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

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Madam Speaker, the Carter ruling is quite clear in the need to acknowledge both the charter rights of patients in choosing their end-of-life care and the charter rights of medical practitioners. I do not believe that the bill has adequately done that. It will leave it to the provinces and medical associations, and I feel this is an abdication of our responsibility as parliamentarians.

[Yasmin Ratansi, Liberal, Don Valley East, ON]

Madam Speaker, I appreciate this opportunity to discuss the Government of Canada's commitment to establish a framework for medical assistance in dying.

On April 16, I hosted a town hall meeting for the residents of Don Valley East on this matter. As we know, this is a very emotional and personal matter. It was important for me to listen to my constituents' concerns and to ensure that their concerns were heard. Some of my constituents wanted dementia and Alzheimer's to be included, others wanted advance directives, and some wanted protection for the vulnerable.

In order to ensure that there is no confusion on what this bill is all about, I am taking this opportunity to speak on the matter.

Being part of the Abrahamic tradition, I had to park my own beliefs and listen to my constituents and ensure, as a parliamentarian, a balanced approach. Some of my constituents thought that this bill does not go far enough. Others felt that we should not allow it. To help my constituents have a say in this matter, I have asked them that when this bill goes to committee to make a submission to the justice committee.

The Supreme Court of Canada's decision in Carter has significant implications for provincial and territorial governments, and touches many Canadians in a very personal way. A number of individuals have already been granted exemptions by provincial superior courts to access medical assistance in dying. This is in keeping with the conditions set out by the Supreme Court's decision to extend the timeline for its ruling to come into effect to June 6, 2016. It is now time for us to establish a legislative framework for medical assistance in dying to legally become part of the options available to Canadians at their end of life.

Bill C-14 would provide Canadians with greater autonomy over their health care at the end of life, while also providing protection to health care providers and to individuals who may be vulnerable. It would provide provinces and territories with a strong foundation for implementation.

Canada is not the first to implement medical assistance in dying. In Europe, for example, three countries have legislated access to medical assistance in dying: Belgium, the Netherlands, and Luxembourg. In the United States, four states have legislated access.

Where Canada is unique is in the jurisdictional complexities we face. In Canada, the federal government has exclusive jurisdiction over criminal law. However, health care is a shared jurisdiction between the federal, provincial, and territorial governments. Primary responsibility for the provision and delivery of health care services rests with individual jurisdictions. The provinces are responsible for hospitals, the delivery of health care, and regulation of the medical profession, among other things.

As provinces and territories bear ultimate responsibility for the implementation of medical assistance in dying, the scope of the federal legislation has a significant impact on them.

That is why our government has been working collaboratively across governments, while at the same time respecting jurisdictional roles and responsibilities.

When health ministers met in January, they came to an agreement that a robust and consistent regime across the country is in the best interests of Canadians. Health Canada has also engaged in ongoing discussions with health officials in the provinces and territories to hear their views on many aspects of this important issue.

By establishing national eligibility criteria and safeguards, this bill will help ensure consistency across the country as well as respect the underlying criteria of the Canada Health Act.

The proposed legislation will set out who is eligible to receive medical assistance in dying and the safeguards that must be adhered to for medical practitioners to be protected from criminal responsibility.

Provinces and territories cannot modify these Criminal Code exemptions through their own legislation or regulations.

However, the provinces and territories can legislate or introduce policy measures with respect to aspects of medical assistance in dying under their jurisdiction. This could include identifying any special training for offering medical assistance in dying, specific forms to be filled out, or how the cause of death should be recorded.

However, in order to respect the principle of accessibility upheld in the Canada Health Act, provinces, territories, and regulatory bodies would need to consider the implications that any additional guidelines or regulations would have for patient access.

The bill gives the Minister of Health the authority to make regulations about the information to be collected and the processes for collecting it. Working with provinces and territories will be critical to determining how a pan-Canadian monitoring mechanism can be put in place, the types of information to be collected, and the reporting requirements among other elements.

In reviewing the bill, I see that the government has taken into account the concerns of some health care providers; that is, the protection of their conscience rights. The Supreme Court was clear that providers should not be compelled to provide medical assistance in dying. However, the government is also aware that the exercise of such rights may constitute a barrier to access for those who are seeking it.

To address these issues, the government will work with provinces and territories to support access to medical assistance in dying, while respecting the personal convictions of health care providers. This could include, for example, a pan-Canadian system that would facilitate access for patients to willing providers of medical aid in dying.

