to this bill this evening. It is a bill whose progress I have followed with particular attention and the opportunity to speak tonight is one that I am very appreciative to have.

I want to say at the outset that I will not be voting for this bill. I do not support this bill and I do not support its intent. I do, however, want to commend the member, who has proposed this bill and who has led this fight, for her diligent work on this file, her sincere and informed opinion and understanding of this issue, but I believe it is one of those issues where people who have equal interests can have different points of view. It is a sensitive issue and it may well be an issue that needs a more fulsome debate in this country.

I want to speak to this bill from two points of view. I want to speak to it from a personal point of view. Like most members of the House, I have had experience with people who have died with dignity. It has had a profound effect on my life and the lives of my family and it has certainly had a profound effect on how I view this bill. I want to talk personally in a way that I would not normally about my own situation. I want to talk about my parents.

My parents both had cancer. I do not believe that cancer beat them. I think they beat cancer even though cancer took their lives. My father was diagnosed with inoperable cancer in July 2001. The prognosis was very bleak but he started an aggressive treatment of chemo. He had chemo treatments 24 hours a day and it worked. My father entered a remission period and had a remarkable period of remission in his life. While on remission, he visited Africa and Russia. He did the social development work that mattered very much to him. We felt as close to my father in that period as we ever did.

In November 2002 the cancer returned, and a few weeks later my mother was diagnosed with bowel cancer, one week before Christmas. I am one of seven children. My two sisters became full-time caregivers for my parents from Christmas 2002 onward. By mid-January, my mother was in palliative care, although she was at home, and our family was honoured to care for her. We cared for her in her home. On March 31, 2003, she passed away. Three days after her funeral, my dad was told that his chemo treatments were no longer advised and he came off chemo and entered palliative care as well. He passed away on May 13, six weeks to the day after my mother.

I tell this story because my parents died at home, in peace and sure that they were headed to a better place. We knew as their children that they were ready to leave this world. They both fought cancer with great courage and neither one of them were people to give up without a fight. They felt entirely in control, not only at the end of their life but in control of their death.

It is hard for anybody who has seen people they love die, like so many have, and not be impacted by that. I want to speak to how that impacts my view on this bill because my parents both made a decision. I can recall the conversation with my father when he said that he would no longer be eating. He was at home and he had decided that he would no longer eat. He knew he was ready to go. I do not think he ever actually said to us that he was going to die in two or three days but he was in control of that part of his life and he knew it was time. Likewise, my mother made those same decisions. The opportunity for us as family to be with them in those circumstances was an opportunity I cherished.

When I think about people my age with parents, it seems that one of two things happens. They either die in circumstances quicker than we would like or sometimes they take longer in their passing than they would probably like for the sake of their own family.

However, I do not believe that we needed this legislation to allow my parents to have control of their death. T go to a place that they were ready to go to was a decision that they made, were comfortable making and were able to make under the laws that existed and under what they considered to be the God that they were prepared to join.

I also do not like this bill because a number of people I represent in my capacity as the critic for human resources, particularly in the disability community, are very concerned about this bill. They do not know exactly where it will lead. At the very least, they think there should be a more serious debate about this before final decisions are made. It should be something that is consulted widely and taking into account the various levels of palliative care.

I do not think anybody here would say that our palliative care system is as strong as it should be. My parents went through this process in Nova Scotia. My father, as a medical doctor, had pioneered some of the palliative care back in the 1970s. He was at the bedside of many people when they passed away and was a big believer in palliative care. When he passed away we were very fortunate in that we are a reasonably well off family. We are not rich but we are comfortable. There are seven kids. Every day, every one of us would go and talk to our mom and dad and be with them when they needed help. We had a prayer session three times a day with a great gospel from the Benedictine monks called the The Glenstal Book of Prayer: A Benedictine Prayer Book.

We took great comfort from all of those things, but the palliative care system is not strong enough. Many people in Nova Scotia and in the rest of Canada simply do not have access to palliative care or even, in some cases, home care that we need to have. That is where I believe our efforts should be.

Let us look at what other nations are doing with the issue of euthanasia. Let us consider what supports we have for people in the community. The experience I had with my parents led me to believe that if there is one thing that we should all strive to have in Canada, and that we as parliamentarians should fight for, it is the opportunity for people to die at home if they wished to. Most people cannot afford that because its costs money to have night nurses and day nurses.

For us, because there were seven children and because we had parents who made it easy, we were able and in fact honoured to provide that service to our parents, perhaps as some small, tangible appreciation for all they had done for us.

