Bill C-14 (Historical)

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

This enactment amends the Criminal Code to, among other things,
(a) create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process;
(b) specify the eligibility criteria and the safeguards that must be respected before medical assistance in dying may be provided to a person;
(c) require that medical practitioners and nurse practitioners who receive requests for, and pharmacists who dispense substances in connection with the provision of, medical assist­ance in dying provide information for the purpose of permitting the monitoring of medical assistance in dying, and authorize the Minister of Health to make regulations respecting that information; and
(d) create new offences for failing to comply with the safeguards, for forging or destroying documents related to medical assistance in dying, for failing to provide the required information and for contravening the regulations.
This enactment also makes related amendments to other Acts to ensure that recourse to medical assistance in dying does not result in the loss of a pension under the Pension Act or benefits under the Canadian Forces Members and Veterans Re-establishment and Compensation Act. It amends the Corrections and Conditional Release Act to ensure that no investigation need be conducted under section 19 of that Act in the case of an inmate who receives medical assistance in dying.
This enactment provides for one or more independent reviews relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.
Lastly, this enactment provides for a parliamentary review of its provisions and of the state of palliative care in Canada to commence at the start of the fifth year following the day on which it receives royal assent.

Criminal Code

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

Mr. Speaker, I rise in the House today to speak on an issue that may very well be one of the most significant, important social issues that this Parliament, in the life of this government, will ever face. This is not a matter that I take lightly, the issue of life or death.

Over the last few months, I have had the opportunity to speak with constituents in my riding. I have read the letters and emails they have written in. I have consulted with spiritual leaders from many faiths in the communities within my riding. I have sat through every single minute of this debate, because the magnitude of the legislation is something that deserves our thoughtful consideration. It is also something that has been weighing heavily on me, because regardless of my personal beliefs, I represent the tens of thousands of friends and families in the beautiful riding of Cariboo—Prince George.

For years I have worked toward my dream of becoming a member of Parliament, because I knew this opportunity would afford me the chance to make a difference, to be part of meaningful change, and to leave our country better for generations to come, but nothing truly prepares one to vote on a piece of legislation of this magnitude.

I am at the age and the point in my life where, unfortunately, I have seen my fair share of human suffering. It is a true test of humans to watch a loved one, a friend, or even a stranger, who is faced with intolerable suffering with no hope of recovery.

It is a reality that physician-assisted suicide will indeed become law. This we know is true. In 2015, the Supreme Court of Canada issued a landmark ruling in Carter v. Canada, stating that the laws preventing Kay Carter from ending her life in Canada were contrary to the Charter of Rights and Freedoms.

Kay Carter was a schoolteacher, a wife, and a mother. She was suffering from severe spinal stenosis, a disease that was making it impossible for her to move her body. She was 89, and because medical assistance in dying was illegal in Canada, Carter and her family travelled to a Swiss medical clinic, where she chose to end her life in 2010.

It is not in dispute that Carter was faced with intolerable suffering, but Carter's family and their lawyer have publicly stated that they believe that Kay Carter would have been ineligible for medical assistance in dying under Bill C-14. Therefore, my question for my colleagues across the floor is this. If this legislation was built to address the decision of Carter v. Canada, then why would it likely exclude the very case that opened the door for physician-assisted suicide in our country?

Many have expressed their concerns that this legislation is unconstitutional. Benoît Pelletier, a professor from the University of Ottawa, appeared before the special committee tasked with studying assisted suicide. He said that people suffering with illnesses that are terminal or cause intolerable suffering are at risk of being encouraged to seek an assisted death. He also said:

...all persons are potentially vulnerable. Being vulnerable does not disqualify a person...from seeking an assisted death, but it does put that person at risk of being induced to request a death....

This is among the most troubling testimony. Beyond legal implications, the opposition to Bill C-14 crosses party lines. We have heard from Conservative, Liberal, and NDP members, as well as concerned senators, multiple witnesses, and organizations such as the B.C. Civil Liberties Association, the Alberta Court of Appeal, and the Canadian Bar Association. At the core of our democracy is the ability to have thoughtful debate and discussion on a wide range of issues. Some of these issues are easier to address than others. Sometimes there is a unanimous consensus, and sometimes there is not.

