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.

[Steven Fletcher, As an Individual]

Okay, thank you, Mr. Chairperson.

Thank you everyone for the opportunity to comment on Bill C-14.

My comments are going to be brief and focused on the bill. I've already spoken in front of the joint committee, and I initiated some private members' bills in the previous Parliament on this issue. I've also written a book called Master of My Fate on the parliamentary process.

I would like to first of all commend everyone involved. This is a difficult issue. There are some very good things in the bill. I found in many ways that it mirrored the private members' bills that I had introduced. This includes the provisions around making sure that people who may have a vested interest in the demise of an individual are not involved in the decision-making process. I encourage you to keep that in the bill. It's not an amendment; it's a thumbs-up for what is there.

I would also say that on the age of consent at 18, the bill is probably realistic at this time.

I think, though, that we need to collect empirical data over the next few years to find out where the demands and the needs are, and why people would request a physician-assisted death, by having a mandated parliamentary report that is public, with empirical data. It could perhaps be funded through the Canadian Institutes of Health Research. In order to make good public policy, you need good empirical data, especially on such a difficult issue as this.

Now, on the amendments, the Supreme Court was very clear that sections 241 and 14 of the Criminal Code unjustifiably infringe on section 7 of the charter and are of no force or effect at this time. Moreover, the Supreme Court made it very clear that the prohibition for physician-assisted death for a competent person “who...clearly consents to the termination of life and...has a grievous and irremediable medical condition (including an illness, disease, or disability) that causes enduring suffering that it is intolerable to that individual in circumstances” that they find themselves in....

The bill clearly is not consistent with the Supreme Court decision on the issue of terminal illness and that you have to be on a trajectory of end of life in order to take advantage of one's charter rights. I can understand, politically, why this was done, but it is quite frankly something that will go to the courts, and it will be changed to what the Supreme Court says. You cannot deny someone their charter rights because they happen to have a disability that may last 40 years, or an illness that goes on forever.

There are unfortunately many such situations that exist, such as ALS. There's also MS or stroke victims. There are many permutations of illness, and by saying that they have to be on a death spiral essentially denies them their charter rights.

The other comment I would have is on proposed paragraph 241(b). It's not clear to me that someone would be made aware of all their charter rights, including physician-assisted death. It seems to say that, if you raise it with someone, you are in deep trouble. I think people would like to know the entire range of options is available to them, including physician-assisted death in some cases. It seems to forbid medical practitioners from expressing that—or anyone else for that matter.

Regarding advance consent, I think this should be part of the mandate of whatever you decide to do for the future. It may be a bridge too far this time around. We've come a long way in a couple of years, but I can understand the challenges with that. But again, if someone has dementia or something happens to them in the future, why can they not state what their preferences are before they lose their cognitive ability? There's nothing in the Supreme Court decision that would prevent that.

Finally, there's been a lot of drama around the Supreme Court decision in the last year, and people are trying to weave their way through a difficult legislative process. I very much get the challenges that you have as MPs, but at the end of the day, it's all going to come back to what the Supreme Court has said.

Committee, without the amendments, particularly in proposed section 241, you're going to have to decide if you are going to force people who are disabled or have a disability or illness to go to the Supreme Court to exercise their charter rights or if you accept what is inevitable and just replace the wording with what the Supreme Court said in the first place.

I'd like to thank everyone for the opportunity to be here today. Of course we always have to realize that offering more resources for people is important, but sometimes all the resources in the world don't make a difference or can't make a difference, and people are suffering every day. We need to be empathetic to those people.

Thank you very much.

[The Chair, Liberal, Anthony Housefather]

We're going to reconvene with the next panel of witnesses. It's a pleasure to have each and every one of you with us today.

We are joined by Steven Fletcher, a former member of Parliament and a new member of the Legislature of Manitoba. Congratulations on your election.

We are joined by the Centre for Israel and Jewish Affairs, represented by Richard Marceau, a former member of Parliament, who is the general counsel and senior political adviser. Welcome, Mr. Marceau.