Let us focus on palliative care and home care. Let us provide the supports that people need in their time of need. Let us be very mindful of people with disabilities, particularly people who are not always able to make decisions on their own and who rely upon others for support, guidance and the everyday aspects of their lives.

I do not support this bill. I truly do commend the member and I commend all people who have expressed their views on this debate. My view comes from my personal experience and my concern for people who are concerned that this bill might impact negatively upon their lives. For those reasons, I cannot support this bill.

Jim Maloway Elmwood—Transcona, MB

Mr. Speaker, I am pleased to rise today to speak to this bill.

Having listened to the presentation by the member for Dartmouth—Cole Harbour, I find that my situation is remarkably similar to his.

Up to two or three years ago, I, too, like other members here, would have advocated for this type of bill thinking that it was a positive solution, but after my experience, which almost mirrors that of the previous member, of having had two parents who both had cancer at the same time, I came to the conclusion that this was not the way to proceed.

I do commend the member for bringing the bill forward because it is important to advance the debate. It is important that pain management issues and palliative care be advanced as quickly as possible.

We were lucky enough in the city of Winnipeg to have a fairly good system of palliative care, so we were able to take advantage of that in both of my parent's cases. While palliative care is well served in the Winnipeg region, I am mindful that half of the population lives outside of Winnipeg and I would expect that palliative care facilities are not available in a lot of those areas. We have a long way to go toward improving our palliative care centre. I am told that the situation in the rest of the country is not as good as that in Winnipeg. I am not sure whether it was the member for Windsor—Tecumseh but I know other members talked about how only 20% of the population in Canada is covered for palliative care in hospices and another 15% of the country is only partially covered.

In terms of jurisdictions, the member for Windsor—Tecumseh made an excellent presentation. He seemed to have the same sort of view as me, that while this was a good place to start the discussion, procedures are not yet in place to proceed with a bill such as this. He talked about other jurisdictions in the world where this is the practice. I have been aware of the situation in Holland for a number of years but I was not aware of the situation in Washington state or in Oregon. My colleague certainly talked about those in great detail. He explained that in the 12 years that the state of Oregon has had such legislation, 93 people were candidates but only 50 actually took their own lives. He indicated that the law was much newer in Washington state so there were smaller numbers to look at.

My colleague said that in Holland, for example, it was basically the frail and the elderly who were using this method and that the minister in charge of the legislation in Holland had actually changed her mind on the issue. This is a minister in the Government of Holland where such a practice is legal, who has inside information about how the system works in Holland, and she has changed her mind on the subject.

This is essentially a work in progress.

I am concerned about the point made by some members that if we were to adopt this measure, it would cut back the impetus to improve palliative care. As long as assisted suicide is illegal, the pressure will still be on governments and jurisdictions to develop palliative care as quickly as possible. If we passed legislation like this bill, then the pressure would be off.

The other major concern we have is people not feeling that they are free to make their own decisions. There will always be cases where mistakes are made. We do not want to develop a situation as I believe exists or may have existed in Holland, where it becomes a place for people from other countries to go to take advantage of the situation. That would develop the whole issue into an industry, almost a business venture. I do not think we want that kind of situation to develop.

Certainly disabled groups in the country have been very clear for many years that they think this is the thin edge of the wedge. They are, and I think rightly so, very concerned about this.

I served in the provincial legislature for 23 years. I do not think anybody, in 23 years, ever phoned my office or asked me to support legislation of this type. This is something we have to take a much more in-depth look at.

Another area that we have looked at is the whole issue of pain management. As the member for Windsor—Tecumseh mentioned, the doctors need more training. There needs to be more training done in the area of pain management. With proper pain management, people can manage a disease much more effectively than they can without proper pain management.

We do not need to have situations where there are people with a terminal disease and we do not have proper hospices and palliative care or proper pain management and people feel there is no way out and it would be so much easier for them to succumb to pressures, perceived or otherwise. The last thing we want is for people to feel they do not want to be a burden on their family any more and do not want to deal with pressure that they think is there. Maybe the pressure is not there, but they imagine it is. We should be encouraging people to fight as hard as possible to stay alive, with the proper pain management systems and proper encouragement. To me, it is a negative to be entertaining the idea that assisted suicide is an option.

I know other colleagues of mine probably would like to speak. The member for Edmonton—Strathcona and I have spoken about this issue before.

