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

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

Mr. Speaker, I thank the member for an excellent speech and for his excellent work. He is my neighbour in the Edmonton area, and I sometimes feel he knows more people in my riding than I do.

I want to ask about a specific case that builds on some of the comments he made. Dr. Nancy Naylor is a case I have mentioned before. She is a family and palliative care physician in Ontario who has said that she is leaving the profession because of the absence of conscience protection in the Ontario College of Physicians and Surgeons' policy and in this legislation.

This is a huge issue of access for her patients, for the people in her community. Why would we push people out of this profession who are currently providing compassionate, loving, and necessary palliative care when we already have a shortage? Why would we push people out of it who want to provide care? Let those who want to provide euthanasia provide it, but let us protect those who want to provide palliative care and allow them to remain in the profession so they do not have their conscience infringed and they are not forced to leave.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, the member speaks my mind basically, because really, I do care and worry about the professionals out there, the physicians who spend their lives studying and going to school, who will be forced to do something they do not want to do. It is as if someone is giving them a gun and saying “shoot me”. Then they have to commit a crime just because they were told to do so. That is not what we want here. We want legislation next to perfect. Hopefully we can get that if we have more consultation and give it more time.

[Sean Casey, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I have a couple of questions for my colleague. First, he said if he were a doctor he would be worried because they are going to be forced to do something. I would ask him to point to the passage in the legislation that forces doctors to do anything. There is absolutely nothing there in that regard.

I would also refer him to the position of the Canadian Medical Association, which has been strongly supportive of the legislation.

However, I want to come back to the issue of not enough debate. The decision was on February 6, 2015. We brought forward a motion on February 24. The government defeated it. That motion would have had the committee's work done by July. Between the day of the decision on February 6 and the election, the previous Conservative government did nothing. How can Conservatives now say we do not have enough time?

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, to answer the first part of the question, the bill is not clear. There are a lot of vagaries. I am not going to represent myself as a member of Parliament and say someone told me so, or the Medical Association told us so. This is not the way we legislate. This is not the way we think.

We need more time. We need to absorb. We need to understand because our conscience has to play in making this decision, and we must do that carefully and thoughtfully.

[Bradley Trost, Conservative, Saskatoon—University, SK]

Mr. Speaker, let me start tonight by thanking my constituents who have written to me on this issue. It is approaching 12 years that I have been a member of Parliament in this place and, unlike some other members, there are issues on which I have received more correspondence. However, I have received a fair bit of input from my constituents and, not surprisingly, it varies. I want to express my appreciation because the democratic process only works when everyone is engaged, when citizens speak what they feel are the fundamental principles involved.

I also want to give a special shout to one of the high school classes at Bishop James Mahoney High School, which I was at last week. We discussed these very profound issues. The young people in a grade 11 class had thought about it deeply. They had read the legislation. They had gone through it, unfortunately I might say, more thoroughly than some of the parliamentarians who may be voting on this in the future. The students had come to some very clear conclusions and understandings about what this is, because however a member will vote on what we are speaking on tonight, this is a moral issue for however we deal it. Not that most, if not all, issues do not have a moral component, but this one in particular is fairly clear.

As has been said by other members, this is also a fairly personal thing. Each and every one of us will have to deal with death at one time in our lives.

I was on the phone earlier today with my mother, and she reminded me that it was exactly a year ago today when she called me and said to go down to the nursing home because my grandma was passing away. She did not pass away that day, but she knew she was dying. I held her. It was one of those times when we begin to think about the consequences.

There had been the previous court ruling. One has responsibilities to family, to country, to everything. As a member of Parliament, I feel that all members of Parliament, even those who cannot speak to this debate, have a duty to tell their constituents how they stand.

The first point I wish to make tonight is one that people need to understand. The law is a blunt instrument. The law is not something that can easily distinguish fine and distinguishable cases. The law is something that is very difficult to implement in very specific situations. In a situation like this where we are dealing with a law that involves the protection of life, we must give the absolute greatest caution and protections to life.

Pollsters ask questions. They ask people how they would vote in this situation or that situation. However, to be perfectly blunt, no pollster can encapsulate the complexity of even one unique situation. Yet we as legislators are asked to make a decision, to come to some sort of conclusion. That is part of our job.

