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

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, while advance directives are clearly wanted by many people in progressive illness conditions, the legislation must make these directives crystal clear. We have to ensure these people really want this, the same safeguards that are there for the present directives. It is something that we must face.

[Guy Lauzon, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, I arrived here a very fortunate man 12 years ago, elected by the electors of Stormont—Dundas—South Glengarry. I really believe that since that time this is probably the most complex and sensitive issue I have ever witnessed come before Parliament, for me personally anyhow.

As far as disclosure goes, I am a practising Catholic. As a result of that, I will definitely be voting against Bill C-14. For me, this is a moral issue. I strongly believe in the sanctity of life. In fact, ever since I can remember, I have taught that life is precious, especially a human life, but also an animal or an insect's life. All through my life I have been taught that life is a gift from God and we should respect it as such.

That is not the only reason I will be voting against Bill C-14. Because this is such an important issue, I thought I should get input from my constituents. I took the trouble of sending a survey to 45,000 homes in my riding. The results were: 65% of the constituents of Stormont—Dundas—South Glengarry were against Bill C-14, and 35% were in favour of the bill, with conditions. I read many of the comments of the 35% and those conditions were rather strict. They called for very limited assisted dying.

I want to thank the joint committee. I wish I had been on the committee, but in other respects I am glad I was not. It must have been a very emotional committee on which to serve. I want to thank all the members for the hard work they put into it, especially the members of the Conservative Party, because they issued a dissenting report. Thank God for that dissenting report.

I must give the government credit for accepting some of the issues included in the dissenting report. They were things like limiting it to competent adults 18 or over. That is so important. If we are to have this legislation, at least we should have that as one of the criteria. The other one was safeguards for vulnerable persons. My colleague, the member for Brantford—Brant, spoke about that. He has a son who is in that category. There was also protection for physicians who disagreed. I have had so many physicians in my riding say that they cannot support this and believe they will be in trouble if they do not support it.

As many of my colleagues said, we have to do this. The Supreme Court of Canada has told us we must. However, if we must do it, let us minimize the damage. There is a way to do that. It is called palliative care.

During the campaign, the Liberal Party promised $3 billion for long-term care, including palliative care. However, in the budget, as my colleagues have stated, there was no hint of any money for long-term care and certainly no money for palliative care. It is nowhere to be found in the budget.

The special joint committee and most of the stakeholders who appeared before it, including the Canadian Medical Association, spoke of the need for a pan-Canadian strategy on palliative care, with dedicated funding. They suggested that there be dedicated funding for palliative care if we were to enact Bill C-14.

My Liberal colleagues are in the House. They are going to have a caucus meeting tomorrow, as will we. Money for palliative care should be brought up at that meeting.

I spoke with the manager of the Cornwall hospice today. Cornwall hospice is in my riding. About eight to ten years ago the community came together. We thought we needed a hospice so we raised funds. Now we have a wonderful 10-bed facility that deals with 100 to 150 patients per year.

I had heard through the grapevine, and through reading, that sometimes people left palliative care. I called the manager of this hospice directly and asked if this had ever happened. He said, “most definitely”.

On average, three to four people leave palliative care in a year. Sometimes they are gone for six months to 24 months. Imagine if some of those people had chosen the route of Bill C-14.

I was doing some reading on this issue, and it really struck a chord in my heart. I would like to quote something that I read, which is from the Euthanasia Prevention Coalition. It says:

Yet of the millions of mis-diagnoses every year, many are terminal mis-diagnoses. We know this because of the thousands of people who “graduate” from hospice each year.

People leave hospices not only in Cornwall, but right across North America and the world. There are so many examples of people outliving terminal prognosis, from Ted Kennedy living a year longer than predicted, to John Norton from Florence, Massachusetts, who testified before the state legislature. When he was diagnosed with ALS, he would have definitely used assisted suicide were it available. Luckily for John, his family, and everyone who has come to know him, assisted suicide was not state policy. He went into remission, and 60 years later he is urging people to reject assisted suicide. I rest my case.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, we consistently hear the opposition benches talk about a commitment toward palliative care. In fact, there is a commitment, which is in the budget document. The Minister of Health clearly indicated that we would be going into a new health care accord.