Throughout the consultations on medical assistance in dying, we heard loud and clear from Canadians calling for more resources for quality palliative and end-of-life care.

With Canada's aging population as well as growing rates of chronic disease, we must consider ways to support the improvement of a full range of options for end-of-life care. This includes better integration and expansion of access to services at home, including palliative care.

Medically assisted dying is a complex and important issue for Canadians and requires collaboration across jurisdictions to ensure that we have a framework that fits within our uniquely Canadian context.

I would therefore like the bill to go before committee where our collective thinking and robust consultation will hopefully result in a better bill, which is satisfactory to all. I think the bill at least provides a foundation for our continued collaboration.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I enjoyed listening to the member's speech. She did something interesting at the beginning where she referenced her personal religious beliefs coming from the Abrahamic tradition. We have heard a number of Liberal members reference their personal religious beliefs, but then also say that they are going to have to in some way park those beliefs.

When I think about the relationship between faith and reason, I am often drawn to think of one of Plato's dialogues called Euthyphro and I would commend it to the reading of hon. members. It discusses the question of the origin of goodness; in particular, is a thing good because it is declared so by religion, or is a thing declared good by a religion because it is intrinsically so? I think most of us would agree that religions declare things good or bad because they are so intrinsically. They do not render a thing good or bad by declaring them so.

It is one thing for the member to ignore religious convictions, but it is another to ignore the underlying realities and truths that those things express.

I want to ask the member to further comment on that dynamic. I want to ask her if she believes in the universal immutable human dignity as a reality, not just as an arbitrary confession. Does the member believe that to be a reality and will that be expressed in the vote she makes on the bill?

[Yasmin Ratansi, Liberal, Don Valley East, ON]

Madam Speaker, for me and for the religious beliefs of all of the Abrahamic tradition, life is sacred. However, what we are talking about here is people who have unbearable diseases, and the Carter case is very clear. As people with religious convictions, we have to ensure that Parliament observes the laws of the land and observes the Charter of Rights and Freedoms. My assessment is that, if we are to move forward with this bill and help our constituents and Canadians live with dignity, we should let this bill go before committee and listen to other concerns and then come up with a robust bill.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, I have been listening with great interest, and this is a profound discussion that we are having tonight. The issue in terms of what people are able to access at end of life has been put before this House, not simply because of the Carter decision and not because of, as some colleagues have said, a narrow rewriting of the legislation. However, if we are going to rewrite this legislation, we have to deal with the huge shortfalls in end-of-life care for those who are wanting to live—the palliative-care needs of the sick and their families. Yet only 16% to 30% of Canadians are able to access quality palliative care. Only four provinces even have a palliative-care framework. It is the responsibility of the federal government to work with the provinces, and also to put the money on the table to say that palliative end-of-life choices are going to be available. However, we saw zero money in the budget from the current government.

If this bill is going to be in place in June, we are going to be in a situation in Canada where people will have technically the right to end their life if they are facing intolerable suffering, but they will not also share the same right to access quality health care for their family if they are living in under-serviced areas and patchwork areas. I am asking why the current government has not stepped forward in advance of this legislation to start dealing with the huge shortfalls we are facing in palliative care.

[Yasmin Ratansi, Liberal, Don Valley East, ON]

Madam Speaker, palliative care is an important aspect. I believe, when I was doing my presentation, I made palliative care part of the comprehensive framework that we have to work with. There are cases in one of the states where it is the Cadillac version of palliative care. Those people who have the Cadillac version of palliative care are the first ones to want assisted dying. I do not mean to say that we should not have palliative care. It is extremely important, and choices are important. However, to have a robust and very strong bill, we need to send this bill to committee and work around it.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Madam Speaker, a report in The Globe and Mail on April 24, 2016, says 13-year-old Sheridan Hookimaw killed herself on the banks of the river that winds through Attawapiskat. The sickly girl had been flown out for weekly medical appointments. She wanted to end her pain, and in the process, she set off a chain reaction not only in her community but in communities right across this country, which we are still dealing with today.

This debate strikes at the very heart of the meaning of life, it strikes at the heart of bureaucracy, and it strikes at the heart of how we care for the most vulnerable in our society. I have been told over and over again that this situation is different, that there is no connection.

In the indigenous world view, everything is interconnected. It is holistic, meaning that when a change is made in one place, the impact will be felt elsewhere, and the two cannot be separated. In the western world view, often we compartmentalize things. We believe that we can play, that we can control certain situations, that we can effect change here and not see change in other places. Above all, we have come to believe ourselves able to predict and control all, to control the future. This does not mean, though, that we should not take action.

