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.

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

Thank you, Madam Chair.

I would just like to add that providing for same-day death or entertaining that possibility, as Bill C-7 would allow for, I believe is virtually unprecedented in any other jurisdiction.

I recall that when we considered the reflection period during the debate around Bill C-14 at the time, we were looking at a 14- or 15-day reflection period, and the government brought forward an amendment to reduce that to 10 days. Even a 14- or 15-day period, as I recall, was significantly less than that which was provided for in the Benelux countries, where the waiting period, at least as of 2016, was in the range of 30 days.

We really are heading down uncharted waters. I think any time we legislate on this issue, in which there are so many complexities and we're dealing with vulnerable persons who are at their most vulnerable state in life in many instances, we need to proceed with care and caution, having regard for the evidence before our committee and having regard for the data coming out of the province of Quebec.

I believe it is imperative that we maintain a reflection period and not go down an uncharted path.

Thank you.

[Chris Lewis, Conservative, Essex, ON]

Thank you, Madam Chair.

I have just a couple of very brief comments. The first one is that I was a firefighter, a first responder, for seven and a half years, so of course I went to a lot of car accidents and I went to a lot of fires, but I was equally a paramedic as well and responded to a lot of folks who had DNR orders. At the time, the fire department I was part of didn't recognize DNR orders, so we would send them to the hospital.

I will tell you that, in my seven and a half years in the small town in which I was a firefighter, on more than one occasion I did meet somebody on the street, a cancer survivor, who upon going to the hospital actually found a new specialist, a new treatment and indeed survived.

My point is this. I think we'd all agree that at the very least we'd have what I call the 24-hour rule. This is now somebody's life, and life deserves, at the very least, a 10-day reflection period.

Again, I go back to my time served in the fire department. I've seen this. I've been part of it. I've seen people who have been in a coma with the doctors saying to pull the plug, and 18 days later they have woken up with thumbs-up and are living a normal life today.

Because I have seen it, because it's first-hand for me, I really don't understand why we would not have that 10-day reflection period at the very least to talk it through. It is absolutely vital.

The last point I would make is that this was the Liberals' legislation through Bill C-14 and if they don't believe now that we need a 10-day reflection period, are they suggesting they were wrong when they put this legislation forward in the first place?

Thank you, Chair.

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

I support this amendment.

The Supreme Court of Canada in the Carter decision contemplated a carefully designed and monitored system of safeguards. Bill C-7 removes one of the key safeguards provided for in Bill C-14, Parliament's response to the Carter decision, and that is a reflection period.

If you look at the legislation as it is currently drafted, it could provide a scenario where there is same-day death and there is virtually no reflection. It is important to note that people do change their minds. Indeed, in the Truchon decision, evidence before the Quebec Superior Court indicated that in the province of Quebec, between December 2015 and March 2018, some 167 written requests were made and subsequently withdrawn by patients, because they had changed their minds. That equals approximately 7% of all MAID requests in the province of Quebec.

I believe this data underscores the need for a reflection period.

With the issue surrounding the loss of capacity, this is already addressed in the existing legislation, in Bill C-14, whereby that period can be shortened where necessary, but that should be limited. It should be the exception; it should not be the rule.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

I think this amendment ignores an important fact. Those who have reached this point in their lives where their medical condition has dealt them a bad hand, we might say, and who are suffering intolerably, have been consulting with their doctors, some for many months. This is not something that happens in any rapid fashion.

We heard from the assessors and providers who carefully monitored what was happening under Bill C-14. They told us very clearly that this does inflict unnecessary suffering. In fact, when you look at statistics about the 10-day waiting period, a very large proportion, over half, of the medically assisted dying occurs on the 11th day. That tells me we are forcing people to wait, and forcing them to suffer in a way that's not necessary if we are truly compassionate.

I will be opposing this amendment.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair.

I'd like to first move CPC-4.

