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.

Physician-Assisted Dying

[Justin Trudeau, Liberal, Prime Minister]

Mr. Speaker, what Canadians expect of this government is to make sure that we are both defending the rights and freedoms of Canadians while protecting the most vulnerable, and that is exactly the balance that we have struck with Bill C-14.

Throughout we have been open to amendments, including accepting amendments from opposition members. We look forward to hearing the deliberations that the Senate is carrying forward on this same piece of legislation.

We are ensuring that this big step that Canada is taking, despite people who think it goes too far and others who think it does not go far enough, is done the right way.

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, it is not just Quebec that is protesting. Peter Hogg, Canada's foremost constitutional scholar, today testified that Bill C-14 fails to respect the Carter decision and will undoubtedly be struck down as soon as it gets to court. He said that the government cannot turn around and exclude a group of people that the Supreme Court clearly ruled have these charter rights.

It is never too late for the government to do the right thing. Will the Liberals finally respect the charter and announce that they are willing to fix the bill?

[Justin Trudeau, Liberal, Prime Minister]

Mr. Speaker, as part of the debates on Bill C-14, we listened to many politicians from all the different parties share their views.

However, we did more than that. We listened to doctors and Canadians. We consulted the public at large, across the country, to ensure that this important and transformative measure regarding medical assistance in dying would be properly designed to uphold Canadians' rights and freedoms while protecting the most vulnerable.

That is the balance we have struck, and we are proud of it.

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

Mr. Speaker, the government had the chance to do things differently with Bill C-14, but it decided to ignore experts, not to work with the opposition, and to limit debate.

Warnings were coming in from all over. Quebec's health and social services minister called Bill C-14 unenforceable. He thinks that the notion of reasonably foreseeable death is medically unfeasible and he refuses to include it in Quebec's law.

Will the government finally realize that Bill C-14 must be amended?

[Justin Trudeau, Liberal, Prime Minister]

Mr. Speaker, if there was ever an example of the reforms that the Liberal Party made to the Senate over the past years removing partisanship and patronage from that place, there is no better example than the NDP highlighting the great work that the Senate is doing weighing in on an important piece of legislation.

I thank the hon. member for her comments about the excellent work done by the independent voices in the Senate, and I look forward to hearing what the Senate has to say about Bill C-14 when it returns to us.

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

Mr. Speaker, Senate Liberal leader James Cowan has now joined the growing number of Canadians saying that Bill C-14 is likely unconstitutional. Cowan said that this government legislation is so flawed that Canadians would be better off with no legislation at all. This bill does not respect the Supreme Court's decision, and it will be tied up in courts for years.

Instead of ramming through Bill C-14, will the government listen to James Cowan and work on getting the bill right the first time?

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

Mr. Speaker, with one more sitting day after today before the stay on the declaration of constitutional invalidity expires, it is now clear that the government cannot meet the June 6 deadline to pass Bill C-14. The Minister of Justice has rightly warned of a legal vacuum absent the legislation, and yet the minister could do something to stop that legal vacuum from arising, namely by applying to the Supreme Court for a short-term extension of the stay to allow time for Parliament to pass legislation. However, the minister has done nothing. She has been all talk and no action. As a result, on June 7, there will be no certainty for patients, no certainty for physicians, and no protections for the vulnerable.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, over the past several months, the Liberal government has refused to amend Bill C-14 legislation in order to provide adequate conscience protection for medical professionals and health care institutions.

They also voted against our opposition day motion that would have guaranteed these professionals their charter right freedom of conscience. Repeatedly we have heard the government indicate that we can count on provincial regulatory bodies to provide conscience protection. However, as we have seen, the Royal College of Physicians and Surgeons of Ontario and the College of Physicians and Surgeons of Saskatchewan have both indicated that there is an expectation on the part of their medical professionals to refer for the practice of physician-assisted suicide.

Enough is enough. Constituents in my riding have been crystal clear. This bill must include clear, ironclad conscience protections for health care professionals and institutions. I hope the Liberal government will listen to Canadians and do the right thing.

