Bill C-14 (Historical)

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

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

Criminal Code

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, the member for Montcalm indicated that the Bloc will be supporting the government's motion in response to the Senate amendments, and I want to ask him specifically about the sunset clause. I listened with great interest to his arguments, but he would know full well that Bill C-14 mandated a legislative review, which was supposed to have begun at the beginning of the fifth year, in June 2020. We are already way past that date.

The government's charter statement raised concerns about extending this law to mental illness, and even the justice committee's review of the bill showed that safeguard protocols do not exist and that it would take a significant amount of time to develop them. I am not necessarily against this, but would the member not agree that it would probably be a better approach to have a full review before we actually engage in an amendment to the legislation?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I do not want to keep members in suspense for too long. The Bloc Québécois will support the government's motion, and I will explain why.

I would like to tell all my colleagues that we need to work across party lines on these sensitive issues and find a way to move forward.

I remind my colleagues that Quebec's end-of-life legislation has often been cited as an example, not only because it is a good system, but also because of the way all members of the Quebec National Assembly worked together to create that system. Quebec's act came into force in 2015. The Select Committee on Dying with Dignity was created in 2009. The legislation was passed in 2014 and assented to in June 2014. This means that there was a process that ultimately involved debate. The Quebec National Assembly was able to consider all the differences and find common ground, which served as the foundation for the act. At the end of the process there were very few people against the act. There was broad consensus on this piece of legislation, both in the National Assembly and among Quebeckers.

In Ottawa, members have always taken action in response to court rulings. The amendments that need to be made to the Criminal Code in order to incorporate all of these sensitive issues are related to a court ruling. In this case, the legislators finally need to take action because the law has been deemed unconstitutional and found to violate fundamental rights.

According to Baudouin and Carter, Bill C-14 deprives people of the right to life. For example, it was depriving Ms. Carter, Ms. Gladu, Mr. Truchon and Ms. Taylor of their right to life because they were being forced to shorten their lives. That is not a trivial matter. It is serious.

My Conservative colleagues are saying that we need to protect human dignity and life. I completely agree, but it is important that we not create the opposite effect of what we claim to defend through government paternalism. Vulnerable people are capable of defending and exercising their rights.

However, it is rather appalling to see that, since Bill C-14 was introduced and since a decision was rendered in Carter, we have placed on the shoulders of vulnerable people, people with irreversible diseases, people who are enduring unbearable suffering, the burden of defending their case before the court in order to get access to medical assistance in dying.

Why are we agreeing to vote in favour of the motion? We are doing so because we need to make progress in a debate like this.

I have said this before and I will come back to it again later. Even though we said that we agree with the underlying principles of Bill C-7, we would have liked for the bill to go a little further. However, we still need to recognize that Bill C-7 responds to situations like those of Ms. Gladu, Mr. Truchon and Ms. Parker.

Bill C-7 also makes it possible for people in the terminal phase of life—I am not talking about the terminal stage of an illness when death is not foreseeable—to avoid waiting the mandatory 10 days with two witnesses before finally proceeding. Many people with cancer go through a long process. Even in the most aggressive cases, it takes a few months. People wait until the last minute to proceed because nobody wants to die. Everyone wants to wait until the last minute and push the limits of what they can tolerate. Once they reach that limit, these people want help.

Once in the terminal phase of life, a person who had been receiving palliative care at home may be taken to the hospital urgently, where health workers will note their rapidly deteriorating condition. Consider a person who, for the past two years, six months or three months, has always told their therapists that they want medical assistance in dying because they do not want to suffer. This person has been receiving palliative care and medication at home, but their condition is deteriorating. Why should they have to wait 10 days for access to medical assistance in dying in the terminal phase of life when the process of dying has begun and is irreversible? Bill C-7 covers this situation and offers this option. That is a step in the right direction.

There are of course other sensitive issues to be addressed, such as mental illness as the sole underlying medical condition. In my remarks last December, I had the opportunity to say that, as a parliamentarian and legislator, I did not have the expertise to reach a decision on that point. I think it is wise that the motion implies two things and that an independent panel of experts is being set up. The panel will have to look at the recommended protocols, guidelines and safeguards for MAID requests from patients with mental illness as their only condition.

Earlier, my Conservative colleague was talking about the requirement to have safeguards that protect the individual and help prevent abuse. Our Conservative colleagues would have us believe that we are in some sort of house of horrors, as though the health care system itself were inherently evil, and we need to protect persons with disabilities because our prejudices about these individuals might cause health care professionals to give up, as though people are going to be coerced and euthanized without their consent. I find it very difficult to understand that kind of rhetoric.

A similar independent panel of experts was set up in Quebec and a report was prepared. I think we should carry on with this work to get a clearer picture. Not only will the panel of experts deal with this issue, but there will also be something else we have been asking for for a long time, and that is the creation of a review committee for the entire body of work. Bill C-7 could have included amendments to C-14, An Act to amend the Criminal Code, which could have led to a new review of the legislation in two, three or four years. In just 30 days a special joint committee will study the issues of mature minors, advance requests, mental illness, palliative care in Canada and the protection of Canadians with disabilities.

Whether or not an election is triggered and there ends up being a change in government this committee is enshrined in law and will begin sitting in 30 days. It will work for a year before tabling its recommendations. We may reach a consensus or hold discussions for at least 12 months, which the court-imposed deadlines did not allow Parliament to do in relation to Bill C-7 and its previous version, Bill C-14. I think it is necessary.

