Bill C-14 (Historical)

An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

This enactment amends the Criminal Code to, among other things,
(a) create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process;
(b) specify the eligibility criteria and the safeguards that must be respected before medical assistance in dying may be provided to a person;
(c) require that medical practitioners and nurse practitioners who receive requests for, and pharmacists who dispense substances in connection with the provision of, medical assist­ance in dying provide information for the purpose of permitting the monitoring of medical assistance in dying, and authorize the Minister of Health to make regulations respecting that information; and
(d) create new offences for failing to comply with the safeguards, for forging or destroying documents related to medical assistance in dying, for failing to provide the required information and for contravening the regulations.
This enactment also makes related amendments to other Acts to ensure that recourse to medical assistance in dying does not result in the loss of a pension under the Pension Act or benefits under the Canadian Forces Members and Veterans Re-establishment and Compensation Act. It amends the Corrections and Conditional Release Act to ensure that no investigation need be conducted under section 19 of that Act in the case of an inmate who receives medical assistance in dying.
This enactment provides for one or more independent reviews relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.
Lastly, this enactment provides for a parliamentary review of its provisions and of the state of palliative care in Canada to commence at the start of the fifth year following the day on which it receives royal assent.

Criminal Code

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, it is an honour for me to rise in the House today as one of 338 federal lawmakers in Canada whose duty it is to make good laws that will have a positive impact on the lives of Canadians now and for generations to come.

The weight of my duties as an MP have become more evident as I have been serving my constituents through the pandemic. Canadians have been struggling intensely for nine months as a microscopic organism called the coronavirus has caused us to shut down our lives and institutions on so many levels.

Today, as I speak on Bill C-7, an act to amend the Criminal Code on medical assistance in dying, the weight of my parliamentary role is compounded because what I say today may be the most important thing I have spoken about in the 12 months I have been an MP. Today, I am compelled to speak from the depths of my heart, conscience and love for my fellow humans, and nothing less, because the very flow of life and death in our nation is in my hands and the hands of each member of this House through Bill C-7.

Bill C-7 came about after the Superior Court of Quebec struck down the reasonably foreseeable natural death clause of this legislation as unconstitutional. This ruling resulted from a case of two individuals with degenerative diseases, Truchon and Gladu, who had sought to repeal this provision in the law and access MAID. The judge asserted what the plaintiffs were really looking for was for the law to recognize equally the suffering, dignity and, ultimately, autonomy of people who, like them, are affected by serious and irremediable health problems without any hierarchy, whether death is near or not.

Bill C-7 would eliminate the clause that requires a 10-day waiting period between when MAID is requested and when it can be administered when death is reasonably foreseeable. Bill C-14, the original MAID bill that was given royal assent on June 17, 2016, already allowed for this period to be waived under specific circumstances, which are if two medical practitioners are both of the opinion that the person's death or the loss of their capacity to provide informed consent is imminent, or any shorter period is considered more appropriate by the first medical practitioner or nurse practitioner in the circumstances.

Many lawyers, doctors, families and advocates for individuals with disabilities feel Bill C-7 has gone beyond what the ruling in the Truchon-Gladu case called for. They feel Bill C-7 is discriminatory to the disabled and risks the abuse of MAID.

Amy Hasbrouck, a representative from the group Not Dead Yet, said this about the court ruling in a press interview: “Basically this decision is saying that as far as society's concerned, it's better to be dead than disabled”. Hasbrouck feels governments should improve services for people with severe disabilities to help improve their quality of life and allow them to continue living in their own homes.

This bill has also raised the concern of deepened challenges on the conscience rights of doctors. There are limited protections for the conscience rights of medical professionals already, and loosening restrictions will cause greater strife to those already uncomfortable with MAID. Throughout the debate, Bill C-7 has raised a lot of concern that as it expands MAID accessibility, it risks palliative care suffering. As a result, patients will view MAID as a better option. Unless there is more focus on improving and expanding palliative care so that palliative care is more accessible, MAID may appear to be the more practical solution for Canadians.

I now speak on Bill C-7 as a potential trigger to another pandemic within a pandemic. Canadians are currently experiencing multiple pandemics within the pandemic. They are struggling with depression and anxiety about their future because of economic uncertainties and collapse. They are facing social isolation. Although uncertain about the full ramifications of the coronavirus, in order to prioritize and protect the health and safety of Canadians, multiple tiers of government across our nation opted to take drastic measures throughout the pandemic with lockdowns and travel restrictions, which have infringed on some civil rights.

Social isolation is putting seniors in a mental health crisis. Recently, Nancy Russell, a 90-year-old woman living in a seniors home, chose MAID because she did not want to go through another lockdown or isolation this winter. According to some MAID practitioners, there is a trend of more reports of seniors interested in MAID and accelerating their timelines because of COVID.

I would like to ask each member in the House this: Is the passing Bill C-7, with its safeguards removed, during a pandemic, when Canadians are vulnerable to depression and suicide, a responsible and timely action? The government had the option to appeal this, but it chose not to.

I fully appreciate that the debate on Bill C-7 brings issues of compassion, dignified death, suffering and personal rights into a complex but profound discourse. Medically assisted death is complex, and debates on human rights are important, but in this time of severe and drastic measures to protect lives and keep Canadians safe from a virus that has the potential to take many lives, the government has entered into emergency mode. It has put health and safety above many important things.

We have allowed the economy to fall apart to flatten the curve and save lives. Canadians put a precedent on saving lives over some basic rights.

Rights do not exist in a vacuum. They exist to support the overarching vision and mandate, which I hope unifies all of us in the House, which is to protect the lives, sustenance and flourishing of humans; to ensure all people, regardless of who they are, their behaviour, ideology or capacity, to be functional in life; to protect their existence and sustenance needs; and to provide individuals with fair opportunities to dream and make the most of their lives. I understand the principles of debate and rights, but in the context of this pandemic we are facing, my humanity and my heart burn like a mother bear for the lives of Canadians.

In a recent report from the Canadian Mental Health Association, 3,800 Canadians died in 2018-19 after being admitted into hospitals for self-harm. With the stress, hopelessness and trauma created by the pandemic, that number is on the rise, especially for the most vulnerable.

In a survey held by CMHA in May during lockdowns, 38% of the people surveyed said that their mental health had declined due to COVID-19, 6% had suicidal thoughts and 2% had tried to harm themselves in response to COVID-19. Based on this survey, if there are 30 million adult Canadians, then it would mean that 1.8 million adult Canadians have had suicidal thoughts and 600,000 have tried to harm themselves as a result of the challenges caused by the pandemic.

The count for the number of Canadians who have died from COVID-19 is 12,211 from yesterday's numbers. If only 6% of the 3,000 Canadians who participated in the survey had suicidal thoughts, that would still be 180 people. What does that translate to in Canada's entire population?

More survey results show that not everyone is affected equally. While 6% of the general population have had suicidal thoughts since the outbreak of COVID-19, suicidal contemplation has been happening with 18% of people already struggling with their mental health, 15% of people with a disability, 14% of people with low incomes and 16% of people who are indigenous. This is not fair.

This is the question I would like to ask all members: Do we, as members, take mental health seriously? Do we recognize that extraordinary suicide prevention must be part of our COVID response? Do we see the danger of passing a bill such as Bill C-7 in the context of a pandemic where we see rising numbers of mental health challenges and suicidal contemplation?

The mental health side of the pandemic does not end with a vaccine, because healing from trauma and financial restoration takes time. What is the message we want to send to the Canadian public right now as parliamentarians? In the name of saving lives, we have allowed families to be separated, and we have allowed businesses and institutions to be pulverized, but what support are we providing to counter the depression and hopelessness that comes from these drastic measures? We should be more focused on creating more access to counselling and mental health support.

For those who say that mental health is a provincial issue, I would say to them that mental health is a serious issue and one that all tiers of government must come to the table to discuss and implement solutions for. We have a responsibility as lawmakers to look at the big picture and understand the time we are in right now.