[Jamie Schmale, Conservative, Haliburton—Kawartha Lakes—Brock, ON]

In June, I think that was the goal. We wanted to deal with this hopefully before we rose by the end of June. I think it's quite upsetting. We gave her lots of notice. We gave her weeks in advance of the meeting. We meet for an hour. I don't think that's a whole lot of time. Bill C-14 is dealt with; it's through the House, anyway.

For her to give us an hour of her time on an issue the governing party feels is a priority to get off the plate, or on the plate, depending on if there's something there.... The fact that she has decided she can't meet before the end of June goes contradictory to what we've been talking about. Let's deal with this. Let's find out if there's something there, and if there is, let's deal with it and let's get through it as fast as possible.

To keep this on the agenda over and over again and drag this out.... Now it's going to go on through the summer, and we'll have to deal with it in September and October when we return. That we just can't find an hour is pretty disappointing, I think.

Air Canada Public Participation Act

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Madam Speaker, I am pleased to be here today for report stage of Bill C-10, an act to amend the Air Canada Public Participation Act and to provide for certain other measures.

Governments, and especially new governments, have to set priorities and decide what they want to achieve during the length of their mandate.

Each party campaigns on a platform that is expected to serve as a road map for its early days as a government. Over the course of the campaign, parties make dozens of commitments. Upon taking office, a government must decide which commitments it wants to prioritize. A government must make decisions on what it wants to do right away, what it will do in six months, in two years, and what it will never do. On occasion, the Supreme Court will force the government to introduce legislation, as has been the case with Bill C-7 and Bill C-14.

Other pieces of legislation, like the budget, are presented each year. Because new governments like to check items off of the list of fulfilled campaign commitments during the first year, we often see legislation that reflects their campaign commitments. However, Liberal campaign commitments, like restoring mail delivery, have been pushed back on the priority list with the promise of consultations. Additional funding for the CBC has been pushed down the list of priorities because of a lengthy consultation process. A response to VIA Rail's proposal to build a dedicated track between Toronto and Montreal will take three years due to consultations.

It took the Liberals seven months to create a committee to enact consultations on electoral reform that is effectively identical to every House of Commons committee, and whose recommendations will be both non-binding and, like the preferred option of the Prime Minister, a ranked ballot.

The Minister of Transport has decided to spend an entire year consulting on the recommendations of the Emerson report, which was itself the product of 18 months of consultations with the entire transportation industry.

On so many issues, the Liberal government has pushed back making a decision to a later date.

However, with Bill C-10, we have none of that. What we have is a bill that came out of nowhere and was not the product of any consultations. Why is the government being so inconsistent?

The Parliamentary Secretary to the Minister of Transport confirmed, during its second reading debate, that she was rushing this bill through so that the stakeholders could provide input during the committee stage. She was outsourcing her government's consultative responsibilities to committee. A parliamentary committee studying a bill is not a consultative body. Its purpose is to probe the bill for weaknesses and address these weaknesses through amendments if the majority of the members agree.

Witnesses at committee, including the Government of Quebec and the Government of Manitoba, highlighted a number of obvious weaknesses in the legislation. The opposition proposed amendments to address some of these problems. In the case of Bill C-10, the Liberal majority did not accept any of these amendments to the legislation.

If the purpose of sending the bill to committee so quickly was so that the stakeholders could provide input on the legislation, then why did the Liberal members ignore the recommendations? This illustrates more inconsistency on behalf of the government.

While all of us support a regulatory environment that allows for a viable legacy carrier in Canada and affordable air travel, I do not think a single Liberal candidate campaigned on reducing Air Canada's maintenance obligations as they are described in the Air Canada Public Participation Act.

Considering the government appears to be in no rush to do anything else, its incredible haste to get this legislation that came out of nowhere passed before the summer has opened up a Pandora's box of questions. By now most members are aware that in 2013 the Government of Quebec, with the Government of Manitoba as an intervenor, brought Air Canada to court to challenge the carrier's assertion that it was fulfilling its maintenance obligations under the Air Canada Public Participation Act. The Quebec Superior Court, presided over by Justice Castonguay, ruled on the side of the Attorney General of Quebec. Consequently, Air Canada appealed this decision to the Court of Appeal of Quebec, and that court upheld the lower court's ruling in November 2015. On January 5, 2016, Air Canada announced that it would challenge that ruling in front of the Supreme Court. Less than two months later, Air Canada began negotiating with Quebec and Manitoba to end litigation, starting with the signing of a letter of intent to purchase 45 C Series aircraft. Whether Air Canada decided it would lose its appeal in front of the Supreme Court or the Government of Canada prodded it to make a purchase of the at the time troubled C Series aircraft, the carrier started to propose real commitments to keep some of its overhaul maintenance work in Quebec and Manitoba.

