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

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, we have been debating this bill for quite some time. The simple response is that we want this healthy debate to continue for the next period of time, however, we also want to see this move on to the work the committee needs to get done.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Mr. Speaker, if I understand correctly, the motion is that the question be now put. I want to know if there are specific concerns because we had agreed to continue the debate this evening and tomorrow evening. What changed?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I thank my colleague for the question.

This does not mean that the debate cannot continue. We are even prepared to sit this evening into the wee hours of the morning to ensure that every member of the House has the time to debate this subject that is so very important to everyone.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, that does not seem very clear to me as a way to operate.

First, none of the leaders was notified. I do not see why the government is suddenly moving the previous question when according to the motion moved by the parliamentary assistant, we expected to debate the bill tonight until midnight and tomorrow.

If this changes nothing, why is this motion being moved like this, without warning? I would like to say that there are already many members who cannot speak in the House, including those in my party. So far, I have had only 10 minutes of speaking time in total on behalf of my party. I do not see why the government is moving the previous question this afternoon, without telling anyone.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I thank the hon. member for his question and his comments.

Once again, all of us in the House recognize that the time and the issue being debated are very sensitive. We have until June 6 to act. That is why we want to give every hon. member in the House the opportunity to debate this bill. We also want to make sure that the bill is studied in committee. That is very important to moving the bill along.

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

Mr. Speaker, I am wondering if the member could confirm the realization that the Supreme Court of Canada decision, which was unanimous, said that we have to have the legislation in place by June 6. Members are going to be able to continue to debate this. There are still discussions and negotiations taking place to facilitate more debate, and we are anxious to see that. However, it is important to recognize that the bill has to get through the committee stage and ultimately to the Senate.

I would hope the member would agree that a responsible government would ensure there is timely passage of this bill, because we are talking about a unanimous decision that was made by the Supreme Court of Canada, and it has to be dealt with by June 6.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I thank the hon. member for his question and his comments.

That is basically it. Once again, we want to make sure that every hon. member in the House will have an opportunity to debate this bill. However, we are all aware that we need to move to the committee stage because we want the bill to be passed.

[Peter Kent, Conservative, Thornhill, ON]

Mr. Speaker, I must say despite the justification offered by the House leader and the hon. member, this is an extraordinary disruption, even though members were assured that debate would continue. As the member should know, the justice committee is now in extended sittings, from early morning to late night, and is still hearing witnesses. Expediting this bill now, changing the schedule now, is not going to change the course or the receptiveness of the committee to consider what eventually we send to committee.

I think this is extraordinary and bizarre in that it is normally the business of the House leaders to confer in the normal business of Parliament while debate continues, as the government assured us it would. We are still wondering why the member has taken this side track in the midst of debate.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, once again, we want to encourage a healthy debate in the House and ensure that all members have the right and the opportunity to speak to this bill. We want to ensure that the bill goes to committee since we have a deadline to meet.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Mr. Speaker, I did not mean to start off my remarks by commenting on this situation of closing debate and calling the question, but this is an absolute shambles, and is making a mockery of what is supposed to be an important debate among members. Most of us have the right to have a free vote on this issue. The Liberals are making a mockery of this place, and I for one am not impressed at all.

To get back to the topic at hand, it is important that we have meaningful debate on this issue. I want to participate on behalf of me and my constituents, and I am sure there are many other members of Parliament who want to do the same thing.

This is very important legislation for our country, and of course members of our Conservative caucus have been very active in the run-up to this debate. We have had some serious reservations leading up to how this bill was to be written. Those reservations were expressed in a dissenting report from the special joint committee that studied the subject. Now, many of us are relieved that the legislation echoed some of the recommendations included in the dissenting report, such as certain limits on minors, and of course, many of us do believe there has to be, according to the Supreme Court ruling, some provision in our law for dying with dignity. However, we do have some concerns, and I am going to express my own, regarding aspects of this bill.

Unfortunately, this bill opens the door to assisted suicide for people with mental health problems, and that worries us.

This bill includes a provision for psychological suffering. This would open a large door. I am worried about how this would apply to the mentally ill. How would this be applied in reality? Are we going down some slippery slope by including this provision for psychological suffering? I am sure there will be an approach to amend this particular section, but right now the amendment to the Criminal Code would add that illness, disease or disability, or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable. This is the concerning provision, and I echo my other colleagues who have raised this issue as well.

Quebec has come up with its own legislation on assistance in dying. In Quebec's law, only people aged 18 and over with a serious and incurable illness who are in an advanced state of irreversible decline in capability can request medical aid in dying.

The attending physician must ensure that his or her patient has clearly consented to physician-assisted dying, ensuring among other things that it is not the result of external pressure, providing the patient with a full prognosis on the condition and possible treatment options along with likely consequences. The physician, under Quebec law, must also ensure the continuation of consent with interviews with the patient held at different times, spaced by a reasonable time having regard to the patient's condition. I would say that these are appropriate safeguards in the Quebec law. I would like to see similar safeguards in the Canadian law.

Another concern to us is in relation to the rights of conscience of physicians and health institutions.

We are very concerned about the conscience rights of medical personnel.