We do not see suicides reported, but all of us know someone, whether directly or by one or two degrees of separation, who has attempted or committed suicide. Let us be sober. The bill before us could open doors to a suicide pandemic during this pandemic. Our duty is to pass legislation that protects the life, sustenance and flourishing of our fellow humans and not make them more vulnerable and susceptible to death.

Canadians need hope. Will my colleagues, with a clear conscience, be able to say that they did everything they could to prevent suicide? Will they be able to say with conviction that they had helped someone find hope and not have to resort to death?

I want to be wrong. I hope there is no suicide pandemic, which the unpredictable waves and lockdowns of COVID-19 would exacerbate, but the government has chosen to put the priority of saving lives at a high cost. Were the drastic measures reasonable or too severe? I think most Canadians would say that saving lives was worth it. Will it be worth saving lives by stopping the spread of a culture of suicide through a bill like Bill C-7 during this pandemic?

The very life breath of Canadians are in our hands right now. I cannot support the bill in the name of mental health and saving lives in this pandemic. I do not want blood on my hands for the death of any Canadians who were inspired by the passing of Bill C-7 to cope with mental health challenges and hopelessness during the pandemic, especially when we do not have enough to give them more hope.

Being a parliamentarian comes with responsibility. Ideology comes with responsibility. Legislation comes with responsibility. Legislation is not separate from the current plight Canadians face. I encourage every member to examine this bill, recognizing there is not enough hope to safeguard against the dangers of Bill C-7.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I apologize for the difficulties we were having.

I do not believe that I was speaking about the uncertainty of a physician's diagnosis. I have been speaking about the safeguards that are being removed from this piece of legislation that allow for an individual to take time to reflect on the diagnosis they have received and to have conversations, not only with their family and friends but to look for a second opinion should they wish to do so.

With regard to how we ensure that federal legislation and provincial legislation work well together, we have previous legislation that has been in place since Bill C-14. We now see where a judge has made a ruling that the government should have appealed.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I appreciate the opportunity to speak at report stage of Bill C-7, an act to amend the Criminal Code, medical assistance in dying, with which the government is seeking to dramatically expand the existing euthanasia regime in Canada.

The government claimed to want to protect vulnerable Canadians. It claimed to be open to our amendments. I see no evidence whatsoever for either of these claims.

Despite knowing full well the concerns that numerous groups had, including those disability rights groups, with the pre-prorogation version of the bill, the minister reintroduced the exact same legislation word for word. In fact, the bill even has the same number. The minister refused to pre-emptively adopt any of the proposed amendments, and has hidden behind the Truchon decision throughout this debate.

What of the Truchon decision? First, it is beyond unacceptable that the Liberal government did not appeal the Truchon decision to the Supreme Court. Truchon struck down vital protections for vulnerable Canadians, protections that this very government put in less than five years ago. Not only would appealing this decision have brought necessary clarity to the legal status of federal euthanasia legislation, it was also the right thing to do.

Instead, the minister used the Truchon decision, which struck down the reasonably foreseeable death requirement in the province of Quebec, to justify a wholesale abandonment of euthanasia safeguards put in place by the previous minister, the member for Vancouver Granville, and the creation of an advanced consent framework, open to any number of abuses.

That member for Vancouver Granville raised these concerns in this place. She said:

Nothing in the Truchon decision...and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard, and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.

However, the minister refuses to listen. A statutory review of the impacts of Bill C-14, required by law, has not been undertaken. That review is mandatory to ensure that the safeguards in place are effectively protecting the elderly and infirm Canadians from manipulation and abuse. Instead of waiting to make these changes until the mandatory review was completed, the Minister of Justice pushed forward his own ideological stance. He blindly pushed Canadians into the dark instead of the light. Sadly, I am not surprised the minister would push this ideology on vulnerable Canadians. When Bill C-14 was introduced, after all, he opposed his own government's legislation. Now, as the minister, he is refusing to listen.

It has always been my priority and that of my colleagues to ensure that any legislation on euthanasia and assisted suicide includes strong safeguards for the most vulnerable in our society as well as for the conscience rights of health professionals. This is clearly not the minister's priority. Instead, by allowing advanced directives for assisted suicide without any legal assurance that individuals will have the opportunity to change their minds and with Liberal members voting down an amendment that would have required those seeking euthanasia to be given an opportunity to refuse it on the day in question, could mean that people could be legally euthanized in their sleep without any opportunity for them to change their mind. This is horrifying. How can the Liberals possibly justify this?

Inclusion Canada, a disability rights organization, has stated that the legislation is its “worst nightmare” and that it is a “moral affront” to equate euthanasia to an equality right. The minister still refuses to listen.

The most egregious, in my view, is the removal of the 10-day waiting period and the need for two independent witnesses. The Liberals also voted against a seven-day-waiting period amendment proposed at committee. They made a deliberate choice to strike down one of the most important safeguards for vulnerable people facing uncertain medical prognosis and have opened Pandora's box to same-day death.

Each of us can think of someone in our lives, perhaps a friend, a grandparent or even a spouse, who has received a serious medical diagnosis. The emotional impact of hearing that news can be overwhelming for both the patients and their families. It can cause depression, anxiety and a great fear of the unknown, especially now in the face of the ongoing pandemic.

Many of us can also think of loved ones who have received terminal diagnoses, only to beat their illness and live for years afterward. However, with the safeguards of two independent witnesses and a 10-day waiting period gone, such stories will be fewer and further between. Without a mandated length of time to collect themselves, to receive support from their families and to learn about treatment options or get second opinions, some people will make emotional decisions based on fear.

Taylor Hyatt, a young woman with a visible disability, shared her experience while suffering from pneumonia and in need of oxygen to help her to breathe. She said:

After taking a cab to the nearest hospital, I was immediately admitted. A couple hours – and many tests – later, the doctor was no closer to finding out what caused my illness. When she finally came to see me, at about 11pm, she said: “The only thing we know is that this infection affects your breathing. You may need oxygen. Is that something you’d want?” My answer was: “Well, of course!” She seemed surprised maybe, or unconvinced, so she asked again: “Are you sure?” I replied, “Well, of course!

Any non-disabled person would have received oxygen immediately, but instead the doctor asked her twice, leaving Taylor to believe that the doctor assumed that because she was disabled she may not want to live. What if Taylor had felt overwhelmed that day and requested euthanasia in a moment of weakness? At the time, she would have had 10 days to reconsider this choice. If this bill passes, she could have died that day and the world would have lost a great warrior for the rights of disabled Canadians. How can we allow for the legal possibility of such a tragedy?

Every Canadian should feel great shame for these failures. We are and we must be better than this. Every great or good society is judged by how it treats those deemed to be the least among them. How can we claim to be either great or good if we treat the Taylor Hyatts of our nation as if their lives are less valuable than our own. We must protect the innate dignity of every human life, knowing that nothing, not time, not illness, not disability, can ever take that dignity away.

Still, the minister refuses to listen. He is ignoring the statutory review but only to weaken protections, not to strengthen them. Not only has he torn down protections for vulnerable Canadians, he has placed medical professionals into an even more precarious position than the current regime by expanding the eligibility and thereby the number of medical professionals who are impacted. The Liberal members voted down an amendment that would have protected the charter rights of medical professionals, trampling their rights in the rush to a predetermined ideological end goal.

Tens of thousands of doctors believe, truly and wholeheartedly, that taking part in an assisted suicide breaches their calling to do no harm. Those beliefs are protected in our charter, but not in this, nor in any other federal legislation regarding euthanasia. Such a glaring omission makes it clear that this minister's priority is not to protect the rights of Canadian citizens but to push his ideology as far as possible. That is something I cannot and will not support.

I would plead with the other place to take the time needed for a sober second thought, removed as they are from the minister's ideological fixation, because the minister is refusing to listen.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, it is a pleasure to be here today because a lot of things need to be said about Bill C-7. For those who are not aware, it is an act to amend the Criminal Code with respect to medical assistance in dying.

Members know I was in Parliament when Bill C-14, the predecessor of this bill, was debated. I heard the debate and discussions about the safeguards that needed to be put in place to make sure we did not go down the slippery slope that many other countries went down when they began to allow assisted suicide and branched further into euthanizing individuals.