We need to acknowledge in cases where there is not consensus that more work needs to be done, amendments need to be considered, and a majority control of the House should not be used to thwart dissenting opinions, especially on an issue of this scope and magnitude.

Dealing with the sanctity of life and death should be cause for more consultation, more discussion, and more debate than that over a pipeline or a budget. We have debated this for approximately 20 hours. Over half of the Conservative caucus has not had the opportunity to debate this subject. Even more of my Liberal colleagues have not had the opportunity to speak on this. It is concerning to me that on a piece of legislation of this magnitude, my Liberal colleagues have not had the opportunity to speak on this. It would appear from the outset that perhaps the Liberal backbenches are, indeed, being muzzled on this important piece of legislation.

Quebec took six years in successive legislative assemblies to develop its physician-assisted suicide law, six years of consultations and commitment to ensure its bill was not just good enough but one that captured most, if not all, concerns and safeguards.

Time and again, we have heard it is good enough at this point. To me, good enough is not good enough when we are talking about life and death. I am a firm believer that it is better to miss a deadline than to get such an impactful piece of public policy wrong. This piece of legislation is likely the most important law in our generation.

The Liberal government should allow all members to speak on behalf of their constituents and engage in further necessary consultations in order to get the legislation right, because the alternative is passing a deeply flawed and in my opinion unconstitutional piece of legislation. Passing Bill C-14 in this manner will result in court challenges that will further deadlock the work of the House and parliamentarians in having a workable document that protects the most vulnerable members of society from abuse.

The debate on assisted suicide over the last few months has opened the door to some of the alternatives that also need to be considered when speaking about Bill C-14. Palliative care is a critical component of this issue. We must always ensure that a proper palliative care strategy is in place. While the government likes to talk about this being core and an important piece in its budget and in moving forward, it has not even been mentioned once in the most current budget.

To ensure that individuals are well informed about their end-of-life options not only physically but to deal with their emotions, palliative care needs to be a viable end-of-life choice. At a time when assisted dying is a hotly contested issue, it is important to engage in conversations around palliative care to ensure that people are making the best decisions to improve their quality of life. We need to protect our most vulnerable.

As I mentioned previously during this debate, I am a father of a mature child who is cognitively challenged. While a healthy and productive member of the community, who I am extremely proud of, my daughter could not, today, make an informed consent, let alone if she was dealing with a grievous and terminal disease.

We also need to consider the medical professionals, the doctors and nurses, who went into their chosen fields to save lives, to improve lives, to ensure that lives are not lost and continue to be healthy. We need to ensure that these individuals are also protected and that the responsibility for this is not downloaded to the provinces. We need to ensure that this piece of legislation does not become a vehicle for those suffering with mental health issues to end their pain or that physician-assisted suicide is not chosen or forced due to obligation or feelings of burden.

Catherine Frazee, professor emerita at the school of disability studies at Ryerson University, said it best when she stated:

At the heart of this debate, we must choose between competing visions of our social fabric. Shall we uncritically submit to the voracious demands of individual liberty no matter what the social cost? Or shall we agree that there are limits to individual freedom, limits that serve all of us when we are vulnerable and in decline?

When we start deconstructing the foundation upon which our society is built, the social fabric, we need to ensure that proper safeguards are in place, a system of checks and balances. This system is not built overnight and it is not built through a limited debate and time allocation. It is built through listening, learning, and acknowledging a wide variety of viewpoints, stories, and opinions, through co-operation and thoughtful analysis and acceptance of amendments, none of which seem to be in line with the Liberal government's priorities.

I would like to thank our colleagues from all sides who have shared their experiences with us over the course of this debate. I appreciate each and every one of their views and their openness in sharing these deeply personal experiences, and I thank those in my riding of Cariboo—Prince George, the countless numbers, who have shared with me their views and experiences.

I would also like to thank the members of the committee who worked tirelessly towards a solution. I thank each of them for taking the time to voice their feelings on this important piece of legislation.

For the reasons I stated throughout my speech, I will not be able to support Bill C-14 as it currently stands.