I'll reflect back on Bill C-14, which was adopted five years ago. It required that individuals be given the opportunity to change their mind after a request was made. This is where death is reasonably foreseeable, but it doesn't mean it's imminent. It doesn't mean it's within weeks. In fact, as we've seen from some cases, it could be years.

In the limited testimony we've had, it became a theme that people can change their mind. We tossed around this idea of life or death. People have said, “This is a life-or-death situation” when often it isn't, but in this case we are literally dealing with life or death.

The majority Liberal government that introduced Bill C-14 put in place a requirement that there be:

...10 clear days between the day on which the request was signed by or on behalf of the person and the day on which the medical assistance in dying is provided or—

It means that if you've signed and said, “I would like to have medical assistance in death”, there would be 10 clear days. There was a reason why that was put in place by the Liberal government.

—if they and the other medical practitioner or nurse practitioner referred to in paragraph (e) are both of the opinion that the person’s death, or the loss of their capacity to provide informed consent, is imminent—any shorter period that the first medical practitioner or nurse practitioner considers appropriate in the circumstances....

When we've discussed this, I've heard other colleagues say, “Sometimes this was just making people wait for no reason.” Well, Bill C-14 provided for that scenario. The 10 days could be waived in circumstances where death is imminent. If someone is going to pass away in two days or a day, no, there does not have to be a 10-day reflection period. Remember we're dealing with cases where an individual may have years to live, and what we're saying is to take that 10-day reflection period. There's a reason it was put in place.

Now we have two tracks—death reasonably foreseeable and death not reasonably foreseeable—without a definition of “reasonably foreseeable”. If someone falls into the other track, there is a 90-day reflection period. If someone falls into death being reasonably foreseeable, under Bill C-14, there was a 10-day reflection period that could be waived. Bill C-7 strips that out. Some may say that it's unnecessary suffering and so on, but what they don't say is that the 10-day period could be waived.

I want to list a few organizations, and every one of us is familiar with these organizations: the Canadian Society of Palliative Care Physicians, the Council of Canadians with Disabilities, and Inclusion Canada. We heard testimony from Inclusion Canada's executive vice-president. The persons with disabilities communities are in favour of this being reinstated. Palliative care physicians, who are end-of-life physicians, are in favour of this being reinstated.

We're not asking for anything earth-shattering here. Some of the safeguards that were put in place by the previous government were just that. They were safeguards to protect the vulnerable. One of them was this 10-day reflection period. Bill C-7 takes it out. This amendment simply keeps it in, and it keeps in the possibility that the 10 days can be waived when death is imminent.

I thank you for your consideration of this amendment.

[Rob Moore, Conservative, Fundy Royal, NB]

Sure. I hadn't planned to actually speak again, but Mr. Thériault made some points that I don't think are on point with what's being proposed here.

He mentions a scenario where someone has hours or weeks to live. Just by the discussion around his own amendment, around reasonable foreseeability of death, we already know that under the previous bill, Bill C-14, individuals with a prognosis of living for well over a year have received assisted dying. We're not being overly prescriptive here, but we have to recognize that some of the individuals who may, depending on the assessment, fall under reasonable foreseeability of death may still have quite a bit of time to live naturally.

What we're saying is, in the wisdom of what the government has put in place under individuals whose death is not reasonably foreseeable, there are going to be people who fall in the margins on both sides of that issue, of that line, that ill-defined line. We've chosen today not to even attempt to define what “reasonable foreseeability” is.

In light of that, I think it's abundantly clear that in the consultation with the physicians one of them should have an expertise in the person's ailment. Whatever that ailment is, we're asking that one physician have that consultation with the patient.

This is not about people who have days to live. This is about people who could have years to live. This requirement has been adopted by the government on their other track. Based on the testimony that we've heard, I think it's abundantly clear that it's important and relevant for those throughout the MAID regime, not just on one track but throughout, that there should be a requirement that they have a consultation with a physician who knows something about their ailment. The risk otherwise is just too great, in my view, for abuse of this system.