Because the law is such a blunt instrument, because the law cannot distinguish in the most subtle cases, and because human beings are valuable, we must give whatever protections we can to life. It is for that reason that, whatever the restrictions that have been suggested by other members tonight, I will be supporting that. I suspect that I will be in the minority in this House in that I will not be supporting the legislation, because I do not support the underlying principle of the legislation. I suspect that I will be in an even smaller minority in that I would be prepared to support the notwithstanding clause to override the Supreme Court's decision.

However, it comes down to that basic and fundamental understanding that the purpose of civil society and the purpose of government is to protect life—life, liberty, and the protection of property. Those are the things that we are to do.

Yesterday, I was at an event where we had a speaker talking about freedom and about the issues involved. He noted that throughout history there have been different forms of government, but mostly they have come down to three basic styles: familial, clan-style government like those in many African tribal societies and like the clan system of northern Scotland; a hierarchical system, such as dictatorships and the system in the Middle Ages when they had the emperor, the king, the serfs, etc.; or a covenantal system, where all members of society agree, sometimes to some degree compelled by law but often through their own decision, to their own actions and their commitment to morality, to be covenanted to be part of and supportive of their neighbour.

That is one thing we need to understand. The basis of constitutional government is a system where we covenant to each other, to support each other, and not because we are forced to through a hierarchical power structure. Yes, there are police, laws, and ways of dealing with wrongdoers. However, each and every one of us has a particular commitment to our fellow citizens throughout our lives, even until the end of our lives. That needs to be thought about in each and every situation as we debate this legislation. That commitment to each other, at the bare minimum, is a commitment to defend the lives of our fellow citizens and fellow human beings.

Earlier last month, in the popular press, there were stories about some doctors in Quebec. I hope this is a mistaken story as these things are often exaggerated, but the story was told that some doctors had refused to treat people who had attempted suicide, even though they were very treatable. The college of physicians and surgeons in Quebec had to set a guideline to say that if people go into the hospital, doctors must treat them and not just assume that because they have attempted suicide, they have given an indication that they want to die. If the people are not covered under either the Quebec law or the Supreme Court ruling, they must be treated. Doctors have a responsibility, a covenant, to protect the life of a human being and that is the job of a doctor in an emergency ward.

When I read that article, I thought to myself that we need to understand that this is one of the consequences of passing this legislation. There are people, regardless of how many protections there are, whose lives will be taken because of this legislation. Again, I hope the story in Quebec was incorrect, but if it was true, there were people who attempted suicide, cried out for help, and unfortunately, were successful, but whose lives could have been saved.

Because of this debate politically, because of the ruling of the Supreme Court, and because of previous legislation by one of the provinces, there is a very real possibility some doctors did not interfere. When we hear about and discuss the suffering that people are concerned about—and in many cases, it is the fear as much as the suffering that people want to end as they come to the end of their lives—we need to understand that each and every one of us, even as we approach the end of our lives, still has that covenant with our fellow man. The question of how much suffering for one human life is one that we are very practically applying today in this legislation.

We need to understand that and ask ourselves how much suffering and fear we want to deal with and how much we want people to take in exchange for a human life. We make those decisions. We have to in society. It is not a morbid question; it is a realistic question. We set speed limits. We do these things. We know there are consequences to actions. We cannot live in a perpetual bubble.

The point I am making is this. Even at the end of life, if one has fear or pain—and I do not doubt the sincerity, the depth, and the agony of people who go through this—the decisions people make as they approach the end of their lives will impact others. There will be others who, because of the changes in this law and the reasons that are given for the law, will be pressured and will lose their protections such as in the cases I referred to in the province of Quebec. That is something we cannot forget. The ultimate duty of civil society and of government is to protect life. We must do it at all costs.

I again want to thank my constituents and my fellow members of Parliament, but to have a clear conscience, I must vote against this legislation. I can do no other.

[Sean Casey, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I thank the hon. member for a very thoughtful speech. Obviously we have come down on different sides of this issue, but certainly what he put into that speech is something that was clearly thought out and very well delivered and expressed.