Knowing all the discussion and thought that went into the reaction to the Carter case, I am very troubled and disappointed that when the Quebec lower court ruled the reasonably foreseeable death provision was unconstitutional or would not be accepted in Quebec courts, the government did not put this forward to the Supreme Court. I feel as though the Supreme Court was involved in the Carter decision in the first place, as it laid out the provisions it thought would be reasonable. A reasonably foreseeable death was one of them, so this should have gone back to it for commentary before coming to this place.

With that in mind, I am also disappointed that the government has not moved forward on the palliative care provisions that were also a clear recommendation from the special committee that studied the Carter decision. It said that without good quality palliative care, we do not have a real choice.

As members know, I brought a private member's bill to the House on this, which was unanimously supported here and in the Senate. I worked with the health minister of the day to put together a framework across Canada to get consistent access to palliative care for all Canadians, because 70% of Canadians have no access to it. As per the Carter decision and the special committee, if we do not have good quality palliative care, we really do not have a choice.

I was disappointed to not even see “palliative care” mentioned in the fall economic update. The words were not even there. The fact the government would prioritize expanding medical assistance in dying without the input of the Supreme Court and without putting provisions of palliative care in place seems to be the wrong priority. Let us let people live as well as they can for as long as they can instead of encouraging them to die. I think that is where we as compassionate Canadians want to go.

Another thing the Liberal government fell down on is the choice not to do the five-year review. When Bill C-14 came through, one of its provisions was about looking at the situation after five years so we would understand whether or not the rules that were put in place were being followed, were adequate and met the intended purpose. That was not done. This was a perfect opportunity for the government to do that work, because we heard anecdotally that in many cases across Canada, the existing rules and safeguards have not been followed. We need to get a quantitative analysis on that and understand how these things could happen and how we can prevent them from happening in the future.

It is disturbing, then, that the government has decided, without doing the five-year review, to make changes to what is happening with respect to medical assistance in dying beyond what was asked for by the Quebec courts. Doing something without reviewing what one already has in place is irresponsible, in my view.

Given that, I have some concerns. The government has removed many of the safeguards put in place in the bill to keep those unfortunate things that we worried about when we were discussing C-14 from happening. For example, there is the 10-day cooling-off period. As anyone who has had relatives suffering through irremediable conditions knows, they have good days and bad days, and on the bad days they can feel like they want to die.

My mother just died in October. At the very end, she was in a lot of pain. I talked to her about medical assistance in dying and it was not something she wanted; she wanted palliative care. I am fortunate that in Sarnia—Lambton we have palliative care. One day she told me she was really thinking about it, but the next day it was not something she wanted, so I really think that 10-day cooling-off period was an important safeguard.

I am sympathetic with one of the changes that was put in, although it should have been put in after the five-year review. It says that once people have signed off on all the documents and the independent witnesses and others who understand the condition have dotted all the i's and crossed the t's, a person perhaps will not be able to give consent immediately before the procedure. I saw this in my mother's situation. At the end, she would not have been able to verbally communicate or even write to indicate her choice, should that have been her choice.

However, removing the 10-day safeguard was a mistake. The Conservatives brought an amendment to try to put it back in and explained why it was important, but it was not received.

The other thing I found troubling was the removal of the independent witnesses. We cannot even get a will without having an independent witness. It seems to me that for something as important as determining one's date of death, it should be a provision.

In Ontario, there is another difficulty, which has to do with conscience rights. There are people who do not want to participate in medical assistance in dying for religious reasons or for personal reasons of conscience, and that is their charter right. This means they do not want to participate in the act and do not want to refer. They do not want to have anything to do with it. In Ontario, medical people are being forced to at least refer. That is still a violation of their conscience rights, and it is troubling that in the debates on Bill C-7, when I asked these questions the Parliamentary Secretary to the Minister of Justice said there are plenty of safeguards in there and it is okay. No, it is not okay. They are still violating rights of conscience and that needs to be addressed as well.

A modified advance consent was opened up to allow people to indicate, 90 days in advance, that they want to have this procedure. Advance consent was studied by one of the committees chartered by Parliament. Its recommendations said that a lot of things need to be considered before we go down the advance consent path. The government has not really done its five-year review, and I remember the member for Vancouver Granville commenting on this very point. There is a lot to be thought out there, and if we do not do it correctly, we will once again have a situation where the intent of the bill is not going to be met. There are going to be new violations in the way we have heard anecdotally, and that will not be a very good situation.

I was happy to see in Bill C-7 the clarification to indicate that if the sole underlying medical condition is mental illness, individuals are not eligible for medical assistance in dying, although there is some controversy there. I have heard from groups across Canada that are calling on the government to allow individuals whose underlying suffering condition is mental illness to receive medical assistance in dying. I think it is not a good idea, and I believe this is in line with what was said by the committee that studied this part of medical assistance in dying. It said many of the mental illness conditions, such as depression, could be treated. These are treatable conditions, not irremediable conditions, and some are glad to see this loophole closed.

The bill intends to:

permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance

We talked about this when Bill C-14 was in this place. At that time, we were not sure about the method of application of medical assistance in dying, whether it could be done with a prescription or not, and there was a concern: What if the procedure went wrong and a person cannot give consent? What do we do then? I am glad to see that situation was addressed in the bill.

Overall, those are my concerns with Bill C-7, and I think the government needs to go back to the drawing board on it. As 50% of the Canadian public seem to be concerned about the existing bill, such as people with disabilities and mental illness, let us go back to the drawing board.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I am very pleased to be joining the debate on this issue. It is an important one, and I want to make sure I reflect what my constituents have been telling me on Bill C-7. The vast majority of them want me to vote against this legislation because it would remove a great many safeguards. It would also, in my view, violate some of the intentions set out in the debate we undertook on Bill C-14.

I remember this was a deeply, deeply personal issue for many parliamentarians in the last Parliament, and it is a deeply personal issue to many of my constituents now. They have stories of loved ones who have grievous chronic conditions and were found to be ineligible because of the way Bill C-14 was structured, but they found solace in the fact Carter had paved the way at the Supreme Court to allow for this exemption to the assisted suicide provisions in the Criminal Code. While this is a debate that is deeply personal to parliamentarians and constituents, the law is not, and the law has to be as clear as possible.

In preparing for this debate, I went back and looked at Hansard to see what I had said previously on this. I had problems with the term “reasonably foreseeable”. I could foresee that a judge at some point would strike down this provision. That is exactly what I raised as an issue with Bill C-14 at the time, and it continues to be an issue in Bill C-7.

“Grievous and irremediable” is the term used in paragraph 127 of the Carter decision. I am always worried when I start quoting decisions of various judges, as I remember it was H. L. Mencken who said that judges are simply law students who grade their own exams.

However, I went through the Carter and Truchon decisions again in preparation for this after hearing the excellent contributions at second reading debate by my colleague, the member for St. Albert—Edmonton. He rightly pointed out that this should have been appealed to the Supreme Court, the original judicial body that decides the laws of the land and if they conform with our Constitution.

Paragraph 682 of the Truchon decision reads:

Individuals in the same position as Mr. Truchon must be allowed to exercise full autonomy not only at the end of life, but also at any moment during their life, even if this means death, where the other eligibility conditions for medical assistance in dying are met.

Looking at the Carter decision, it does not conform to Truchon. Again, this should have been appealed to a higher court. Bill C-7 goes far beyond what was in the Truchon decision and what that single Justice Baudouin said. I really think the government did a great disservice to Canadians by not appealing the decision in order to get a final verdict for parliamentarians to be able to legislate on this question. At the end of the day, we are supposed to be the ones who legislate on behalf of our constituents.

I have concerns many of the safeguards we have talked about are being eliminated. There is a doctor in Calgary, Dr. Thomas Bouchard, who said that the way the government is legislating on this question is reckless. As well, the timeline is incredibly rushed. I would much rather hear from more parliamentarians in the chamber reflecting on the views they are hearing from their constituents, so we can get this right the second time around, now that we are relying on the Truchon decision in the matter.

