This bill was last introduced in the 42nd Parliament, 1st Session, which ended in September 2019.
Jody Wilson-Raybould Liberal
This bill has received Royal Assent and is now law.
This is from the published bill. The Library of Parliament often publishes better independent summaries.
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.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.
Daniel Blaikie NDP Elmwood—Transcona, MB
Madam Speaker, it is kind of funny to hear government members say that palliative care is a priority for them considering that there is nothing for palliative care in the budget.
Can my esteemed colleague help us figure out what is going on?
Robert Aubin NDP Trois-Rivières, QC
Madam Speaker, I thank my colleague for his question. Unfortunately, my response will sound a little partisan, which is what I hoped to avoid on this issue.
That is the kind of response the government has been offering up since coming to power six months ago. The government members went on and on about middle-class tax cuts, but the cuts will not help anyone who earns $45,000 or less. Those people are still not part of the middle class.
They say one thing but do another. What do people remember? Actions. During the election campaign, the Liberals promised to invest $3 billion in home care, which includes many different services. I am sure some of that money could have been allocated to palliative care and incorporated into this bill.
Of the $3 billion that was promised, not a penny showed up in the latest budget for any kind of home care. They seem to have postponed this important element. We have an aging population in Canada and Quebec, and we need to tackle these crucial issues.
Judy Sgro Liberal Humber River—Black Creek, ON
Madam Speaker, I cannot say I am pleased to join this discussion, because I think it is an issue that is very difficult for all of us as parliamentarians, as Canadians, to deal with these very sensitive issues. However, I do want to begin by thanking the constituents of Humber River—Black Creek where many took the time to call or to write my office on the issue, or come by to see me, many in tears, talking and relating to episodes within their own family and their worries about what Bill C-14 would actually mean. As always, I appreciate my constituents' thoughts and the fact that they have taken an active role in what happens here because they understand that the debate here is going to impact on many of their lives.
As might be expected, the issue of medical assistance in dying is one that is difficult for many. The question is deeply personal, emotional, and even spiritual, and I understand and appreciate the concerns and challenges many have with the subject matter before us.
I, too, have struggled with these decisions, as have others. For example, I was deeply concerned when I was first confronted with the report of the Special Joint Committee on Physician-Assisted Dying. In particular, one of the areas I was concerned about was the idea that minors might be able to attain medical assistance in dying. I was also concerned with the notion that doctors who, for legitimate issues of faith or conscience, oppose medical assistance in dying might be forced to participate in this process contrary to their personal beliefs. Both of these things would have made the bill clearly unacceptable to me.
Fortunately, Bill C-14 attempts to address these issues by seeking to find a balance in this legislation, the best approach to ensure that dying patients who are suffering unbearable pain have the choice of a peaceful death and that the vulnerable are protected. I still question whether we have done the very best job we could do. I know the committee worked very hard at this and spent many hours listening to people. I guess I am still looking to see if we can make it better. However, I have to acknowledge the extremely tight timelines we are under, and the House must contend with those deadlines or we will have no protection for anyone.
The Supreme Court decision and the parliamentary timelines over the past year have combined to thrust us into this time crunch that none of us would have preferred to be in. This does not change the fact that we are here now. Nor does it change the fact that the defeat of Bill C-14 would mean the current prohibition on medical assistance in dying would end. The fact is that the Supreme Court unanimously decided that Canadians suffering intolerably have the right to request assistance to end their suffering.
The issue before us is not if, but how, we do this. This is not a political issue for me, and I do not believe it is a political issue for anyone in the House. Like my colleagues, I have looked at this matter as a person, a daughter, a mother, a grandmother, and someone who has watched many friends grapple with the complex, costly, and emotional challenges connected with terminal illness.
Palliative care, parental leave, family leave, and home care, while not directly contained in Bill C-14, must be part of the discussion, and they are. As I listen to the debate, it is clear that the matter is one that members are contemplating in a holistic way. I am pleased to hear again as part of the debate on this legislation that the government is committed to supporting quality end-of-life services and will continue to work with provinces and territories to improve palliative care for everyone. That means we will engage with the provinces and territories to support the development of a pan-Canadian monitoring system to collect and analyze data, monitor trends, and publicly report on medical assistance in dying. This helps to assure us that the government's approach is one of caution, one that is seeking a balance.
I also need to acknowledge the parliamentary secretary's verification that the government will work with the provinces and territories to explore mechanisms to coordinate end-of-life care for patients who want access to medical assistance in dying, while respecting the personal convictions of health care providers.