The member talked so passionately about the sanctity of life. If others in this chamber come down on this issue at this time in the same manner as the hon. member, we will be left on June 6 without any criminal law with respect to medical assistance in dying, and the safeguards that are built into Bill C-14 will not become the law of the land. There will not be a requirement for two doctors to pass opinion on a patient. There will not be a requirement for two independent witnesses. There will not be a requirement for a signed request.

We are in a situation in this Parliament where the question before us is not whether, it is how, and the how that has been put forward is one that contains these safeguards that will be lost if this legislation is not advanced to committee.

Given the member's deep-felt thoughts on the sanctity of life, could he respond to the ramifications that arise out of a defeat of this legislation on June 6?

[Bradley Trost, Conservative, Saskatoon—University, SK]

Mr. Speaker, I appreciate my hon. colleague's comments. I understand very much where he is coming from, and I suspect that is one of the reasons why he will carry the majority opinion of the House.

As I stated earlier, and again I have no doubt that I am in the minority, my underlying preference would have been an absolute rejection and use of the notwithstanding clause, either as a temporary measure to give this House two or three years, whatever time the House deemed appropriate, to deal with this issue, or as a permanent matter.

I would say to the hon. member, there are applications for extension. I realize the Supreme Court would not look all that favourably on it, but it would be necessary. A temporary piece of legislation to say for one or two years the notwithstanding clause would be put in and then other legislation put through later in this Parliament would be another option. Those are various options that I think the House could look at.

Again, I am realistic enough to understand and suspect my opinion is in the minority.

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

Mr. Speaker, I think it needs to be acknowledged that the timeline we have is to a substantial extent manufactured by the government. The Liberals removed the direction to the expert panel to provide legislative recommendations, which would have sped up the process. They had an opportunity, as soon as the special joint committee reported, to bring forward legislation. They delayed and delayed, and now they want us to be concerned about the timeline.

They should propose a better piece of legislation. They should fix the problem and then we can work together to get it passed quickly, but there are no clear criteria. It uses phrases like “reasonably foreseeable”, which are neither medical nor legal terminology. This legislation provides no clear criteria. If it does not do the job that the court asks us to do, which is to create a system of robust safeguards, then what is the point of passing the bill? What is the value of passing a bill that does not actually, in any substantial way, improve on the absence of the bill.

Let us reject the bill and give the government a chance to try again.

[Bradley Trost, Conservative, Saskatoon—University, SK]

Mr. Speaker, I thank the hon. member for his comments, and since it was really more of a comment than a question, I will say I very much understand where he comes from and we have very similar views on this issue. Since this is my last time to raise a comment, I just want to make one last comment before debate resumes.

I did not mention my support for conscience rights, and I want to add one small thing to that. We often speak about conscience rights as if they are conscience rights based upon religion. Conscience rights should be for everyone. It does not matter what our background or what our basis is, atheist, religious, irreligious, whatever it is and for whatever reason.

For the trauma that a person could feel if he or she helped to assist someone else to die, for just that personal reason, even if one supports the principle of the legislation, there should be no restriction on this conscience legislation, whatever we put with the bill.

[Scott Reid, Conservative, Lanark—Frontenac—Kingston, ON]

Mr. Speaker, I thought that rather than giving my rationale and telling people how I will vote at the end, I would do the opposite.

I want to say, first of all, that I will be voting yes at second reading to this bill, so that it can be sent to committee where it can be discussed in principle, and perhaps be amended to make it better than it currently is.

At third reading, I will be guided in my voting by the instructions of my constituents. I am mailing out what I call a constituency referendum. It is effectively a survey designed to ask them in as impartial a way as possible how they would have their member of Parliament vote. The reason I am doing this is that I believe, when it comes to a profound issue of conscience like this, the consciences of my constituents are every bit as good as my own conscience, that of the other members of Parliament, or the people on the Supreme Court of Canada. They will guide me at third reading.

My comments today are, therefore, about the underlying issue that I think is at stake here as we, meaning Parliament, the courts, the policy-makers here in Canada and frankly in every country in the world, must face as we deal with the realities of life and death at this particular moment in time.

Right now, and this is not something that has always been true in our history, life is expensive, maintaining life is expensive, and death is cheap. This is something that has not been true throughout our history.