We're also joined by the Canadian Association for Community Living, Mr. Michael Bach, who is the executive vice-president. Welcome, Mr. Bach.

Each of you has eight minutes, then we're going to move to questions. As all of you know, we're studying Bill C-14, so we would very much appreciate if you would comment on the bill itself and the proposed amendments to the bill, and not general comments you may have made to the special committee.

That being said, Mr. Fletcher, the floor is yours.

Criminal Code

[Phil McColeman, Conservative, Brantford—Brant, ON]

Mr. Speaker, as I approached this speech tonight, I have said to many in my community and my family that this would be the most important speech I ever deliver as a member of the House. I have been here eight years and hope to represent my constituents into the future.

I am going to speak about the most vulnerable, about meaningful safeguards, and about addressing the slippery slope that is Bill C-14.

First, here is full disclosure. I am the parent of a 29-year-old intellectually disabled son. I held the hand of my mother as she exited this world in pain. I watched a very close friend pass away over two years, in pain from a horrible disease.

Earlier in this debate, the member for Durham used words that resonated with me, that we all seek “compassion on both sides of this issue”, and that is essential.

I am going to refer to some messages that have been written and sent. I should also disclose that I, too, have held public meetings. In fact, this issue was brought up during the election campaign, and I stated my position very clearly and concisely to the voters on this particular issue.

I would like to start with a quote from the member for Calgary Nose Hill who said in her opening statement that this is about “the sanctity of human life”, “defining the morality of our country”.

I would like to read the words of someone who is greatly respected. His name is Jean Vanier, and he wrote an article, along with Hollee Card, in The Globe and Mail on March 1. He heads up an organization called L’Arche, and he said:

We in L’Arche have had the privilege of accompanying many on life’s journey, not only in times of health and strength, but in times of fragility and weakness as well. Through this experience we have learned many things.

Most importantly, we have learned that it is the most fragile among us who are the closest to their humanity, to their suffering, and to their need to be loved. It is they who show the rest of us the way to live in truth and in love.

He goes on to say:

This is why we have a special obligation to ensure that the care available to each of us throughout our lives, but especially in our final stages of life, affirms both our dignity and humanity. Otherwise, we diminish our range of experience to include only our independence. We diminish the love we can share, and the vulnerability we can show to one another.

Such a spartan culture ultimately devalues life. In its place we must recommit to honouring and accepting ourselves and others by finding ways to accept our frailties, and the full course of life.

Members can see that Bill C-14 undermines the precarious position of people with disabilities in Canada.

Other interesting comments that were shared with all parliamentarians came from an individual named Hugh Scher, a solicitor and lawyer, who for 25 years has advocated on these issues. By the way, he points out at the very front end of his letter to us that he was not invited to talk at the committee, yet he has advised every party in the House on these issues.

Let us talk about the safeguards he points out.

Judicial or Tribunal oversight to ensure compliance with legislated requirements and to identify vulnerability before the fact is an essential requirement for effective oversight in respect of any regime of assisted suicide;

He goes on to say:

The requirement of judicial or tribunal oversight and of vulnerability assessment and identification before the fact by way of prior review are an essential requirement of any regime of assisted suicide and must be implemented by Parliament in the event that there is to be any prospect of safe implementation of an assisted suicide regime. Failure to implement such measures will leave vulnerable Canadians at significant risk without any means of enforcement or protection from abuse;

By the way, Bill C-14 does not have those protective measures of judicial oversight in it.

Some say the bill does not go far enough. Let us take the example of Belgium and how it has evolved over the years. Thirty-two per cent of cases carried out in Belgium are without any request or prior consent of the individual. Even though the law requires it, it is ignored and it is not prosecuted. The numbers since that bill was introduced until today are staggering. What happens is that society changes. Society changes and this becomes the norm. People start accepting the fact that this is the way it is.