In order to accomplish the type of palliative care that Canadians want and deserve, we need to work with the provinces. This is the only way we can ensure that we have good, quality palliative care in every region of the country.

There has also been a commitment of hundreds of millions of dollars by this government toward improving palliative care. We recognize the value and the expectations of Canadians. Would the member at the very least acknowledge that?

We have to agree to disagree. I understand where the member is coming from in regard to this bill. However, we have a responsibility as parliamentarians to pass this legislation. It would be inappropriate for us to do nothing and let June 6 go by, which will leave a lot more people a whole lot more vulnerable.

However, would the member not at least agree that there is a genuine investment in the future of palliative care, especially if we compare this government's nine months to the ten years of the previous government?

[Guy Lauzon, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, with all due respect to the member across the way, I would like him to show me the cash.

There was a $3 billion commitment in the Liberals' platform, and all of a sudden it is not in the budget. The member is asking us to trust them, that they are going to have an agreement with the provinces and it is going to be there.

Quite frankly, we should not be passing Bill C-14 until we have palliative care in place. We heard about the gentleman lived 60 years. Imagine if he would have taken advantage of Bill C-14, assisted suicide. However, we have to talk about Bill C-14, which is a different case.

With all due respect, as I said, I would like to see the cash.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Madam Speaker, I would like to thank my colleague for talking about palliative care. In my opinion, that is an important issue that has not been brought up and talked about enough.

It does not make any sense to say that people who are diagnosed with a terminal illness have two choices. One of those choices is not a very good one, so we are going to offer people medical assistance in dying. Meanwhile, the palliative care that is available may be less than optimal, or there may be none available at all.

Many palliative care facilities are non-profit organizations. We can therefore provide them with direct assistance. These facilities need to raise thousands of dollars every year to provide their services. They would like to have bigger rooms to make more space for family members.

Does my colleague agree with me that the choices that are being offered to patients do not make sense? One of those choices is not a very good one, so rather than choosing the best option, people have to choose what seems like the least of the bad options in their circumstances.

[Guy Lauzon, Conservative, Stormont—Dundas—South Glengarry, ON]

–Madam Speaker, I agree with my colleague. Her question is very relevant.

I am going to do a little self-disclosure here. My first wife passed away from cancer. Cancer is not a pleasant disease to die from. When she was dying, the specialist called us in and said that they were not going to give her any more treatment. My wife said that she did not want to die. The doctor said that the truth of the matter was that nobody ever wants to die.

My wife and I had talked about this. I spoke up and said that Carol was not afraid of dying. She was a very spiritual lady and she knew where she was going in the next life, but she was afraid of the pain, as I was afraid of watching her go through the pain. I expressed that to the specialist.

He took my wife's hands in his hands and said, “Carol, I promise that you will not feel any pain. There is no need to have pain if the medication is proper. I promise you, and I promise your husband that there will be no pain in this death.”

That put her at ease.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, I would like to start this evening by acknowledging the difficulty of this task. Certainly the Minister of Justice faces a very daunting one. It is clear that Canadians have varied beliefs and deeply held convictions when it comes to the issue that is before the House today. I appreciate that the justice minister has attempted to find a law that balances the autonomy of individuals and the rights and responsibilities of the Canadian community as a whole, while simultaneously protecting the vulnerable among us.

It has been said that a society can be judged by how it treats its weakest members. I believe that is true.

I have to confess that I have wrestled with this legislation and continue to do so today. It seems as though the Supreme Court of Canada, with the Carter decision, has forced us into an unending abyss of grey. I prefer clear lines. I like black and white wherever possible.

I believe that doctors exist to save lives, not take them, and I believe that we as a society should always contend for life and not against it. However, the Supreme Court of Canada has ruled otherwise, and thereby robbed Canadians of clarity when it comes to this issue.

Assisted dying is now permitted in Canada, and we as parliamentarians have been tasked with the responsibility of putting legislation in place.

To that end, I would like to take a few minutes to share with the House and with the Canadian public my reflections on the proposed legislation. In particular, I would like to explore whether or not the rules and regulations within this legislation are adequate to protect the most vulnerable Canadians among us from being encouraged or pressured into pursuing assisted dying.

To be clear, this legislation is far better than what was recommended by the special joint committee, but there are still a number of things that cause me concern.