This is important because it would ensure that the concerns raised by many within the medical community would be addressed.
I mention this for a key reason. Canadians want religious freedoms to be protected for all Canadians, including doctors. Canadians also expect their government to respect and defend the Charter of Rights and Freedoms. Bill C-14 would attempt to do this while putting safeguards in place to protect the vulnerable as well.
Again, the Supreme Court of Canada unanimously decided that Canadians who are suffering have the right to medical assistance in dying. This means that the issue before us again is not if but how. After extensive consultation and extensive work by the committee, the government is proposing a framework that considers different interests, including personal autonomy toward the end of life, the protection of vulnerable persons, and the rights of conscience.
Access to medical assistance in dying, as envisioned under Bill C-14, would be available only to those who meet these conditions: mentally competent adults who are in an advanced state of irreversible decline in capability; who have a serious and incurable illness, disease, or disability and are experiencing enduring and intolerable suffering caused by their medical condition; and who have deaths that have become reasonably foreseeable, taking into account their condition.
For me, this is not just a discussion about the extension of life, nor should it be exclusively a decision about prolonging one's death. In instances where the end of life is near, the court has spoken and Parliament must now step up. If we fail to take action, we know the consequences, so doing nothing is not appropriate.
In order for me to support Bill C-14, I need to be assured of the government's firm and unwavering understanding that it will continue to support quality end-of-life services and will work with provinces and territories to improve palliative care. Again, end-of-life care is not just about medical assistance; it is about so many other things.
We have to remember Dr. Low in Toronto and his appeal by video to end his own life. We remember Sue Rodriguez. We remember all of those. Do I have a right to decide who dies and who lives, or that someone should endure the kind of pain that many are suffering? What would I do if my husband had ALS and begged me to end his life because he could not stand the pain? Do I have the right to say no? However, I also believe that it is God's right to call us all.
Bill C-14 is attempting to deal with a very difficult issue for all of us and for Canadians. Let us get it to committee. Let us see if we can make it stronger and make it better so that we are putting the emphasis on the palliative care and on the kinds of drugs that would eliminate the pain and make people more comfortable, so that none of us will have to make that decision.
Mark Warawa Conservative Langley—Aldergrove, BC
Madam Speaker, I listened intently and I want to thank the member for her speech. She brought up Dr. Don Low who was a microbiologist who died from brain-stem cancer. She mentioned his suffering. In fact, he was not in pain and he died in the arms of his wife eight days after making that video. However, he would have qualified because he was at end of life. He was not physically suffering, but he was suffering and when we asked what was the suffering, it was that he had lost control of bodily functions.
We heard last night at the justice committee that somebody who is in an adult diaper who is suffering dementia is seen as somebody in a pitiful state. My mother-in-law, a wonderful person, had dementia and was in a similar state but I did not see her as pitiful. Would the member see somebody who has dementia and is in an adult diaper as suffering and being in a pitiful state?
Judy Sgro Liberal Humber River—Black Creek, ON
Madam Speaker, they might be in a pitiful state. However, that does not mean that one would end their lives because they are in a pitiful state. In our eyes, there are a lot of people who are in a pitiful state when we look at them. However, nobody says that they necessarily want to end their lives. We may not like to see them suffering and reduced to a pitiful state, as the member called it, but they do not necessarily see that. Therefore, what we are trying to do is find that balance.
I hate the idea that anyone would be in such pain that they would ask to have his or her life ended. I would like to make that person as comfortable as possible and help him or her in every way we humanly can. I do not want to see a whole lot of people saying that their lives are miserable and that they want to end them. There are a bunch of conditions in Bill C-14. They would have to get two opinions. There is a whole list of things. Therefore, it would not be done casually. However, it is all in the eye of the beholder.
I do not want to make this easy, and I do not think Bill C-14 does that. It is trying find a balance that is fair for people to be able to make a decision if they are in a horrific situation. My seatmate may be in that situation.
What would the member say if he was asked and the person fit the conditions? I am not sure.
Sheri Benson NDP Saskatoon West, SK
Madam Speaker, I want to thank my hon. colleague for her comments and her openness to look at and share the fact that we do need to move forward on the how, and that the government needs to be open to amendments and ensure that what we find at the end is compliant with the case so that people can move forward in a good and positive way.
The member also commented on people sharing their beliefs and views. Of course, I have had those in my office as well.