The impact of this bill on people in Toronto may be very different than on the people in Nunavik or Attawapiskat. Our role as parliamentarians is to place ourselves in the moccasins of others, to place ourselves outside of our own experiences, to see the world through another cosmology and other world view, and to see the impact that our decisions may have on others.

We are making profound changes in concepts surrounding life, which cannot be undone in the future. In the indigenous tradition and philosophy, we are required to think seven generations into the future. If I am wrong and there is no connection between Attawapiskat and physician-assisted dying or suicide, if the average person does not see a connection and communities do not see a greater stress, then I will gladly say I was wrong; but if there is an impact, which is caused by the valorization of suicide, then what?

When the House passed amendments to the Criminal Code on other issues in our criminal justice system, who would have thought that indigenous peoples would now make up 23.2% of the prison population? It seems that madam justice is blind to the suffering of many of her fellow citizens. We have equal laws, and yet the treatment and effects are unequal across our country. We make laws often for the average person, but the impact is felt most by those who are on the margins of society.

Even though we have the Gladue rulings in our justice system and cases where we are supposed to take into consideration someone's upbringing, someone's past, unfortunately, those are not reflected in our justice system. Therefore, how can we be assured that the changes we are making today in the House will not have an equally detrimental impact on others?

My earliest memory, one of my strongest memories, is as a little six-year-old boy. My mother had just lost a house. We were in tough economic times in Calgary, Alberta, and she could no longer support us. She was a single mom, and she went off on the road looking for work. She decided at one point she could no longer raise me or my little brother by herself and she needed help, so she went to her ex-husband, my father. My father was a residential school survivor, an alcoholic, and a member of gangs. We knew all these things.

We knew he had a terrible temper. We were told this as young children, and we were very scared as children. We were dropped off at his place, with his parents, my grandmother and grandfather, and we were very upset. It is the only time that I remember my brother peeing his bed, because of the stress, because my mother had to find work because of economic stresses in her life.

I remember climbing a tree in the back yard and wrapping a rope around my neck at the age of six. This is a true story. People often think it cannot be true, but this happens in our country, like the case of the 13-year-old girl in Attawapiskat.

I wrapped that rope around my neck and thought, “Should I jump off into this universe, which is before me?” It was in that back yard that somehow I made the decision to climb down out of that tree and unwind that rope from around my neck.

If in my life I had seen, or I had known, that my grandmother had somehow used physician-assisted dying or physician-assisted suicide, or others in my family had completed the irreparable act, then it would have made it much more difficult for me to continue.

We might not think the impact will be there, but we do not know. We assume we know these things. We are deciding the future of a few for the end of a few.

In the case of Sheridan Hookimaw, as a society, we are unable to provide the necessary care, the love and the protection. We have failed our most vulnerable.

The Canadian Webbian bureaucracy was unable to respond to the needs of a 13-year-old girl. How can we be sure that it will now be able to respond to the needs of all in the future in our societies?

This debate is about life itself. Indigenous people never knew of suicide. It was unheard of in indigenous communities. Yet it now continues to plague our communities, and the spirit of suicide seems to always be there.

Life is not easy. It is about struggle, about fighting for another day. If indigenous peoples had committed suicide, then we would not be here today for all the trials and tribulations we have faced.

I participate in one of the high ceremonies of the indigenous custom and tradition of the Plains Cree. It is called the sundance. It is a four-day ceremony, and for three days and three nights, no food or water shall pass my lips. I pierce my body to sacrifice myself for others, in prayer for them. I do this not for myself, not to ask for something for myself, but for others.

In the sundance, in the sundance lodge, my Sundance Chief David Blacksmith talks about the spirit of suicide, how it is coming to take our young and is starting to take our old people, how it is affecting our society, how it is destroying our sense of community, and I have to listen to it. I have to be moved by the words he brings, because the people surrounding me in the sundance have all been affected by it.

We are placing ourselves now outside of nature. Nature itself is hard, to strive, to struggle, to see another day. It is a struggle that is noble. Now placing the tasks in the hands of the state removes us from nature, telling the state that it will now be the one who will be enabling us to do these things; someone else will be deciding, bureaucracy will now be deciding.

Others may feel that they are a burden. Others may say that they are a burden. I think there is something noble in sacrifice and in striving in the struggle for life itself, to hold someone's hands in the final moment, to have to grow up and not simply say, “I am going to hand it off to someone else to look after, but that I will stand there or I will sit there, holding your hand at that exact moment. Even in your final breaths, even though it may be difficult, we will continue on”.