As the Government of Quebec has recently placed over $1 billion U.S. into the C Series program, it was obviously pleased to see Air Canada make the first major purchase of the aircraft.

This point cannot be made clear enough. Air Canada was forced to negotiate a settlement with Quebec and Manitoba because the carrier lost in court.

What Air Canada has proposed to settle its lawsuit in the case of Quebec is the purchase of the C Series and a commitment to undertaking maintenance of these aircraft for 20 years in the province. Air Canada also proposed to create a centre of excellence in aircraft maintenance in Quebec. In the case of Manitoba, Air Canada announced a willingness to transfer about 150 jobs from other parts of the country to Winnipeg. It is worth noting that these are not new jobs, merely work that is being shuffled from one part of Canada to another.

These Air Canada commitments to do maintenance work on narrow body aircraft in Canada are good, but these are not listed in the act we are debating today. Air Canada is making these commitments because it lost in court on the Air Canada Public Participation Act.

The Provinces of Quebec and Manitoba understand that if the law is repealed, as is being proposed by the Liberals, then their negotiating position with Air Canada will be swept out from under them. That is why both provinces explicitly asked the Standing Committee on Transport, Infrastructure and Communities during the study of the bill to only allow this legislation to pass upon conclusion of their litigation against Air Canada. These calls came on deaf ears.

None of the Liberal members at the committee questioned the statements by Manitoba's deputy premier or Quebec's minister of the economy asking for more time, or attempted to justify the prompt passage of this legislation. The Minister of Transport's own officials also confirmed at committee that there was no legal or technical reason why speedy passage of the legislation was necessary.

Therefore, here we are. We have a bill in front of us that two provincial governments have asked for its coming into force to be delayed, and there are huge questions concerning why it is being rushed through Parliament so quickly ahead of the rest of the Liberal agenda.

We also have the problem that the Liberals are missing an important opportunity to make Air Canada and the entire aerospace sector annually more competitive. The Emerson report, which I mentioned earlier in my remarks, made a number of good suggestions that would stimulate the aerospace sector while maintaining jobs in Canada. For example, the government could tie all airport improvement fees to specific projects, explicit sunset provisions, which would ensure that these fees are to fund a specific project and not the airport's overall operations. They could look at overhauling the airport security model to mirror those used at major international airports, like London's Heathrow or Amsterdam's Schiphol, which have clear customer service standards and much lower delivery costs.

However, the bill does not do any of that, and we have not heard any indications from the Minister of Transport that measures to improve the competitiveness of the entire airline industry are forthcoming.

I look forward to questions from the government and opposition members.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Mr. Speaker, I am pleased to rise in the House to speak, perhaps for the last time, to Bill C-10, an act to amend the Air Canada Public Participation Act and to provide for certain other measures. There are very few other measures, as this is a small bill.

I will be sharing my time with the hon. member for Elgin—Middlesex—London. I am sure that her speech will be very good and that she will have a lot to say about Bill C-10.

We have had many opportunities to speak to Bill C-10 over the past few weeks. We had the opportunity to hear the government say all sorts of things about the importance of Bill C-10 and the need to act swiftly. However, when we asked for the real reasons behind the urgency, which led the government to adopt a time allocation motion for Bill C-10, we got no response. The government says one thing and does another or, in many cases, does nothing.

From the beginning our only question has remained unanswered. We really wanted a justification for the time allocation motion. Why the need to pass Bill C-10 now, when at the beginning of this Parliament there was no urgency?

We asked the question in the House during question period and also in committee. We never received a single sensible answer explaining why Bill C-10 had to be passed so quickly.

I searched books, history, and everywhere in order to understand how the government could justify adopting a time allocation motion for a bill like C-10. I finally found the answer. It is in the Liberal Party of Canada's DNA that I found the reason for the urgent need to take action on Bill C-10.