To come back to the social acceptance of Bill C-7, I would point out to my Conservative colleagues that an average of 80% of people across the country approve it, from 88% in Quebec to 77% in Alberta. I think moving forward is a reasonable compromise. If in 24 months MAID is made available to people with mental illness, this deadline will help determine the necessary safeguards to make practitioners comfortable with this as well. In fact, we need to hear their point of view on this.

On the issue of advance requests for medical assistance in dying, I find it timely that the committee will start sitting in 30 days and that its members will work hard across party lines for the benefit of people who are suffering, like Sarah Demontigny. We will not forget these people, and we will establish a process to ensure that the advance requests they are drafting today will apply once our work is done. That is my hope.

Without making assumptions about the results of our efforts, I think we can come up with something better than the amendment proposed by the Senate if we have meaningful discussions and hear from witnesses. This would make it possible for Quebec, which is responsible for implementing this practice of advance requests, to properly regulate it. We could identify how to best amend the Criminal Code to allow for this.

I spoke about the legal aspect, but I will now come back to the fundamental principles. We are in the process of reaching a compromise because reason dictates that we must move forward. Bill C-7 represented a step in the right direction with the official commitment of an expert panel on mental health. I think it would be a good idea that the special committee I mentioned be a joint committee. This would ensure that everyone is doing the same work and hearing the same witnesses at the same time to eventually arrive at a conclusion, rather than having a game of ping pong between the two chambers—one of which is outdated, in our opinion. Let us rally together.

We are doing this for those who are suffering, who have waited too long and who, today, have hope that we will finally complete this work. I believe that the government's motion represents the light at the end of the tunnel for these people, because there is a deadline and we will get there if we all act in good faith and without partisanship.

Bill C-7 already contains fundamental principles, which I will repeat. First, death—my death, just like my life—belongs to me. Why did I say that and why did I say earlier that the Conservatives are practising government paternalism?

I said those things because my own death is a very personal thing, and the state must not tell me what to do or make decisions for me. The state should be creating a framework to protect my decisions. I do not think people should be pressured or forced to go into palliative care until their last breath or to request medical assistance in dying.

During any clinical study, the patient is the standard. When someone who is ill has determined their own limit of what is tolerable, we need to listen to what they are telling us and what comes out of their suffering. This allows us to provide support.

I find it very disturbing that in the debate on medical assistance in dying, MAID and palliative care are always pitted against each other, but in reality, it is a continuum and they complement each other. Later in my speech I will define the notion of human dignity.

Who would not want to receive palliative care before dying from a serious degenerative disease that causes intolerable suffering? We all want relief; no one wants to suffer.

When it comes to end-of-life care, the least you can give someone is palliative care. Unfortunately, for the past 50 years, palliative care has not been the only answer for everyone, unless one is ideologically committed and determined to prove it. At that point, someone comes to the patient's bedside and imposes some religious or other ideology. No, that is not it.

We are in a process where it is imperative that we consider that palliative care can be successful even when a patient's request for MAID emerges. Why? Because the patient is at peace and ready to let go. In fact, I hope all my colleagues are at peace and able to let go when the time comes. This could also be an example of very good palliative care. Palliative care is about support when someone is dying, the easing of suffering and psychological support. It is possible that some will die after suffering until the end, but it is also possible that some are ready to let go. That is when they can be supported.

It is not up to the family or the state to make decisions on behalf of the dying patient or the person suffering from a serious and irreversible condition causing intolerable suffering. The underlying principle of Bill C-7 puts into perspective what is enshrined in law for every human being, namely self-determination.

The law guarantees everyone the right to self-determination. Why take this right away from me at the most intimate moment of my life, meaning my death? Why should the state be allowed to take away my right to self-determination in my decision to suffer until I die in palliative care or to seek MAID? It would be utterly absurd for the state to assume that power.

The state must provide us a framework to be able to do this. I often hear members talk about human dignity. Human dignity implies that we must absolutely—

[David Lametti, Liberal, LaSalle—Émard—Verdun, QC]

Madam Speaker, first of all, if we fail to meet this deadline, we will have a different regime existing in Quebec than in the rest of Canada. In Quebec, the Bill C-14 regime would be enlarged to include death that is not reasonably foreseeable without any kind of safeguards. On the other hand, Quebeckers would not benefit from the Audrey Parker amendment or the other compassionate improvements that we made in the end-of-life regime.

In the rest of Canada, there are people who would like to have access to MAID who are not at the end of their life. They would be denied. This is a source of suffering for so many people and they would like it to be alleviated, but they would also not have access to the new benefits in the bill, such as the Audrey Parker amendment.

[David Lametti, Liberal, Minister of Justice]

moved:

That a message be sent to the Senate to acquaint Their Honours that, in relation to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), the House:

agrees with amendment 1(a)(ii) made by the Senate;

respectfully disagrees with amendment 1(a)(i) because this matter, including questions of most appropriate precise definitions, whether those definitions should be included in the Criminal Code or elsewhere, and whether any consequential amendments or protections relating to issues such as consent and capacity are necessary in relation to such an amendment, will also be addressed by the expert panel and the upcoming parliamentary review, and the Government will collaborate with provincial and territorial health authorities to ensure a consistent approach;

respectfully disagrees with amendment 1(a)(iii), 1(b) and 1(c) because it would permit advance requests for medical assistance in dying before an individual has a grievous and irremediable medical condition, a change which goes beyond the scope of the bill, and further, this expansion of the medical assistance in dying regime requires significant consultations and study, including a careful examination of the safeguards for persons preparing advance request and safeguards for practitioners administering medical assistance in dying, all of which could be part of the parliamentary review undertaken to study this important type of advance request to reflect the crucial input of Canadians affected by the medical assistance in dying regime;

proposes that, with respect to amendment 2:

the portion of paragraph 241.31(3)(a) before subparagraph (i) be amended by replacing it with the following:

“(a) respecting the provision and collection, for the purpose of monitoring medical assistance in dying, of information relating to requests for, and the provision of, medical assistance in dying, including”;

clause 241.31(3)(a)(i)(B) be amended by adding after the words “respecting the race” the words “or indigenous identity”;

subparagraph 241.31(3)(a)(i) be amended by deleting “and” at the end of clause (A), by adding “and” at the end of clause (B) and by adding the following after clause (B):

“(C) information — other than information that must be provided in relation to the assessment of eligibility to receive medical assistance in dying and the application of safeguards — respecting any disability, as defined in section 2 of the Accessible Canada Act, of a person who requests or receives medical assistance in dying, if the person consents to providing that information,”;

paragraph 241.31(3)(b) be amended by replacing it with the following:

“(b) respecting the use, analysis and interpretation of that information, including for the purposes of determining the presence of any inequality – including systemic inequality – or disadvantage based on race, Indigenous identity, disability or other characteristics, in medical assistance in dying;”;

as a consequence of amendments 1(a)(ii) and 3, proposes that the following amendment be added:

“1. New clause 3.1, page 9: Add the following after line 20:

“Independent Review

3.1 (1) The Minister of Justice and the Minister of Health must cause an independent review to be carried out by experts respecting recommended protocols, guidance and safeguards to apply to requests made for medical assistance in dying by persons who have a mental illness.

(2) A report containing the experts’ conclusions and recommendations must be provided to the Ministers no later than the first anniversary of the day on which this Act receives royal assent.

(3) The Ministers must cause the report to be tabled in each House of Parliament within the first 15 days on which the House is sitting after the day on which they receive the report.”;”

proposes that, with respect to amendment 3:

section 5 be amended by replacing it with the following:

“Review

5 (1) A comprehensive review of the provisions of the Criminal Code relating to medical assistance in dying and their application, including but not limited to issues relating to mature minors, advance requests, mental illness, the state of palliative care in Canada and the protection of Canadians with disabilities must be undertaken by a Joint Committee of both Houses of Parliament.

(2) The Joint Committee shall be composed of five Members of the Senate and ten Members of the House of Commons, including five Members from the governing party, three Members of the Official Opposition, and two Members of the opposition who are not Members of the Official Opposition, with two Chairs of which the House Co-Chair shall be from the governing party and the Senate Co-Chair shall be determined by the Senate.

(3) The quorum of the Committee is to be eight Members whenever a vote, resolution or other decision is taken, so long as both Houses and one Member of the governing party in the House and one from the opposition in the House and one Member of the Senate are represented, and that the Joint Chairs be authorized to hold meetings, to receive evidence and authorize the printing thereof, whenever six Members are present, so long as both Houses and one Member of the governing party in the House and one Member from the opposition in the House and one Member of the Senate are represented.

(4) The Committee must commence its review within 30 days after the day on which this Act receives royal assent.

(5) The Committee must submit a report of its review – including a statement of any recommended changes – to Parliament no later than one year after the day on which it commenced the review.

(6) When the report, referenced in paragraph (5), has been tabled in both Houses, the Committee shall expire.”;

section 6 be amended by replacing the words “18 months after” with the words “on the second anniversary of”.

Mr. Speaker, I would like to begin my remarks today by acknowledging the comprehensive study and debate on Bill C-7 in the other place. I applaud their diligence in holding a pre-study of Bill C-7 this past November and an in-depth committee study of the bill earlier this month, and a thematic third reading debate two weeks ago.

The matter of medical assistance in dying, or MAID, is a serious and complex one. The Senate has given it serious thought, and I believe we have given it serious thought in our response in this motion.

Before discussing the amendments, I want to remind hon. members of the process that got us here.

As members will recall, the bill proposes a legislative response to the Superior Court of Quebec's Truchon and Gladu decision in which the court ruled that it was unconstitutional to limit MAID to persons whose death was reasonably foreseeable.

To develop this bill, my colleagues, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion, our parliamentary secretaries and I held round table discussions across Canada with over 125 experts and stakeholders.

The government also ran a public online survey, to which over 300,000 Canadians across the country responded. A report summarizing the consultations was released in March. Our government fulfilled its mandate by creating this legislation. The whole process resulted in the bill that was introduced in the House last February.

As hon. members know, we had a thorough debate on this bill before the work of the House was suspended.

The objective of the bill is to recognize the autonomy of individuals choosing MAID as a means of relieving intolerable suffering regardless of the foreseeability of their natural death, while at the same time protecting vulnerable persons and affirming the inherent and equal value of every person's life.

Bill C-7 proposes important changes to the Criminal Code's provisions on MAID in response to the Truchon decision and informed by the results of the January and February 2020 consultations. We recognize these changes represent a critical shift. Our government has been working very hard since the Truchon decision on responding to this important court ruling and remains committed to doing so as quickly as possible.