The first is a lack of access to quality palliative care within the nation of Canada. Right now, only 30% of Canadians have access to palliative care. Without access to all end-of-life options, a person cannot make a fully informed decision with regard to how they will face their death. Palliative care affirms that fighting to preserve life is our natural instinct and that dying is a part of our natural human experience.

Palliative care empowers a person to come to the end of his or her life with dignity intact and in a state of comfort. It deeply concerns me that we as a society are willing to invest significant dollars into assisted death before allocating adequate funds for palliative care. Why are we shifting to placing greater emphasis on death than on life?

Furthermore, I am concerned about those who acquire a disability during their life. In my role as the critic for persons with disabilities, I was able to consult with many organizations from across the country as well as organizations within my local constituency, and with a broad number of individuals who currently suffer from a disability. These personal stories helped to shape the concerns that I hold and will deliver today.

Without exception, every person who acquired a disability in their life told me that they experienced a period of intense depression as they adjusted to their new reality. For some, this period lasted days, and for others it lasted years. However, the hope they shared with me was that despite how different their life looked after they adjusted to their disability, they did regain purpose, joy, and dignity.

All of these individuals continue to face significant daily challenges. Quite a few of them rely on others for basic needs, such as eating or personal hygiene, and many even live with chronic pain. However, all of them have come to value the life that they lead and live with dignity, honour, and respect.

The message that these individuals brought forward to me was that in their previous lives they did not have a clue with regard to how it was possible to live with purpose and dignity while having a disability. This attitude took a while to discover, and they did so within the circumstances of their condition.

This is why I was pleased to see that the justice minister held her ground and did not allow for advance consent.

The Supreme Court, in many previous decisions, has defined the concept of continuous consent. We often hear about this in relation to sexual assault trials, but the principle is active in this case as well. Both the trial judge and the Supreme Court specifically limited assisted dying to a competent adult person who clearly consents to the termination of life. This consent needs to be given throughout the entire procedure. A previous declaration cannot fully appreciate how a person's understanding of his or her own condition changes as he or she learns to adapt to the new reality. Simply trusting someone's preconceived concept of what they will be like in the future is not a reliable mechanism for determining how they will actually be with their future condition.

I appreciated the reference from the minister to the need to protect vulnerable persons. The Supreme Court rightly found that the intent of the previous Criminal Code provisions was to protect vulnerable people from being induced to suicide. The Supreme Court validated this intent with its Carter decision. The unfortunate reality of people with disabilities and those with degenerative conditions is all too often one of poverty. In this circumstance, these individuals are entirely reliant on community access initiatives in order to live lives of dignity.

I have heard tragic stories of individuals who, with minimal community supports, such as adequate home care or assistance in transportation, could easily live a dignified existence. However, because these individuals were left in isolation and vulnerability, they wanted to access assisted suicide. They wanted to end the suffering that had nothing to do with their condition and everything to do with their social vulnerabilities. This is the harsh reality. Without strong safeguards in place, vulnerable people could be influenced to accept assisted dying because of non-medical social circumstances.

For this reason, all of the major organizations I have talked with from across Canada that work with persons with disabilities have called for a prior review by an expert to assess non-medical social vulnerabilities. This is not currently part of the legislation that is proposed. Something that I believe is absolutely essential to any legislative framework as we go forward is to have a prior review by someone with the expertise to determine if isolation, depression, burden, or poverty are impairing the ability of someone to make a competent decision with regard to assisted dying.

I commend the Liberal government for reintroducing into this debate the concept that physician-assisted dying must be connected with a condition that would lead to death. I appreciate this provision. As an alternate member of the Special Joint Committee on Physician-Assisted Dying, I saw a number of members of that committee from both the House of Commons and the other place argue that assisted dying should be offered to any individual who felt he or she was experiencing “enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”

The emphasis was on the perceived experience of the individual rather than a physical condition. There is no science to this approach, and no external diagnosis. If followed to its logical conclusion, this so-called criteria would allow anyone to access assisted dying without any accountability whatsoever. However, by tying assisted dying to an external medical diagnosis, it would move this process to something beyond the relative experience of the individual. This is critical to lessening the slippery slope that would inevitably exist with this legislation in place.