[The Chair, Liberal, Larry Bagnell]

The other one, as you can probably guess, is a student. A lot of MPs are being shadowed today by students, and Maris is here. Welcome.

We welcome Marc Bosc, Acting Clerk and Philippe Dufresne, the Law Clerk and Parliamentary Counsel, and our visitors.

Just so the committee knows, our long-awaited family-friendly interim draft report will come out on Thursday afternoon. It's in translation.

In terms of our first item of business for this morning, for anyone who wasn't here at the time, we have already had the Clerk and the Law Clerk here to give their opening remarks on the question of privilege on Bill C-14, but they had just got through their opening remarks when we got called to a vote. They're back to do that question and answer round. In the second hour, we'll do the other question of privilege. More than likely, it's committee business. We'll do that in the second hour, as well as any other committee business people want to do.

Without further ado, I think we'll go to the first round. We'll start with Mr. Chan.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, that is the salient question: what happens on June 6? I asked for a report from the Library of Parliament. It said that it will be the Carter decision and that it will be applied differently across Canada. In each province it will be the College of Physicians and Surgeons that will determine that. In Ontario, it will be required by physicians whereas in some provinces it will not be. In some provinces the provincial government will be engaged and in others it may not. Therefore, we will have a hodgepodge of how this will be applied across Canada. That is not in the interests of Canadians. Therefore, we need to pass this. Legislation is required. The problem is that Bill C-14 needs to be amended. It has some big holes in it. I hope the government will co-operate and listen to members of the opposition and listen to Canadians and fix Bill C-14.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, I want to thank the Minister of Justice for being here today to speak in the House and for sharing her perspective and the government's perspective on Bill C-14. I found her to be always available and very thoughtful, and I thank her for her involvement.

I have been honoured to be part of the joint committee that dealt with the bill starting in January. I was also part of the justice committee when Bill C-14 was sent there. As the minister said, the opinions on this issue of assisted suicide are very diverse. Within each of the parties it is very diverse. However, I want to thank all members of Parliament for being respectful and working together on this important issue.

We are dealing with this issue because of the Carter decision. The Supreme Court said in the Carter decision that this must be allowed. The Criminal Code will be amended, and it is up to Parliament to come up with safeguards, not that this is permitted. However, the Supreme Court decided that we are to create safeguards.

We have also heard that 84% of Canadians want this. However, that statement that we have often heard is a little misleading, because 84% of Canadians do support this under certain criteria, and that criteria is that the illness is terminal, and the person is suffering terribly and repeatedly asks to have assisted suicide to end their suffering. Therefore, it is important to remember that it is under certain conditions.

I have consulted with my constituents on this issue. I sent out a householder, and I was very thorough and non-partisan. The householder I sent out provided a background and laid out all the different issues that Parliament is having to deal with: conscience protection, palliative care, who can provide this service, should there be judicial oversight, should the cause of death be listed for data collection as assisted suicide or euthanasia, mature minors, and on and on.

I had response to this householder, and one week ago, I had our second town hall meeting on this. In both cases, we had a huge response from the constituents. Actually, we have had more of a response to this issue through emails, phone calls, letters, and responses to the householder. We have had more responses on this than on any other issue in the last 12 and a half years that I have been a member of Parliament. People are very engaged and understand what the issues are and the challenges that the House faces.

Again, I thank the Minister of Justice, but as a critique, I think the government could have approached this a little differently, instead of dominating the committee structures, instead of bringing in time allocation, and instead of saying no to all the amendments.

The minister spoke about the 16 amendments, which, of course, were Liberal amendments. Of the amendments, there was one that the Conservative Party and the NDP at committee agreed with, and that was on conscience protection. We asked that all physicians, health care professionals, nurse practitioners, pharmacists, or anybody who is a health care professional who does not want to be involved with this have the right to say no. However, the government turned down that amendment.

The fact is, the parliamentary secretaries in the committee talked to each of the members on that committee and told them that the Liberals were not going to support that. Then the parliamentary secretary of justice actually spoke at the committee and said that the government did not support amending like that.