The UN rapporteur on the rights of persons with disabilities said that MAID violates the right to life of persons with disabilities. I had a disabled daughter who passed away in the last Parliament, and I cannot but think that had she been able to grow up to be an adult that she would have been placed in an awful situation. I likely would have been her guardian in her later years, and I would have been placed in a situation looking after a loved one who would be rendered eligible for MAID. I cannot be there all the time.

I have had many constituents tell me they are concerned about their minor children and whether, once they have grown up and become adults, they will be able to be with them all the time to ensure that, when they go to the hospital with a medical condition, MAID is not pushed onto them. My constituents are concerned that MAID may be pushed on them because palliative care options may not be there. They are concerned the chronic conditions that are found to be grievous, irremediable and cannot be cured with current medical technology would lead to them being pushed into MAID by physicians, whether rightly or wrongly.

My colleague from Foothills and my colleague from Abbotsford raised excellent points, and I do not want to retread on the same matters they spoke about.

Constituents in my riding have constantly told me that they understand the debate on whether medical assistance in dying should exist in Canada. It was settled in the previous Parliament in Bill C-14. The question before us is what types of safeguards need to be in place.

In the Truchon decision rendered by Justice Beaudoin, it says that it should be open to people beyond what the Carter decision of the Supreme Court said. This is the box that Parliament should legislate within. We have to be conscious of that. Just as I have issues with death needing to be reasonably foreseeable, there were ways that we could have fixed those issues, but not with what is in Bill C-7. It goes far beyond what Truchon called for in any of the sections. In reading the decision, I do not see Bill C-7 meeting those goals.

Every single step in the process is a safeguard for that a person. They may change their mind, reflect on the questions, or obtain access to better palliative care or new technologies that render care for them better and simpler, or perhaps relieve them of a chronic condition.

I am thinking of my other three live-in kids, who have a chronic kidney condition called Alport Syndrome. It is incurable right now, and it leads to kidney failure eventually. I do not know if many members have spoken to those who are on dialysis, but it is deeply unpleasant.

I know one person on dialysis who does half marathons. I have walked 100 kilometres in the Kidney March right next to Said, who lives in my riding. He is a two-time kidney transplant recipient. He told me how difficult dialysis is and how one's mental health suffers from it.

He explained the difficulties around it, but he persevered and went through it. I think of my children in the future. If a cure is never found for their Alport Syndrome, and they are on dialysis or waiting for a kidney transplant, what will the options set before them be? What will be the safeguards available for them when the time comes and perhaps they want to make decisions and a choice like that.

I have had constituents who are surprised by their family members having made a request for medical assistance in dying at the hospital. They were completely unaware of. That should be taken into account. That is why the 10-day cool down period allows family members to be in the know.

All of our deaths are reasonably foreseeable. That was my complaint on Bill C-14 in the last Parliament. However, we do not have to die alone, and family is there for those types of difficult places. I was there for my daughter when she passed away. Even though we may consider this debate difficult, after a judicial decision, we have to get it right. Our personal views should be set aside. What our constituents believe to be the right thing to do in this matter matters the most.

I am trying to reflect what I have heard from my constituents who have express deep concerns over the lack of safeguards. Too many of them are being eliminated merely four years after the previous legislation was passed in Parliament. This is probably going to be the most important debate that many of us have in the scope of our parliamentary careers. I know that is what I will think after my time in Parliament is done. This will have been the capstone, the greatest, most important debate.

I want to reflect what my constituents have said. While dying with dignity is a slogan I have often heard, so is living with dignity. We have to ensure we put the resources and the time. We have to ensure the ability to protect our physicians and nurse practitioners, who are providing this service in the different provinces and territories, and that proper safeguards are in place, so that those who are vulnerable, those who are disabled, are not looked upon as the next person for whom MAID should be offered.

Safeguards are important. This legislation does not meet the expectations of my constituents. I will have to vote against it.

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Madam Speaker, by way of clarification, amendments were accepted at committee. One was by the NDP with respect to accessing expertise in rural and remote communities and one by the Green Party in respect to ensuring consultation happens between the Minister of Health and the Minister of Disability Inclusion.

Over the last couple of days we have heard a lot of debate on safeguards and why some safeguards are being eased while others are being increased. What I would put to the member is that we have the benefit now of four years of data after the advent of Bill C-14 in the last Parliament. What that data has shown us, and what the results have shown us, is that some of the safeguards were not doing the work they were intended to do.

The 10-day reflection period, for example, was prolonging suffering among those who were availing themselves of MAID because some were ensuring they would be able to provide final consent on that 10th day by depriving themselves of their own pain sedation medication.

Does the member agree that, in certain instances, safeguards like that need to be revisited and altered to address the need to be compassionate and alleviate suffering?

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, of all the pieces of legislation that I have debated in the House over the years, this one, Bill C-7, more than any other, deeply distresses me.

Four years ago when the Supreme Court created the right to assisted suicide in Carter, whether we liked it or not it became the law of the land. The court also set out the parameters of what that right entailed, and those parameters were addressed in Bill C-14 with the appropriate safeguards built in. Among those safeguards the most important was, arguably, that death had to be reasonably foreseeable in order to qualify for medical assistance in dying, or MAID.

Fast forward to 2019. In a puzzling decision from a Quebec court, a single judge ruled in Truchon that parts of the federal law on MAID were unconstitutional because, in her view, they were too restrictive. Among the safeguards deemed too restrictive was the requirement that death be reasonably foreseeable. One single judge of a lower court made a decision for all of Canada that was literally about life and death. What is worse, the Liberal government chose not to appeal this decision to the Supreme Court. Canadians have a right to ask the Prime Minister why not. Instead of appealing the case to determine whether the nine justices of the Supreme Court agreed with the lower court judge, this government immediately brought forward new legislation, presumably because Truchon reflected the Prime Minister's own ideology.

The new bill is a dramatic departure from the protections included in the original MAID legislation. It has confirmed the fears of many: that the initial legislation represented the crest of a steep, slippery slope towards a much more expansive and dangerous approach to euthanasia.

One of the primary functions of government is to protect the lives of its citizens. In fact, the right to life is expressly enshrined in our charter. Sadly, the bill before us fails to protect the lives of our most vulnerable. It would remove the critical safeguards contained in the original MAID legislation. Removing these safeguards would have irreversible consequences. What is deeply disturbing is that Liberal MPs steadfastly refused to allow additional hours of debate to ensure that the law would reflect the will of Canadians, and they obstinately refused to accept reasonable amendments to Bill C-7 that were brought forward by our Conservative MPs.

These amendments were supported by a broad cross-section of stakeholders and included things such as leaving in place the 10-day reflection period before choosing death, ensuring the right to withdraw consent and protecting vulnerable patients by requiring the patient to be the one who first requested information on MAID. These were eminently sensible amendments that supported the autonomy of the individual while protecting the vulnerable, so it is fair to ask why the Liberal government did not support these amendments and why there is a rush to ram this legislation through the justice committee.

The Truchon case also highlights the role that judicial creep plays in the evolution of social policy in Canada. Four years ago, many of us expressed great apprehension that the original Bill C-14 would be expanded by future court decisions, and that these decisions would leave more vulnerable populations exposed to the reach of medically assisted suicide. Although our concerns were summarily dismissed at that time, Truchon and Bill C-7 have fully borne out our concerns, which is why more and more disability groups, I believe around 72, have set the alarm bells ringing and are vehemently opposing this legislation. They argue that this legislation amounts to “a deadly form of discrimination”, making it easier for disabled persons to die than to live. Again, piece by piece, the protections for the vulnerable that were promised in the original assisted suicide bill are being stripped away. In the future, things can only get worse unless we say a clear no to Bill C-7.

I have great sympathy for our fellow citizens who suffer from intolerable pain and are pleading for relief. Concern and compassion are hallmarks of life in Canada, and are qualities I hope we never discourage or disparage. However, I would also hope the primary focus of care for these individuals, at least in the first instance, would always be a higher level of palliative care.

What the government has done instead is focus on expanding the opportunities for Canadians to end their lives rather than improve them. This bill would allow Canadians with a mental illness or other disability to end their lives through assisted death even if they were nowhere near death. The government's own annual reporting revealed that, last year, 87 disabled Canadians who died with medical assistance had been denied access to critical disability support services. That is simply unacceptable. Canadians with disabilities deserve better.