One thing that is important to me, and I would welcome her comments on, is including provisions to protect health care providers. For many people it is a faith-based decision. We need to protect their rights and ensure that this is included in the bill so that those folks, and the people who are supporting them, feel comforted that it is there and their rights are protected.
Judy Sgro Liberal Humber River—Black Creek, ON
Madam Speaker, certainly a fundamental part of the bill is rights and freedoms for everyone, including those in the medical profession who would be asked to assist people who qualified under the conditions of Bill C-14; with respect to those aspects of it they would have to be. However, they have rights to be protected as well, and the bill has to ensure that it is protecting the rights of our medical professionals.
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.
Kevin Sorenson Conservative Battle River—Crowfoot, AB
Madam Speaker, it is always a pleasure to stand in the House to debate the issues of the day, although this is not one that I would have ever chosen to debate in the House. It has been debated before a number of times. Each time it was defeated, and each time it brought me a certain degree of relief when it was.
I want to thank the many constituents of Battle River—Crowfoot who have contacted me about the issue of doctor-assisted suicide. This issue has been raised a number of times, as I said, and every time my constituents have been very vocal in their opposition to making assisted suicide available.
There are some who disagree and are willing to support efforts to make assisted dying available in very limited circumstances, but the vast majority of my constituents in Battle River—Crowfoot, and, I dare say, most Canadians, do not want to unleash doctor-assisted suicide on our country. Why? It is because we have seen what has happened, to be quite frank, in other countries, how it started, and where it is now. I am not sure if we are going down any different road.
One of constituents from Bashaw, Alberta, sent me a letter and a paragraph in that letter sums up how things seem to be going. I will quote what was said. The letter states:
We want students to make responsible decisions for themselves about all manner of things from sexual activity to career choices to not inflicting self-harm. At the same time, we tell them they are only advanced animals with no eternal purpose. On the reserves, especially, we talk about our respect for the Elders and then as a broader society we discuss how we can help our elders kill themselves. We encourage youth to stay away from drugs and excessive alcohol consumption. Then we discuss how to legalize marijuana.
Here we are today with the Liberal government forcing us to pass a law that would legalize doctor-assisted suicide. We should be talking in the House about palliative care and end-of-life treatment. Did we hear that or see a line item in the budget? No, not a mention.
We should be providing funding to improve and provide palliative care to our aging population in our cities and rural communities. The previous Conservative government started the consultation. After the Carter decision, many submissions were made by Canadians. It is a difficult issue in households across Canada for families who face this and confront the issue. It is a very controversial and highly emotional issue.
Many Canadians believe that the Supreme Court's decision in the Carter v. Canada case is another instance of judicial activism. That was stated in many of the letters received by my constituency office. The court struck down the criminal laws against physician-assisted dying. Many Canadians supported the laws against doctor-assisted suicide. There was a very small group asking for this, the smallest of minorities, but the Supreme Court gave these special interest groups what they wanted.
I believe the Liberal government has shirked its responsibility to educate Canadians on what we are debating. There has not been enough consultations with individuals, groups, and experts. Even today, in the midst of this debate, which has been a good debate, the Liberals tried to shut down the debate. The Liberals have not taken into account a range of interests in Bill C-14, such as those advocating religious freedom. The previous speaker talked about the conscience rights of physicians and health providers and many are advocating for safeguards to protect the vulnerable. This bill is not a compassionate approach that considers all pertinent interests.
I do not believe the Special Joint Committee on Physician-Assisted Dying did a sufficient study. Quebec studied this issue for six years. Other countries studied it for years. However, the court has given Canada only a matter of weeks of study. The committee did not study what happened in other jurisdictions where we have seen this brought forward. The special joint committee heard from pro-euthanasia lobby groups. It had some of the pro-euthanasia groups appear on three separate panels.
Kevin Sorenson Conservative Battle River—Crowfoot, AB
Madam Speaker, three times pro-doctor-assisted suicide groups testified, but the committee did not hear from any anti-euthanasia advocacy groups.
Now the government is telling us that the justice committee, during its hearings, will allow amendments. The Liberals say that the committee can make amendments and better define things like conscience rights, or what happens when a doctor refuses to assist a person to commit suicide. The committee may look at the term “reasonable foreseeable death” or the issue of advance consent. However, I have no faith in the Liberal-dominated committee that will hear Bill C-14.