One of the issues with Bill C-14 is the fact that, in the preamble, there is a statement to allow for further study for mature minors and persons with mental illness. To me, I interpret that as code. That code is saying that those who want wide-open, available euthanasia, death on request, are not to worry, that it is coming. That is the code. If we look at the report of this particular special committee and what it brought back to Parliament, stating what these people would love to have, we see the code that it will be coming. It is written right in the preamble of the bill.

Some have said that it is the incremental expansion over the course of time in ways not yet contemplated. Over time, citizens become more used to it. Over time, the law would encourage and encompass people with more ailments and younger patients. There is a dangerously contagious effect of assisted-suicide laws that has been observed in the Benelux countries and in the jurisdictions that have had this law on the books for a long time. This is about the sanctity of human life, defining the morality of our country, as the member for Calgary Nose Hill so accurately said.

Let us talk just a minute about the conscience rights of health professionals in institutions. These are not in the bill. We would have to amend this bill to have these rights in there. At my public meetings, we had many doctors who expressed their view that this was absolutely essential for them to carry on in practice really and they would look to alternative jurisdictions to not have to abide by this. That is also for health care professionals in general.

Moving on to palliative care, I and the people of my riding are very fortunate to have the finest palliative care in the country. One of the individuals who spoke at the public meeting said she has watched many people at end of life resolve issues among their friends and family, who would never have had the chance. These are people who have passed along in the best possible environment.

My comment is that the Supreme Court has forced us to this position. If we are to have a law, we must have a law that is as airtight as possible. We must protect the most vulnerable. If one person dies because of a badly scripted law in this country, it will all be on us.

I appreciate the time to speak tonight.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you, Chair.

Thank you to all the witnesses.

Mr. Scher, in your presentation you mentioned that the first problem with Bill C-14 is that it provides legal immunity to any person who directly participates in euthanasia and assisted suicide. I submit to you that's over-broad. It provides blanket immunity to people who assist in medical assistance in dying, which is a much more constrained circumstance.

Would you like to comment on that?

[Murray Rankin, NDP, Victoria, BC]

Someone suggested there are no protections in this C-14 for the vulnerable, which, of course, is absurd. One of them is the eight conditions listed in 241.2(3), so-called safeguards, one of which, Dr. Smith, is to provide the opportunity to withdraw consent at the end and in a sense require you to confirm your consent to receive medical assistance in dying at the very last, immediately before the medical assistance in dying is provided. I'd like your views on whether that's workable in the real world of morphine drips and intense pain at the end of life. Is that workable, in your judgment?

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

Mr. Speaker, it is certainly an important and sobering issue that I rise to address, which is on the minds of many Canadian families.

Last year, the Supreme Court of Canada found the current Criminal Code prohibition on physician-assisted dying to be constitutionally invalid. This decision required the government to revisit Canada's long-standing prohibition against euthanasia and assisted suicide.

Bill C-14 came about as a response to the Supreme Court ruling on the Carter case. The Carter case determined that persons who satisfy the following criterion of being a competent adult, suffering intolerably from a grievous and irremediable condition, and able to give their clear consent, have a right under section 7 of the charter to physician-assisted dying, or PAD.

Since that decision, the government appointed a Special Joint Committee on Physician-Assisted Dying to make recommendations on a legislative response. Liberal and NDP members in the main report for the special joint committee recommended a very permissive physician-assisted death regime beyond the parameters set aside by the Carter case. Their original report included provisions that suggested that physician-assisted death be available to persons with terminal and non-terminal illnesses, and to persons with physical and psychological conditions. What was most concerning, however, was the suggestion that the government would, in the future, study issues related to physician-assisted death for minors.

The recommendations and provisions suggested by the original report would set Canada on a very treacherous path. In response to these concerns, my Conservative colleagues released a dissenting report, which reined in some of the worrying suggestions and put forward a framework that more closely reflects the Carter decision.

In the dissenting report, my colleagues raised key issues that the legislation could tackle, which included limiting physician-assisted death to competent adults 18 or over; safeguards for vulnerable persons, including a provision for a psychiatric assessment; no advance directives; and conscience protections for physicians. Bill C-14 has adopted some of these key provisions from my colleagues' dissenting report.