The government says that it is open and transparent. That can be found in the Speech from the Throne, which states:

...the Government is committed to open and transparent government. ...[the Government] will promote more open debate...it will not resort to devices like prorogation and omnibus bills to avoid scrutiny.

A time allocation motion is a device. We have had the opportunity to look at the budget bill, which is also an omnibus bill. The government says one thing and does another, or does nothing at all. That is what I discovered when I analyzed the process for Bill C-10, which has brought us here today.

The government has adopted a number of time allocation motions. I am thinking of Bill C-10, Bill C-14, Motion No. 6, and the electoral reform that the government wants to unilaterally impose using its majority. So much for openness and transparency.

With regard to Bill C-10, in just a few months, we have seen the government, for no real reason at all, decide to lose some of its credibility with the provinces. How? The government announced on a number of occasions that it wanted to usher in a new era of improved relations with the provinces.

In the throne speech, the government also said the following three times regarding three files:

To give Canadians a more secure retirement, the Government will work with the provinces and territories.... To create more opportunities for young Canadians...the Government will work with the provinces and territories.... And to support the health and well-being of all Canadians, the Government will begin work with the provinces and territories...

Those three excerpts from the throne speech show the government's willingness to work with the provinces and territories and its interest in doing so. However, the government says one thing and does another, or does nothing at all. We are seeing it again. We saw it yesterday. The government has said a number of times that it is listening to the provinces and wants to work with them.

Yesterday, the Quebec minister of health and social services spoke about another bill, Bill C-14. What did Mr. Barrette have to say about Bill C-14? He said that it was unenforceable and that, given the current context, he would be very careful about going forward with Bill C-14. He added that, personally, for professional and governmental reasons, he does not think it is a good idea to go forward with Bill C-14. Mr. Barrette is a minister in a province with which the government wants to build good relations. However, the government moved a time allocation motion on Bill C-14. The government is not letting members of Parliament speak about it.

I have other examples, but I do not have the time to share them all in four minutes. When Bill C-10 was first debated in committee, Minister Garneau talked about good relationships with the provinces in his speech:

In light of this development [Air Canada's commitment to creating centres of excellence], the Government of Quebec and Air Canada announced an agreement to discontinue the litigation...

Given all these positive developments, we believe this is the perfect time to modernize the Air Canada Public Participation Act...

Minister Garneau said that this was what the provinces wanted, but that is not true. I do not want to say that it is not true, but it is misleading. This may appear to be the case, but that is my interpretation.

Criminal Code

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, the hon. member urged us at the end of his speech to vote for Bill C-14. I would like to ask him if he could outline three good reasons why we should.

[Ramesh Sangha, Liberal, Brampton Centre, ON]

Mr. Speaker, it is a great pleasure for me to have this opportunity to share my ideas and opinions regarding Bill C-14 to amend the Criminal Code.

In a unanimous decision on February 6, 2015, the Supreme Court of Canada turned down the provision in the Criminal Code, giving Canadian adults who were mentally competent and suffering intolerably and enduringly the right to a doctor's help in dying.

The court suspended its ruling for 12 months, with a decision taking effect in 2016, giving the government enough time to amend its laws. In January 2016, the court granted an additional four-month extension to its ruling suspension.

Until now, it is a crime in Canada to assist another person in ending their own life. As a result, people who are grievously and irremediably ill cannot seek a physician's assistance in dying and may be condemned to a life of severe and intolerable suffering. A person facing this prospect has two options: they can take their own life prematurely, often by violent or dangerous means, or they can suffer until they die from natural causes. The choices are cruel.

This enactment would amend 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 criteria for eligibility, 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 further to, medical assistance in dying; provide information for the purpose of monitoring medical assistance in dying; 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 statues being affected.

We have reached to the final stage of debate in the House regarding the process, with hours of debate on Bill C-14.

The biggest thing during these debates was the sense of compassion with which the House heard from members debating for their individual constituents. That is the reason the bill touched the hearts of not only the members of the House, but also the hearts of Canadian from coast to coast to coast. Now, when the bill has reached to its final stage, I appreciate and congratulate every member for actively participating in building the most important and valuable laws on assisted dying and also the government for affording full opportunity to all members to be part and parcel of this delicate and important legislation.