As the Minister of Justice just said, the government is going to leave it to negotiating with the provinces, and download that responsibility to the provinces. However, what we are doing in Bill C-14 is amending the Criminal Code of Canada. Prior to the Carter decision, it was illegal to assist anybody in a suicide. It was legal to commit suicide but illegal to assist somebody. It was considered homicide if someone assisted somebody.

Under the Carter decision a physician can, under certain conditions, provide assistance in a suicide and euthanasia. That amendment to the Criminal Code also could be elaborated on to say that it would be a criminal offence to force health care professionals or any individuals through coercion or intimidation, to participate in the death of another individual against their will. That is what we suggested.

When Bill C-14 gets referred to the Senate it will have to deal with it. I believe the Senate will refer this legislation back to the House. It is going to refuse to accept Bill C-14 the way it is and it will provide proper conscience protection for physicians.

We heard from the Canadian Medical Association that 70% of physicians in Canada do not want to be a part of this. They do not want to be forced through coercion, intimidation, or threats that they will no longer be able to practise at this or that hospital if they do not participate.

In a National Post article called “'Killing' patients vs. 'doing their job': Sharp division of opinion on whether doctors should be required to assist in suicide”, a doctor says she has been practising medicine for 37 years. The family doctor has decided not to renew her medical licence in June of this year. Dr. Naylor has no desire to quit medicine but she says she is appalled at the thought of being forced to refer. Dr. Burke, who practises physical medicine and rehabilitation in Windsor Ontario, said he is renewing his medical licence in Michigan where assisted suicide is illegal.

I have heard this at town hall meetings across the country and at the two I had in my own community. A young medical student asked me if physicians were going to be forced to do this and I said that there is a good possibility because in Bill C-14 the government is leaving it up to the provinces. We have already heard that the College of Physicians and Surgeons of Ontario will require physicians to effectively refer, which means that a doctor must follow that person through the whole process to make sure he or she does get euthanized if that is what the individual requested. The doctor must participate.

Physicians across this country, like those I just mentioned, are going to refuse to participate, saying they are now of retirement age and will retire or will relocate to another jurisdiction where they will not be forced to be a part of this, which goes against their conscience. A shortage of physicians and nurses will create a medical emergency in Canada. We will have a shortage of physicians and nurses in Canada because they will be forced to participate in something that goes against their conscience.

The government has an opportunity to do the right thing. It refused to do it in the House so it will be left to the Senate. The Senate will decide and it will amend Bill C-14. It will come back to the House in an amended form. We do not know how long that will take but it is obvious that the June 6 deadline will not be met. I hope the government will play differently then and will co-operate with the Senate and not strike down its amendments.

It is better to have Bill C-14 than nothing but it does need to be amended. The government needs to be more open-minded and congenial and work within this parliamentary environment and come up with legislation that represents where Canadians are at on this issue, not where the government is at.

[Jody Wilson-Raybould, Liberal, Vancouver Granville, BC]

Mr. Speaker, in terms of amendments, 16 have been made to Bill C-14, which have strengthened the proposed legislation with respect to seeking to draw the balance between personal autonomy with protection of the vulnerable and ensuring that we do as much as we can to protect the conscience rights of medical practitioners.

I recognize the member's multiple submissions to the House on this legislation. I also recognize the tremendous experience of years of discussions that the province of Quebec has had with respect to putting in place its own laws.

With respect to Kay Carter, I am absolutely certain that Ms. Carter would qualify under the eligibility regime as presented in Bill C-14. We specifically ensured that we provided a broader definition around what grievous and irremediable meant and we put in place eligibility criteria that would ensure there would be flexibility in our regime and provide medical practitioners with the ability to engage with their patients. They are the most familiar with their patients and by virtue of that relationship can determine whether there is eligibility or not.

[Jody Wilson-Raybould, Liberal, Minister of Justice and Attorney General of Canada]

moved 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 third time and passed.

Mr. Speaker, I want to begin today by acknowledging the contributions of all members of the House, in particular, the members of the Standing Committee on Justice and Human Rights, for how they have approached our debate on Bill C-14.

It is clear that members from all parties have engaged closely with their constituents, members of other parties, and their own experiences to make thoughtful and genuine contributions to our country's conversation on medical assistance in dying. This is one of the most important issues that this Parliament will address.