The main safeguards in Bill C-14 include limiting euthanasia and assisted suicide to physical illnesses only, and putting in place an age restriction for such procedures. For those individuals who fall under the criteria for PAD, there is no specific referral to a psychiatrist in order to determine whether there are underlying mental illness issues that would compromise their capacity to give an informed consent.

Letters have been pouring in from communities in my riding. I did promise my constituents that I would listen and study all of the important points that have been raised.

This situation has pit the gravely ill against their own family's moral positions, and I too have been touched by the many stories that I have heard. Departed friends and family members had spoken to me in the past about allowing for a merciful end to their suffering, a position that many of us may find ourselves in when our time has come.

However, I am concerned that amendments may be introduced in committee to make the current legislative framework more permissive, or that an opening is presented for regulation to allow for the same permissiveness later on. This concern does not come from thin air, but rather from the very study penned by the special joint committee. Perhaps there could be amendments that would spell out a more restrictive legal framework so that we could effectively ensure that the safeguards are there to always protect the most vulnerable.

Canadian families on all sides of this debate are left anxious as to what lies ahead when the bill moves forward. The Carter case has forced Canadians to come to terms with this difficult decision.

I want to reiterate what my Conservative colleagues have been saying in the weeks leading up to this debate: our priority as parliamentarians should be to ensure that any new legislation developed conforms strictly to the Supreme Court decision, nothing more and nothing less.

Most Canadians want to see the government focus on improving palliative care, as it is an integral part of end-of-life care. There was unanimous agreement from the special joint committee and stakeholders, including the CMA, on the need for a pan-Canadian strategy on palliative care with dedicated funding. If it were up to Canadians, a national strategy on palliative care would be priority number one.

The conscience rights of health care professionals should also be taken into consideration. For some, physician-assisted death is against their moral code. It would be unjust to force a medical professional to act against their convictions. The oath to do no harm is founded in our commitment to look after one another and to care for our most vulnerable through viable medical interventions that honour the sanctity of life. There are many physicians and other health care providers that have raised this issue both with their members of Parliament and at committee. We parliamentarians need to address this for their sake.

There are harsh lessons to be learned from past experiences of jurisdictions such as Belgium. After legalizing euthanasia, deaths from such interventions increased every year. Safeguards were allowed to be removed and euthanasia is now available to individuals who are experiencing mental distress.

One of the most troubling instances of this slippery slope was when the Belgian parliament approved a bill that removed the age restriction from physician-assisted death, a provision actually recommended by our special joint committee report. This PAD extension to minors was not included in the original legislation passed by Belgium years before either.

The slippery slope is a real social phenomenon. We cannot allow Canada to go down that path. We cannot allow any legislation on physician-assisted death to be permissive. Provisions must be restrictive as the Carter case dictates it to be. Canadians expect us to be steadfast in delivering a fair and clear legislation, but we have to avoid expediting any circumstances that would lead to fewer safeguards.

I urge my colleagues to learn from these harsh realities and lessons. While it has become imperative that the House pass legislation before June 6, it is equally important to make sure that we have an effective piece of legislation.

It is also true that not having a legislative framework to address physician-assisted death is equally irresponsible. Without a comprehensive legislative framework, Canada would consist of a patchwork of provincial protocols that would create other serious concerns.

We must also remember to be realistic. Even with safeguards, consent can be coerced and vulnerable individuals will never be without risk. In Belgium, there are cases where physician-assisted death was administered without explicit consent; it could very well happen here. Life and death decisions should never come easily, nor should it come from anyone other than oneself .

Life is truly a gift and we must treat it as such. Providing care should always be the priority, and I hope that a pan-Canadian strategy on end-of-life care is also unveiled. This legislation as it is does not carry sufficient provisions and safeguards. We can do better. We owe it to our constituents to do better.

I hope that if the bill is sent to committee, parliamentarians will have the chance to amend it further to include improved safeguards.