Every student who has taken an introductory class in politics would be familiar with the concept that laws are a social contract within Canada. When a law is struck down, it means that by extension every Canadian is in part affirming a previously banned behaviour that is now legal. It may not seem like a big distinction to limit assisted dying to conditions that reasonably could be expected to cause death, but it will in fact make a significant difference in the society we build going forward.

If we are a compassionate society that believes in protecting the vulnerable, it means that we believe society has the ability to overrule the impulses of the individual when we determine that those impulses would cause harm to the individual or harm to another person. This motive to save others is one of our redeeming characteristics as human beings. To allow this procedure to be accessed based on the subjective experience of individuals who feel they are in pain from a non-terminal condition would fundamentally alter the social fabric of our society. We are a society that contends for life. We must remain as that.

We as a Canadian society need to ensure that we do not tell those living with a disability, those who have to rely on others for the necessities of life, and those who face chronic pain with courage and determination, that their lives are not worth living. It is easy to lose sight of the broader implications to society when one focuses only on the post-modern concept of relative truth. Such an approach makes it impossible to argue with a suicidal person that his or her life is worth living. However, when we affirm objective truth, that is truth that remains true. Whether an individual believes it or not, it is so because we as a society have chosen to believe it.

[Pierre-Luc Dusseault, NDP, Sherbrooke, QC]

Madam Speaker, I thank my colleague for her speech.

I get the impression that she may have lost sight of the essence of the Carter decision, which specifically referred to the right protected under section 7 of the Canadian Charter of Rights and Freedoms. This is the right to life, and the right to life also includes the right to choose what to do with one's life. That was the essence of the Carter decision.

Does my colleague think that the bill we are studying will at least honour the essence of this decision? Is it an appropriate response, or do we need to go further? Some experts have said that with this bill, Ms. Carter might not even have been eligible for medical assistance in dying.

Does my colleague think that this bill is an appropriate response to the Carter decision? Does it go far enough, or could it have included Ms. Carter in the services offered in accordance with the charter?

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, this piece of legislation has to do with the right to life. That is what the Carter decision was going after. Therefore, I find it somewhat ironic that we are introducing assisted dying when dealing with the right to life. We, as a Canadian society, have always contended for life. Doctors exist to preserve life. They take an oath to fight for someone's life. Therefore, at the end of the day I must ask this question. How does the Carter decision contend for life?

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, I would like to address something that my colleague did not address. That is the ability for a doctor to be compensated in the issuing of euthanasia. I feel that this act should only be done out of an altruistic desire. Therefore, there should be no compensation or benefit to the doctor whatsoever in order for this to proceed. I was wondering if she has any comments on that.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, with respect to the right of a physician to be compensated for this procedure, it certainly poses some concerns for me. A physician takes an oath that he or she will do all that is possible to contend for life, to protect life. To suddenly be compensated for assisting someone in having that life taken seems contrary to the oath that a doctor takes. To consider compensating a doctor for taking a life could perhaps contribute to abuse of this, going forward, and a lack of accountability for doctors, which means that we could have lives that are prematurely ended without that individual giving direct consent to have it done or being forced to do so.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I thank my colleague for her excellent remarks and for her great work in general on behalf of the disability community.

I want to further probe this issue of palliative care. Some members in other parties have said that palliative care is great but that we do not have to deal with it right now because this is the issue of euthanasia or assisted suicide and that we can deal with palliative care at another time. However, what we have learned from the expert panel is that there is a necessary connection between these two things. If we do not provide palliative care, people will be pushed toward euthanasia or assisted suicide even if that is not something they want. Therefore, we have to offer a robust palliative care option in order for people to genuinely express their autonomy.

What I would like to see is the actual discussion of palliative care in this legislation. I would like to see this legislation protect a right to palliative care to ensure that option is available as well. I want to know if my colleague would agree with me on this.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, the Carter decision was made to protect the autonomy of individuals to preserve their choice at the end of life. Therefore, it would seem to me that, if we are to protect someone's choice, we should make all end-of-life options available to them. Palliative care is certainly an essential one.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, I am thankful to have this opportunity to speak on Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts.

Assisted suicide is a grave matter and has serious implications for all society, in the short term and in the long term. Based on the experiences of countries like the Netherlands and Belgium, which have legalized assisted suicide, we can know with great certainty that vulnerable populations, such as seniors, youth, and those who struggle with mental illness, will inevitably be put at risk.