Anybody who reads the novels of the Brontë sisters is aware of the fact that in the mid-19th century, and in every century before that, life was relatively inexpensive to maintain, in part because the ability of medical technology to keep people alive was so limited. The doctor would arrive, perhaps bleed someone if they had a simple fever, and then, at least this is how it happens in the novels, advise the relatives to prepare themselves. The financial difference between life and death was very limited.

That is no longer true. I want to make this point in the context of a health issue that has nothing to do with euthanasia or the assisted suicide or assisted dying debate, but it really illustrates just how expensive life is in a world of improved technology and pharmaceuticals.

This month, May is cystic fibrosis month. I know somebody who has cystic fibrosis, and I have become very passionately involved in this. Every year, I encourage members of Parliament to wear a rose, and we will all be doing this next Wednesday, in honour of those who have cystic fibrosis. I wear the cystic fibrosis pin today.

Now there was a drug introduced in 2012, called ivacaftor, trade name Kalydeco, which, for the 4% to 5% of cystic fibrosis patients who have the delta-F508 mutation of the gene with the CFTR protein, for that small segment of cystic fibrosis sufferers, this drug effectively turns what would otherwise be a terminal disease into a manageable illness that is problematic but not fatal.

It is available at a very high cost to them, their families, or the public health care system, depending on where the patient lives. The cost to get access to Kalydeco is approximately $300,000 American per year. The patents on drugs are typically about 20 years long. Presumably at the end of that 20-year period, the cost will drop dramatically, but right now it is $300,000 per year. Members can do the math, $300,000 times 20 means that it is $6 million to keep one individual alive.

It is well worthwhile, but the fact is that life is expensive, whereas denying them this care, and some provinces do not give public funding for the drug, is cheap. That costs very little. I do not mean to suggest that the drug company is charging unreasonably, or any of these other subsidiary questions. It cost $458 million for Vertex, the company that developed this drug, to bring it to market. My observation is simply that life is very expensive and maintaining life is expensive. Death is cheap.

Now, turning to palliative care, of course it costs a great deal less than this to keep people alive on palliative care at the end of their lives. However, the fact is that denying care is less expensive. This is exclusive of the Supreme Court ruling. It is exclusive of whatever is in Bill C-14 or should, or should not, be in Bill C-14. This creates a dynamic in which there is a strong financial incentive for policy-makers to promote the less expensive option, as there is in everything.

In this case, it means that the incentive to do what is necessary to allow the life option as opposed to the death option is reversed or weakened. This means the incentive to not provide palliative care is going to be very strong.

In this situation, the Supreme Court of Canada ruling in Carter v. Canada is likely to have tilted the dynamic in favour of death as a solution to the high-cost problem of maintaining lives that are deemed to be not worth living.

To make the point about how this is relevant, I want to quote from what the health minister said on the Friday before the break, in her speech on the issue. I had the good fortune to be able to question her afterwards about this. She said:

Today, Canadians are aware, and have a general understanding, of palliative care. However, some studies have [shown] that the overwhelming majority, perhaps 70% or more of us, do not have access to it, particularly in rural and remote areas. Many providers are not well trained to provide palliative care services.

I think she was just presenting what she regards correctly, as a fact. However, read this a different way and a more sinister meaning becomes evident. We lack the funds, or the provinces lack the funds, for palliative care, but death is the less expensive way to ensure that no one lives an unbearable life.

Again, I do not think she meant this in a sinister way. The implication was simply there to be found, and taking her words and reading them a little differently, we see that implication.

Faced with this problem, the problem brought upon us by the fact that we can extend life in a way that never could before but with limited funds and, inevitably, there are not enough funds to deal with all the life needs that are out there, the wrong move taken for a reason that seems noble but is poorly thought through could have disastrous consequences.

To make this point, I want to turn to one of the best books on public policy I have ever read, Lectures on the Relation between Law and Public Opinion in England during the Nineteenth Century, by the great Albert Venn Dicey.

Writing about Lord Shaftesbury, the well-meaningful philanthropist and statesman, he writes something that I think could well be applied to the Supreme Court's ruling in Carter v. Canada:

...the natural desire of an ardent philanthropist to save from immediate suffering any class of persons who are unable completely to protect themselves against oppression, and to do this by the means which lie nearest to hand, without deeply considering whether action which gives immediate relief to [these] sufferers...may not possibly in the end produce evils of untold magnitude.