To fully understand the slippery slope I referenced earlier, one need only look to the recent report from Dr. Ivan Zinger, Canada's chief correctional investigator, who exposed deep flaws in our current MAID regime as manifested in Canada's prisons. He cites the case of one terminally ill prisoner who was serving a two-year sentence. The inmate sought compassionate early parole to die a natural death in his community. Parole was denied. He then sought and received an assisted death. This is a gross misapplication of assisted suicide, and raises important questions about whether the government is adequately supporting Canadians who are facing difficult end-of-life decisions. Dr. Zinger has called for an absolute moratorium on all assisted suicide in Canada's prisons.

More broadly, I call into question whether the government is exercising the requisite caution and care to avoid unnecessary overreach and ensure that MAID is not abused or misapplied.

Equally disturbing is the concern that MAID would increasingly be used by the poor to escape their dire circumstances. A recent article in Maclean's, entitled “Dying for the Right to Live”, concluded that some disabled Canadians were considering MAID because they “simply cannot afford to keep on living.” The article referenced Susan, which is not her real name, who explained that because she had dietary restrictions food banks were not an option for her, and that a livable income was literally a matter of life and death. She said:

An increase [in income support] is the only thing that could save my life. I have no other reason to want to apply for assisted suicide, other than I simply cannot afford to keep on living.

How many other Susans are out there, for whom expanded availability of MAID represents a quick exit out of their circumstances? Who is next, children or perhaps Canadians struggling with mental illness who ask for assisted suicide because they fear being a burden to their family and friends? These are the vulnerable the Liberal government promised to protect. Members will recall that when the former minister of justice originally tabled MAID, she emphatically declared, “we need to be absolutely confident that we would not be putting vulnerable people at risk”, yet here we are today chipping away at the very protections that were so blithely guaranteed by our Liberal colleagues not so long ago.

I do not believe that Canadians expected that assisted suicide would be extended to those not terminally ill or near death, nor do I believe they would support MAID being used to displace a commitment to deliver a higher level of palliative care in our country. Similarly, I do not believe Canadians are in any way comfortable with the idea that our country would shirk its responsibility to the indigent by providing MAID as an escape from abject poverty.

For something as final as death and something as precious as life, should we not be taking a greater amount of time and care in debating and implementing the end-of-life options for Canadians? Instead of ushering in a new world of options for Canadians to seek death, should we not be doing our very best to incent Canadians to choose life?

[Peter Kent, Conservative, Thornhill, ON]

Mr. Speaker, when I last rose in the House to speak to the matter of physician-assisted death in 2016, I noted that the legislation then before us, Bill C-14, was neither the alpha nor the omega in the continuing conversations on the topic that Canadians have had for decades.

The Supreme Court had forced that legislative moment on reluctant politicians with the Carter decision, although the conversation had been simmering across society from the last century into this one.

However, in 2016, Bill C-14 brought us nowhere near where the Supreme Court had ruled Parliament must go. It was an interim step. It was a very cautious first step that was driven home with the Truchon-Gladu ruling in Quebec, which ordered that a class of people denied eligibility for medical assistance in dying by Bill C-14 were indeed entitled to access medical assistance in accordance with the Carter ruling.

The legislation before us now, Bill C-7, as amended in committee, under-amended I believe, and I will get to that in a moment, goes considerably beyond Truchon-Gladu. That said, the past five years of medically assisted death has brought Canadian society to a much more accepting place than in 2016; that increased acceptance of the practice justifies the additional provisions included in Bill C-7.

To my point that Bill C-7 was under-amended by the justice committee, the Conservatives hold that, for a variety of reasons, not least of which the WE scandal prorogation that wasted six valuable weeks in the summer, Bill C-7 has been indecently rushed through committee with not nearly adequate consultation. In the shadow of time allocation, signalled by the Liberal House leader last Thursday, it seems it will be denied adequate debate now during report stage.

This flawed process makes even more important the separate full and comprehensive parliamentary review of medically assisted death demanded by Bill C-14.

At committee, the Conservatives proposed nine amendments to better protect vulnerable groups, reasonable amendments, all rejected by the Liberals, but amendments which I hope Senate colleagues will consider in the upper house. I say that with some expectation of that actually happening as a result of testimony before the Senate's legal affairs committee last week by the Minister of Employment, Workforce Development and Disability Inclusion. In fact, the minister endorsed exactly the same point as was proposed by one of the Conservative amendments, which was voted down by Liberal members of the House justice committee. She said, unambiguously, that health practitioners should not be allowed to discuss the issue of assisted dying until a patient asked.

Admittedly, this is a particularly difficult issue and one of context. I understand why anyone, but particularly a person with disabilities might feel improperly, even terrifyingly pressured, depending on how the matter is raised by a doctor. There is quite a difference between a physician informing of a range of choices facing a seriously ill patient and directly recommending assisted death.

The Canadian Nurses Association advised the Senate committee that the law should explicitly allow doctors to raise the issue with patients, as did the Canadian Association of Medical Assistance in Death Assessors and Providers. Dr. Stefanie Green told the committee that it would be unprofessional not to lay all the options on the table. I am sure we will all follow Senate dealings on this question very closely.

The disability inclusion minister testified as well before the Senate committee that she was open to considering an amendment to Bill C-7 that would impose a 12-month sunset clause on the proposed ban on individuals suffering solely from mental illnesses to seek an assisted death. Legal experts have made it abundantly clear that if that clause remains in Bill C-7, it is destined, almost certainly, to return to the Supreme Court where it will almost certainly be found to be unconstitutional. This is another consideration to watch closely.

Over the years since Bill C-14 was passed, and now as Bill C-7 is being rushed to law, a dark cloud has hung over discussion and debate, and that is the government's still unkept promise, a broken promise actually, to better provide choice, a meaningful alternative to physician-assisted death.

In 2015, the Liberals made a campaign commitment to invest $3 billion in long-term care, including palliative care. In fact, the importance of access to palliative care and end-of-life decision-making was one of the few unanimous points of agreement in the special joint committee's report to Parliament in February 2016.

The government promised to expand the availability of accessible, affordable, acceptable palliative care for all those who for reason of conscience, faith or choice decided not to avail themselves of physician-assisted death. The Liberals' inconsistency in the matter of choice in other circumstances aside, this is a promise that must be fulfilled. It is essential that hospice and palliative care capacity in the country be vastly expanded to provide for those who would choose a meaningful alternative to MAID.

As I said in the House four years ago, my personal decision, which will determine my vote on this legislation, is a product of three individuals and their experiences and my own.

In my previous life as a journalist, I followed closely the unsuccessful legal crusade of Sue Rodriguez, as ALS steadily increased its smothering, deadly grip on her. I was seized by her rhetorical question posed to all Canadians, “If I cannot give consent to my own death, whose body is this? Who owns my life?”

When I first came to Parliament 12 years ago, I became close to another thoughtful, courageous Canadian, a fellow MP, the Hon. Steven Fletcher, Canada's first quadriplegic MP, re-elected three times. Steven did not give up after a life-changing accident. He met immense challenges and he overcame them.

However, in two private members' bills tabled several years ago, which I seconded, and in testimony before the justice committee in January 2016, Steven made a powerfully convincing argument for self-determination to one day make a final decision. Steven argued for a law by which an individual could make one's own decision based on one's own morals and ethics, but under guarantee there would be no pressure on that person from society, family, friends, or the facility in which he or she might be.

I was also powerfully persuaded by the tragically tortuous passing of my brother-in-law, a brilliant academic, by Alzheimer's. I informed the House during debate on Bill C-14 that should such an end one day face me, I would surely compose an advance directive and that one way or the other it would be fulfilled.

Finally, as a cancer survivor, I have had many hours of reflection during treatment and since to personally ponder the issues involved in medically assisted death and Sue Rodriguez's quite powerful rhetorical question: Who owns my life?

