An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

This bill was last introduced in the 42nd Parliament, 1st Session, which ended in September 2019.

Sponsor

Status

This bill has received Royal Assent and is now law.

Summary

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.

Elsewhere

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.

Votes

June 16, 2016 Passed That a Message be sent to the Senate to acquaint their Honours that this House: agrees with the amendments numbered 1, 2(d), 2(e), 4, and 5 made by the Senate to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying); proposes that amendment 2(c)(i) be amended by replacing the text of the amendment with the following text “sistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.”; proposes that amendment 3 be amended in paragraph (b) by adding after the words “make regulations” the words “that he or she considers necessary”; respectfully disagrees with amendment 2(a) because requiring that a person who assists to be free from any material benefit arising from the patient's death would eliminate from participation the family members or friends most likely to be present at the patient's express wish, and this would violate patient autonomy in a fundamental and inacceptable manner; and respectfully disagrees with amendments 2(b), 2(c)(ii), and 2(c)(iii) because they would undermine objectives in Bill C-14 to recognize the significant and continuing public health issue of suicide, to guard against death being seen as a solution to all forms of suffering, and to counter negative perceptions about the quality of life of persons who are elderly, ill or disabled, and because the House is of the view that C-14 strikes the right balance for Canadians between protection of vulnerable individuals and choice for those whose medical circumstances cause enduring and intolerable suffering as they approach death.
June 16, 2016 Failed That the motion be amended by: ( a) deleting the paragraph commencing with the words “respectfully disagrees with amendments numbered 2(b), 2(c)(ii), and 2(c)(iii)”; and ( b) replacing the words “agrees with amendments numbered 1, 2(d), 2(e), 4, and 5” with the words “agrees with amendments numbered 1, 2(b), 2(c)(ii), 2(c)(iii), 2(d), 2(e), 4, and 5”.
May 31, 2016 Passed That the Bill be now read a third time and do pass.
May 31, 2016 Failed That the motion be amended by deleting all the words after the word “That” and substituting the following: “Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be not now read a third time but be referred back to the Standing Committee on Justice and Human Rights for the purpose of reconsidering Clause 3 with a view to ensuring that the eligibility criteria contained therein are consistent with the constitutional parameters set out by the Supreme Court in its Carter v. Canada decision.”.
May 30, 2016 Passed That Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), {as amended}, be concurred in at report stage [with a further amendment/with further amendments] .
May 30, 2016 Failed “Health, no later than 45 days after the day”
May 30, 2016 Failed “(7.1) It is recognized that the medical practitioner, nurse practitioner, pharmacist or other health care institution care provider, or any such institution, is free to refuse to provide direct or indirect medical assistance in dying. (7.2) No medical practitioner, nurse practitioner, pharmacist or other healthcare institution care provider, or any such institution, shall be deprived of any benefit, or be subject to any obligation or sanction, under any law of the Parliament of Canada solely by reason of their exercise, in respect of medical assistance in dying, of the freedom of conscience and religion guaranteed under the Canadian Charter of Rights and Freedoms or the expression of their beliefs in respect of medical assistance in dying based on that guaranteed freedom.”
May 30, 2016 Failed “(3.1) The medical practitioner or nurse practitioner shall not provide a person with assistance in dying if the criteria in subsection (1) and the safeguards in subsection (3) have not been reviewed and verified in advance (a) by a competent legal authority designated by the province for that purpose; or (b) if no designation is made under paragraph (a), by a legal authority designated by the Minister of Health in conjunction with the Minister of Justice for that purpose. (3.2) The designation referred to in paragraph (3.1)(b) ceases to have effect if the province notifies the Minister of Justice that a designation has been made under paragraph (3.1)(a).”
May 30, 2016 Failed “(3.1) As it relates to medical assistance in dying, no medical practitioner or nurse practitioner may administer a substance to a person if they and the medical practitioner or nurse practitioner referred to in paragraph (3)(e) concur that the person is capable of self-administering the substance.”
May 30, 2016 Failed “(d) their imminent natural death has become foreseeable, taking into account all of their medical circumstances.”
May 30, 2016 Failed
May 30, 2016 Failed “(f) they have, if they suffer from an underlying mental health condition, undergone a psychiatric examination performed by a certified psychiatrist to confirm their capacity to give informed consent to receive medical assistance in dying.”
May 30, 2016 Failed “(f) prior to making the request, they consulted a medical practitioner regarding palliative care options and were informed of the full range of options.”
May 30, 2016 Failed
May 18, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at report stage of the Bill and one sitting day shall be allotted to the consideration at third reading stage of the said Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at report stage and on the day allotted to the consideration at third reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and in turn every question necessary for the disposal of the stage of the Bill then under consideration shall be put forthwith and successively without further debate or amendment.
May 4, 2016 Passed That the Bill be now read a second time and referred to the Standing Committee on Justice and Human Rights.
May 4, 2016 Passed That the question be now put.
May 4, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at second reading stage of the Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at second reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and, in turn, every question necessary for the disposal of the said stage of the Bill shall be put forthwith and successively, without further debate or amendment.