In response to this, the danger is that we will do what Dicey warned about Parliament reacting. He was talking about the British Parliament. He was writing of a different century, but this is a warning that is well taken by any Parliament dealing with this kind of situation.

He said:

...laws passed to meet a particular emergency, or to satisfy a particular demand...produce, in the long run, more effect on legislative opinion than a law which openly embodies a wide principle. Laws of emergency often surreptitiously introduce or reintroduce into legislation, ideas which would not be accepted if brought before the attention of Parliament or of the nation.

This legislation is being introduced in haste in response to an artificial deadline, and it is an artificial deadline, set up by a Supreme Court which has a noble goal in mind but which has not, in my view, looked at all the implications of what it is trying to do. In dealing with a highly atypical set of cases, all of our jurisprudence in Canada at the Supreme Court level is based upon suffers of ALS who, on that bell curve of different ways in which people can die, either fully in charge as ALS sufferers are of their wills and their minds but not of their bodies or, at the other extreme, like Alzheimer's sufferers perhaps in reasonable physical health but not in possession of their faculties, and everybody in between. We have used that set of cases that have come before us because that is the way the court system works. Only the mentally capable can get their cases to the court and the court has generalized in a way that leads, potentially, into a hasty reaction that could lead to a principle being introduced into our law which may have, as Dicey says, unfathomable consequences.

I ask us all to move very cautiously and to seriously consider the possibility of amendments to this legislation in the coming weeks, as we go into committee.

[Sean Casey, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I would like to ask the member about what he describes as an “artificial” deadline.

The Supreme Court has imposed a deadline of June 6. This is a deadline that was imposed after we asked for a later deadline. On June 6, there will be serious ramifications if a law is not passed. I am at a bit of a loss to understand what is artificial about what the Supreme Court has said.

Surely this is not a reflection of disrespect for the court, but it must mean something. However, I am very unclear as to what it means, because I think the court was pretty clear.

[Scott Reid, Conservative, Lanark—Frontenac—Kingston, ON]

Mr. Speaker, I could have used the word “arbitrary”, and perhaps I should have said that instead of “artificial”.

It is arbitrary. There is nothing special about June 6 other than the fact that the Supreme Court said that was the day on which this part of the Criminal Code would simply cease to be in force or have effect.

The court could have acted as the American court would have done and simply said that this law had no force or effect right now, period. It could have done that, which would have produced a different legislative reaction. We would not have reacted in the haste to get legislation rammed through by a certain date if it were not for the fact that the law was not being struck down until a future specific and relative approximate date. Therefore, in that sense, it is highly arbitrary and artificial.

Throughout my comments, I have tried to indicate that I am not trying to be disrespectful either of the court or of the drafters of the current legislation. I am simply observing that we are potentially, as a system, responding in a very much sub-optimal way to the great health care issue of our time, which is the fact that we can save many lives, but we do not have the financial means to save all lives in the way we might choose to do. That is an issue that is going to confront us over and over again.

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

Mr. Speaker, there have been a number of references throughout the day to some very vague promises, whether it is relating to palliative care or conscience protection for doctors, which is referred to somewhat vaguely in the preamble.

I would like to ask my colleague if he feels that these are adequate promises for Canadians to hang their hat on in expecting a palliative care program when there has been nothing in the throne speech, nothing in the budget, that would actually show any type of follow through.

I believe some amendments should be made to the bill to make that a requirement, at least a consultation, and then consultation could be followed up by actual accessible and affordable palliative care. Also, there should be some clear language that would give health care workers and health care institutions a guarantee that they would not be required to participate in any way in physician-assisted suicide.

[Scott Reid, Conservative, Lanark—Frontenac—Kingston, ON]

Mr. Speaker, earlier today I discussed with my hon. colleague for Kitchener—Conestoga his suggestion that a mandatory palliative care consultation ought to be required prior to the process that is contemplated in the law to physicians or nurse practitioners signing-off on an assisted death request. That is an excellent proposal.

We do have a shortage of these practitioners in Canada. The fact is that I can get a prescription right now electronically from someone who is not in the same room as me. Some kind of provision could be made for this. A budget could be provided for it. Right now, zero dollars have been provided for it, and I do not think the palliative care initiative that the government has talked about deals with this kind of consultation, which would be preferable.