In closing, I would like to pay tribute to friends and family I have lost along the way. My mother and father, Verna and Herman Dreeshen, in life taught me and others so much about compassion and kindness. My parents also showed so much during their final days about strength of character, faith, and the realities of life. Of course, they are both dearly missed. The care they received was exceptional and there were opportunities for us to talk.

I remember specifically when my father passed away I had been in the House for two weeks. The first week we had elected a Speaker, so I had the chance to go home that weekend and talk to him about the individuals I had spoken to, such as Ken Dryden whom I did not agree with politically but I certainly did on hockey. We had a chance to talk.

I also had a chance, during the next break, to speak with the prime minister and talk about different issues and things that were going on. To be able to relay that information to him the week before he died was very important.

I say to all Canadians, as we face this sobering reality for ourselves and our loved ones, that they should know they are always in our hearts and prayers.

[André Schutten]

My concern there is that there is nothing built into the code as it's drafted, that is, Bill C-14. There's no oversight for somebody else signing for another individual. Both James and Pieter are unable to sign for themselves. Under this provision as it's written somebody else can sign on their behalf. James and Pieter would both testify that they have very supportive families so it wouldn't be an issue for them. Perhaps there is a family where they see a family member such as James or Pieter as a burden. They could sign on their behalf possibly without Pieter or James being fully aware or possibly under coercion and there are no checks or balances. There's no clear oversight to test whether that signed statement is then voluntarily being given by someone like James or Pieter.

If you're going to get consent through written means then there are other ways you can get that from someone like Pieter or James. I would recommend that this committee consult experts in this field. You could find different ways so the consent comes directly from the patient involved, not some other proxy.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

Mr. Speaker, I often say it is a pleasure for me to rise, because it is such an incredible honour to even stand in the House of Commons and attempt, in our own ways, to try to represent the great group of Canadians from our territories. Yet, as I approached Parliament this evening, thinking about this particular debate, I found myself struggling to use the word “pleasure”. It is simply because this debate strikes at the very heart of some of the most difficult questions we face as legislators, that we face as Canadians, that we face as friends and family of those who have faced the incredible difficulty of end of life.

There has been a certain amount of trepidation and perhaps fear from many of us in this place to talk about end of life, end-of-life care, the palliative care question, and to talk about end of life and the issue of medical assistance in dying, physician-assisted suicide.

I suppose there are some things required of us all in this debate. One is to fully appreciate and understand that great sense of responsibility and to bring to this conversation as much humility as we can muster. For some of us in elected office, humility is not always at the ready and available. It is also perhaps to bring the best wisdom we can from those who know a great deal more about this subject than we might.

Oftentimes we say that we have to separate the personal from the political, that we as legislators have to act purely in the best means and understanding that we have about the law and how we wish to craft the law in a way that is defensible at the Supreme Court and representative of our constituents. Yet, this debate brings those two things together for many of us.

This is incredibly personal for any who have stood in the House and spoken to this bill, or who will, if one reflects back on any experiences we have had with family members facing those challenges at end of life.

The Supreme Court of Canada ruled unanimously and gave Parliament a timeline to work toward creating legislation. It struck down the laws in Canada as it saw them. Many of those judges were appointed by the previous Conservative government.

What concerns me in what we see before us today is the government, as we often hear, has attempted to strike a balance. It has attempted to seek a perfect middle ground on such a contentious issue. While I admit that is a very difficult thing to do on legislation on an issue like this, we raised a number of concerns at the special committee.

We continue to raise those concerns, even though the New Democrats support getting this bill to the committee stage so we can hear from those witnesses who now have seen the final legislation. We need to understand whether it is constitutional, whether it is helpful, and whether it will actually achieve what the Supreme Court and Canadians have asked us to do.

I mentioned in the past that it was with regret that after the Supreme Court came down with a very clear directive to Parliament to form a new law, to create new rules for our country, the previous government was unwilling or unable, for whatever reasons, to begin that work at all. We sought to pass a motion in the House of Commons to start the committee process, to bring the witnesses in so we could hear from them, but we were also six to seven months out from an election. The government seemed to not want to really talk about it.