After months of review of Bill C-7 in both the House of Commons and the Senate, we are now at a critical stage. There are Canadians who are suffering intolerably and would become eligible for MAID under the government's proposed changes, but they are currently unable to access the medical assistance in dying regime. This matter has been thoroughly examined, and Canadians need to be able to access the regime. We are renewing our commitment to the parliamentary review to look at the wide variety of other issues related to MAID outside of Bill C-7, but it is essential that we pass this legislation.

Following its thorough debate, the other place has adopted five amendments to Bill C-7. The most significant amendment is the sunset clause that would repeal the mental illness exclusion 18 months after Bill C-7 receives royal assent. I know that many senators and some witnesses from whom they heard believe that the exclusion of mental illness unjustifiably infringes the equality rights guaranteed by section 15 of the charter. I do not share that view. It is my opinion as Minister of Justice and Attorney General of Canada that the mental illness exclusion is constitutional because it serves a protective purpose and is narrowly crafted.

I have spoken before about the inherent complexities and risks with MAID on the basis of mental illness as the sole criterion, such as suicidality being a symptom of some mental illnesses, the impossibility of predicting whether in any given case symptoms will improve or not and the increased difficulty of capacity assessments. These are the concerns that led the government to exclude mental illness as the sole condition for MAID eligibility, given the proposal to broaden it beyond the end of life context. This decision was accompanied by a commitment to further consider the issue of MAID for mental illness in the parliamentary review required by former Bill C-14.

We heard from witnesses who share those concerns, but we also heard from several others who said that excluding everyone with mental illness as a sole underlying condition could be stigmatizing and pointless.

Some mental health experts believe that practitioners can assess the eligibility criteria case by case, particularly the voluntariness of each request and each patient's decision-making capacity.

In November 2020, the Association des psychiatres du Québec released a discussion paper exploring safeguards and procedures that could be put in place for the provision of MAID on the ground of mental illness alone.

While I do think the exclusion is constitutional, and I do not believe that we are fully prepared to safely proceed with the provision of MAID on the ground of mental illness alone, I also hear the concern expressed by Canadians that this exclusion fails to address the issue of whether and when the provision of MAID will be permitted to alleviate intolerable suffering due to mental illness.

That is why I propose that we support the sunset clause, but with an amendment so that it would repeal the mental illness exclusion after 24 months instead of after 18 months, after Bill C-7 comes into force. In combination with this amendment, I am also proposing the enactment of the requirement that the Minister of Health and I establish an expert panel to review safeguards protocols for guidance for such cases. We would give this group of experts 12 months to consider these difficult questions and make their recommendations to us, which we will make public by tabling their report in Parliament. The government and Parliament would then have 12 additional months to consider what safeguards should be legislated before the exclusion is repealed.

We hope this compromise can be acceptable to the other place. While some work has begun on potential safeguards for this group of persons, the work is far from complete and enacting legislation takes time. We think 24 months is still an ambitious timeline to implement such an important change in Canada's MAID policy, but it still provides a fixed timeline in the relatively near future for considering MAID eligibility on the basis of mental illness.

We also welcome the Senate's amendment concerning the parliamentary review. We suggest making a few changes to the timetable for completing the work, and we think it is appropriate to include key issues that this review will address.

The parliamentary review should address important issues, most of which were highlighted during the procedures and committee debates on Bill C-7 in both chambers, including palliative care in Canada, protecting Canadians with disabilities, safeguards for persons with mental illness, medical assistance in dying for mature minors, advance requests for medical assistance in dying and the legislation on medical assistance in dying more generally.

The spirit of the amendment aligns with the government's commitment to make it easier to call for a parliamentary review as soon as possible following royal assent to Bill C-7. This review is absolutely essential for the future of medical assistance in dying in Canada.

During consultations and the committee process in the House and in the Senate, we noted that a certain number of issues should have been reviewed and addressed, but they required a more in-depth study than was possible to carry out within the court-imposed deadline.

Bill C-14 calls on Parliament to conduct that review, and we are using this message today to initiate the process. While the motion sets out important issues that need to be examined, I do not expect the list to be limited to only those issues. Medical assistance in dying is a very broad subject, and we hope to hear from many Canadians on a wide variety of subjects related to it.

Having heard from many witnesses and spoken to many Canadians about Bill C-7, I know that people have different views on these issues. They are challenging issues, and I look forward to the parliamentary review, to hearing from many more Canadians on the subject and to seeing what comes out of this review.

I will let other colleagues speak in greater detail about the Senate amendments to the MAID monitoring regime. I will say that I am proud to support this Senate amendment, with some modifications to make it more inclusive, as a necessary step in the right direction toward gathering better data to inform us all, going forward, about the operation of MAID in Canada. Good data is what grounds good policy, and by knowing more about who requests MAID and why, we can assess the impact of broadening the MAID regime and provide Canadians with the transparency and public trust that such a regime requires.

That brings me to two Senate amendments that I do not believe we can support.

The Senate adopted an amendment that will enable people whose death is not reasonably foreseeable to sign a waiver of final consent. Bill C-7 set out a general policy on the waiver of final consent that intentionally limited it to the most obvious cases with the least amount of uncertainty, specifically when a person's death was reasonably foreseeable and the person was ready to receive medical assistance in dying.

Since the question of expanding the circumstances in which medical assistance in dying can be administered in the absence of contemporaneous consent requires more in-depth study, it is best if it is addressed by the parliamentary review. I know that many people will be disappointed with that decision.