In many cases, it might be a conclusion that it is not available in one's area, but at least no one would die uninformed. Also, I think it would create pressure from relatives to start making better or more widely accessible palliative care. It is an excellent idea. If it is not incorporated into the legislation, then it should be incorporated in a later bill, which would amend the act.

With regard to the issue of conscience rights, here is the problem. The right to request that one's death be caused, the right to end one's own life as a part of the right to life in section 7 of the charter, now that the courts have interpreted that right this way, imposes an obligation on others who are in a position of being state actors or semi-state actors. This would require them to assist a person. They cannot withhold this right from a person. Seeing as doctors are people who have a monopoly over health care because of their position, which is created by the state, they may be forced, unless there is a specific provision in the law, to provide that care. That is the danger, and I hope it will be corrected in amendments to the bill.

[Kelly McCauley, Conservative, Edmonton West, AB]

Mr. Speaker, before I start, I would like to thank my friend from Yellowhead for his kind words on Fort McMurray. The devastation there is overwhelming. I would like the people there to know they have my prayers, and I am sure the thoughts and prayers of everyone in the House today.

I used to work in Fort McMurray. In fact, the very first hotel I managed just burned down. I know the people there will be counting on our support, and the people there know everyone in the House will be supporting them.

I rise today to discuss Bill C-14. This is obviously a very difficult issue for many people in the House, and I appreciate the views expressed here today and in yesterday's debate. Members oppose the bill on faith-based grounds, legal grounds, ethical grounds, and for other reasons. Others praise and support the bill.

I truly respect each member's personal contribution to the parliamentary debate. I would like to express my gratitude to the members of the Special Joint Committee on Physician-Assisted Dying. It is probably one of the most difficult, if not the most difficult, issues we are going to face in this Parliament.

We all know someone who has died in pain, a loved one, a child, a colleague. We have all seen the ravages of disease on the body of people we once saw only as the embodiment of life and hope. I have lost two of my most beloved uncles to cancer. One of these uncles was a lifer in the Royal Canadian Navy, who finished his career in service to Canada as base commander at CFB Esquimalt.

Commander Larry Dzioba, as any commander would be, was ready for his battle that would come. He fought cancer to the end and was still living independently, in relatively good health, up until the final two days before he passed away. I credit his strong Ukrainian stock for his strength and always think that he viewed pain as something to be tolerated.

Another uncle of mine, Michael McCauley, passed away after years of chemotherapy and radiation. In the end, he passed away at home in his bed surrounded by his family. He maintained his dignity until the very end.

Another very close friend of mine, my dear friend Peter, died of lung cancer a few years back. Peter and I worked together at the famed Deerhurst Resort in Muskoka, pre-gazebo days, and later together in Edmonton. Peter went from diagnosis to death in just three months, but his family and friends will forever be grateful to the wonderful staff at the Cross Cancer Institute in Edmonton, who ensured that Peter lived his final days as comfortably as possible and with dignity.

Unfortunately, however, far too many Canadians suffer due to inadequate palliative care. A 2015 study shows that anywhere from 15% to 30% of Canadians have access to adequate palliative care, and even at the highest levels of the spectrum, it is nowhere near enough.

This is where my concerns with Bill C-14 begin. From the bill's preamble, I quote the following:

Whereas it is desirable to have a consistent approach to medical assistance in dying across Canada

The government wishes to have a universal approach to assisted suicide in Canada, but does not state the need for universal access to palliative care across Canada. Members of the House have repeatedly commented on access to broadband Internet as a human right, yet there is nothing about a human right to palliative care. The government commits to broadband expansion in its 2016 budget, but if we search “palliative” in budget 2016, we get the message ''no matches were found''. It is disgraceful and shameful.

The health minister has said that $3 billion will be committed over four years for palliative care across the country, but there are no details on this. It is not listed once in the budget. There is no information on how it will be rolled out or how it will be paid for.

In fact, the $3 billion is probably the same $3 billion that the Liberals promised in their election campaign for increased home care services. It is not specifically for palliative care, which they are stating now, but for home care services.