The government struck some process that has since not borne any fruit, and now we are under the proverbial legislative gun. We are sitting late. The committee has worked incredibly hard. I want to thank all members, Conservative, Liberal, and New Democrats alike, who worked tirelessly to bring us incredibly important recommendations, some which made it into this bill, some which did not.

I know the Liberal co-chair of the committee has expressed his disappointment on some of these important issues. Yet, we face this time crunch, somewhat of Parliament's own manufacturing, unfortunately. While the process has been hard worked at, it perhaps will need some revising as the bill moves forward.

Let me take some specific moments and some concerns that we raised. The protection of medical practitioners, while it appears in what is called the preamble of the bill, in the aspirations of the bill, it does not appear in the actual heart of the legislation, it does not appear in the law. For those in the medical services community who have sincere religious, heartfelt beliefs that prevent them from assisting someone with end-of-life procedures, we need to have the most complete protection for those health care professionals.

I come from northern British Columbia. This is an absolutely contentious issue. Faith leaders from a broad set of denominations and those working within the medical profession, who are incredibly dedicated and gifted medical service providers, have come forward with serious concerns. I am not able to allay their concerns with what I see in this legislation.

We helped unanimously pass a motion from the member for Timmins—James Bay to finally have a national palliative care strategy. It is the other side of this coin. While there is the incredibly important issue of what happens at that moment of end of life, for all the moments leading up to that, what kind of care do we offer those who are passing from this life? What kind of honour, respect and love do we offer them through our medical system, through this great Canadian public medical system?

For so many years, governments have spoken the words. They have said that palliative care is important. They have said that they care for our seniors, for our elders, and for our sick, yet we see nothing for this in budget after budget. We do not see the ability to lift up that burden together and provide that palliative care. In some senses, Bill C-14 would be an opportunity to enshrine at least into law the requirement for the country to finally have a national palliative care strategy. It is disappointing that it is only referenced as opposed to being brought in with full weight and structure.

I was also disappointed because the committee worked so hard. As a New Democrat, it is difficult for me to credit a joint Senate House of Commons committee. However, I know those good senators came to this process with an open mind. They worked very diligently and came up with a series of recommendations for the government over a number of the issues, and they were simply ignored.

That brings me to another concern. Legal and medical experts told us that even Ms. Carter would not actually qualify for assistance under this bill. She brought this case to the Supreme Court. She suffered so much. Her family went through hell trying to achieve the services they desired and had to go all the way to the Supreme Court. It finally won that arduous process.

Rather than get that perfect place where the government has sought to balance the competing interests over such a sensitive topic, my concern is that the government has muddled it entirely and invited future challenges in court. We have also heard from some of the lawyers who presented in front of the court. They said that this legislation would be challenged almost immediately. Therefore, what have we just gone through?

The committee met many hours and heard from dozens of witnesses. We looked at the very clear ruling from the Supreme Court. Then we came out the other end with something in the middle that offered neither side any great solace, if there are just two sides in this debate. We have heard from a number of the groups that have worked tirelessly on this issue, for decades in some cases, of their disappointment and dissatisfaction. Happily, the way the process works in our Parliament, the bill can go and be remedied.

This is the true test for the new government. This is its first constitutional legislation. This is the first time it must meet the challenge of the charter in legislation. Will it meet that challenge with the humility, courage, and intelligence that is required to do the right thing, not just the right thing by the courts, but the right thing by Canadians who are desperately seeking the ability to end their life on their terms when they are suffering so greatly? For us, to stand in judgment of them and their families, for us to say we will decree, under more and more narrow definitions, who can actually access this service seems dangerous to me. It seems hubris and unintelligent. This is simply because we invite years more of litigation in the courts and years more of uncertainty and suffering by those very families that are already suffering with a family member whose life is coming to an end in such terrible conditions.