I'll leave it at that. Thanks, everyone, for your consideration of the amendment.

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

Thank you, Madam Chair. I will speak in support of this amendment.

I want to reiterate a point that Ms. Findlay made, also as a lawyer, that in order to execute a valid will, two witnesses are required. Here we're talking about the most significant procedure that could be undertaken in someone's life, namely to end their life, and the safeguard required would be less than that which is required to execute a valid will.

I can say that when Bill C-14 was debated, there was widespread consensus around the need for there to be two witnesses, and not only two witnesses, but two independent witnesses.

The legislation that the government has put forward not only removes the very common-sense requirement that there be two witnesses, but it goes further than that and removes the requirement that there be independent witnesses. Indeed, under Bill C-7, someone attending to a patient's health could be a witness. That obviously raises concerns around conflict of interest, coercion—subtle coercion, unintended coercion—having regard for the power imbalance that exists, for example, between a medical health professional and a patient, particularly vulnerable persons.

The evidence that we heard at committee, in the very limited hearings we held on this bill, was overwhelming in terms of support for maintaining this safeguard, including from the Canadian palliative care association, among other witnesses.

I have not seen any convincing evidence to demonstrate that the witness requirement in any significant way impedes access to physician-assisted dying. On that basis, I believe this is an important safeguard to protecting vulnerable persons. That was backed up by the evidence. On that basis, I hope that this committee sees fit to pass this amendment.

Thank you, Madam Chair.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair. I'd like to move this amendment.

What our amendment would do here is the following.

Bill C-14 required two independent witnesses. Parliament, in its wisdom, with a brand new regime of medically assisted dying, included that requirement. To me, when you're dealing literally with life and death, it makes sense that there would be that requirement for two independent witnesses.

What Bill C-7 does is remove the requirement for two independent witnesses.

In listening to stakeholder interventions on this bill, particularly the Canadian Society of Palliative Care Physicians, which represents the physicians and others who are dealing with people at end of life, we hear a lot of talk about how it's not a true decision if you don't have appropriate palliative care. A lot of people pay lip service to palliative care, but any one of us, if it's someone we know, is going to want that person to have the best palliative care opportunities as possible in an end-of-life situation.

The Canadian Society of Palliative Care Physicians supports this amendment that would maintain the requirement for two independent witnesses. You can imagine, with the different dynamics of how, when we're talking about assisted dying and about Bill C-7.... Bill C-7 dramatically—dramatically—changes the law in Canada when it comes to assisted dying because, in fact, now people don't have to be, as we would have thought before, at end of life. They may have a prognosis that says they have 30 years to live or that says they have 20 years to live.

So, in light of that expansion, I think it's important that we maintain safeguards that make sense. To me, it makes abundant sense to have two independent witnesses, to have the request, as the Criminal Code says, “signed...by the person—or by another person under subsection (4)—before two independent witnesses who then also signed and dated the request”.

I can tell you, as someone who has dealt with legal matters before, that you don't want to have one witness to something anyway. Having two witnesses eliminates any degree of uncertainty that could exist. There are always going to be challenges, but I think of...for the.... In Parliament's wisdom under a Liberal majority government when Bill C-14 came forward, there was the requirement.

This amendment is not earth-shattering. It is as modest as possible, and it's saying, “You know what? Let's maintain that safeguard.” That's what this was couched as; it's a safeguard.

We've heard testimony that we're dealing with the most vulnerable in Canadian society, that we're dealing with people who are in very difficult times, that we're dealing with literal life-or-death decisions, so let's maintain the safeguard.

That's why I'm moving this amendment, CPC-2.

Thank you, Madam Chair.

[Rob Moore, Conservative, Fundy Royal, NB]

Thanks, Madam Chair. I think I was in the midst of speaking to this particular amendment when the last meeting ended.