Last year, I had the opportunity to meet Sandra Demontigny, who was diagnosed with early onset Alzheimer's at 39 years of age. She is an advocate for advance requests for medical assistance in dying. We had a long conversation. I was very touched by her story, her beliefs and her book. We will soon begin an in-depth study of this important issue during the parliamentary review.

Finally, while I appreciate the efforts at clarifying what constitutes a mental illness in the MAID context, this is a matter that can and will be addressed by the expert panel and the upcoming parliamentary review, and the government will collaborate with provincial and territorial health authorities to ensure a consistent approach. Through this work, I am confident there will be consistency on the scope of the exclusion, going forward.

Medical assistance in dying has always been a difficult issue that generates a variety of opinions on all sides of the issue. It is an issue that strikes deeply to every Canadian's personal morals and sensibilities. As such, it requires different interests to be considered. I firmly believe that Bill C-7 does so. The law would continue to require informed consent and a voluntary request made by a person with decision-making capacity, while also creating a more robust set of safeguards when the person's natural death is not reasonably foreseeable. These safeguards would require significant attention to be paid to all of the alternatives that might help alleviate suffering on the part of a person whose death is not reasonably foreseeable.

I believe that Bill C-7 is one important and prudent step in ensuring greater respect for the autonomy of a broader category of Canadians who are suffering intolerably. Our legislation would make only the necessary changes to ensure a MAID regime that is responsive to our experience to date and respects the charter rights and freedoms of Canadians to autonomy and safety. In Carter the court said, “the risks associated with physician-assisted death can be limited through a carefully designed and monitored system of safeguards”, and that is exactly what Bill C-7 would continue to do.

I look forward to working with all members of Parliament to pass these reasonable amendments prior to the court deadline on Friday. If the suspension period expires without the passage of Bill C-7, Truchon would come into effect without the benefit of the protection, safeguards and exclusions of our proposed bill. I encourage all members of the House to support the government's motion on the Bill C-7 amendments.

Alleged Premature Disclosure of Contents of Bill C-22

[Rob Moore, Conservative, Fundy Royal, NB]

Mr. Speaker, I am rising on a question of privilege concerning the recent premature disclosure of the contents of Bill C-22, an act to amend the Criminal Code and the Controlled Drugs and Substances Act.

Yesterday, the CBC posted online, at 8:47 a.m., an article that outlined details of Bill C-22. Bill C-22 was introduced in the House later that morning. The article outlined several measures contained in the bill, including amendments to the Criminal Code and the Controlled Drugs and Substances Act and the elimination of several mandatory minimum penalties. The article also boasts a reliance on sources, not unlike in the case I raised with you, Mr. Speaker, on another matter of privilege almost one year ago.

On February 25, 2020, I was on my feet in the House defending the privileges of the House on the matter of the premature disclosure of the contents of Bill C-7, an act to amend the Criminal Code (medical assistance in dying). In that case, The Canadian Press posted an article that disclosed the details of the bill before it was introduced in the House and after the bill went on notice.

On March 10, 2020, Mr. Speaker, you came back to the House with your ruling. You said:

First, based on a reading of the Canadian Press article on Bill C-7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House.

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one’s intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

As everyone knows, the Department of Justice, unfortunately, has a history of leaking the contents of government bills. On April 19, 2016, the Speaker found that there was a prima facie case of privilege regarding Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying). At the time, he said:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

Another question of privilege was raised on March 19, 2001, regarding, once again, the Department of Justice briefing the media on a bill before members of Parliament. In that ruling, Speaker Milliken said this at page 1840 of the House of Commons Debates:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government’s discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

The Speaker found another case of contempt on October 15, 2001, once again involving the Department of Justice, which does not seem to learn, after it briefed the media on the contents of a bill prior to the legislation being introduced in the House.

We are being asked once again to deal with the contemptuous actions of the Minister of Justice and his justice team. We have had countless rulings from the Speaker. The House has expressed itself on numerous occasions. We have had three debates and extensive committee studies.

The message is crystal clear, yet the responsible minister continues to draft bills and then leak those bills to the media, ignoring the will of the House. I ask, Mr. Speaker, that you find a prima facie case of privilege, and I am prepared to move the appropriate motion.

Criminal Code

[Ted Falk, Conservative, Provencher, MB]

Mr. Speaker, for the record, I want to restate that I voted against Bill C-14 when it came before the House four years ago. We have come to a difficult spot as a country and as a nation when we diminish the value of life.

I believe that all life is important. This piece of legislation, based on the ruling in the Truchon decision in Quebec, goes much further than that ruling suggests. It also does not provide the proper protection for conscience rights for medical professionals. It takes away that 10-day reflection period. That is an important note to make because as I said, 263 people changed their minds during that 10-day reflection period. This bill removes it. This is same-day death being proposed by the Liberals.

If someone is having a bad day facing an illness that they think is unbearable and degenerative, and for whatever reason they request medical assistance in dying, they do not have the 10-day reflection period to see whether that was the right decision. Under this legislation, that decision would be permanent and final.

[Ted Falk, Conservative, Provencher, MB]

Mr. Speaker, what results from this bill is truly a matter of life and death. The decisions we make here always have some ripple effects on others, but this bill needs to be about protecting the rights of some of our most vulnerable.

It is from a place of deep conviction that I speak on Bill C-7. My hon. colleague for Thunder Bay—Rainy River echoed some of these concerns and convictions in a CBC article written by Kathleen Harris. He states:

I don't like voting against my party, but as someone with a medical background and somebody who has dealt with this issue over the years a lot, I think morally it's incumbent upon me to stand up when it comes to issues of health and life and death.