I want to congratulate again the members who served, particularly the member for Victoria, who brought his legal wisdom and his compassion to this conversation, as well as the member for Timmins—James Bay, who first and most importantly raised this issue of palliative care and the need for that strategy. To all members of the House, we must find our convictions, find our courage, do the right thing, and do what is necessary both legally and morally.

[Pieter Harsevoort, Association for Reformed Political Action]

I thank you all for allowing me to come here and for the privilege of speaking to you, members of the committee.

I'd like to echo James's concerns and add my own two cents. I do have concerns with Bill C-14, including it's lack of linguistic precision.

Sadly, I feel the bill is dangerously dependent on euphemisms. Throughout, “medically assisted dying” is used to describe what is, in reality, physician-assisted suicide. This is problematic in the way that it undercuts palliative care. After all, what is palliative care if it is not medically assisted dying? I urge you to please use accurate terminology so that termination of life is not confused with palliative medicine.

Furthermore, the proposed law necessitates that, in order for someone to assist an individual with suicide a medical professional must be of the opinion that the person meets all the criteria, including the opinion that they have a grievous medical condition. Since the term “grievous” is vague, an attempt is made to make that definition more specific in proposed subsection 241.2(2).

However, even here, Bill C-14 runs into problems. How is one to define “intolerable suffering” as opposed to “tolerable suffering”? The reality is that intolerable suffering is relative. Suffering is modified by many diverse factors. Therapies and treatments are readily available to address all of these factors. Not only is unendurable suffering relative, but it is too much to ask a physician to judge whether or not someone is indeed experiencing intolerable suffering.

In order to ensure that physicians don't approve euthanasia for vulnerable persons like James and myself in moments of weakness, specifics must be added to clause 3. This means including the need for reasonable proof, rather than mere opinion, in proposed paragraph 241.2(3)(a), and the addition of a specific prognosis in proposed paragraph 241.2(2)(d) to replace the phrase “natural death has become reasonably foreseeable”.

Proposed subsection 241(5) provides an exemption for aiding an individual to self-administer a substance for the purpose of ending their life. In an attempt to respect autonomy, the key checks and balances put in place elsewhere in the bill are hereby bypassed. We cannot just assume that people will be protected by the safeguards outlined in proposed subsection 241.2(3).

Most importantly, there must be oversight to ensure that patients are given the opportunity to revoke the request as outlined in proposed paragraph 241.2(3)(h). We must be careful that the appropriate balance mentioned in the preamble to the bill is not skewed too far towards autonomy, at the expense of vulnerable persons in need of protection, such as James and me.

The only true protection of the sanctity of life is a ban on euthanasia, but barring that, these recommendations will improve the situation for the disabled and ill.

[James Schutten, Association for Reformed Political Action]

Hi. I am James Schutten. Thanks for the opportunity to speak to you about this important issue.

When I was two years old, I was diagnosed with spinal muscular atrophy, which has left me with serious physical disabilities. I require someone to set up my feeding tube, suction my trach, turn me over in bed, take me to the bathroom, and scratch my head. I am not telling you this to make you feel sorry for me. I don't feel sorry for myself. However, you need to know that these professionals and family members need to care about my life and whether I live or die.

This is why I needed to talk to you about your draft law legalizing doctor-assisted death, and how that law will affect me and others like me.

I've gone to the hospital because of illness, and medical staff questioned whether extreme measures were worth it. This makes me very nervous, because I feel as if I am not worth the trouble. Thankfully, my family has my back to speak with the doctors on my behalf. If I have anxiety now, how much more if Bill C-14 comes into effect?

What if society started from the perspective that I do have value? What if people didn't view me as a burden for others to carry? I am one of those people who the Supreme Court of Canada thinks should have this right to doctor-assisted death. What if, instead, I had the right to palliative care or resources to help me continue to be a productive member of society?

I believe others like me feel the same way, but this right to die makes me feel as if society thinks I should choose to die.

Therefore, I urge you to add to proposed subsection 241.2(3) the requirement that palliative care is meaningfully made available to the patient.