I think for all of us this is an opportunity to provide some clarity—clarity grounded in witness testimony. Some of the testimony I've been receiving on this bill has been around a phrase that was really under Bill C-14 and is now under Bill C-7, and it's so important. That's the phrase “reasonably foreseeable”. There is no definition of reasonably foreseeable.

I heard argument on this particular amendment, BQ-3, that somehow it could possibly be less certainty. I think it's just the opposite. It's abundantly clear that just the opposite would be true. By we as parliamentarians putting in this amount of “12 months”, we have....

It's paramount to this bill, because it involves which track someone who is seeking medical assistance in dying will be going on. We say in Bill C-7 that if your death is reasonably foreseeable, then there are certain safeguards in place—fewer safeguards than were there under Bill C-14. Under Bill C-14 there were the safeguards that there had to be two independent witnesses and a 10-day reflection period. Other safeguards that in fact were in Bill C-14 are taken out in Bill C-7.

If your death is not reasonably foreseeable, then you're on another track. Those of us who have studied this bill know this. The whole bill turns on reasonable foreseeability. In my readings on this, and from speaking with physicians and hearing and reading briefs from physicians and from those in the disability community, as well as hearing of some cases where I think the definition of reasonably foreseeable has been stretched to its absolute maximum of someone's imagination, I think it is incumbent upon us to provide some degree of certainty over what we mean, as a Parliament, as legislators, when we say reasonably foreseeable.

This particular amendment talks about the “prognosis of 12 months or less” remaining. I think this makes abundant sense. I want to thank the member for bringing it forward.

You know, there are people who are watching, of course, the committee deliberations. I haven't made it a secret that I think there should have been more time to hear witness testimony. I really think, if we're honest with ourselves about what we heard around the table, what we heard from members of the disability community, it was an eye-opener for everybody. Whether we're willing to admit that or not, I think it was an eye-opener. I would like to have explored some of these issues further with them.

We were presented with the perspective that somehow in the physician community there is overwhelming support for this bill, but then, as we studied it, we realized, no, that's not the case. I mean, every one of us, as committee members, received a letter signed by 800 or 900 physicians. That's a huge number. Someone said, well, that's not as many as there are in all of Canada. Of course not; but if 900 physicians sign a letter, then I, as a member of Parliament, am going to take notice of that.

Based on the feedback that I've seen, I really think we're doing our job by being a bit more certain in what we mean. I mean, “reasonable foreseeability”—that kind of language is wide open. To the best extent possible, we should give certainty in our laws.

If you're travelling down the highway and you see a sign that says, "Your speed is reasonable”, what does that mean? Does that mean 70? Does it mean 90? Does it mean 130 kilometres an hour? I know for me, it might mean something different than it means for you. “Be reasonable.”

“Well officer, I was being reasonable.”

“No, you weren't being reasonable.”

Who decides what's reasonably foreseeable?

I'm in New Brunswick and I recognize we're a big country. We had a big discussion this morning on how big the country is and how it covers many time zones. In New Brunswick, on most highways, it doesn't say, “Be reasonable”. It says 110 kilometres an hour. I know if I'm over that, I'm speeding. If I'm at 110 or under, I'm not speeding. I think that makes sense. I also think it makes sense for us to define in some way what reasonable foreseeability means. That's why I'd like to speak in favour of BQ-3.

Thank you.

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

Thank you very much, Madam Chair.

I wish to speak in support of the points that have been raised by Ms. Findlay.

I want to say, at the outset, that I have a lot of respect for you, Madam Chair. We served on the justice committee through the entirety of the last Parliament. I know you as a colleague and as someone who, I believe, is doing your best to try to work co-operatively with members and to make this committee work as best as possible.

In the last Parliament, in the justice committee, we dealt with some pretty significant pieces of legislation, including the predecessor to Bill C-7, namely Bill C-14. Throughout, there were certainly disagreements on policy and broad issues.

One of the things I really appreciated about this committee was that we could look at the issues and the legislation before us in a serious way. That didn't mean putting aside partisanship, because there are legitimate differences. However, we worked together in a collegial way. I believe all members of the committee, regardless of their perspectives, worked in good faith together.