Bill C-14 represents the government's policy choice to address medical assistance in dying, a choice that is fully informed by consultations with Canadians and experts and takes into account all the interests and values surrounding this matter.

When the Carter decision came down in February 2015, one debate ended and another began. It was no longer a question of whether Canada would permit medical assistance in dying, but rather it was about how our country would do it.

Bill C-14 would create a statutory framework for medical assistance in dying that considers the perspectives of those who may wish to access it; those who are concerned about its consequences, including vulnerable persons who could be put at risk by the legalization of this practice; and those who may be asked to provide the assistance.

While the Carter decision told us that an absolute prohibition in the former law went too far, it did not tell us how medical assistance in dying should be implemented. The Supreme Court of Canada acknowledged that the issue “involves complex issues of social policy and a number of competing societal values”. The court stated that it:

emphasized that there may be a number of possible solutions to a particular social problem, and suggested that a “complex regulatory response” to a social ill will garner a high degree of deference.

The challenge facing Parliament is about setting new boundaries. Who should be eligible for medical assistance in dying; what safeguards should be required; how will it be monitored; and what issues require more study?

A proposed law that answers these questions must comply with the charter, but that does not require replicating the Carter decision. The Supreme Court of Canada has recognized that the relationship between the courts and Parliament should be one of dialogue. Just as Parliament must respect the court's ruling, so too must the court respect Parliament's determination of how to craft a statutory scheme in response to the court's judgment.

It is helpful to know how this dialogue has played out in previous instances. For example, in R. v. O'Connor, a 1995 charter challenge in a sexual assault case, the Supreme Court mandated the disclosure of therapeutic records in the Crown's possession and set out a common law procedure for the production of these records.

In response, Parliament enacted a statutory disclosure regime that differed in significant ways from the court's approach. The court upheld the constitutionality of that statutory regime, noting that it could not be presumed, just because Parliament's scheme looked different from what the court had envisioned, that it was unconstitutional.

Instead, there is this dialogue between the legislative branch and the courts. The court can provide the general parameters for a response, but it is for Parliament to craft the regime. Details of that regime matter because they necessarily engage fundamental choices of our rights and values and reconciling the tensions that sometimes exist between them.

In developing a response to the Carter decision, the government was called on to simultaneously promote autonomy, protect the vulnerable, affirm life, prevent suicide, support persons with disabilities, respect freedom of conscience, and fully consider many other valuable interests. As we went about this, we remained mindful of our constitutional framework and the divided jurisdiction between Parliament and the provinces and territories.

In weighing these values and making these policy choices, we were not alone. In the past number of months the national conversation on medical assistance in dying has been rich and fulsome, and no doubt it will continue.

Following the introduction of Bill C-14, the relevant standing committees of Parliament, including the justice and human rights committee and the Senate legal and constitutional affairs committee, which conducted the pre-study of the bill, have heard diverse perspectives from stakeholders and experts on all aspects of medical assistance in dying. Bill C-14 strikes a balance regarding eligibility and safeguards, as well as setting out what the federal law should do and what should be left to the provinces and territories to regulate.

Not everyone agrees with these policy choices. Still, I am confident that the decisions fall squarely within the range of alternatives that are legally open to Parliament to adopt. It would have been easy for the government to cut and paste the language from the court's decision into a new federal statute, but such an approach would have meant ignoring all the consultations and evidence that I have just referenced. It would also have fallen far short of developing a complex regulatory regime to balance competing interests, which the court said was the task of Parliament to craft and not the courts.

That evidence, presented over the past year, confirms that medical assistance in dying may pose risks to the vulnerable, even in circumstances where there is a general consensus that the person should be eligible for the procedure. That is why the bill provides for significant procedural safeguards, even when all of the eligibility criteria are met. This is why the bill would also put in place the necessary legal framework to monitor how medical assistance in dying is implemented in Canada.

In terms of eligibility, the policy choice made by the government was to focus on persons who are in an advanced state of irreversible decline and whose natural deaths have become reasonably foreseeable.