Criminal CodeGovernment Orders

May 3rd, 2016 / 5:10 p.m.


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NDP

Tracey Ramsey NDP Essex, ON

Madam Speaker, in his impassioned speech, my colleague from Foothills brought up one issue that I have also heard about from my constituents and I understand it is a concern for Canadians. It is about health practitioners' personal conscientious objections. Through our work in the all-party committee, the NDP made a clear recommendation to the government that no health care worker should ever be compelled to participate in assisted dying and should be legally shielded from unfair consequences resulting from that personal decision.

We in the NDP are concerned that these protections are not included directly in the legislation, even though the government promised that they will be addressed soon in non-legislative measures. We are going to hold the government to that promise.

I ask my colleague, will your party hold the government to that promise as well?

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May 3rd, 2016 / 5:10 p.m.


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NDP

The Assistant Deputy Speaker NDP Carol Hughes

I would remind members that they address questions to the Chair and not to colleagues in the House.

The hon. member for Foothills.

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May 3rd, 2016 / 5:10 p.m.


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Conservative

John Barlow Conservative Foothills, AB

Madam Speaker, absolutely, one of the top issues that has come up in my riding is protection for health practitioners to make this decision on their own and not have it imposed on them. This goes to the point that I think all of us are trying to make. There are so many issues that still need to be addressed.

My colleague on the other side has said that there have been all kinds of opportunities to debate this. Six or seven of my colleagues who are hoping to speak on this later this evening may not have that opportunity because the government is putting closure on this debate.

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May 3rd, 2016 / 5:10 p.m.


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Conservative

Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK

Madam Speaker, throughout this discussion and debate, I have heard many heartfelt positions. I have also heard many calls for the bill to go to committee, where amendments can be made to it. I truly feel that most Canadians believe, as the member has indicated, that this bill is about someone's mom, dad, sister, or brother who is on life support with a terminal illness.

I wonder if the member might be able to give some idea, if the bill were to go to committee, if there are any amendments that could be made that he would find appropriate.

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May 3rd, 2016 / 5:10 p.m.


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Conservative

John Barlow Conservative Foothills, AB

Madam Speaker, the safest thing to do with this bill would be to make it as tight and as rigid as possible. The Carter decision involved a competent adult suffering with a terminal illness. That is how we should have kept it.

I do not think we should now have psychological issues as an underlying factor and a decision to study mature minors. I do not think we should be starting here; we should be starting here, making it as narrow and as strict as possible, and not try to put the cat back in the bag afterward. We need to ensure that this remains about competent adults who are suffering from a terminal illness.

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May 3rd, 2016 / 5:10 p.m.


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Conservative

Candice Bergen Conservative Portage—Lisgar, MB

Madam Speaker, I am going to try to watch my time, and I hope to be on the same timeline as you are.

I am grateful to have the opportunity to speak to Bill C-14, which is a bill that makes amendments to the Criminal Code and other acts that would, for the first time in Canadian history, make it legal for someone to have medical assistance in taking his or her own life.