I guess what is disappointing—again, with the greatest of respect I have for you—is that, as Mr. Moore said, we are based upon a rules-based system. We need to respect members' schedules and their time commitments.

In the five years now that I've been a member of Parliament, I have never been in a situation where the chair of a committee unilaterally called a meeting prior to the agreed-upon schedule. I talked to Mr. Moore last night, who served here for 11 years, from 2004 until 2015, and then since 2019. That's 12 years in this place. He noted that he had never seen anything quite like this.

In terms of my schedule, this has actually caused quite a bit of disruption. In fact, I had a press conference that had been scheduled for 10 a.m. It was ready to go. There were a number of stakeholders who were prepared to attend that press conference at that scheduled time.

I happened to find out about this scheduling change around six o'clock last night. I happened to find out from another member, whom I was working with to coordinate the press conference. As a result, we had to completely rearrange the schedules of multiple individuals, causing considerable inconvenience.

Had I not been moving ahead with a press conference, I might not have even heard that the committee schedule had been changed. It's true that you sent out an email, but I think there should be a reasonable expectation amongst all members that we shouldn't have to look at our email every 10 minutes or every hour, because somewhere out of thin air a committee meeting is going to be called.

Indeed, in terms of this committee's schedule, the whips of all parties had agreed that committees that fit within our time slot are to meet no earlier than 11 a.m. Part of the reason for that is time zone issues and the considerable issues they cause for members who are living on the west coast—a three-hour time zone change. Ms. Findlay had to be here at 7 a.m.. Had I not been here in Ottawa, it would have been 8 a.m. for me in Edmonton.

I guess what this illustrates—again, this is not out of any disrespect to you, Madam Chair—is the process involving Bill C-7. At every step of the way, the government has sought to ram this legislation through without meaningful consultation with experts, with physicians, with key stakeholders. We've had four meetings, which have provided limited opportunity to hear from witnesses on a whole range of concerns that have been raised, from the disabilities rights community, from many health professionals, from the UN special rapporteur on the rights of persons with disabilities.

We have seen, and in fact the press conference I held today.... This is a point I want to raise after we deal with the question of privilege brought forward by Ms. Findlay, about the voices of physicians who sought to submit briefs to this committee, but whose briefs were rejected because of an arbitrary deadline to submit briefs that no one knew about, other than perhaps the Liberals. This speaks to a process that is fundamentally flawed, and it cannot stand.

I hope, Madam Chair, you will take seriously the concerns that have been raised—I believe, in good faith—by my colleagues, in particular Ms. Findlay, who has raised a number of substantive points, and that going forward we will govern ourselves in such a way that we abide by schedules.

At the very least, in the circumstances, it would seem to me appropriate that the vice-chairs would have been consulted, but even that didn't happen. And so, here we are: members spread out across the country having to completely rearrange our schedules to deal with what is one of the most complex and important issues before Parliament.

I think the point of privilege raised by Ms. Findlay needs to be dealt with, and going forward I think there needs to be an assurance provided to all members that we will stick to the allotted schedule. If we simply stick to the allotted schedule, I think we will prevent these issues from arising.

We've had issues, as Mr. Moore noted, when the meeting went over schedule. I know that in part sometimes it was because of your effort to accommodate members; nonetheless, it creates issues.

Again, I hope that going forward we will abide by our schedules, and that with that understanding we can work in a collegial way—disagreeing when necessary, but having a level of respect that I think is so important if this committee is to function in a way that I think all Canadians hope it will as we deal with the very important issues that are before our committee.

Thank you, Madam Chair.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair.

An individual's ability to access MAID does not hinge on this particular amendment. This amendment, as I understand it, is to fill the legislative vacuum that is being created with this legislation. If we asked every member of this committee and everyone participating today to define someone whose death is reasonably foreseeable, we could get 32 different answers because this legislation doesn't get the job done. It's not precise. It's our job, wherever we're able, to provide precise direction, especially on a piece of legislation that is literally dealing with life or death.