Recall that medical assistance in dying is exceptional because, from a criminal law perspective, it is a situation where one person actively and knowingly participates in the death of another. We criminalize and strongly condemn this conduct in all other circumstances. The only place in our criminal law where this conduct is justified is in self-defence, where individuals are permitted to take a life but only in order to save their own life or someone else's. While medical assistance in dying has medical and health law aspects to it, we cannot lose sight of this dimension either, because it is the criminal law power that is the primary source of Parliament's jurisdiction to address this issue, and it was the criminal law that, before the Carter decision, stood in the way of medical assistance in dying.

Having given careful consideration to the risks that may be posed when anyone, even a physician or nurse practitioner, is permitted to end another person's life, the balance reflected in Bill C-14 is that medical assistance in dying should be a choice for Canadians about how they die, so that they may have access to a peaceful passing. The bill would create a complex regulatory regime to respect this choice and ensure it is exercised in a voluntary and fully informed manner. Equally, the criteria ensure that, for Canadians who are not declining toward death, the focus of medicine remains on improving life, not ending it.

We also recognize that there are those who believe that the law should permit access to medical assistance in dying in other situations. The government heard these concerns loudly and clearly. The Standing Committee on Justice and Human Rights amended the bill to ensure that one or more independent reviews be initiated within six months of the bill receiving royal assent to further examine issues around the eligibility for mature minors, advance requests, and requests where a mental illness is the sole underlying medical condition.

We welcome this amendment and want to emphasize that we will remain open-minded to the evidence that these reviews gather and as Canadian data begins to be generated on how medical assistance in dying is actually working.

The decision to study these three issues further is supported by people who work with patients day in and day out in these three areas, who have been some of the most prominent voices calling for Parliament to proceed with caution.

With respect to mature minors, the Canadian Paediatric Society, represented by Dawn Davies, testified before the Senate committee that there “is simply not enough information to reach an enlightened decision” on this matter and that “It is appropriate that the first iteration of legislation on physician-assisted death does not include...minors”.

She also stated that there have not been sufficient consultations on this issue. The usual capacity and assessment processes, which Bill C-14 supports as appropriate for adults, may not be the right approach for mature minors. We need to consider this issue further.

Advance requests is another area where additional evidence is needed. We have heard many times over the past year that advance requests are likely to be sought in circumstances where persons are suffering from diseases such as Alzheimer's or dementia, but even the Alzheimer Society of Canada has stated in its public position paper that medical assistance in dying should only be possible when a person is competent at the time the assistance is administered. It says that advance requests not only pose risks to vulnerable patients, but they could also contribute to false stereotypes, undermining its message that it is possible to live well with this disease. Further study on this issue is the right policy.

On mental illness as a sole condition motivating a request for assisted dying, it is not surprising that reputable individuals and organizations, including the Centre for Addiction and Mental Health and the Mental Health Commission of Canada, support further study before legislating in this area. Moving forward in this way does not deny the suffering that these illnesses can cause. Rather, it ensures that we get it right and protect some of the most vulnerable and stigmatized persons in our society. For these reasons, I believe that Bill C-14 represents the right policy choices to answer the difficult questions the Supreme Court of Canada left for us as parliamentarians to resolve for 36 million Canadians.

I will now turn to the legal considerations, which play a crucial role in this seminal piece of legislation.

A consistent area of discussion has been around whether Bill C-14 is constitutional. As the Minister of Justice and Attorney General of Canada, I am of the firm opinion that the bill is consistent with the charter and is a justifiable response to the Carter decision.

Bill C-14's eligibility criteria directly respond to the Carter decision. They clarify the intended scope of eligibility, acknowledging the submission of the Canadian Medical Association, which represents 83,000 physicians who will, with nurse practitioners, be responsible for implementing and applying this law in their daily practice. This organization has stated that the language in the bill is a significant improvement over what it views, from a medical perspective, as the court's unworkable term “grievous and irremediable”.

What was the scope of the Carter decision? I appreciate that there are many differing interpretations of the decision, and I acknowledge that the Alberta Court of Appeal recently read Carter in a broad way, while some judges in the Superior Court of Ontario have read it more narrowly. I believe that the Carter decision was about the factual circumstances of that case. At the end of the day, Bill C-14 will be measured against the charter as a whole and not the Carter case. As the Alberta Court of Appeal recognized, “the interpretation and constitutionality of eventual legislation should obviously wait until the legislation has been enacted”.