Perhaps this is just another step on the road of moral relativism that we are in nowadays, but even our judiciary cannot serve as a balance between the different societies making up Canada. We are in a sorry state. We have truly entered a new age, one of the throwaway culture where all boundaries are starting to crumble.

Finally I would like to say, in the words of Elder Winston Wuttunee, “If you cry, your children will die”. It is dangerous to abandon one's self to the luxury of grief. It deprives one of courage and even of the wish for recovery.

From an indigenous perspective, I look at this bill and I cannot support it, because it leads to a place where I do not believe we are looking out for the interests of all people within our society. It is not allowing us to fully comprehend the needs of everyone who makes up Canadian societies, but really, it is taking us down a path that is very dangerous, and we do not know where it ends.

Let us be very careful in this House, and take the time that is necessary as we make our decisions.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, I would like to thank my hon. colleague for sharing his views on this.

I know I will be reprimanded for this, but I am disappointed by the disrespect that one of his own colleagues made while he was speaking, by walking not once but twice directly in front and making noises, while he was trying to give that heartfelt presentation.

I have considerable concerns with the bill, and my comments are neither for nor against, but on the timing, the time we have to debate it and the rush to get the legislation through. Quebec took six years to, hopefully, get it right.

I have an adult child who is 28 years old. She presents herself as mature and is beautiful, but cognitively, she is developmentally challenged. My concern is that there are not enough measures in the bill as it exists today that would protect the cognitively challenged. It says a “competent” adult has the right to make this request. Who determines that adult is competent to make that decision, and are there enough safeguards in place for those who are cognitively challenged?

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Madam Speaker, not being a lawyer, I am not sure. However, I know once we start doing a process, once we have gone down this path, we cannot go back. We need to take time to look at Quebec and see what happens there, how it plays out in that jurisdiction, before we start elaborating in other jurisdictions.

I understand that there are people who are suffering, but I do not think we have dealt properly with the suffering that goes on in many communities. We have not taken the time to really understand or to make sure that they feel protected.

I do not have a lot of comments to offer the member, but it is a concern as well.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, it was very unfortunate that my colleague invoked the name of young Sheridan in the House in this debate. She did not die because she was suffering from an incurable illness like Lou Gehrig's disease. She died because of lazy indifference from federal and provincial officials, from poverty, and the fact that we do not have mental health workers. It took months to get her body home through the bureaucratic red tape, as the family could not deal with the trauma.

What we are dealing with here is our obligation before the Supreme Court. This is our job. However, it is extremely dangerous and unprofessional to invoke the suffering of those children as a way to say that we are not doing our job here.

We have a job to do before the Supreme Court, but we also have a job for those children, so a young child like Sheridan will never ever be denied mental health services because some official says we will not give it to them, or that they are going to have to live in a squalid shack because some official will not sign off on the housing agreements. Those are fundamentally different.

Knowing the family and what these children have gone through, it is very unfortunate that my colleague has used those stories to somehow conflate these two issues, which are fundamentally different.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Madam Speaker, unfortunately, perhaps the member fails to understand indigenous philosophy, which is about the interconnectedness of everything. The member may believe that these are unconnected events, but in fact they are connected. We could debate about the definition of the bill. We could say “medically assisted dying” or “medically assisted suicide”. Our use of terminology is very important. If we use “medically assisted suicide”, it has connotations to it that people will understand. I am sure at some point that people will be banging on the doors at some emergency wards and saying they are suffering, they want to end it, and ask for help.

I apologize if I offended anyone in invoking the name of the young girl, but her name is in the newspapers and her case is well known. If we cannot speak truth in this place and use the truths that are out in society here in the House of Commons then where else will it happen?

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Before we resume debate, I want to remind people that when others are speaking it would be good to allow that person to speak without going back and forth. I want to make sure we keep that level of respect here in the House.

Resuming debate, the hon. member for Calgary Shepard.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, as I rise today to speak about the grave implications of Bill C-14, I am reminded of the Yiddish proverb, which says: “From fortune to misfortune is a short step; from misfortune to fortune is a long way”. I am afraid that the legislation being brought forward by the current government is a short step to misfortune, and the path with proper safeguards would be a long one.

This is a difficult subject, but the floor of the House of Commons was made to debate weighty subjects, to define how we live in our Confederation, to seek out the objective truth, and to legislate wisely.