As mentioned in the dissenting report, section 2 of the Canadian Charter of Rights and Freedoms guarantees all Canadians freedom of conscience and religion. The dissenting report clearly states that there was near unanimous agreement among the witnesses that physicians who objected to taking part in physician-assisted dying for reasons of conscience should not be forced to do so. Although not obliged directly by this legislation to provide PAD, physician-assisted dying, the obligation to refer patients through an effective referral infringes on the spirit, and I would say the letter, of section 2 of the charter. I therefore believe that such a regime is unnecessary and note that Canada would be the first jurisdiction in the world to require an effective referral regime.

I believe there are better models that would protect the charter rights of physicians and provide access to physician-assisted dying, but under this legislation, physicians who conscientiously object to physician-assisted dying are required to provide information to their patients on how to access PAD and to advise the government of his or her patient's request. I believe this is unfair to the physician and this legislation does not sufficiently protect physicians' rights. I also believe that health care institutions that object to offering physician-assisted dying and related services should be exempted in accordance with the Supreme Court's determination that individual collective aspects of freedom of religion and conscience guaranteed under the charter are indissolubly intertwined.

In my home province of Ontario, the current policy of the College of Physicians and Surgeons is that it is a requirement not only to refer, but also to provide services that are within the standard of care of an emergency situation. Therefore, passing this legislation without conscience protection would mean that PAD would enter the standard of care and would fit within the existing policy framework of the College of Physicians and Surgeons in Ontario. It means that in my jurisdiction, there would be an effective right to force the physician to be part of this process even when she or he does not want to be part of the process. This is a major and grave concern to me and to physicians in my constituency as well.

The other issue that should concern us is whether this legislation respects the Carter decision and would it survive a charter challenge. I would say there is sufficient and grave cause to understand that this may not be the case. I would put it to my hon. colleagues, if we cannot pass legislation that could survive a charter challenge, why are we going through this process in the first place? Again, it makes a mockery of the situation.

I am hopeful that the government, as the bill moves forward, would accept amendments to ensure that everyone's charter rights are respected whether they be physicians or medical personnel, and that the charter rights of vulnerable persons be respected as well. We owe it to Canadians to get this right the first time, to protect the conscience rights of physicians and health professionals while respecting the parameters of the Carter decision.

Canadians expect us to work hard and do this right.

I want to acknowledge that the other point raised by my colleagues is a good one. Where is the palliative care money, the $3 billion in funding for palliative care? There is no mention of it in the budget. As they say sometimes in politics as in life, the devil is in the details. Where is the funding going to come from? How is it going to be allocated? It is absolutely imperative the government take decisive action on palliative care.

That ends my comments on the bill, but I want to reiterate that the shenanigans that went on before I rose are absolutely unacceptable to free and democratic debate on an issue of conscience for many members of this House, for all members of this House. I object to the motion being put forward in the way that it was. I object to the process that is being put forward by the government as it tries to shut down debate of members who want to advance their positions and those of their constituents.

[Vance Badawey, Liberal, Niagara Centre, ON]

Mr. Speaker, innovative models across Canada are integrating palliative care approaches across the nation in a variety of settings, including the home, incorporating advance care planning, preparing more health care, including more providers to deliver palliative care, recognizing the importance of family and friend caregivers and their needs, along with other good practices throughout our great country.

Other than palliative care which the member mentioned at the end of his comments, what other services besides those that are being practised today throughout our nation would he recommend be put in place for this program?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Mr. Speaker, I thank the hon. member for his thoughtful question. Indeed, as a former provincial minister of health and federal minister of health, I think it is important that we find ways to integrate and coordinate our care for the individual. That is absolutely correct.

I would also, though, mention to the hon. member that in my consultations with those in the palliative care infrastructure in my riding, they were not exactly thrilled with the prospect that they would be associated with physician-assisted dying. They see themselves as a final resting place before death, as a place of hope, as a comfort place, rather than a place where this debate over physician-assisted dying would be the focus.

I think we have to be careful. I think we need more palliative care; however, we also need a process by which we get to the right conclusion and the right part of the health care system.

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

Mr. Speaker, I appreciate the comments from the hon. member for Parry Sound—Muskoka.

Perhaps the motion which was just moved is not to limit the debate and the comments coming from this side. Over the course of the debate and the discussion we have had over the last day and a bit, we have also heard some dissenting remarks from the government side, as well. Perhaps the motion is not just to stifle the debate on this side but also to stifle it within the government's own party.

I wonder if my hon. colleague feels the same.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Mr. Speaker, that same thought had crossed my mind. I was originally supposed to be speaking at 3:20 p.m. It is nowhere near that time now. The only conclusion I could come to is that hon. members on the Liberal side of the House were declining their speaking spots. Maybe there is some great dissension going on in the Liberal caucus right now over the bill, that all of a sudden the bill is not as popular as the manipulators on that side of the House thought it was going to be and now they want to shut down debate not only for those of us on this side of the House, but on their own side of the House as well. I find the whole thing outrageous.

The House resumed consideration of the motion that Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be read the second time and referred to a committee, and of the motion that this question be now put.