Bill C-14 addresses both dimensions of section 7 of the charter, respect for autonomy and respect for life. The bill would strike a new balance between these interests through a comprehensive regulatory regime, which would receive deference from the courts. The proposed law would respect individual autonomy for persons who choose medical assistance in dying, but would do so in a careful manner that preserves other crucial objectives: promoting suicide prevention, preventing social stigma of life with a disability, and protecting society's most vulnerable persons from a risk of premature involuntary death.

While Bill C-14 requires that an eligible person be on a trajectory toward death, the flexibility purposefully built into the bill's criteria would allow medical practitioners to respond to a wide variety of medical circumstances, not just predictable diseases that are subject to fixed prognoses of life left to live.

Indeed, unlike some U.S. state regimes that require a specific prognosis, Bill C-14 does not require a strict relationship between the medical condition and the cause of the person's reasonably foreseeable death.

I do not agree with those who say that the Carter decision means that Parliament is constitutionally mandated to enact one of, if not the broadest, assisted dying regimes in the world, and that Parliament has little scope to consider other societal interests aside from autonomy. The court acknowledged that medically assisted death involved complex issues of social policy in a number of competing interests. In matters of this nature, the charter analysis takes into account the fact that there is no single manifestly correct balance of competing interests that are engaged. Deference will be shown, provided that Parliament's solution falls within the range of reasonable alternatives.

Bill C-14 is reasonable. It would provide people who are in a path towards death a choice that would respect their wish to die with dignity. Equally, it would limit medical assistance in dying to persons in these types of circumstances in order to prevent the normalization of suicide, protect vulnerable persons who were disproportionately at risk of inducement to suicide, and affirm the equal value of every person's life.

This balancing of interests addresses the inherent risks associated with permitting medical assistance in dying, and represents what the trial judge in Carter described as a “carefully-designed system imposing stringent limits that were scrupulously monitored and enforced”. Such a system is necessary because the suffering that can lead someone to request assisted dying does not just come from the condition; it also comes from how our society too often treats people with such conditions.

Under an approach where any serious medical condition is eligible, the law would be saying that an assisted death could be an acceptable treatment for a soldier with post-traumatic stress disorder, a young person who suffered a spinal cord injury in an accident, or a survivor whose mind was haunted by memories of sexual abuse.

These are difficult but necessary situations to talk about, because cases like these are the unavoidable consequence of an assisted dying law where the only limit on eligibility is an individual's subjective experience of suffering.

As both the justice and human rights committee and the senate committee heard from several witnesses, the risk to vulnerable people, as well the crucial objectives of suicide prevention and affirming the value of the lives of all Canadians could be greatly increased unless eligibility was limited to persons who were approaching the end of their lives.

As I said, when Bill C-14 was introduced, assisted dying is a matter that touches us all and challenges us all. Divergent views on the bill remain, but we have a responsibility to act for all Canadians. The interim court approval process ends on June 6. If there is no legislation in place at that time, medical assistance in dying will lack a legal framework outside of the province of Quebec.

There is even uncertainty as to whether the court's remedy in Carter, if it came into force on June 6 in place of a statutory regime, would have the legal effect of completely striking down the existing criminal law that prohibits consensual killings and the aiding of suicides outside of an assisted dying context.

While most medical regulators have published interim guidelines, there would be no mandatory or consistent national safeguards. It could be possible, for example, for a physician to end a mature minor's life, depending on the province. Different jurisdictions require different numbers of witnesses, and some provide no waiting period at all.

Uncertainty around Carter parameters would persist and likely lead to inconsistent results in who would be found to be eligible, even between medical practitioners in the same jurisdictions.

We have a choice: To have a statutory framework in place with all of the national-level safeguards and protections that I have described, or having none. Bill C-14 reflects the kind of society we should aspire to be, one that respects individual autonomy and one that affirms that the lives of all Canadians have inherent value and are equally entitled to the protection of the law.

I call on all members of the House to support Bill C-14.