I am honoured to participate in this debate on Bill C-7 as I was with Bill C-14. Bill C-7 would correct the major deficiencies of the original legislation, but it is still deficient. Whatever happens in the Senate, I hope the parliamentary review, which should have occurred before consideration and passage of Bill C-7, will now more thoroughly examine this evolving law and properly lead to eventual amendments, chief among them measures to better ensure protection of Canada's most vulnerable.

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Madam Speaker, I think it is unfortunate and inaccurate to conflate the idea of discrimination in this context.

First, the charter of rights requires that persons with disabilities be able to make the exact same decisions about their body and their passing as persons with ability, which is what the Truchon decision references.

Second, there is reference to conscience protection rights in the Carter decision, and I have already referenced that. Also, there is a reference to it in the preamble of the previous bill, Bill C-14, and I referenced that. Out of an abundance of caution after amendments that, I believe, were moved by the member for St. Albert—Edmonton in the last Parliament for further clarity, a further amendment was made with respect to conscience rights in Bill C-14. To purport that conscience rights are not protected in this legislative scheme is categorically false.

There have been assertions of a culture of coercion or encouragement towards accessing MAID on the part of practitioners. Is the member aware of any instances, not just in her province but anywhere in this country, where such instances of coercive behaviour of medical practitioners have resulted in a prosecution under the Criminal Code?

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Madam Speaker, as a point of clarification, there are four protections for conscience rights in this regime: the preamble, section 9 of the former Bill C-14, section 2 of the Charter and paragraph 132 of the Carter decision.

In terms of persons with disabilities and respecting their autonomy, I refer the member opposite to the comments of Senator Petitclerc, former Conservative minister Steven Fletcher, and many others who have indicated that there is a heterogeneity of views among the disability community.

Last, the question I would put to the member opposite comes from the Truchon decision at paragraph 678. The court addressed the issue of the competence and dignity of persons with disabilities and said:

Where natural death is not reasonably foreseeable, the consent and suffering of the disabled are worthy only of the sympathy of Parliament, which has adopted a protectionist policy towards every such person, regardless of his or her personal situation. As soon as death approaches, however, the state is prepared to recognize the right to autonomy. This is a flagrant contradiction of the fundamental principles concerning respect for the autonomy of competent people, and it is this unequal recognition of the right to autonomy and dignity that is discriminatory in this case.

That is the court in Truchon disavowing the previous regime and requiring this Parliament to extend the regime to ensure the competence, dignity and autonomy of persons with disabilities.

I was wondering if the member opposite would care to comment on that paragraph.

Motions in amendment

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, as the saying goes, never two without three.

I rise today in the House of Commons to speak once again to the issue of medical assistance in dying as it pertains to Bill C-7, an act to amend the Criminal Code. However, this time we have a deadline set by Justice Baudouin, namely December 18, 2020, so there is a sense of urgency now.

I am likely repeating myself today, but many people here have had unique experiences involving the end of a loved one's life. I am thinking in particular of one of my old friends, Stéphane, who died in palliative care at a very young age, in his twenties. He was supported by the excellent Maison Au Diapason. He was one of the youngest patients to die there and one of the first as well. This type of assistance is essential and useful.

As the Bloc Québécois critic for the status of women and seniors, I naturally took a special interest in this bill. In this speech, I will be reminding everyone of all the work that my party has done on this important issue, while emphasizing the great sensitivity of Quebeckers when it comes to medical assistance in dying. I will conclude with the position that certain seniors' and women's groups have taken on this issue and the recommendations they made that are extremely useful, but that are already several years old. They too are starting to get impatient.

First, let's talk about the reason for this debate. In September 2019, the Superior Court of Quebec ruled in favour of Nicole Gladu and Jean Truchon, both of whom had incurable degenerative diseases. The court stated that one of the eligibility criteria for medical assistance in dying was too restrictive, both in the federal legislation covering MAID and in Quebec's Act respecting end-of-life care.

These two brave individuals, with whom I have mutual acquaintances, simply asked to be able to die with dignity, without needlessly prolonging their suffering. Mr. Truchon, who had cerebral palsy, had lost the use of all four limbs and had difficulty speaking. Ms. Gladu, who has post-polio syndrome, is not able to control her pain with medication and cannot stay in the same position for too long because of the constant pain. She has said that she loves life too much to settle for mere existence. That is what she said.

What we are talking about here is the criterion of a reasonably foreseeable death. Justice Christine Baudouin said it well in her ruling:

The Court has no hesitation in concluding that the reasonably foreseeable natural death requirement infringes Mr. Truchon and Ms. Gladu's rights to liberty and security, protected by section 7 of the Charter.

That is the crux of our debate. These advocates had been denied medical assistance in dying because their death was not reasonably foreseeable, even though they had legitimately demonstrated their desire to stop suffering. Jean Truchon had chosen to die in June 2020, but he moved up the date because of the pandemic. Nicole Gladu is still living, and I commend her for her courage and determination.

The Bloc Québécois's position on this ethical issue is very clear, and I want to thank the member for Montcalm for his excellent work. I will not be as technical as him, but he showed us that we are capable of working together, and I thank him for all of the improvements that he made to this bill.

As many members have already pointed out, legislators did not do their job properly with the former Bill C-14. As a result, issues of a social and political nature are being brought before the courts. We need to make sure that people who have irreversible illnesses are not forced to go to court to access MAID. Do we really want to inflict more suffering on people who are already suffering greatly by forcing them to go to court for the right to make the very personal decision about their end of life? This will inevitably happen if we cannot figure out a way to cover cognitive degenerative diseases.

Obviously, we agree that we need to proceed with caution before including mental health issues, but that is not the issue today, since MAID in mental health-related cases was excluded from the bill. Once again, this matter was brought before the Standing Committee on Health via a motion moved by my colleague from Montcalm.

Second, I want to talk about how important Quebec is in this context. Quebec enacted the country's first legislation on this subject. Wanda Morris, a member of a B.C. group that advocates for the right to die with dignity, talked about how a committee that got the unanimous support of all parties in the National Assembly was a model for the rest of Canada. She said it was reassuring to see how it was working in Quebec and that people were happy to have the option to die with dignity.

However, it is important to know that this bill was first introduced by Véronique Hivon and that it was the fruit of many years of research and consultations with individuals, doctors, ethicists and patients. Whereas 79% of Quebeckers are in favour of medical assistance in dying, only 68% of people in the rest of Canada are. Those numbers are worth knowing and mentioning.

In 2015, when all parties in Quebec's National Assembly unanimously welcomed the Supreme Court's ruling on medical assistance in dying, Véronique Hivon had this to say:

Today is truly a great day for people who are ill, for people who are at the end of their lives...for Quebec and for all Quebeckers who participated in this democratic debate...that the National Assembly had the courage to initiate in 2009.

I believe that, collectively, Quebec has really paved the way, and we have done so in the best possible way, in a non-partisan, totally democratic way.

For the third part of my speech, I would like to tell you about a meeting I had with the Association féminine d'éducation et d'action sociale in my role as the Bloc Québécois critic for status of women, gender equality and seniors. At this meeting, these brave women shared with me their concerns about this issue.

I will quote the AFEAS 2018-19 issue guide:

Is medical assistance in dying a quality of life issue? For those individuals who can no longer endure life and who meet the many criteria for obtaining this assistance, the opportunity to express their last wishes is undoubtedly welcome. This glimmer of autonomy can be reassuring and make it possible to face death more calmly. ... As the process for obtaining medical assistance in dying is very restrictive, those who use it probably do so for a very simple reason: they have lost all hope. ... This process cannot be accessed by individuals who are not at the end of life. ... People with degenerative diseases, who are suffering physically and mentally, do not have access to medical assistance in dying.

A brief submitted in 2010, or 10 years ago, to the Select Committee on Dying with Dignity, explained that the last moments are not always difficult because there are standards to guide medical practice and medical advances help relieve pain. However, despite everyone's goodwill, some people do have unfortunate experiences. Consequently, to prevent prolonged agony from depriving some people of their dignity and control over their lives, there are those calling for as a last resort the right to die with dignity, or the right to die at a time of one's choosing with assistance in this last stage.

