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

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

Sponsor

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill.

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

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.

Votes

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

Criminal CodeGovernment Orders

May 3rd, 2016 / 10:55 p.m.


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Conservative

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.

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May 3rd, 2016 / 10:55 p.m.


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Conservative

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.

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May 3rd, 2016 / 11 p.m.


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Conservative

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.

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May 3rd, 2016 / 11:10 p.m.


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NDP

Robert Aubin NDP Trois-Rivières, QC

Mr. Speaker, discussions on this topic are always interesting, even this late at night.

Once again, my colleague caught my attention with his comments about medications that exist to alleviate suffering during the palliative care stage. We cannot ignore the fact that these medications precipitate death and that quite often, they make the patients disconnected from reality. The drugs may alleviate the patients' physical suffering, but they also affect their consciousness.

I think this bill is an opportunity for us to take a different perspective. Instead of taking the perspective of a caregiver supporting someone at the end of their life, let us look at this from the perspective of someone who is dying and who could, with this legislation, make an informed decision to die, fully conscious, surrounded by loved ones. I would venture to say that this dying person would truly be able to enjoy the love of his or her dear ones in those last moments of life. I think that is the objective, or one of the objectives, of this bill. I would like to hear my colleague's thoughts on that.

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May 3rd, 2016 / 11:10 p.m.


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Conservative

Kelly McCauley Conservative Edmonton West, AB

Mr. Speaker, I do not find a lot to disagree with in my colleague's comments. The issue is we do not have proper palliative care. He is talking about a situation where in a utopia proper palliative care is offered and all other options are offered and available, as opposed to what we have right now in Canada where only a very tiny percentage of people have that option available: “I can die now peacefully with my full conscience, my full mind, because I have no choice because I don't have the proper care waiting for me in a month”.

I do not disagree with my colleague on that. Where I believe we have to go is to full proper palliative care for all Canadians.

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May 3rd, 2016 / 11:10 p.m.


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NDP

Pierre-Luc Dusseault NDP Sherbrooke, QC

Mr. Speaker, I thank my colleague for his speech.

I am concerned about the possibility that a health care institution as a whole could refuse to provide medical assistance in dying, which is now a charter-protected right. What is the danger in an entire institution taking that stance? Patients at that institution would be denied their charter right.

Is my colleague concerned about this too?

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May 3rd, 2016 / 11:10 p.m.


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Conservative

Kelly McCauley Conservative Edmonton West, AB

Mr. Speaker, it was very clear in my speech. My concern is that the bill does not address conscience rights for health care providers. It has to be paramount in the bill before it goes forward. Doctors, nurses, and medical practitioners should not be forced against their conscience and beliefs to perform assisted suicide.

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May 3rd, 2016 / 11:10 p.m.


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Conservative

Harold Albrecht Conservative Kitchener—Conestoga, ON

Mr. Speaker, I have a quick question on the whole issue of protecting the vulnerable. Certainly there are some elements in the bill that give the impression of protection for vulnerable people, but there is no system of prior review to ensure that the independence of the doctor or the witnesses is actually supported. I wonder if my colleague would comment on the need for a prior review to ensure the protection of the vulnerable from coercion and to ensure the independence of the witnesses.

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May 3rd, 2016 / 11:10 p.m.


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Conservative

Kelly McCauley Conservative Edmonton West, AB

Mr. Speaker, I, too, believe that we need a much better oversight written into the law, both for conscience rights and for independence of people making this decision. I implore the government to work hard. We recognize that this assisted dying or suicide bill will eventually go through. I implore colleagues across the way to ensure that these rights for patients and an independent overview are put into the law.

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May 3rd, 2016 / 11:15 p.m.


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Conservative

Bernard Généreux Conservative Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC

Mr. Speaker, if I may, before beginning, I would like to join my colleagues in sending my thoughts and prayers out to the people of Fort McMurray, Alberta, and all Albertans. We know that a number of Quebeckers are working in Alberta. The media are reporting an incredible tragedy that is taking place as we sit here in the House. I want everyone there to know that we are thinking of them.

I thought long and hard before speaking to this important issue tonight, not because I did not want to talk about it or because the subject was not important to me, but because this is a hugely complicated issue. It took Quebec more than six years of work, thought, and study to reach a consensus, and even after all that work, it was not unanimous.