However, the House has addressed the issue several times over the last decades. In 1983, the Law Reform Commission of Canada recommended against legalizing or decriminalizing euthanasia or assisted suicide. In 1993, the Supreme Court dismissed the challenge by Sue Rodriguez on the Criminal Code prohibition of assisted dying. In 2006, Bill C-407, a bill that would have allowed physician-assisted suicide in certain circumstances, died on the Order Paper in that Parliament. We can see in the chronology the hesitancy to legalize assisted suicide, and for good reason.

Bill C-14 would impact how Canadians view the worth of their lives and the lives of their loved ones. The safeguards we put in place must protect Canadians from abuse when it comes to physician-assisted suicide, and that is something all Canadians can agree on. We must ensure that, as far as possible, the legislation we craft mitigates the harm inherent in legalizing the killing of human beings.

Additionally, I remind my fellow parliamentarians that the ruling of the Supreme Court in Carter v. Canada directly contradicts the Supreme Court's 1993 decision in Rodriguez v. British Columbia. In that ruling, the Supreme Court was clear when it stated that section 241(b) of the Criminal Code of Canada was in fact constitutional. It reads:

Every one who

aids or abets a person to commit suicide,

whether suicide ensues or not, is guilty of an indictable offence

At that time, it was ruled that the Canadian Charter of Rights and Freedoms confirmed its legality.

Millions of Canadians believe that the Supreme Court erred in its interpretation of sections 1 and 7 of the charter. Despite this, I recognize that the court made a unanimous decision. Therefore, the question before us is no longer whether assisted suicide should be legalized or not, but rather to conform with the Carter decision in what the contents of the legislation should be, as well as the safeguards. That is the matter before us.

Many of my constituents have reached out to me with concerns about the direction that this legislation is taking. Bill C-14 would fail to provide stringent limits. It would fail to keep the deadly wolf of abuse and misapplication at bay.

Constituents like Alexia Blackwell wrote to me that, “Legislation must clearly spell out the protections provided by the Charter of Rights and Freedoms so that caregivers and their organizations will be protected from coercion or discrimination.”

Canadians must have access to palliative care before and alongside physician-assisted suicide so that their first end-of-life option can always be a peaceful, compassionate, and natural death.

Palliative care provides compassionate and ethical end-of-life care for those suffering intolerably as a result of a grievous and irremediable medical condition. It must always be presented as an alternative to physician-assisted suicide.

I would also like to note that in 2014, the House voted in favour of a motion brought forward by the hon. member for Timmins—James Bay, which read:

That, in the opinion of the House, the government should establish a Pan-Canadian Palliative and End-of-life Care Strategy...ensuring all Canadians have access to high quality home-based and hospice palliative end-of-life care...

That is the sort of care we should be working towards.

A very important safeguard, and one that I feel has only been partially addressed by the bill before us, is the conflict of interest that is bound to arise if we do not ensure that physicians are prohibited from benefiting directly or indirectly from recommending or performing physician-assisted suicide. I say this because, like millions of Canadians, I firmly believe that no person in Canada should profit from death. Since physicians in Canada are paid directly by their provincial health authorities, they cannot be placed in a situation where helping a patient choose physician-assisted suicide, or an extensive palliative care plan, or a chronic disease plan could be influenced by a consideration of monetary gain.

Similar prohibitions on physicians profiting for performing the physician-assisted suicide procedure exist in other jurisdictions that have now legalized the procedure, including Germany, Switzerland, and Oregon. These laws exist for good reason. As much as we may not like the idea, it is possible for unethical physicians to promote the idea of assisted dying over other health care alternatives if they stand to benefit from it.

The Dutch government, concerned over accusations that the practice of euthanasia was being abused, undertook studies in 1990, 1995, and 2001. Physicians were guaranteed anonymity and immunity from what they revealed in regard to violations of the guidelines. Therefore, the findings of these studies are indicative of what was going on in the practice of their profession.

It quickly became apparent that half of Dutch doctors had no hesitation in suggesting that their patients consider euthanasia, which compromised the necessary voluntary nature of the process. In addition, 50% of these cases were not reported, according to a study by researchers from the University of Ghent in Amsterdam.

Even more alarming was the fact that a quarter of the physicians said that they were terminating the lives of patients without an explicit request from the patient. Another third of the physicians said that they could conceive of doing so; they were not just thinking that they could do so.