Bill C-7 opens up Canada's assisted dying regime. Originally, under C-14, someone's death had to be reasonably foreseeable. Bill C-7 says that, no, your death does not have to be reasonably foreseeable in order to access MAID. This means that someone who is not dying, as we may think of, someone who may have 10, 15, 20, 30 years to live, is eligible to receive MAID under Bill C-7.

It is incumbent upon us, I believe, to try to be a bit more precise. We've seen scenarios where someone is given six months to live, two years to live. That happens all the time. These are the calls that doctors make. I don't accept that saying 12 months is somehow making any more difficult a situation than just throwing something up against the wall, which is what we're doing with reasonable foreseeability—no one knows what that means. In a country of over 30 million people, with doctors in all of our provinces and territories with decisions that have to be made that are literally life and death, we're saying, “We don't know what to say. You guys figure it out.” We could have grave inconsistencies throughout the country when it comes to which track someone would be on with regard to assisted dying. There are different safeguards on different tracks, so it matters whether someone's death is reasonably foreseeable or not as to which track they fall into.

I think this is a reasonable amendment. I think it enables us to do our job as legislators to have a bit more precision—quite a bit more precision—in the legislation that we're dealing with. It's for that reason that I will be supporting this amendment to define “reasonably foreseeable” as 12 months. I listened to the testimony as members did, Madam Chair. I've seen some of the submissions. There is no definition of what reasonable foreseeability is, and that, in my view, is not acceptable. It's for those reasons that I will be supporting this amendment.

Thank you.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair.

I want to echo the points Mr. Cooper just made.

Mr. Garrison mentioned or, I guess, presupposed how some future court may look at this. It's a reminder of how we came to be in this situation in the first place, when the court decision, the Truchon decision, significantly changed what was a brand new piece of legislation, which was Bill C-14. It was less than five years old and hadn't even had its first review. That decision said that someone no longer needed to be in a situation in which death was reasonably foreseeable. The government, rather than appealing the decision, instead immediately dropped any efforts to defend its own legislation and then introduced Bill C-7.

I don't think the consultation with the disability community, with persons living with disabilities, has been robust enough. I say that based on the four days of testimony we had. On one particular day, a number of the groups represented spoke for Canadians who are living with disabilities. As Mr. Cooper just put it, we have an obligation and we have international obligations to do the right thing. The message we heard back is that people are going to be put in a position based only on their being a person living with disability, which puts them at a disadvantage compared to everyone else.

I think quite the opposite. Unfortunately, this bill singles this group out. We've been hearing that loud and clear, if members of the committee have been getting the same correspondence I've been getting, from groups from coast to coast, local groups as well as national groups, representing Canadians living with disabilities, who find some of these amendments to be an affront to them as Canadians who are seeking to be wholly involved with all that our country has to offer.

That's why I think we have an opportunity here. I'm just asking members of the committee to really think openly about what we heard and about what Mr. Manly has very thoughtfully put forward. I'm reading every word of his amendment, and to me it speaks exactly to “deprivation, social disadvantage, lack of support or perceived discrimination”. What this amendment is saying is that the decision to receive assisted dying cannot be the result of one of those conditions. How can we as committee members in good conscience not support an amendment that responds so directly to the testimony we heard and that provides an element of safety? We're going to get to other amendments later that were.... While Bill C-14 had protections in place for Canadians under our assisted dying regime, some of those protections are being pulled out with Bill C-7.

I think this amendment is a thoughtful way of saying, “We're listening and we're acting cautiously. We're proceeding with caution and we, above all, are going to take every step necessary to protect the rights and the ability of persons living with disability to be fully engaged in our society.” I know committee members heard what I heard: that this bill is in danger of really hurting a lot of Canadians living with disability and how they see themselves as participants in Canadian society.