The proof is that most of the palliative care facilities in Quebec have not begun offering this option to their clients within their facility. I am going to focus on that in my remarks.

The joint committee recommended making more resources available for palliative care to improve access across Canada. I agree with that recommendation.

I had the opportunity to tour a palliative care centre last year when I visited my brother-in-law, who was dying. This evening, before speaking to the House, I also called an acquaintance who sits on the board of directors of a foundation that helps fund these types of homes in my riding. This person confirmed what I had noted last year. The mission of these homes is to take care of the dying and not to take their life. These homes support patients in their final weeks, days, and hours of life. The services and support that the individuals themselves and their families receive at these homes are essential so that they can live their final moments in dignity.

I believe it is important, as we prepare to pass such a law, to have the time to study it and put it in place. I do not believe that it is appropriate to move so quickly on such important issues as life and death.

My acquaintance also told me that she had lost a colleague a few weeks earlier. Her colleague knew that he was sick and that she was connected to the administration of the home. He told her that he wanted the opportunity to make use of the new Quebec law on end-of-life care and that he very much wanted to have access to such care. The weeks passed, and it came time for him to enter the home, where he could end his days in peace, with the idea of making use of the new Quebec law.

My acquaintance had the opportunity to visit him before he passed, and this man told her that he no longer wanted that option because he appreciated the care and attention he received from the staff and volunteers in the home so much that he wanted to live until his last breath. He probably talked about that option because he was afraid of suffering, of losing control, of making his family suffer. All of his fears were legitimate.

This example shows that it is possible for someone to live with dignity, surrounded by family members, in settings tailored to their needs, with attentive and, above all, competent people around for this extremely important stage in any human being's life.

I am giving these examples, not because they are something I experienced, but because they illustrate some of all the different possibilities and situations that could arise.

My colleagues who sat on the joint committee worked very hard to ensure that certain provisions would be included in the bill, and I would like to talk about those provisions now. They are all equally important and they represent an essential minimum in the bill before us today.

We identified five important points and we insisted that they be included in the bill. The first is that medical assistance in dying should be available only to adults. It should not be made available to minors. Medically assisted dying should not be made available to people who are mentally ill. The conscience rights of doctors must be protected and consent to the termination of life may be given only at the end of a person's life. Finally, palliative care needs to be improved.

In my opinion, that last point is an important aspect of the bill. Services like those offered by Maison Desjardins in Rivière-du-Loup, which is in my riding, should be available all across Canada, given how important these facilities are to those who work there and those who use them. The government should therefore invest in these types of services and facilities across the country. In the absence of any evidence to the contrary, the government has no plans to do that at the moment.

Another person I know in Montmagny has been receiving cancer treatment for many years. She decided to start up a palliative care facility in the Montmagny and L’Islet region, where she has been working tirelessly for many years. An army of volunteers are helping her and supporting her in her illness and in setting up the facility. My hope is that when her time comes she will be able to benefit from all of the effort she put into that facility. In order to ensure that these types of facilities are available, the government needs to create the proper conditions to help communities take matters into their own hands and offer places across Canada where people can live out their final days with dignity.

What we are really talking about in the House tonight is human dignity. It is crucial that all future decisions be made in a way that ensures that end-of-life care is available all across Canada. That is crucial.

In closing, in my riding next Friday, my colleague from Louis-Saint-Laurent and I are organizing an evening of discussion to promote a better understanding of this very serious issue. Knowing that we were elected on October 19 and given how quickly everything is happening right now, I feel as though we are caught in a trap and working against the clock, which means we cannot make informed decisions. In spite of everything, I will be voting in favour of this bill at second reading, so that the bill can go to committee and we can examine the committee's recommendations.

This does not mean that I will vote in favour of the final bill. I am committing to making a decision after listening to my constituents. I think this is a fundamental decision. There is absolutely no doubt in my mind: as the representatives of our constituents, we must listen to them and allow them to share their views. We do not have much time to respond to this bill. I was listening to my colleagues earlier and it occurred to me that June 6 is an arbitrary date. There will be a June 6 in 2017, a June 6 in 2018, and so on. I think we should be taking the time to really think about this legislation and make it as complete as possible.

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May 3rd, 2016 / 11:20 p.m.


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NDP

Robert Aubin NDP Trois-Rivières, QC

Mr. Speaker, I listened closely to my colleague.