I also appreciate the extensive hard work done by both the Minister of Health and the Minister of Justice and by the members of the Joint Standing Committee of the Senate and the House.

Being new to this legislative process, I was thrilled to watch yesterday's voting by the House on numerous motions. I saw members were in favour of few motions and were against on other motions. I realized the importance of these motions on assisted dying for the members of the House. That is the way of members use their choices out of their own conscience and the will their constituents. I realized the real sense of democracy and a true parliamentary decision process being adopted.

This enactment to amend the existing Criminal Code is an important step and is auxiliary to new enactment regarding medical assistance in dying. Being legislators, it is our duty to see that medical service providers and other persons who provide assistance in medically assisted dying are legally safe.

As we all know, this is a first major revolutionary enactment. Going forward, there may be many ancillary issues cropping up. I and my Liberal caucus colleagues as well as many other members of the House are keen to see that bill should pass. I urge all members of the House to vote in favour of Bill C-14, an act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Mr. Speaker, I appreciate the hon. member's comments because I am one of those people who does champion not just palliative care but recommitting this country to universal health care access. We have all heard through assisted dying many stories from our constituents, who are very disconcerted. It is really scary for ordinary Canadians to read the text of a bill that could be passed tonight, and then to have almost platitudes, very ambiguous comforts about palliative care. That is where the problem is.

I do agree that it is very important, and I think maybe the hon. member misses my point that it should have been front-loaded. Those details should have come first, and then present the text for Bill C-14. That makes it that much easier for people to be able to accept. I know as recently as last week, I heard people who are heartbroken saying, “My father was in the hospital hallway for nine days before he passed away. What are you going to do about that? I don't want to hear any more about Bill C-14. What are you going to do about that?” My heart breaks.

It is not just that my heart breaks. I know now I have to show some federal leadership like all of us here. That needs to come first. It would be very easy for the current governing party to stand up with some real hard-core statements, not these ambiguous things that are meant to placate us and just sort of distract us from the issue.

Where is this money? Recommit to the Canada health accord. Enforce the Canada Health Act when it comes to home care. You could make three bold statements right now that would change the whole atmosphere of this. That has been missed and that is what is highly frustrating. When it comes to working with other jurisdictions, yes you have to take federal leadership that is strong and true, and strong—

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Mr. Speaker, as members are aware, Bill C-14 now goes to third reading, which gives the Senate two days to consider it before the June 6 deadline.

While I acknowledge the government's expressed desire to get the bill passed before the Supreme Court's June 6 deadline, I think most people agree that this is too important a piece of legislation to rush, especially considering that in its present form it is not likely to pass constitutional muster. On this, I second NDP justice critic, the member for Victoria, when he said, “I cannot accept passing a bill that I know to be unconstitutional”.

The key flaw of Bill C-14 is the end-of-life requirement of a reasonably foreseeable natural death. This is the part that conflicts with the Supreme Court, which did not require terminality or end of life, and therefore, according to the Carter decision, infringes on the charter rights of all those who have a grievous and irremediable condition that causes them intolerable suffering but who are not dying as a result.

The Canadian and Quebec bar associations, various other legal experts, and now the Alberta Court of Appeal, have said that this requirement conflicts with the Supreme Court. Medical groups do not like it either. The body that represents every provincial medical regulator has come out against the bill as being too vague for doctors to follow.

The NDP put forward a number of amendments that would have improved the bill tremendously. Had they not been rejected, the bill would likely have had a better shot at making it through the Senate.

We suggested removing the controversial end-of-life requirement, which is almost certainly unconstitutional, and replacing it with the exact words that the Supreme Court used in its decision. However, the Liberals rejected that.

Of more than 100 amendments moved, just 16 were accepted, and they were mostly minor technical clarifications. However, the NDP did manage to secure agreement on two amendments that were introduced and adopted unanimously, and that was clarifying conscience objection rights and adding a stronger commitment to palliative care.

As criticism grows against the bill, the government increasingly falls back on the excuse of a deadline imposed on us by the Supreme Court, which is not exactly true. The court said that it would give federal and provincial governments a year to put in place more complex regulatory regimes should they choose. On June 6, an exemption is opened in two Criminal Code offences for patients and physicians acting within the guidelines that the court set out in the Carter decision.