Another brief pointed out that there have been four separate attempts to introduce similar legislation, specifically in 1994, 2005, 2008 and 2009, but these bills have never gone further than first reading. This needs to pass.

I will now read the conclusion from the AFEAS brief, as it is really powerful:

Over the next few months, AFEAS members will continue to reflect on the framework in which individuals losing their autonomy or suffering from an incurable, disabling illness, or experiencing acute physical or mental pain without any prospect of relief will be able to clearly and unequivocally express their desire to stop fighting to live and seek assistance to die.

Establishing the framework in which these decisions are made will be critical to ensuring that abuse cannot occur. The guidelines must be clear and precise so that all individuals can freely express their own choices, without any constraints and with full knowledge of all available options. It will be essential that all end-of-life services, including palliative care, be available and effective throughout Quebec so that patients have a real choice and do not feel forced to accept a “default” option because of a lack of adequate services or undue pressure from others.

I will also close now, in the hope that all of these comments and the lived experiences of the people in Quebec who made the request and wanted to die with dignity will afford Bill C-7 the same unanimous support from all members of the House of Commons so that we may all freely choose when we die. Let's take action.

[Arif Virani, Liberal, Parkdale—High Park, ON]

Madam Speaker, I thank the member for his contributions today and in this Parliament. I offer my sympathies to him for the loss within his family.

The point I was making earlier in this debate was simply to reflect what we heard during the consultations. The 10-day reflection period is entrenched in the old Bill C-14. When Canada was embarking on this for the first time in its history, it was deemed necessary to do the work of ensuring that consideration and time for reflection was available.

What we have found four years after the fact, after extensive consultations, is that the goal of that 10-day reflection period was not actually doing what it was intended to do. As an unintended consequence it was actually prolonging suffering.

The point underscoring this difference in views on either side of the House is that when people get to the stage of asking for medical assistance in dying, they have already reflected upon it. They have already considered it and have gotten to that point after very appropriate and measured determination.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I would note that Madam Justice Baudouin, in rendering her decision and finding that the reasonably foreseeable criteria contravened section 7 and section 15 of the charter, based her analysis on only one objective of Bill C-14, namely to protect vulnerable persons from being induced in a moment of weakness to ending their lives.

The justice ignored other objectives of law, including the sanctity of life, dignity of the elderly and disabled, and suicide prevention. On that basis alone, the decision should have been appealed.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

moved:

Motion No. 2

That Bill C-7, in Clause 1, be amended by deleting lines 25 to 31 on page 3.

Motion No. 3

That Bill C-7, in Clause 1, be amended by replacing line 8 on page 5 with the following:

“(i) ensure that there are at least 120 clear days between”.

Madam Speaker, I am pleased to rise to speak at report stage of Bill C-7 and, in particular, with respect to the two very modest amendments that we in the official opposition have put forward to the legislation, namely, to maintain a 10-day reflection period and to extend the reflection period of 90 days to 100 days where death is not reasonably foreseeable. Both of these amendments are supported by the evidence that was heard at the justice committee in what was otherwise a very rushed process. It need not have been this way and it should not have been this way.

One year ago, the Attorney General should have done what we on this side of the House called on the Attorney General to do, and that was to appeal the Truchon decision. That would have provided clarity in the law and it would have provided Parliament with time to appropriately respond legislatively if necessary, but the Attorney General did not do that. Instead, he rushed ahead with legislation purportedly aimed at responding to the Truchon decision, legislation, I might add, that was introduced with very little consultation.

The legislation went well beyond responding to the Truchon decision. The legislation fundamentally changes the medical assistance in dying regime that was passed in this Parliament a mere four and a half years ago and in so doing, the Attorney General and the government pre-empted a legislative review that was mandated by Bill C-14.

As a result, what we have is a rushed process to deal with a shoddy piece of legislation that recklessly puts vulnerable Canadians at risk. It is why virtually every disability rights organization in Canada opposes this bill. Indeed, 72 national disability rights organizations wrote to the Attorney General and pleaded with him to appeal the Truchon decision. Those pleas fell on deaf ears.

More than 1,000 physicians have penned a letter to the Attorney General opposing this bill. The UN Special Rapporteur on the rights of persons with disabilities expressed concern about Canada's medical assistance in dying regime and questioned whether Canada in fact was living up to its international obligations under the Convention on the Rights of Persons with Disabilities.

I will quote Krista Carr, the executive vice-president of Inclusion Canada, an organization that represents the rights of persons with disabilities, who said this of Bill C-7, “Bill C-7 is our worst nightmare.”

Catherine Frazee, professor at Ryerson University, former chief commissioner of the Ontario Human Rights Commission and a leading advocate for the rights of persons with disabilities, said “our equality is, right now, on the line” with respect to Bill C-7. She noted that the careful balance between individual autonomy and equality carved out in Bill C-14 had been upended in Bill C-7.

Dr. Heidi Janz of the Council of Canadians with Disabilities said:

Bill C-7 would enshrine a legal form of ableism into Canadian law by making medical assistance in dying a legally sanctioned substitute for the provision of community-based supports to assist people with disabilities to live.

You must ensure that MAID does not weaponize systemic ableism in Canada.

In the face of those concerns right across the spectrum from physicians and experts to persons with disabilities and their advocates, we, on this side, thought it appropriate we proceed in a cautious and deliberate way, having regard for the complexity of the issue, the lack of consultation and the very short time frame before us to consider the radical changes brought forward by the government in Bill C-7.

Therefore, at the Standing Committee on Justice and Human Rights we put forward reasonable amendments, including maintaining a 10-day reflection period, having regard for the fact that people do change their minds and having regard for the feedback that was provided.

We put forward an amendment to ensure there be two independent witnesses. When one executes a will, one needs two witnesses. One would expect that at the very least there would be a safeguard at least as robust as in the case of executing a will when we are talking about ending one's life, but no, the government removed that safeguard.

We put forward an amendment to extend the reflection period where death is not reasonably foreseeable from 90 days to 120 days, having regard for the fact it is often not even possible to access palliative care or other supports within 90 days. What good is a reflection period of 90 days if one does not have access to alternatives within such a time frame? That amendment was rejected by the government.

Consistent with what the Minister of Disability Inclusion said, and having regard for the horrific evidence we heard of Roger Foley, who was coerced into making a request for medical assistance in dying, which he recorded, this should always be patient-initiated so coercion is limited and to guard against that.

In closing, let me just say that what we have is a piece of legislation that does the opposite of what the Supreme Court called on Parliament to do in Carter, namely, to provide for a carefully designed and monitored system of safeguards. This legislation eviscerates those safeguards, and on that basis, is unsupportable. It needs to be defeated out of hand.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair.

Thank you, Mr. Thériault, for moving this amendment.

I think it's an interesting amendment. I think it's a timely amendment. It just raises a number of concerns that I have, and I do have some questions about the amendment.

Mr. Maloney just referenced our committee's having to deal with this, but my reading of this is that the amendment as proposed by Mr. Thériault says that “their application must be undertaken by any committee of the Senate, the House of Commons or both Houses of Parliament that may be designated or established for that purpose.” It says “designated or established”, similar language to what's used in Bill C-14. We, the justice committee, would not necessarily be the committee tasked with this review.

The reason why it's important, I think, to consider this amendment is that we're moving at lightning speed on a brand-new-to-Canada area of law. Up until Bill C-14, providing assisted dying was strictly prohibited within our Criminal Code. This is what's being amended and what was amended with Bill C-14. Bill C-14 was a response to court decisions, and Bill C-14, which was passed by the previous Liberal government, involved a mandatory five-year review. It used similar language to this amendment. It was not prescriptive as to whether it would be a review conducted by a joint committee of both Houses, a specified committee within the House of Commons, or a new committee put together for the purpose of the review.

As we know, that review, which was to take place this past summer, did not take place. Could a review have taken place in some capacity? Well, we were able to do a lot of things this summer. We all recognize the challenges faced with COVID. However, here's why it's important. The minister has signalled a number of topics for the review: minors, persons whose underlying issue is mental health only and not some other disability or injury, advance directives. You'd think that a review like that would inform new legislation. Unfortunately, with the decision in Quebec.... That was not appealed to the Quebec Court of Appeal, and it was not appealed to the Supreme Court of Canada.