I know what he means about confronting death. Many people, who are well supported in palliative care homes decide to see things through to the end. Both the Quebec legislation and the Canadian legislation we are currently studying provide for the right to withdraw a request up to the last minute.

I would like my colleague's opinion on the following. There is a major difference between the Quebec legislation and the proposed Canadian legislation. Under the Quebec legislation, a health care professional must be present until the very end. However, under the Canadian legislation, a health care professional could give the patient the lethal drug and then leave the patient alone. That seems unthinkable to me. We cannot talk with so much compassion for hours and then imagine that under this bill, someone could be given the drug he needs to end his life without anyone by his side throughout the process.

I would like to know what my colleague thinks about that.

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May 3rd, 2016 / 11:25 p.m.


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Conservative

Bernard Généreux Conservative Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC

Mr. Speaker, I totally agree with my colleague.

The Quebec law was thought out over a period of six years. During those six years, there were studies and discussions between the parliamentarians and with the public, and working groups were set up. We have roughly six months to do as much here in Canada.

The legislation as presented has some extremely dangerous grey areas. We must review this legislation properly to ensure that we have it right. Our responsibility as legislators is to take every precaution to ensure that the legislation is the best it can be.

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May 3rd, 2016 / 11:25 p.m.


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NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Mr. Speaker, my colleague made the comment that he would be happier if we could take six years to create this legislation. I wonder if he would like to comment on what would happen in the interim. I have already had one of my constituents choose to end his life through legal means, before we had this discussion here, because that is what he has available to him through the Supreme Court decision. I wonder if the member would like to comment on that.

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May 3rd, 2016 / 11:25 p.m.


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Conservative

Bernard Généreux Conservative Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC

Mr. Speaker, with respect to time, let us go back to the moment when Quebec legislators decided to introduce a bill. If they had decided to work faster because people could not have access to end-of-life care, I do not think that would have been the right approach.

The right approach is to take the time to get this bill as close to perfect as possible. That is not the case right now. In answer to my colleague's question, I think we should take as much time as we need. Time is a space. We need the opportunity to discuss this with each other and with Canadians because we know that people's opinions about this bill vary widely across Canada.

Quebec was very innovative in its approach to this kind of legislation, and it is important for us to enable openness around this law and understanding across Canada.

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May 3rd, 2016 / 11:25 p.m.


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Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, because of the procedural direction now being taken by the government, I think this will probably be one of the last speeches in this debate.

I want to recognize the tone of the debate that has taken place. I know members have spoken politely, softly, and respectfully. This has been the tone on all sides. However, I wonder if I may stretch that tone a little bit.

This is the most important issue that Parliament will deal with, I suspect, in a very long time. Without resorting to personal attacks, this is an issue to get angry about, if there ever was one.

The mistakes that we stand to make in this legislation mean that men and women may die who would not have otherwise, who will be missed because of the absence of advance review, who will be pressured forward because of the lack of palliative care, and who will be matched with willing physicians because of allowances for doctor shopping, even if they have been identified as not meeting the criteria by their own and other physicians.

Tonight, we should be angry. Canadians should be angry. While speaking softly and politely about the need to talk about death and the need to listen, the government is proceeding to shut down debate after only two days. The invocation of closure in this case will not in any way affect the timeline of this bill. We know that.

It is already being studied at the justice committee, and even days of additional debate would not prevent the justice committee from proceeding on the timeline it has already set. A vote would not change that. It would not affect the timeline at all, and yet the government is proceeding to shut down debate with its notice of closure motion coming forward tomorrow.

Canadians who care about this issue from all sides, Canadians who care about the important role we have as legislators to examine and debate legislation in this House, these Canadians should be angry about what is happening on this legislation.

The absence of meaningful debate increases the significant chances of error when it comes to shaping legislation that is, in my view, already riddled with problems. An error on an issue this important will mean unnecessary loss of life.

I have already spoken about my substantive concerns on this bill, but by way of quick review, this legislation contains no meaningful safeguards because even the exceptions in it are riddled with holes. The written consent provision excludes those who cannot sign. The waiting period can be routinely waived. Mental illness is not at all clearly excluded.

The requirement that death be reasonably foreseeable is too ambiguous to effectively exclude anyone. The requirement that two doctors sign off merely encourages doctor shopping. Even if the already-ambiguous criteria are not followed, people who kill an unwilling patient can be let off the hook if they claim a reasonable but mistaken belief that the criteria applied.