Legalization of assisted suicide has also greatly undermined the public trust in the medical system in these countries. That is why I am opposed to legalizing assisted suicide.

Bill C-14, in its current form, leaves segments of society vulnerable and provides no protection for professionals or institutions, and undermines the credibility of our health care system and the important work that health care providers do to help people live.

I urge members to take great care with this legislation and to weigh every word to ensure that our most vulnerable people are never placed at risk.

In the past, this House has debated capital punishment, another means in which to take a person's life. Capital punishment was rejected, in part because the risk of ending one innocent life was one life too many. Should that same principle not guide us in our debate today?

Ray Pennings, co-founder of Cardus, recently expressed the importance of this in an editorial, writing:

While every word in a legal definition matters, the language of this debate matters in a broader setting. How do we as a society understand personal autonomy and the taking of one's life? How do we distinguish between a group of teenagers on an aboriginal reserve entering into a suicide pact, after deciding that life is not worth living, from citizens with a terminal diagnosis, fearing they've become a burden to their families and society, who similarly decide that death is preferable to life?

The debate is hardly new, but there are distinctions that can be made which require care and a precision of language. It is concerning that the utilization of language is heading in the opposite direction.

Mr. Pennings goes on to demonstrate this shift in the two Supreme Court of Canada cases. In the 1991 Rodriguez decision, which upheld the prohibition against assisted suicide, the term “assisted suicide” was used 92 times. However, in the 2015 Carter decision, in which the Court came to an opposite conclusion, the term “assisted suicide” was used only 23 times, while the term “assisted death” was used 24 times.

When we look at the current legislation before us, we see that the term “assisted suicide” does not appear at all, the term “suicide” appears only seven times, and the phrase “medical assistance in dying” is used 72 times.

In 20 years, we have progressed from recognizing the value and dignity of life and making every effort to discourage people from suicide, to now offering assisted suicide as a form of health care and calling it “medical assistance in dying.”

While I find many parts of Bill C-14 alarming, I want to start with this shift in the language. It is misleading to use “medical assistance in dying” in the context in which this bill does. Medical assistance in dying is not helping people choose to end their lives. Medical assistance in dying is what the medical community calls palliative care or hospice care.

As Canadians, we are blessed to live in a country that has a great health care system, with many physicians who care deeply about helping their patients live fulfilling and healthy lives. When circumstances change and patients are facing an incurable deadly disease, these same doctors use their medical knowledge to relieve pain and suffering through end-of-life care. This is real medical assistance in death.

That is why I believe amendments are necessary to correct the hijacking of real health care. First, Bill C-14 should be amended to replace “medical assistance in dying” with simply “assistance in dying”. This would separate assisted suicide from health care.

Second, to complement the removal of medical terms from Bill C-14, I recommend amendments that allow for licences to be given to individuals through the Department of Justice that allow them to assist others in ending their life. This would eliminate the requirement of the medical community to be involved, as well as any concerns around the conscience rights of doctors. Licensed individuals, including doctors who wish to participate, could assist in the assisted suicide process and allow our health system to remain focused on its primary objective of providing health care to all Canadians.

Third, I believe the eligibility for assisted suicide in Bill C-14 must require that individuals seeking assisted suicide first be provided with counselling or psychological services and a legal judicial review.

There are a number of amendments that I believe are also critical for the bill, but many of them have already been raised by my colleagues. I want to return to what is truly at the heart of this debate; that is, protecting vulnerable members of our society and reducing the suffering of those who are dying.

This has been raised by many members from all sides of the House. Helping people die with dignity is not, and never will be, achieved through legislation of assisted suicide. Rather, helping die well can only be achieved through improving our focus upon palliative care. Every Canadian has the right to quality health care, and this includes high-quality palliative care.

That is why I have seconded a motion on palliative care tabled by my NDP colleague, the member for Timmins—James Bay. This member has pointed out often that there has been no real commitment by the government to palliative care.

I was recently moved by a comment from my colleague in the other House, Senator Betty Unger, a registered nurse, who wrote:

Access to palliative care is as much a Charter right as access to physician-assisted dying.... [M]ost people will acknowledge that there is something terribly wrong when a government does more to guarantee that the living can die, than to ensure that the dying can live.