It would also make it legal for not just a doctor, nurse practitioner, or somebody involved in the medical community, but an aid, somebody outside of the medical community to kill someone, should the person want to be killed, if the conditions that are set out in this legislation are met.

It is an extremely serious matter that we have before us, and no doubt it will go down as a historic matter. It is something that will go down in history.

I want to take a couple of moments to address a few things. I want to begin by talking about where and how we got to this place, and build on some of the things that my colleague just talked about. The Supreme Court of Canada ruled just over a year ago that it was a charter right for Canadians to be able to have medical assistance in dying. The court gave us a year, a very short time frame, to talk about it, to consult, and to come up with legislation.

I want to take this opportunity to articulate not only my frustration but the concern of many of my constituents and many Canadians in what seems to be happening over and over again. Certainly, the Supreme Court is within its purview to make these decisions that have huge and lasting implications on Canadian society. Unfortunately, what is happening is Canadians feel, and it is becoming more and more prevalent, that they have no say in these matters, whether it is issues like assisted death, which is before us right now, or legalized prostitution, which we had to deal with in the last Parliament.

We are also seeing laws that have been passed in both this House and the other place that are being overturned by the Supreme Court of Canada. We have seen this in recent years and even recent weeks.

I would say for the record, and I would suggest, that it might be time for the government to start using the tools that we have at our disposal to bring some more balance back to our process. We have the legislative branch of our democracy and we have the executive, which are both accountable to voters. Then we have our judiciary, which is a very valuable part of it, but it has become what I believe and what my constituents are telling me imbalanced. They feel that there are nine people down the street in Ottawa who are making very important decisions, and the Canadian people have no say in them.

The tool that we had when the Conservatives were in government is the notwithstanding clause. For the record, I want to say that I think we might have to, and I know the government now has four years and there is a lot that can happen, for the people of Canada, start using that.

We are, though, at a place where the Supreme Court has ruled, and we absolutely respect that. Even though we might disagree with something that is said by a judge or a number of judges, in Canada, we respect the law and we follow the law.

Again, my colleague talked about how the Liberals could have asked for more time, and certainly that is something that could have been done, but we are now at a place where we have to look at a law and either pass the law or not.

I will not be able to support this piece of legislation. I believe it is flawed. My constituents have not had enough time to talk about it and be part of the process. A number of the issues that are concerning about the bill have already been articulated. I want to reinforce that I am very concerned there is not enough protection for vulnerable persons who may be victims or easily manipulated.

In my previous role, I worked a lot with people with disabilities with a variety of abilities. I met recently in Winnipeg with an individual who has an intellectual disability, but is a very smart, capable individual. He said to me, “Sometimes we can be taken advantage of when we are getting a new phone. It is so easy to manipulate us.” He said, “I am worried if somebody is trying to encourage some of us to die, we can be easily manipulated.” There is very little protection in this legislation for vulnerable Canadians.

There is also no protection, or very little protection, as has already been stated, for doctors, nurses, or other medical practitioners, or institutions for that matter, where killing someone goes against their conscience. The federal government has a duty to protect their rights. This bill could be strengthened by protecting those rights.

Also, it is very unclear and ambiguous, as far as language goes, around waiting times, around those who can sign for a patient, and there is very little oversight as far as who may have a financial benefit if somebody were to have an assisted death.

There are number of huge concerns. More time is needed to fix these flaws and to protect the vulnerable and rights of conscience.

Last, I want to talk a bit about my experience working in palliative care. I was a volunteer for a number of years. It was really something to behold to be with people as they went through those last stages of life.

However, there are a lot of misconceptions about what assisted suicide is, what assisted death is. I talked to one of my friends this weekend and she said, “Well, of course, Candice, if I'm in a vegetative state, I would like to be able to have the cord unplugged. I don't want to be kept alive.”

I said to her, “That's not assisted suicide. You absolutely already have that right in Canada to have a living will, to have a do-not-resuscitate order, to refuse medical treatment.” Those are all things that are already entrenched in law and that Canadians have the right to refuse. I think even our Prime Minister talked a number of years ago about his own father refusing medical treatment when he had cancer. Absolutely every Canadian has that right.