There is not a vacuum, and to be blunt, murder will not become legal, nor will medical aid in dying return to being illegal without a federal law in place.

Over the past year, every provincial medical regulator has developed guidelines for medical aid in dying that physicians must follow. These safeguards are very close to the safeguards proposed in Bill C-14. Federal leadership is necessary to ensure that access is equitable across Canada and to prevent a patchwork, but it is not strictly necessary to ensure basic access right now. Therefore, this final push to get the bill through the House is most unfortunate, and it is not the outcome we had hoped for.

The NDP worked long days in good faith with other parties, but it is better than passing a flawed bill, defying the Supreme Court, and infringing on the charter rights of suffering Canadians, which prompted this legislative response in the first place. For us, this is not a partisan issue. We have collaborated with all parties from the start on this and will continue that constructive approach, especially when it comes to championing the causes for our health care and palliative care.

We had a chance to get this bill right, but the government does not seem interested in listening at this point. It is important here to step back and reflect on how we got to where we are now.

In February 2015, a unanimous Supreme Court ruling established the charter-protected right of competent adult Canadians experiencing enduring and intolerable suffering as a result of grievous and irremediable medical conditions, including a disease, disability, or illness, to access medical assistance in dying. In February 2015, the Supreme Court unanimously decided in Carter v. Canada that Canadians who are suffering intolerably because of a grievous and irremediable medical condition have a charter-protected right to access medical assistance in dying.

The effect of the ruling was suspended until June 6, 2016. The reports of an interprovincial task force and a federal expert panel, as well as a wide array of witness testimony, were considered by a joint special committee of Parliament, resulting in 21 recommendations on a legislative response to Carter.

We succeeded in adding major actionable recommendations on palliative care to that report. This issue of palliative care is what, for myself, goes directly to what I object to most about Bill C-14 in its current state.

Should the government rush into a bill like Bill C-14 without also having a plan to shore up and extend palliative care? The answer is, of course, most emphatically no, it should not.

As noted in the recent report by the Canadian Cancer Society, “Right to Care: Palliative care for all Canadians”, there are gaps in palliative care across the country. As my colleague mentioned in her speech, it is very heart-wrenching to know some of the stats and facts about what is actually available right now in palliative care for Canadians.

It is an epic fail for the government to be putting forward a bill while at the same time ignoring the real tangible details that we need to give us confidence as we move forward in a future with medical-assisted dying. That was so insensitive.

About 45% of cancer patients die in acute care hospitals, even though most Canadians prefer to die at home. Not only are acute care settings more costly than dedicated palliative care, they are also not equipped to provide the most appropriate care to palliative care patients and their families.

Palliative care can increase the efficient use of our public health care dollars, but increased care outside of a hospital setting can place undue financial hardship on family caregivers. Health care costs tend to increase substantially in the months and weeks before death, due to increasing frailty and dependence on health care services.

We believe that the government should take a lead in providing appropriate funding for palliative care. Improving palliative care in all settings, including outside the hospital, should result in a more efficient use of health care dollars.

However, there will be upfront costs to facilitate change. Federal, provincial, and territorial governments should work together to establish a financing plan, and create a national palliative care transition fund to ensure the changes needed to improve palliative care in Canada can take place.

When I look at the latest version of Bill C-14, it states that:

...it commits to working with provinces, territories and civil society to facilitate access to palliative and end-of-life care, care and services for individuals living with Alzheimer’s and dementia, appropriate mental health supports and services and culturally and spiritually appropriate end-of-life care for Indigenous patients.

Now, it is all well and good, but precise commitments need to be made, and this bill is quite vague.

The only other time palliative care is mentioned in the bill is:

....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.

On the fifth year? To me, this seems to be way too far in the future. Canadians of all political persuasions and faiths, indeed, Canadians of goodwill everywhere deserve something more definite and concrete than a promise to review palliative care within five years.

This is all the more disappointing, given that the government could have addressed this issue in its recent first budget as it knew that we would soon be debating Bill C-14. However, as we know, not a single dollar was earmarked for palliative care measures. We should have fortified health care, palliative care, home care before we crafted Bill C-14. It would have alleviated our anxiety on what the future holds.