I find it heartbreaking that we are putting doctors and legislators in this position. As the member opposite suggests, the primary issue is protection of conscience rights for medical professionals, health care providers, and the rights of hospices and other institutions not wanting to cause the death of people in their care.

As a Maclean's editorial explains, many doctors who may be willing to expedite the natural process of dying, given their traditional role to relieve suffering, would likely be threatened by the qualitative and ethical distinction between hastening a death that is drawing near and ending a life that is expected to persist. This is a very valid point.

When one senator asked an expert witness whether it was true that medical professionals were leaving because of the lack of conscience rights, Dr. Leonie Herx replied that she knew of doctors who took early retirement for reasons of professional integrity or because of their own personal moral compass.

Do we want to harden the hearts of those who, because of their very own world view, cannot comply? These are people who feel that MAID is a betrayal of their professional commitment to save lives, a betrayal of their faith or a betrayal of their conscience.

A CBC article says it rather well:

Rather than instilling hope and helping to build resilience by focusing on options for living, health care providers will now be asked to discuss an early death.

Many helpful voices express serious reservation with this bill. Constitutional lawyer and author Don Hutchinson explains that this bill does not provide a sound structure and protection for all people, especially those living with disabilities, chronic pain or mental illness.

The executive vice-president of Inclusion Canada told us that for the disabled community, Bill C-7 is their “worst nightmare”. Their “biggest fear has always been that having a disability would become an acceptable reason for state-provided suicide.”

Colleagues may say that will never happen. Many of us never thought that we would be here debating same-day MAID, yet here we are. We are hearing stories that are happening today even with the current legislation.

Palliative care consultant Dr. Herx described the experience of Candice Lewis, “a 25-year-old woman with a developmental disability and chronic medical problems”. When she entered the ER, a doctor approached her mother and suggested that she consider MAID for her daughter. She refused. The doctor promptly told her she was being selfish.

The disabled community has made it very clear, time and again, that they have suffered at the hands of our current legislation and they feel directly targeted by this new MAID legislation, as no other community is directly referred to in the proposed amendments to the current legislation.

Despite the holes in the current legislation adopted in 2016, the government is pushing for a further expansion to the eligibility of MAID at an alarming pace. Krista Carr, executive vice-president of Inclusion Canada, explains that the community of Canadians with disabilities and their families have long feared that “having a disability would become an acceptable reason for state-provided suicide”.

According to the Council of Canadian Academies, without its reasonably foreseeable natural death provision, Canada would become more permissive with respect to medical assistance in dying than any other jurisdiction in the world.

There are also the voices of Lemmens and Krakowitz-Broker. They explain that, unlike in any other country in the world, the new bill fails to explicitly require that all reasonable options be made available and tried before allowing physicians to end a patient's life. Even when that decision for MAID is made, we absolutely need to reserve the right for people to have a change of heart.

Dr. Leonie Herx, the past president of the Canadian Society of Palliative Care Physicians and chair of the division of palliative medicine at Queen's University, sees life stories every day that show how people can change their minds with respect to MAID. She refers to one beloved patient who arrived at her clinic asking for MAID, but quickly abandoned his quest after being assured of his worth and that he was not a burden.

Recently, the member for Vancouver Granville asked the justice minister in the House why the 10-day reflection period and reconfirmation of consent were waived in this proposed new legislation. She said that the removal of these safeguards was not required by the Truchon decision: the ruling the Liberals chose not to appeal.

I noted the member's comments with great interest, given that she was the former justice minister who brought forward the original bill to legalize MAID in Canada, known as Bill C-14. In response to her questions and other critics, the current justice minister replied that the 10-day waiting period only increased suffering and that he had even heard of people who stopped taking their medications during this period.

Ensuring that all Canadians have access to care needs to be our top priority to address the needs of suffering Canadians. Death cannot, and should not, be the only choice to end excessive suffering. I have talked to many health care providers who say that we have the tools and resources here in Canada to alleviate all kinds of suffering, and even to alleviate the anxiety of individuals facing imminent death.

John Diefenbaker once said, “Freedom is the right to be wrong, not the right to do wrong.” Canadians value our right to think freely, to consider our thoughts and opinions, and to change our minds if we so choose. The elimination of the 10-day reflection period and the requirement to reconfirm consent takes this option away from those facing this difficult situation. How are we preserving the right for people to change their minds when we waive the waiting period? It would seem that this bill makes the choice for MAID to be final and irreversible.

That is not what is reported in the “First Annual Report on Medical Assistance in Dying in Canada, 2019”. It says that 3.6% of the patients who made a written request for MAID subsequently withdrew that request. While that may not seem like a very significant number, to put it into context 263 people out of the 7,336 people who completed written requests later chose to change their minds because they had the opportunity to do that in the 10-day waiting period. That is 263 lives. Every single one of them deserved the right and the freedom to make that decision. This piece of legislation before us would take that right away from individuals.

Experts speaking to the Senate committee on Bill C-7 discussed how, in the proposed bill, MAID eligibility would apply to treatable diseases where death was not imminent. This is also where the bill adds a 90-day assessment period. It is no wonder that people with disabilities or chronic illnesses feel threatened by this legislation. This addition is especially concerning when people are faced with a sudden, dramatic life-changing illness or disability, as it often takes much longer than three months to gain a renewed perspective.