However, that is not at all what we are talking about today. That is not the decision that we are forced to make in a hasty way. That is not the decision that Canadians are being cheated out of being able to talk about, and being able to even, dare I say, vote on. It should be a major issue for Canadians to have major input. We are not talking about refusing treatment. We are not talking about saying “do not resuscitate”. We are not talking about palliative sedation, either.

My sister passed away nine years ago from cancer. Some of my family members said, “I think she died because the doctor gave her a lot of morphine when she was in pain.” No, she did not die from the morphine. She died from the cancer. Palliative sedation is not assisted suicide.

I find it ironic, in a very sad way. I just finished my 308 conversations in my riding last week. The 308 conversations was an initiative of the Canadian Mental Health Commission. It was a wonderful idea for 308—at that point 308 members of Parliament, now there are 338 of us—conversations around how we prevent suicide and how we better equip ourselves as community leaders, as health practitioners, as people working with youth, to prevent suicide.

I had these meetings. About 70 people were there, committed to preventing suicide in our communities in Portage—Lisgar. I said, “Folks, I am now going back to Ottawa and I am going to be debating how we can help people commit suicide.”

This is a very difficult issue. It is not one that we can just excuse and say, “Well, in this case, we don't want these people to die, because they're young people who have bullied on the Internet, so we want to make sure they don't commit suicide, but for somebody else who might have a mental illness and just has no hope, we want to be able to help them commit suicide.”

That is wrong and I do not think we can easily reconcile the two. I think we need to talk about it and we need to have protections in place.

Palliative care is very important. It is about giving hope to people. Studies show that if people have a terminal illness and they are assured they can die pain-free, they choose life and they let God decide when they go.

I think we can all agree, absolutely, that it is about helping people and giving them hope, whether it is a mental illness or whether it is a terminal illness; we give them hope and we help alleviate their pain. I do not think we ever want to see choosing death as the honourable way out. We never want our loved ones to feel like it would be more honourable if they chose death. I think we can all agree. Let us choose life every step of the way. Let us choose life.

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May 3rd, 2016 / 5:20 p.m.


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Liberal

Arnold Chan Liberal Scarborough—Agincourt, ON

Madam Speaker, I want thank my friend, the member for Portage—Lisgar, for her contribution.

I want to go back to the beginning of her contribution, where she talked about the potential application of section 33 under the charter. It was actually part of the context of my own remarks when I talked specifically about its use and application. Of course, this Parliament has never actually used section 33 yet, to apply it to any particular piece of legislation. I am wary about its use, given that we are ultimately talking about where there has already been a determination by the courts and certain individuals' rights protected under the Charter of Rights and Freedoms would then be subject to a legislative override under section 33.

Is there a particular test that my friend, the member for Portage—Lisgar, thinks should be applied, in terms of helping parliamentarians assess when it would be appropriate to use section 33?

I had suggested that we would use the same kinds of tests that would be found under section 1, in particular, trying to minimally impair the rights of someone where their charter rights have been protected.

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May 3rd, 2016 / 5:20 p.m.


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Conservative

Candice Bergen Conservative Portage—Lisgar, MB

Madam Speaker, those are very important questions.

As my colleague has said, one of the things we have not done is that no parliament has used the notwithstanding clause. Those are discussions we almost do not want to talk about because there seems to be some negativity. Even now, if the current government were to talk about it in any context, there would probably be some. It is almost politically incorrect to talk about it. We should be having these conversations, whether in formal or informal groups. What would be the test? Personally, I think one of them would be that if a government decided to invoke the notwithstanding clause, it then commit to take that particular issue to the electorate so that there would be an extra layer of test on it.

Those are good questions. I do not have the exact answers. All I know is that there is a growing sense of voters who feel they have less ability, when they were not even asked about the issue of assisted suicide in the election. Some of them still think that palliative sedation is assisted suicide, when it is not. There has to be a better way whereby Canadians know that they have a voice, and that our system is equally empowered so that there is not one part of our democratic system that has more power over the other.