It is a very difficult issue for people, but it is something we all will have to face at some time. I think the time has come for us to rely on medical decisions and pain management issues and proper hospice care. That is the way we should look at it. That is the way we should move forward to develop a comprehensive palliative care system in this country so that we give people more options so that they, in their own minds, do not view assisted suicide as the only option available and choose that option when they perhaps should not be choosing that option.

The Acting Speaker Barry Devolin

Resuming debate. The hon. member for Timmins--James Bay will have three minutes.

Charlie Angus Timmins—James Bay, ON

Mr. Speaker, I am very proud to speak to this bill. I would say at the outset that I think the House of Commons is the place for this debate. I have received thousands of letters from my constituents who are deeply concerned about this issue.

This is a discussion that is worth having because the issue of suffering, the issue of death is perhaps one of the most profound issues we can deal with as a society. It touches each of us. Each of us is brought into the final moments of death at a level of intimacy and concern we never would have felt possible.

I spent much of the last three weeks with my father at the palliative care centre in Scarborough General Hospital. I want to say on the record that the palliative care that exists in this country is second to none. Two years ago I spent time with my brother-in-law as he lay dying at Perram House in Toronto. The experience I had there had a profound impact on me and my whole family and our understanding of this.

The question before us today is what we should be doing as a society. It is an issue that cuts to the very essence of this House of Commons. We need to bring forth the option of saying we have to maintain the ability of Canada's health care system to manage pain for people in palliative care so that they can go through that final journey.

It is possible to do it without taking the option of saying we have to go the assisted suicide route. I understand why people might believe that is an option, but I do not believe it is the option we should be taking as a society. To take that position and for us to vote on this in the House of Commons means more than making a statement. We have to provide the resources necessary so that our medical systems and our families have the support they need. Otherwise we will be leaving the sick, the suffering and the dying in a situation in which they should not be left.

It is possible to have good pain management. It is possible to treat people with dignity right through the final moments. However, that has to be a decision we make as a society and a commitment we make to each other that we will be there as a society, we will be there with the medical system, we will be there as family and we will be there as a community.

This debate has reminded us of the need to make that commitment. I hope this House of Commons will make that commitment when the time comes to vote.

The Acting Speaker Barry Devolin

The hon. member for La Pointe-de-l'Île has a five-minute right of reply.

Francine Lalonde La Pointe-de-l'Île, QC

Mr. Speaker, I would like to start by thanking all my colleagues who took part in the debate, but I want to say that palliative care and my bill on the right to die with dignity are not mutually exclusive, but complementary.

I wrote something in 2005, before I learned I had cancer. I wrote this, and I still believe wholeheartedly in it:

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.

It is the individual who must choose. It is not society that must choose for the individual. The individual must have the freedom to choose at the end of their life.

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.

I could quote Justice Cory, who also says that section 7 of the charter gives Canadians the constitutional right to life, liberty and security of the person. This provision emphasizes the dignity inherent in human existence. Death is an integral part of life and as such is therefore entitled to the constitutional protection provided by section 7. A person should have the right to choose their own death.

I understand why my colleague's parents made the choice they did. His father was a doctor. It was their choice. Nonetheless, sometimes the end of life comes after a period of extreme suffering and at a time when people can decide they no longer can tolerate their life, their dependence on others and their unending suffering. I have sent hon. members a text a constituent sent me on what it is to suffer and I invite hon. members to read it. People can decide their limits and ask for assistance to die and not to live for another month or two just to suffer more and become more emaciated.

I can tell you that when I wrote that, I did not know what unbearable pain was. Now I do and I have learned that medicine, with all its progress, can only provide help with side effects such as hallucinations or other terrible effects to the body. We have to have the right to choose. I am speaking on behalf of the vulnerable. They are the ones who need this type of legislation the most because only this type of legislation will allow them to be the people they choose to be. There are currently many places where people can die and with all the instruments available to doctors, it is possible to help people die without them having to ask.

A person's right to choose is what is at the heart of this bill. I am asking hon. members to vote in favour of this bill in order that it may be referred to a committee. Then members of the committee could examine what seems—

The Acting Speaker Barry Devolin

It being 6:28 p.m., the time provided for debate has expired.

The question is on the motion. Is it the pleasure of the House to adopt the motion?

The Acting Speaker Barry Devolin

All those in favour will please say yea.

The Acting Speaker Barry Devolin

All those opposed will please say nay.

The Acting Speaker Barry Devolin

In my opinion, the nays have it.

And five or more members having risen:

Pursuant to Standing Order 93, a recorded division stands deferred until Wednesday, April 21, 2010, immediately before the time provided for private members' business.