It is no wonder the former health minister, Dr. Jane Philpott, and the member of Parliament for Vancouver Granville wrote an editorial for Maclean's urging Parliament to proceed with caution, and questioning whether there was enough medical and social evidence to even understand the implications of these potential changes.

Saying that we are at a defining moment in history by approving this bill without further amendments is not an overstatement. I am thankful for the opportunity to highlight these very real risks, and I want to urge the Liberal government to address the bill's serious challenges.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, my colleague is absolutely right about the importance of conscience protections for physicians, which is why we brought forward amendments to this bill to provide for conscience protections.

The members across the way say, “Nothing to see here. No need for such protections.” They point to a recognition of conscience protections being in the preamble of Bill C-14. Could the member speak to that?

Second, I would note that the Carter decision, paragraph 132 states:

Nothing in the declaration of invalidity which we propose to issue would compel physicians to provide assistance in dying.

Yet that is happening in Ontario, violating the charter rights of physicians.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, before I begin my speech, I would like to attempt to bring this room to a place of peace. I know this is a very sensitive topic and we all have our ideas and our passions. Some of us have different ideologies on this, but I think it is beautiful that these heated debates are happening because that is what is required to work through an issue like this. Life is not simple. It is complicated. When there are challenges, they require us to be real and work through our emotions and ideas until we come to a place where there is agreement and a compromise that everyone can agree on.

Throughout the debate, I have heard my party being accused of filibustering or trying to delay passage of this bill. I find that heartbreaking, because this issue has to do with life and death. As was stated many times, death is final and irreversible. It can impact people beyond the scope of those who are seeking it.

Rather than attack the motivation of other members on this topic, I would like to ask all members to continue in our debates, understanding that this is a very complicated issue. We can have discussions that are real, but avoid comments like the minister made about the religious right, which I found offensive.

Hope is a journey. It is not something that can be bought like going through a drive-thru to buy McDonald's. Hope is something that accumulates over time and for different reasons, for different people. It requires a huge scope of places that the person who is struggling for hope goes through. It requires a full course to arrive at the doorstep of someone who is suffering, and sometimes it arrives unannounced.

One thing I find troubling about this bill, any time I have debated on it, has been the perspective of hope. Hope is the most sacred gift we have as human beings. Life is not perfect. We go through life struggling, but the beauty of the human spirit is our determination to triumph over adversity. We see things like this among so many people who come close to committing suicide. Look at someone like Christopher Reeve: a famous actor who played a superhero. Everyone looked to him as Superman, yet because of a riding accident he lost many faculties and contemplated suicide. With support in his very limited way of living, he was able to live out the rest of his life. His ability to overcome his challenges made him a greater hero.

I am not saying this to belittle suffering. When I was 17, my father was taken to emergency in the hospital because his heart had stopped. His heart had been beating irregularly and at one point it actually stopped. When I arrived at his hospital room I saw his slippers, but he was not in his bed. His roommate said to tread quietly as my father was in an urgent emergency crisis. I stepped away. I was frightened, as a 17-year-old. Because his heart had stopped beating, they were taking him for emergency surgery.

The most traumatizing aspect of this experience was witnessing him jolting and screaming in pain because of the electric shocks being applied to him. It was a very painful experience to watch. When I was talking with my father about this bill recently, he said that in those moments he counted about 10 shocks before he passed out.

He said it was the most tormenting experience he had had in his life, that it felt like someone had taken a hammer and was beating him down, and that he could not stop it or control it. He said that the only reason he fought through this to stay alive was the thought that he had three daughters to take care of. That gave him hope. Fortunately, he lived on. He has a pacemaker, and he is all right.

The reason I bring this up is to acknowledge that sometimes suffering is painful. I picture my father going through that every day to the point that he really wanted to die, and I am applying this to those who are legitimately seeking MAID. That law passed. This was debated in 2016 as Bill C-14, and it passed. The purpose, as I perceive it, was to offer a dignified death to those who would seek it.

I have great concerns with some of the details on safeguards removed from this bill. I fear that this removes access to hope even more. We have heard many experiences and stories, some coming from the justice committee. The time that is required when a person is suffering from something like a spinal cord injury can be more than 90 days, for them to regain that trajectory of having hope and wanting to live. Granted, it would be very painful and I would never want to be in that situation, but there are those who overcome.

This bill would allow a person who has just suffered a life-changing spinal cord injury, for example, to end their life just 90 days after the catastrophic event that caused the injury. When a person is at their most vulnerable, experiencing unimaginable stress, a doctor could be forced to suggest ending their life. That is the option there.

From my understanding from doctors and witness testimony on the record at the justice committee, suicidal ideation after a catastrophic medical episode is very common. There is the possibility, with good care and support, that these transient suicidal thoughts could often take longer than 90 days to overcome. In recent weeks we have heard many of these stories of people who went through serious personal tragedy, but who have ended up living amazing lives and doing incredible things on the other side of it.

I would like to share the story of David Shannon. David suffered a spinal cord injury in a rugby scrum when he was 18 years old. He shared that after his accident, he lay in bed, close to death more times than he wishes to contemplate. He went on to have a career in a non-governmental organization with leadership, and he practises law. He said:

... I have accomplished a lot in my life. I've crossed our great country by the power of my wheelchair — coast to coast. I've jumped out of an airplane at over 25,000 feet.

It explains all the things he was able to do because he chose to live.

My fear is that removing these safeguards will create that truncation of hope that requires that full course for a person to regain their trajectory. If that is truncated, the big question is, “What if?”