Today the Liberals are in a hurry to pass the bill and send it to committee. I have served and chaired many committees, I have seen how witness lists have been tightly controlled. I do not believe the views of average Canadians will be heard at this committee. I do not believe the religious community in Canada will even be given the chance to testify. I think we will see a Liberal-dominated committee that will turn down all amendments that might change the bill.
We already saw that at the previous special joint committee. That is why the official opposition had to table a dissenting report to the conclusions of the committee. We listed the problems that must be addressed. I am thankful for some of those issues being addressed in Bill C-14.
There is a void in Canada, and elsewhere for that matter, on behalf of people who do not ever deal with death and dying on a day-to-day basis. Many are in absolute fear of dying. It is the great unknown. There is a chance there will be unbearable pain and suffering, many people believe. We do not know.
Palliative care experts tell us that it is possible to find balance in the human body. The human body is very good at shutting itself down, and palliative care is all about assisting each individual in that process compassionately.
My daughter and wife both serve as nurses. They have been at the bedsides of those who are dying and have compassionately cared for them, making certain that pain is addressed, or that there is very little pain in some cases.
The provinces will decide certain questions on the bill. Health services are, as we know, a provincial jurisdiction. The government knows this and it is trying to wash its hands of some of that issue. In fact, the Liberal government knows there are going to be many problems within the bill when we move forward to the next level and try to get unanimity among all the provinces and territories.
The government has already said that it will continue to study the issues of doctor-assisted suicide. Some have said that we will continue to study the issue around mature minors. Will they someday be able to receive assisted suicide, or people with mental illness? The government is going to study that as well as advance requests.
We know we live in a time where there is a slippery slope. Here we are debating Bill C-14. Most of us think those are the parameters today, but what will they be tomorrow? If it is a right today for some people to have doctor-assisted suicide, why is it not then a right for someone else? How long do we think it will before the courts take that one on and change what we may very well want to implement here today? I think it is a concern for people on both sides of the House. It is not good enough, so we need to do some of this work before we talk about the many other things.
There are a couple of areas of concern with the bill that need to be addressed at committee. Canadians need to be certain that physician-assisted dying is limited to competent adult persons 18 years of age and older. We need to ensure safeguards for vulnerable persons and confirm their capacity to make decisions about their life or being killed. We need conscience protections for physicians, and this is the big one.
We need conscience protections for physicians, nurses and other medical practitioners who oppose physician-assisted dying. Once Bill C-14 is passed into law, without conscience protections, euthanasia and assisted suicide will enter the standard of care.
I should have spoken more quickly, because I have about five more pages. It is a heartfelt issue. I believe in the sanctity of life.
Bob Bratina Liberal Hamilton East—Stoney Creek, ON
Madam Speaker, I want to assure my colleague across the way that in our group, we have taken all of these concerns to heart.
I heard a lot in the discussion about political motives. We do not have any political motives other than having to answer the Supreme Court's request that we present a bill by June 6. One should not be predicting what the outcome of a committee will be. We are approaching this, I believe, in a fair, honest, and principled way.
The question I have is as follows. What is it, so far, in the bill that says we are making someone do something they do not want to do? Is there something in the bill that sounds like we are making someone do something that they do not want to do, whether it is to take some sort of medicine to end their life or to provide the service?
Kevin Sorenson Conservative Battle River—Crowfoot, AB
Madam Speaker, I do not think I talked about the motives of the government a lot in my speech. We all understand the government is doing this because the Supreme Court made a decision and directed us to do it. I am not saying there are certain political motives. Forgive me, if it came across that way. I certainly did not mean to say that.
However, I am skeptical. I am very pleased when I hear the member say that he believes in good faith that amendments will be taken at committee, and that in good faith we will hear from all different types of witnesses. To be honest, I have seen in the past where it has been shut down. We saw it in the joint committee. It was a very narrow group of witnesses to which the committee was able to listen.
On the member's other question, which was—
The Assistant Deputy Speaker NDP Carol Hughes
We do have to get to another question. Questions and comments, the hon. member for Essex.
Tracey Ramsey NDP Essex, ON
Madam Speaker, this issue is something with which all of us are grappling, those who live in our riding, our family members, and friends.
The member mentioned palliative care and the fact that there was absolutely no money allocated for it in the budget. I believe a strong palliative care goes hand-in-hand with this bill.
Could the member speak to the ways that a commitment from the Liberal government could ensure that people have the option of palliative care when they are at the end of their life?