Alarmingly, the health minister said in January, just before meeting with provincial health ministers, that "more money isn't necessarily the only solution”. The $3 billion is promised, yet it does not seem to exist anywhere in the budget and, according to the government, may not be necessary. I would argue that virtually every doctor who treats terminally ill patients would disagree.

It is paramount that the government states immediately how it will ensure equal access to proper palliative care across this country. It is unfathomable that the government would introduce assisted dying legislation without announcing a detailed strategy to prevent terminally ill Canadians from believing doctor-assisted suicide is their only option.

The government has a moral obligation to outline such a strategy and provide adequate funding immediately. It is not enough to simply spout off a few talking points, get in a few good sound bites, and then hope it is later forgotten.

The government has not done nearly enough to think through this bill in its haste to meet the Supreme Court's deadline. It has not begun to consult with the provinces on many of the responsibilities that will be downloaded onto them. For example, Alberta has been working on this for five months with no apparent consultation with the government.

I believe assisted suicide is not the answer to the complex problem of human suffering, whether it be physical, emotional, or even spiritual suffering. Medical advances specifically in pain management drugs have gone a long way in helping the suffering bear pain and keep their dignity. What is really needed above and beyond the medical advances and improvements in palliative care is a willingness to be involved in the lives of those who suffer. The reasonable answer to suffering is love, companionship, and hope for the better, hope for tomorrow, for hope allows us to continue on.

In addition to the philosophical objections that I have to this bill, there are many practical concerns. One is the lack of education on the matter of alternative methods for care of the terminally ill. For example, a survey of pre-licensure pain curricula in the health science faculties of 10 different Canadian universities showed that many would-be doctors receive less training in pain management than their counterparts in veterinary medicine. Meanwhile, a survey of over 1,100 doctors and nurses showed that those who treat fewer terminally ill patients, therefore knowing the least about symptom management, are most likely the ones in favour of assisted suicide, whereas those with the most experience with symptom management and end-of-life care tend to oppose it.

Dr. Max Chochinov, a noted specialist on palliative care, explains that the will to live is directly inverse to the amount of pain and that loss of dignity drives wanting to die and treatment of pain can improve sense of dignity.

I realize that we will have doctor-assisted suicide in Canada. The courts have decreed it, and society appears to demand it, but we in this House must ensure that we are doing everything to ensure we protect the vulnerable and enshrine the belief that all life is precious before we introduce a new law.

There are holes that must be addressed before Bill C-14 becomes law. Like many others in the House, I am disappointed that there are no provisions to protect the rights of doctors, nurses, and other medical practitioners who object to participating in assisted dying or referring on conscience grounds. We must protect their rights regarding referrals as well.

My own doctor stated on the issue, “not selling you a drug but sending you to a street corner for drugs where you are murdered makes me just as complicit in your death.” I enjoy the bluntness of my doctor.

It is not enough to simply leave it to the provinces or to say that there is no problem because so far no health professional has been forced against his or her conscience to perform certain acts. The rights of health care professionals must be respected and must be enshrined in federal law. It has always been our society's custom to assist the suffering, to be by their side, and not to kill them. This practice must be reaffirmed, and a respectful approach to human life must be upheld, one that recognizes that the intrinsic worth with which every human being is endowed is not eradicated by suffering.

Life is precious and I believe that our nation's laws must reflect this fact. In the Gospel of Life, Pope John Paul II wrote very eloquently about the issue of assisted suicide. He stated that assisted suicide is a crime which no human law can claim to legitimize. However, he further stated that elected officials “could licitly support proposals aimed at limiting the harm done by such a law and at lessening its negative consequences at the level of general opinion and public morality. This does not in fact represent an illicit cooperation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects.”

Doctor-assisted suicide is already a reality in Canada. While I acknowledge that Bill C-14 reflects many of the safeguards of the dissenting report put forward by my Conservative colleagues on the special committee, it is still a flawed piece of legislation. It does not include an obligation to provide all possible palliative and pain management options to terminally ill patients. It does not mandate that funding be given and then maintained for end-of-life care. It does not guard the conscience rights of medical professionals. Beyond this, Bill C-14 does not offer a legitimate and proper attempt to limit the evil aspects of suicide. It is for these reasons that I will not be supporting this bill.