The position I would take is that, when you have new legislation, part of the role.... We have a joint.... In Canada, we have a Minister of Justice and an Attorney General. The Minister of Justice is responsible for justice legislation, like what we have before us today, but the Attorney General has a distinct responsibility as well. The Attorney General's job, among other things, is to defend, within the court system, Government of Canada legislation. The Attorney General did not do that. In fact, at the first opportunity....

So, you have a brand new, shiny bill—created with a majority Liberal government—called Bill C-14. It provides for medical assistance in dying. It has a number of safeguards. It includes a requirement that one's death must be reasonably foreseeable. Well, the court decision struck down that aspect and said that, no, a person's death does not have to be reasonably foreseeable. Instead of seeking clarification, instead of defending the legislation....

There's a reason why, at the limited committee meetings we had, we heard overwhelmingly from the persons with disabilities community about their concerns with Bill C-7. Many of those people we heard from, including individuals who appeared before this committee, would not have been eligible for assisted dying under Bill C-14, but now would be eligible under Bill C-7. They're concerned with the message that sends to their community.

This is why this provision is important. The government did not initiate. The government still hasn't initiated.

Provincial legislatures are up and running. The House of Commons is up and running; we're having this committee here today. People are used to meeting virtually. To my understanding, all of our witnesses at this committee on this bill and future bills are going to be, by and large, appearing remotely. We heard from physicians, from people in the disability community, from MAID assessors, from MAID providers, from psychiatrists and from a broad spectrum of Canadians. Other parliamentary committees, even today, are doing the same type of thing that we are doing.

This legislative responsibility that we had in Bill C-14 to have a committee look at the state of assisted dying in Canada five years after the passage of Bill C-14 was supposed to have been completed already. It hasn't even started, and now we hear that maybe it will start in January.

Some of the things that were supposed to be studied in this review are things that we're dealing with on Bill C-7 right now. The Truchon decision did not deal with advance directives, but this legislation has advance directives in it. The Truchon decision did not say that the 10-day reflection period was unconstitutional. It didn't say that having two witnesses, two doctors, including a doctor who specializes in the ailment that the person has.... It didn't raise any of those things. It didn't say there was anything wrong with them, yet those changes are included in Bill C-7.

We could debate whether we agree or don't agree with those changes, but what is not subject to debate is that those changes were necessary to respond to the Quebec court decision. They simply were not. They were added into this legislation.

Parliament, in its wisdom, in passing Bill C-14 said that after five years we're going to study this. Implicit in that is that the study would inform future legislation. Instead, five years later we have new legislation that raises tremendous concerns across Canada.

I certainly went into this study with a open mind to look into Bill C-7. We heard from witnesses. The more I hear, the more concerns I have. We have palliative care doctors saying that there is no protection for conscience rights and that there is no protection for people who have had MAID suggested to them, maybe repeatedly, when it's not something they are considering. The disability community said that this makes them second-class citizens and that this is a “nightmare” scenario. Those are their words, not mine. Those are the words we heard from enabling accessibility and from other groups like Canadians with Disabilities. We heard from Roger Foley, a person who took the time to appear before this committee to make the case. It was a very selfless action on his part because he is doing this for people who are going to be in his situation in the future.

We have to listen to those voices.

The five-year thing didn't work, because here we are. Yes, we know there were issues this summer, but here we are and November is almost over. We're coming into December. There is no reason this study couldn't have started. The reason it hasn't started is that maybe they don't want to hear what it has to say before they pass more legislation, like Bill C-7.

In a vacuum, where we did not have the benefit of this study, we have Bill C-7. How many days did we spend studying Bill C-7? Four. This relates directly to the amendment being proposed by Mr. Thériault. We had four days to study something that profoundly changes the law in our country—completely different. Should Bill C-7 become law, the law when it comes to assisted dying in Canada will be profoundly different than it is today. That's without any debate. There's no argument that what we're doing right now is going to have a profound impact.

As a parliamentarian, I did not participate in the debate or the votes on Bill C-14. I would have liked, though, to have the benefit of that parliamentary study, whether it was the justice committee, a hybrid committee, or a committee of the Senate and the House. I would have liked to have the benefit of a robust study, hearing from a variety of witnesses who could have informed us in our deliberations now.

Without the benefit of that, we have this committee. In this committee, we took four days. The first day was taken up by the ministers, who, of course, enthusiastically supported their legislation. Of course they do. This isn't a partisan thing, because when we were in government, we would enthusiastically support our bills.

I haven't seen a sincere effort to reach across the aisle and say that we recognize the diversity of our country, that we recognize there are 338 elected parliamentarians who are all here to do a job, that we recognize that we are all equals around the table and that no one party, mine included, has a lock on good ideas. Every party represented here today, if we're honest with ourselves, may bring things of value to the table.

We have moved, and we have talked about 10 Conservative amendments. None of our amendments would have been earth-shattering. Some of them, in fact, just put back safeguards that the Liberal government itself saw fit to put into Bill C-14. I want to be abundantly clear that without even the benefit of this parliamentary review that's in Bill C-14, the government, the same government that passed Bill C-14, the Liberal government, is peeling away the safeguards that it included in Bill C-14.

Some people might say they don't work. How do you arrive at that conclusion without the benefit of the parliamentary study that you saw fit? People like to cite different groups. We can all do that. When we all do that, I think it should inform our decision-making. It doesn't mean any one group is 100% right, and I don't believe any one group that we heard in our limited testimony is 100% wrong.

Frankly, when I see the receptiveness of the government to some of the very fair, well-thought-out and appropriate amendments the Conservatives raised.... I hope it's not leading to the conclusion that the Liberals feel they know it all and they have a lock on good ideas. I'm willing to agree with some of the amendments from other parties, and I happen to agree with this one.

I agree with BQ-4, because I hope we're not banging our heads against the wall. If the government ignored a five-year study, well, maybe it will ignore a one-year study. They ignored the one that was supposed to take place after five years; maybe they'll ignore this one, which is supposed to take place after 12 months.

I hope this isn't the case. I hope we can send the message that if there is any area of law that deserves safeguards, that deserves a deliberate look at the implications in the application of the law, it's assisted dying. There's no question about that. It's literally life or death. It may not be the group that's here today. It may be some future parliamentarians, but I want future parliamentarians to be informed by a robust study before they make new decisions and amendments.

Frankly, those of us on the justice committee right now did not have the benefit of that type of study. I refuse to accept that the four days that we spent on witness testimony—the first day being the ministers—was a robust study of this bill. It wasn't. This bill and the people who appeared before it.... How about the people who didn't get to appear? How about the Canadians who didn't get to appear? They didn't have their say. I know some of them have been sending in briefs that help to inform us as parliamentarians.

We can't have the thinking that one group knows best or that one party knows best. We're not going to properly study things before making legislation. That cuts across party lines. It doesn't benefit any of us. It does a disservice to Canadians if we think we can do up a first draft of legislation, put a stamp on it and say it's good to go and it doesn't really matter what people have to say about it. Frankly, that's what we saw this time. I think four days was clearly not enough. We've been saying that all along.

Now we're studying it clause by clause, but we're studying it clause by clause with the limited benefit of the limited testimony we've heard. The testimony we have heard leads me to the conclusion that the safeguards that were in Bill C-14 should have stayed in Bill C-7. They should not have been stripped out. Further expansion of MAID in Canada should have followed only after a robust parliamentary study, as was contemplated in Bill C-14. We, as parliamentarians, have an obligation to put in those safeguards, which include review of the legislation, so that we can protect the people.

I believe everyone around the table wants to protect vulnerable Canadians. We may all have a different approach to that, but there's absolutely no harm in including a parliamentary review.

I support this amendment. I believe it sends the right message, and I think it will also help inform future parliamentarians on future legislation dealing with MAID. We, this group, this current justice committee here in November 2020, did not have the benefit of this type of review. I hope future parliamentarians do have the benefit of this type of review. That is why I am pleased to support BQ-4.

Thank you, Madam Chair.