Look past my wheelchair, and see that I am an asset in my community. I volunteer at a nursing home a few days a week and help out at an elementary school, all of which I really enjoy.

I don't believe that anyone has the right to choose exactly when to die. God alone decides, and he does not make mistakes. He has a purpose for everything. My faith and family add value to my life. Instead of investing money into a bill which normalizes the choice of death, our country should invest time and money into giving people with illness, disabilities, and old age a will to live.

I have one last thing to say. I want you to know that I am not a public speaker. I was very nervous to come here, but I feel that this goes far beyond just me and my insecurities and limitations. I need to speak up because this is so important. Please remember me when you make your decision.

Thank you.

The House resumed consideration of the motion that Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be read the second time and referred to a committee, and of the motion that this question be now put.

[André Schutten, Legal Counsel, Association for Reformed Political Action]

Thank you very much, and good evening, honourable members.

My name is André Schutten. I'm a lawyer with ARPA Canada. We were intervenors in the Carter case, and we have analyzed the various legislative and policy proposals that have been published since that decision was released in February by the Supreme Court.

I want to emphasize at the beginning that Parliament is not forced to pass a law legalizing euthanasia or assisted suicide. If Parliament passes such a law, it does so willingly and cannot wash its hands simply because the Supreme Court made you do it.

In fact, the Supreme Court made an error, and Parliament has a moral duty to correct that mistake. Parliament has a legal option—and I'm not talking about the notwithstanding clause—to fully protect all human life by prohibiting euthanasia and assisted suicide. I would be happy to discuss during the question period how that can done as an amendment to Bill C-14.

If Parliament insists on choosing to legalize assisted suicide and euthanasia, it will put the lives of vulnerable people at unacceptable risk, thus violating their constitutional right to equal protection of the law. The Supreme Court Law Review just published an article that I wrote making that very argument. Again, during the question period, I'd be happy to take questions on how Bill C-14 and the Carter decision actually violate section 15 constitutional rights of men like James and Pieter, who are sitting beside me.

Now I'm a healthy, able-bodied Canadian, as are all of you, including the doctor you just heard from, but I don't think we fully appreciate the disadvantage that Bill C-14 puts on some of our fellow Canadians who courageously face many obstacles that we will never face. Instead of me trying to convince you of those types of things, I've asked two such Canadians to share their perspectives directly with you, to comment on how Bill C-14 affects them, and then to share changes that they believe are necessary in order to make them feel a little more secure living in a post-Carter Canada.

I'm going to turn it over to James first, and then to Pieter.

[Angus Gunn]

Well, I don't think it can be said that Carter compels the extension of this opportunity to advance directives. I think the logic of Carter, however, compels that conclusion.

I think what you can be assured of is that if advance directives are not incorporated into this bill, there will be litigation over that issue. I think it's a given that either it will be put into the bill or its absence will be challenged. This is not an issue that I think will be left to the legislature ultimately. I think the courts will be asked to opine on this point if Bill C-14 remains silent on the point.

Notice of time allocation motion

[Andrew Scheer, Conservative, Regina—Qu'Appelle, SK]

Mr. Speaker, I think I have a more reasonable approach to managing some of the debate left for Bill C-14. Therefore, I would seek the unanimous consent of the House for the following motion:

That, notwithstanding any Standing Order or usual practice of the House, on Tuesday, May 3, 2016, the House shall continue to sit beyond the hour of daily adjournment for the purpose of considering Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), at second reading, and when no member rises to speak, or at 12:00 a.m., whichever is earlier, that debate be deemed adjourned, and the House deemed adjourned until the next sitting day.

[Dominic LeBlanc, Liberal, Leader of the Government in the House of Commons]

Mr. Speaker, an agreement could not be reached under the provisions of Standing Orders 78(1) or 78(2) with respect to the second reading stage of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).

Under the provisions of Standing Order 78(3), I give notice that a minister of the crown will propose at the next sitting a motion to allot a specific number of days or hours for the consideration and disposal of proceedings at the said stage.