I think this amendment, if we could all support it, Madam Chair, would go a long way to saying that we heard and that we were listening when they took the time to appear before us as witnesses.

[Philippe Méla]

Thank you, Madam Chair and Mr. Moore.

CPC-1 basically adds to proposed new section 241.5, which is described in CPC-10 on page 19 of the package.

As you point out, it basically criminalizes the activity of compelling health professionals to provide medical assistance in dying. The bill does not create a criminal regime. Unlike Bill C-14, which was creating a new criminal regime for all sorts of activities related to medical assistance in dying, Bill C-7 doesn't do that. Therefore, the amendment would go beyond the scope of what the bill does.

[Rob Moore, Conservative, Fundy Royal, NB]

Yes, it's on the amendment, Madam Chair.

My concern with this is that, in fact, this has everything to do with palliative care. The testimony we heard on the bill at committee certainly was that the quality of palliative care can have a direct impact on a person's approach to assisted dying.

Witnesses told us about a number of factors that go into that decision. Palliative care was certainly front and centre as a significant factor. In fact, when we talk about a person's choice to pursue assisted dying or not, it was presented to us that it's not a true choice if a person does not have access to palliative care, so I'd disagree.

I think this particular provision amends the Criminal Code. That was what was required when we brought in Bill C-14, and indeed in Bill C-7. It was required that some provisions in the Criminal Code be amended when it comes to counselling someone. The legislation touches on any number of factors dealing with consultation and dealing with the expertise of individual physicians.

It's quite clear to me that this particular amendment should be ruled in order.

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

Thank you for that, Madam Chair.

My understanding is that when we go back in the medical assistance in dying regime to when we enacted Bill C-14, we find there was a subsection added to the Criminal Code. We added subsection 241(5.1) to section 241, and that sets out the offences of counselling and aiding a person to die by suicide. We did that under Bill C-14 in 2016. What that subsection does is clarify that it's not an offence for various health care practitioners, including some who cannot provide MAID, such as social workers, to provide information to a person about the lawful provision of MAID. This amendment seeks to specify that no offence is committed when such information is provided to a person who didn't ask for that information in the first instance.

What I understood is that because Bill C-7 doesn't propose to amend section 241 of the code, as such it is likely outside the scope of the bill. That is, I think, what you were driving at with your ruling. However, given that your ruling has been overturned by the members of the committee, I'm happy to debate the substance of it.

Welcome to the Department of Justice officials and the Department of Health officials. I'll make some submissions, but I'll also invite the lawyers from the Department of Justice to opine on it as well.

The first point is simply that we all understand the important work that all of the practitioners are doing, be they nurses or physicians. That should be stated on the record. We appreciated the submissions from the Canadian Nurses Association in that regard. Medical regulators or colleges are the ones to turn to when reconciling the competing interests from a medical practice point of view. That's the first point.

However, here we're dealing with the criminal law, and that's what Bill C-7 is all about. From my perspective, there's currently no current problem to address because when you trigger the criminal law, it's not actually the providing of information but the intention of the person who is doing the providing that is at issue. Merely providing information about MAID one way or the other doesn't amount to counselling or abetting somebody to die by suicide. Counselling or abetting somebody to die by suicide requires an intention to encourage or persuade someone to die by suicide or MAID, whether or not they actually carry it out, which is important. Whether or not a patient requested information about MAID is not directly relevant to the guilt or innocence of somebody who provides that information. The intention of the person who provides the information is the critical factor.

On that basis, I don't think this amendment is addressing an issue that arises properly under the scope of the criminal law as it is currently constituted, because it is about the action of the individual as opposed to the intent of the individual. The intent of the individual is also critical to the evaluation of the crime, if a crime is deemed to have been committed, and that crime can be committed independently of whether the person actually passes or not.

Those would be my perspectives. I'm wondering if Ms. Klineberg or Ms. Quesnel might want to weigh in on this from a departmental perspective.