We must not be naive about the possibility of coercion. That is why I am asking the government to amend paragraph 241.2(6)(b) and delete “other than standard compensation for their services relating to the request”, thus making the assisted-suicide decision and the provision free of any financial consideration.

Another issue I have heard brought up frequently is the lack of definition for the phrase “intolerable suffering”. I have heard a lot of talk about this particular issue. Should the definition of suffering include those struggling with mental illnesses, those struggling financially perhaps, or those who suffer from intense boredom? We should be protecting people from their suicidal desires rather than enabling them. After all, is that not the whole point of the excellent mental health initiative called Bell Let's Talk campaign, which we all support?

We cannot simultaneously work to end depression and suicide while also creating legislation that would allow people to request assisted dying simply because their situation has led them to consider their personal suffering intolerable or their death reasonably foreseeable. Realistically, this would fundamentally change the practice of psychiatry, the central focus of which is to develop good mental health that prevents suicide and shows persons the value of living and the inherent dignity of their condition.

Considering this incoherency, we must ensure that requests for physician-assisted suicide are considered objectively by a judicial review body that ensures the request is voluntary, well considered, informed, and consistent over time. This regulatory body must ensure that consent is actually being given by the patient requesting the physician-assisted suicide, and that all requests are reported to this body. The need for this sort of regulatory body is evident when we consider other jurisdictions where physician-assisted suicide is legal.

According to a study published in the Journal of Oncology Practice, over 500 people in the Netherlands are euthanized involuntarily every year. In 2005, a total of 2,400 deaths by euthanasia or physician-assisted suicide were reported, representing 1.7% of deaths in the Netherlands. There were 560 of these deaths that occurred without proper documentation of consent. In Belgium, the rate of euthanasia deaths that occur without explicit consent is three times higher than it is in the Netherlands.

Speaking of ambiguous requirements, it is the inevitability of life that it must end. From the moment we breathe our first breath outside our mother's womb, it is reasonably foreseeable that we will die. That is another vague, confusing term that at best fails to provide any meaningful guideline for physicians or their provincial colleges as they evaluate individual requests. Another vague term is the definition of medical practitioner as a person entitled to practise medicine under the laws of a province. This is problematic because that definition changes from province to province. In my home province of Alberta, it includes osteopaths, also known as chiropractors.

When deciding whether to provide assisted dying, physicians can follow their conscience without discrimination. No one should be compelled or coerced to provide assistance in suicide. I held a round table last week with participants who were for and against assisted suicide. I asked the question, regardless of whether people were for or against, what part of the bill they believed was most critical. They said it was protection for conscience. The people want an extension to protect the ability for people to say no based on moral and ethical grounds.

We must be very careful that Bill C-14 will not force Canadian physicians with deeply held religious, moral, or ethical beliefs about the sanctity of human life to go against both their conscience and the Hippocratic oath. I believe that section 2 of the Charter of Rights and Freedoms that protects freedom of conscience and religion, as well as freedom of thought, belief, opinion, and expression applies here. Further, what is the point of any of these rights if we cannot express them through action or inaction without state coercion?

I could go on about the ways that Bill C-14 would go far beyond the recommendations of the Supreme Court, how it lacks the strict safeguards referred to in Carter, or the broadly worded definitions that are a problem. I could speak of the irresponsibility of poorly defining the person who is eligible to undertake or to perform assisted suicide.

This bill is based on badly reasoned and inadequately researched recommendations from a committee that failed to seek proper input from a broad diversity of Canadian beliefs and opinions. The National Assembly of Quebec got it right by allowing for six years of debate, through three different assemblies, to study and consider all of this.

To finish, I urge the government to move significant amendments to this legislation or drop this bill entirely and table a better one. The path back from the misfortunes of this bill are too significant to get it wrong.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I am sure the member is somewhat familiar that this decision was made by the Supreme Court well over a year ago. The previous government virtually did nothing to address the issue. It had a panel, and I recognize that, but it fell far short in trying to come up with any sort of legislation. We had opposition days to encourage the Conservative government to take action, but it chose to do nothing.

In hindsight, does the member believe there was an obligation on the former government to at least advance the issue in a more timely fashion? By doing that, who knows where we might be today. However, at the very least, we need to recognize the restraints we are currently under with the Supreme Court of Canada. We still have to go through the Senate. Does he believe there will be value in getting this to committee so we can talk about the many ideas we are hearing today and listen to what Canadians have to say in the hopes that—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Order, please. We have to give time for the answer so other people can ask questions as well.

The hon. member for Calgary Shepard.