I have said that we have here a perfect storm: ambiguous criteria and a reasonable but mistaken belief clause, which means that it would be nearly impossible to prosecute anyone who kills a patient, even without consent. We have heard the data from countries with similar systems and the impact they have on patients who do not consent.

All of these problems could be fixed through amendments. A requirement for advance review by competent legal authority would ensure that those who do not consent are not pushed forward against their will. Provisions on palliative care and conscience protection would better protect the autonomy of patients and would also protect the autonomy of physicians.

We could discuss these changes. We could make these changes. We ought to.

Tonight, I want to also do what other members in this House have done, and that is to share stories about life and stories about death.

My story starts around the turn of the last century in Germany, with a Jewish doctor named Rudolf Kuppenheim, the first person in his family who was able to get a university education. One day in the course of his practice, a young child named Gertrud was brought to him for treatment for diphtheria. At the time, the usual treatment was to make a small slit in the throat that would allow the afflicted child to breathe. The child's mother, however, resisted this treatment. Her mother refused to allow Dr. Rudolf Kuppenheim to make the necessary incision, because it would leave a scar. The mother believed that the scar would prevent her daughter from getting married.

Rudolf became angry, very angry, and justly so. He berated the woman for putting her daughter's life at risk. Notwithstanding the social pressures and the challenges that a young woman might face in that culture and time, this girl's life, her value, her dignity, were not dependent on whether or not she could find a husband.

As it happened, that girl not only got married, but she later married that doctor's son. That couple had a daughter who was born Ursula Lilly Kuppenheim, and Ursula Lilly Kuppenheim was my grandmother.

She grew up in a society that denied her dignity as well. As a half-Jewish child, she lived through the horrors of the Holocaust, only able to leave Germany after the war. Her mother had her dignity denied because she might have been hard to marry off. She had her dignity denied because of her Jewish heritage, but the shifting vagaries of social attitudes never changed who these women were: human beings.

Rudolf Kuppenheim and his wife tragically took their own lives when the Gestapo came to their home. Suicide is always a tragedy, but I understand that they were in a position where they felt that they had no other choice: suicide or tortured death in a concentration camp. No just society forces people to make that choice, but at the time my grandmother lived.

In 2006, my grandmother, or Oma as we called her, died of cancer. Everyone dies, but not everyone truly lives. Across continents, from persecution to extensive contribution, my grandmother truly lived.

She always told us that she wanted to die like Abraham, Isaac, and Jacob did. They did not suffer or get sick, at least at the time of their death. They just realized that they were about to die, called their families together, and said goodbye. That is what she wanted, but it did not happen that way. She did suffer very much.

Suffering is a part of the human condition. It is just and right that we seek to minimize it. It is also just and right that we understand that a human who suffers does not cease to be human, to have value, to have dignity. She had dignity from the moment she was born to the moment she died, whether her dignity was denied because of her Jewishness or because of her illness.

Members here have to understand that the so-called dying with dignity movement is shaped by a very dangerous view of humanity. It views human beings as instrumental or experiential creatures, valued for what they do or for the quality of their experiences, but that is not what we are. We are in fact creatures with intrinsic value.

We value the dignity of human beings, not principally because they are useful, because they are having a good time, or because they want to be valued. We value human beings because of what they are. We understand intrinsically the difference between human rights and animal rights, rights for creatures which have feelings and experiences only, and rights for creatures that have value intrinsically. This movement, this presumption that the ill or disabled lack dignity could not be more wrong.

I want to conclude with a final appeal to all members. If they have grave concerns about this legislation, stand up and vote against it at second reading. I know some members are worried about the possibility of a legal vacuum, but this legislation replaces ambiguous criteria with other ambiguous criteria. It does not create any kind of review mechanism. Fundamentally, it replaces one vacuum with another.

There is a better way. If members vote down this legislation or even ensure that the vote is closer, the government can, will, and indeed must come back with a more serious bill, and if it does a better job of incorporating certain specific proposals we have made, then we can all work together to ensure a quick passage of a better bill.

Alternatively, if we go along just because we want to proceed, we will have entrenched a piece of legislation that will cause real problems, life and death problems, problems that will be very hard to fix.

It is disgusting, but we have a proposal to invoke closure on an issue so vital, on an issue of life and death, after only two days of debate. We must stand up to this. We must make our stand. I have made mine and I ask members in the House to make theirs.