Madam Speaker, as others have said before me, we are debating this evening one of the most important issues of our time. It is not just an important issue but a difficult issue. In fact, it is a real constellation of difficult issues and difficult decisions. It is an issue that has been a concern in Canada for decades, including the case of Sue Rodriguez more than 20 years ago. We are talking of it again because of the landmark Carter decision that has instructed Parliament to create legislation to legalize and regulate medically assisted dying.
Like all members of the House, I have received many letters, emails, phone calls, and personal representations from all sides of the issue. Some people are concerned that because of the restrictions in the legislation they would not be eligible for the procedure should they need it in the future; while others are worried that medical practitioners who have ethical concerns would not be able to opt out if they wish.
Obviously we need good legislation that clearly spells out the eligibility criteria for this procedure as well as the regulations around the actual procedure itself. Because of these needs, I am generally in favour of this legislation, but I feel that it is deficient in several regards.
We have to ensure that this bill properly addresses the Supreme Court decision. The last thing we need is to prolong the suffering of grievously ill people through more litigation.
As I mentioned, we also need to ensure that the practitioners who are undertaking these procedures are protected regarding their roles and moral beliefs. Last week in the House, I tabled a petition from many of my constituents on this issue.
We need to ensure that people with progressive illnesses have access to suitable palliative care, as many people have mentioned here this evening. They need access to palliative care, pain management, and home care so that medically assisted dying is not set out simply because other more appropriate actions are not available.
Finally, we need to ensure that this procedure is equally available across the country.
The need for this procedure is clear as was laid out in the Supreme Court decision. One of my constituents has already requested legal access to the procedure, several months ago, without waiting for our action here as his suffering was so great. He waited through the foot-dragging of the previous government, but could wait no longer. Clearly, other Canadians who are suffering through intolerable pain and discomfort will continue to access this service through more complicated legal channels if we do not pass legislation here.
Just last Friday, I met with another constituent who is suffering with advanced progressive multiple sclerosis. He wanted to talk first about federal funding for research into experimental treatments for MS. Because of the advanced nature of his disease he was not able to access the present experimental treatments, but he desperately wanted others to have greater access in the future. However, now that he cannot dress himself, bathe himself, or even shave his face, he feels that life with any dignity is fast slipping away. He is deeply concerned that he would not be eligible for medically assisted dying because his natural death may be years away and not “reasonably foreseeable” as this bill now states. Many experts feel that even Kay Carter, who brought the case before the Supreme Court, would not be eligible for medically assisted dying under the criteria now set out in Bill C-14.
The same constituent also recounted how difficult life is for his wife as he faces his progressive illness. He would like better access to home care services and later palliative care, so that his wife can have respite from his daily care. However, these services are not available equally across Canada. We desperately need a national palliative care strategy and the funding that goes with it to ensure that patients who need this care have access to it. Bill C-14 refers to palliative care in its preamble, but it is silent after that. The government was silent on palliative care in the budget, despite a promise for $3 billion for home care in the election campaign.
Hospice care is also needed across this country, but it is even less available than hospital palliative care. In my riding, there is only one hospice centre and it is five hours by road from the east side of the riding. I have met with an active hospice society on the eastern edge of the riding, but it is struggling to find funding for a hospice, despite a clear need for it and a strong case that it will save a considerable amount of money in the local health care system. This disparate amount of care is a concern to me, since we do not want people choosing medically assisted dying simply because they do not have access to proper pain management, palliative care, home care, or hospice treatment.
Finally, I would like to talk about advance directives. Many people with progressive diseases would like to provide their loved ones and physicians clear instructions regarding their fate if they become incapable of giving those instructions at a later date because of their deteriorating physical condition. The special joint committee that studied this issue made a recommendation to allow advance directives regarding medically assisted dying under certain conditions, but this recommendation is not included in Bill C-14. Certainly advance directives must be crystal clear if they are to be used, but it is an issue that we must face.
To conclude, I feel that the eligibility criteria put forth in this bill may not reflect the Supreme Court ruling that brought us to this point. While we have to be careful to protect the most vulnerable in our society, many Canadians, including the constituent I mentioned at the start, will suffer even more than they are now if we get this wrong.
I know that this debate will continue at committee and I hope some of the concerns I and others have raised will be addressed in the few weeks remaining before the June 6 deadline.