I would call upon the government to demonstrate that it views palliative care as much as a charter right as assisted suicide.

Assisted suicide and euthanasia is one of the issues that influenced my decision to run as a member of Parliament. It is an issue that also concerns many of my constituents.

Earlier this year, I sent out a survey to my constituents on assisted suicide and euthanasia. Over 92% of my constituents responded that they were opposed to assisted suicide being available to children. The vast majority also took the time to express they opposed assisted suicide for all people, not just children.

My constituents also expressed concern that doctors must be given conscience protection, including Michelle, who wrote, “Doctors take an oath to save lives, they should not be asked to end them by patients or families' choice”.

Opposition to assisted suicide in my riding also crossed party lines. Amy wrote me, “As a Liberal supporter, I feel torn on these issues. I can understand both sides. However...this issue seems almost equivalent to legal murdering”.

On the issue of pain and suffering, Maggie wrote to me, “Having seen friends and family make decisions in the midst of pain and weariness, and having been through deep depression and weariness of emotional pain; I know that clear good decisions are never made in the valleys of life. I've come through wanting to end my life and experienced more joy than I [ever] thought...possible”.

My constituents also include 14 first nation communities in northern Alberta. During the special joint committee hearings earlier this year, Dr. Alika Lafontaine, who is the president of the Indigenous Physicians Association of Canada and who also works throughout northern Alberta, said:

What we are pleading for in indigenous communities is not medically assisted dying. That already exists in more ways that can be counted. What we are pleading for is medically assisted life.

Indigenous physicians want to help indigenous people live, not die.

Dr. Lafontaine also expressed that there have not been “meaningful consultations with indigenous peoples” and that “the effects of creating a literal program where patients intentionally die within the medical system will further disengage and disenfranchise indigenous patients and families”.

Earlier this year, I asked the Minister of Health about the consultations, and she admitted that the Liberal government did not consult directly with indigenous organizations on assisted suicide legislation.

Indigenous leaders tell me, “Nothing about us without us”.

I am deeply concerned about the impacts that legalizing assisted suicide would have on the indigenous communities.

Finally, the topic of suffering is often raised when discussing suicide. The argument is made that assisted suicide should be made available to all who suffer, even children. Proponents will argue that life with pain and suffering is undignified life and, therefore, assisted suicide should be available to anyone suffering pain.

I could not disagree more. People's dignity is not tied to their circumstances, but comes from the very fact that they are human.

More important, our health care providers are incredibly talented at helping patients manage pain. Even when it comes to children in palliative care, doctors are not—I repeat, not—seeking assisted suicide as a solution.

Dr. Stephen Liben, director of the Montreal Children's Hospital's pediatric palliative care program, said:

There aren’t these children that are asking to please die now. It never happens.... The last thing I need as a palliative care physician for children is a euthanasia law—the last thing....

This would not be an extra tool for relieving suffering at all, it would only muddy the waters and make things more confusing.

I cannot support Bill C-14 at this time, but should significant amendments be made in the protection of conscience rights of health care workers and the removal of health care references, I would consider support.

[Tracey Ramsey, NDP, Essex, ON]

Madam Speaker, the member highlighted some language earlier, such as the use of the word “suicide”. In the outline of the legislation provided by the government, there is a definition of “medical assistance in dying”. I believe that using this particular term is important. It is important for Canadians, when it comes time to make this choice, that the word “suicide” is not attached to it, because it is a choice they are making at a time in their lives when they are in great distress and pain.

I do want to highlight for the member that there are two definitions. The first one is the administration of a substance by a medical practitioner or authorized nurse practitioner that causes a person's death and the second is the one he has been referring to, which is the prescription or provision of the substance that the person then self-administers. There are two separate pieces and that is why “medical assistance in dying” has come forward.

He also mentioned the medical community. The Canadian Medical Association strongly welcomes the federal legislative and non-legislative responses that we put forward. Taken together, the proposed legislation and federal commitments to work with the provinces and territories go a long way to ensuring we reach a consistent framework in medical assistance in dying across all jurisdictions in Canada.

We find ourselves at the current juncture and it is not simply about whether we in the House feel that this legislation should be implemented. It is the rules that we are going to be putting around it.

I would appreciate it if the member would speak to the amendments that he would like to see put forward in committee.