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May 3rd, 2016 / 5:25 p.m.


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Conservative

Todd Doherty Conservative Cariboo—Prince George, BC

Madam Speaker, we have heard talk on the government side about how important this debate and discussion is, and that it has done what it has done on other issues. It pointed fingers at the government of the past saying that it did not get anything done and that this is really important, yet earlier today we saw the current government try to force closure on this debate. My concern is this. The government has limited the discussion all along the way, whether in the special committee or within this debate today.

In sending this bill to committee, because ultimately that is where we are going with this, does the member believe that, given everything that we have seen with the government to date, there will be that fair and open consultation on this legislation that the government is telling us to just trust them with and that the assurance is there? Does the hon. member have the same concerns that I have with respect to what we have seen in the past?

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May 3rd, 2016 / 5:25 p.m.


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Conservative

Candice Bergen Conservative Portage—Lisgar, MB

Madam Speaker, I am typically the first to get in a good partisan jab here and there. I definitely think that there are members of the government who want to shut this down quickly, get it over with, and move on to something else. However, I have to believe that there are members of the Liberal Party, members of Parliament who are part of the Liberal caucus, who have some of the same concerns we have, and my hope is that they will speak up.

I know we have heard a lot about the current government wanting to give backbenchers more say and more influence in the government. Therefore, I am hoping that they are hearing from their constituents, and that they also recognize how difficult and how important this is. I hope that there will be a free vote on this. Then, I hope that they will advocate strongly in their caucus for the appropriate amount of time to be given, and that they will consider amendments.

What we are counting on in this case is the integrity, the strength, and the individual ability of Liberal backbenchers to stand up in a strong way to maybe some of those in the front who want to move things along quickly. That would be my hope.

This is really difficult. It is not easy for anyone. I have to believe that the backbenchers and the government have the best intentions in mind.

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May 3rd, 2016 / 5:25 p.m.


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Beauséjour New Brunswick

Liberal

Dominic LeBlanc LiberalLeader of the Government in the House of Commons

Mr. Speaker, pursuant to Standing Order 26(1), I move:

That the House shall continue to sit beyond the hour of daily adjournment for the purpose of considering Bill C-14, An Act to amend the Criminal Code and make related amendments to other Acts (medical assistance in dying), at second reading.

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May 3rd, 2016 / 5:30 p.m.


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Conservative

The Deputy Speaker Conservative Bruce Stanton

Will those members who object to the motion please rise in their places?

And 15 or more members having risen:

There being more than 15 members rising, the motion is deemed to have been withdrawn.

(Motion withdrawn)

Notice of time allocation motionCriminal CodeGovernment Orders

May 3rd, 2016 / 5:30 p.m.


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Beauséjour New Brunswick

Liberal

Dominic LeBlanc LiberalLeader of the Government in the House of Commons

Mr. Speaker, an agreement could not be reached under the provisions of Standing Orders 78(1) or 78(2) with respect to the second reading stage of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).

Under the provisions of Standing Order 78(3), I give notice that a minister of the crown will propose at the next sitting a motion to allot a specific number of days or hours for the consideration and disposal of proceedings at the said stage.

Notice of time allocation motionCriminal CodeGovernment Orders

May 3rd, 2016 / 5:30 p.m.


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Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I think I have a more reasonable approach to managing some of the debate left for Bill C-14. Therefore, I would seek the unanimous consent of the House for the following motion:

That, notwithstanding any Standing Order or usual practice of the House, on Tuesday, May 3, 2016, the House shall continue to sit beyond the hour of daily adjournment for the purpose of considering Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), at second reading, and when no member rises to speak, or at 12:00 a.m., whichever is earlier, that debate be deemed adjourned, and the House deemed adjourned until the next sitting day.

Notice of time allocation motionCriminal CodeGovernment Orders

May 3rd, 2016 / 5:30 p.m.


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Conservative

The Deputy Speaker Conservative Bruce Stanton

Does the hon. opposition House leader have the unanimous consent of the House to propose this motion?