Physician-Assisted Dying

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

Mr. Speaker, I am honoured today to present a petition signed by hundreds of Ontarians regarding Bill C-14, requesting consideration and accommodation for medical practitioners, stringent legislation, as well as sufficient time for consultation.

[Robert Sopuck, Conservative, Dauphin—Swan River—Neepawa, MB]

Mr. Speaker, I have the honour to present a petition on behalf of the Family Action Coalition, signed by citizens from right across Manitoba.

The petitioners request that the government allows sufficient time for broad consultation on Bill C-14, that there are sufficient protections for the vulnerable, and that conscience rights for health care providers are protected.

[Rachael Thomas, Conservative, Lethbridge, AB]

Mr. Speaker, the other petition I present in the House today is a lengthy petition from members all across the province of Alberta, my home province.

The petitioners are coming forward with the Family Action Coalition with regard to Bill C-14. They are asking for stringent safeguards to be put in place on behalf of the vulnerable. They are asking for conscience protection for medical practitioners, and they are also calling on the government to consult widely with regard to Bill C-14.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Mr. Speaker, I am pleased to rise to present a petition on behalf of constituents right across British Columbia. The Family Action Coalition has put together a petition outlining that there should be adequate safeguards in any legislation, such as Bill C-14, that parliamentarians should seek to consult in a timely and robust way, as well as to make sure that conscience rights are protected.

Criminal Code

[The Speaker, Geoff Regan]

The House will now proceed to the taking of the deferred recorded divisions on the motions at report stage of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).

The question is on Motion No. 1. If it is negatived, we will have to vote on Motions Nos. 3, 4, 6, 12, 13, and 14.

The House resumed from May 20 consideration of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), as reported with amendments from the committee, and of the motions in Group No. 1.

Public Service Labour Relations Act

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Mr. Speaker, I would like to thank my colleague from Sherbrooke for his very relevant question. Yes, I feel the same way as he does and I agree with his analysis of the situation.

The government is trying to comply with a Supreme Court decision by doing the minimum. It is trying to do only what it has to by inventing concepts, contradicting itself, and even going against the Supreme Court's decision

This shoddy work is going to once again end up before the courts. The same thing happened with Bill C-14. It is the same principle, and that bill is a far cry from the Carter decision. The government needs to be more professional when drafting its bills.

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

Mr. Speaker, that is probably one of the more absurd comments I have heard on the decisions.

The Supreme Court did not require the House of Commons to legislate. It said that existing law, both for Bill C-14 and Bill C-7, was unconstitutional, and if the House of Commons would like to legislate something else, this was the deadline by which it must do it. The Supreme Court suspended its judgment to a date to allow the House of Commons, if it so chose, to pass legislation, very much the same as what happened with the abortion legislation in Canada. When the Supreme Court ruled that abortion violated the security of the person, it gave a period of time for Parliament to act. Parliament tried twice to act and failed to pass any legislation. The world did not end, but the Supreme Court decision was implemented.

That is exactly what would happen on Bill C-14 and Bill C-7. The Supreme Court does not instruct Parliament to do anything. It gave us the opportunity to say that if we felt there were regimes or restrictions that would meet the constitution that we would like to put in place, we had this much time to do it.

I do agree with the member that the Conservatives wasted a lot of that time. However, the present government has wasted a lot of time calling all different kinds of bills instead of dealing expeditiously with those on which it feels it has a deadline.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, the member seems to be somewhat confused with regard to the issue of urgency. We need to recognize that when the Supreme Court of Canada makes a decision, all members have a responsibility to respect that decision. The two bills the member had made reference to are in fact directives coming from the Supreme Court of Canada. Both issues have been granted extensions.

Could the member provide some comment on whether he believes that parliamentarians do not have to respect what the Supreme Court of Canada has said? Is that the New Democratic approach for dealing with decisions that have been made by the Supreme Court of Canada?

The Supreme Court of Canada has been very clear on this issue, and this legislation is before us today because of that. Just because the Conservatives did not do their homework on this bill or Bill C-14, as legislators, we have a responsibility to, at the very least, listen to what the Supreme Court says, and from the government's perspective, to take action to make corrective measures.