This morning, in a CBC article, about a member of the Liberal government:

He said he worries the resulting legislation may not address people who are "transient" in their wish to terminate their lives, such as someone who has a permanent disability or who now needs chronic care. Those feelings of anguish can fade over time as they adjust to a changed reality, he said.

I think, with a bit of time, people may come around to the fact that there are reasons they want to live.

I want to thank my colleagues for their heated debate. I appreciate where they are coming from, but I would like to ask each one to take a moment of deep thought and ask if it is not worth protecting and safeguarding hope so that people have that opportunity through a longer time period to rediscover hope and have a chance to live past that darkness and move into a place of light.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Madam Speaker, I feel honoured tonight to be speaking to Bill C-7 given the many great speeches by my Conservative colleagues, who are concerned about our citizens and especially those in the disability and senior communities.

I speak today deeply concerned about Bill C-7 and the changes being proposed in the legislation. I know this is an emotional issue for everyone, and it is an important discussion we are having this evening. Any legislation that is introduced in Parliament requires a thorough review, but this is especially true for bills that are literally matters of life and death.

It is my firm belief that the federal government should have appealed to the Supreme Court to get certainty on the framework within which Parliament can legislate. Unfortunately, that did not happen, so here we are with a rushed bill that puts the lives of our most vulnerable at risk.

Make no mistake: As a Christian I am firmly against the use of medically assisted dying. That said, I understand that the courts have made a ruling and the legislation is required. However, we must ensure that this type of legislation includes safeguards for the most vulnerable in our society and for the conscience rights of physicians and health professionals.

That is why we Conservatives introduced a number of reasonable amendments to reinstate protections that the Liberal government has simply removed, which is troubling. These include reinstating a 10-day reflection period when death is reasonably foreseeable, extending the reflection period when death is not reasonably foreseeable, protecting vulnerable patients by requiring that the patient be the one who first requests information on medical assistance in dying and protecting the conscience rights of health care professionals.

It is unfortunate that these amendments have been rejected by the government. I am deeply concerned that this legislation will allow assisted death for Canadians who are not dying by removing the requirement that a person's death must be reasonably foreseeable for them to be eligible for assisted suicide and euthanasia.

My dad is 86 and my mom is 76, and as the son of two elderly Canadians, I am very concerned about what this would mean for our nation's seniors and the positions they may be put in when trying to access health care. Will they be placed in a position where they will have to decide between care and ending their lives because of outside pressure? As the bill expands medically assisted dying further, there is a risk that palliative care will suffer and, as a result, patients will view medically assisted dying as a better option.

I know Canadians share my concerns. It must be said that every national disability organization in Canada opposes this legislation. Krista Carr, executive vice-president of Inclusion Canada, said at committee, “Bill C-7 is our worst nightmare.” These organizations caution that removing the end of life requirement discriminates against those who are disabled and puts their lives at even greater risk. Ms. Carr notes:

The end-of-life requirement was the only safeguard whereby disability was not the sole criterion. By having a disability itself under Bill C-7 as the justification for the termination of life, the very essence of the Charter of Rights and Freedoms would be shattered. Discrimination on the basis of disability would once again be entrenched in Canadian law.

It is shameful that in the Liberal government's rush to pass the bill before Christmas, it continues to neglect to address legitimate concerns being raised by persons with disabilities.

I am also deeply concerned about the limited protections for the conscience rights of our medical professionals. While some doctors and health care workers may have been comfortable with medically assisted dying under Bill C-14, the continued expansion may cause them to rethink their participation.

Others who have always been against medically assisted dying are already feeling the pressure to go against what they believe. As the Physicians Alliance Against Euthanasia said in a news release just last March, “The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving their profession even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.”

Members of the justice committee have heard first-hand from disability advocates vehemently opposed to Bill C-7 and its rapid expansion of medical assistance in dying. They argue it amounts to a deadly form of discrimination, making it easier for persons with disabilities to die than live. It is shameful.

Health care professionals have also spoken out, concerned not only about their conscience rights but also about the speed at which the government is trying to pass Bill C-7. To quote Adam Taylor about the lack of consultation on this legislation, “As an emergency and family doctor, I know the importance of consultation, along with the day to day experiences and sufferings of Canadians which cannot be ignored. I'm terrifically concerned about this.” Even so, here we are, and the Liberals are continuing to push through the bill, ignoring concerns of those who would be directly affected by these changes. Again, it is shameful.

As the Evangelical Fellowship of Canada said in its submission to the House of Commons Standing Committee on Justice and Human Rights, we must carefully consider the impact of Bill C-7 and the concerns being raised by many Canadians, particularly Canadians with disabilities. The legislation, not to mention the human lives the bill would negatively affect, is too important to be rushed.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Madam Speaker, we know that physicians are very concerned about conscience protections for medical practitioners. Right from the beginning, with Bill C-14, many stressed that this should be part of Bill C-7, yet the Liberal government has totally ignored it and punted it down to the provinces. I believe it is impacting palliative care and impacting people's perspectives of serving in the medical profession. I would just like some comments from the member in that regard.

[Gary Vidal, Conservative, Desnethé—Missinippi—Churchill River, SK]

Madam Speaker, I knew entering federal politics would mean participating in many very important debates in the House, but speaking on matters of life and death brings that to a whole new level. As someone who comes from a small city in northern Saskatchewan and now has the privilege of representing the entire northern 52% of Saskatchewan, I hope to bring somewhat of a unique perspective to this debate.

As we stand here in Ottawa and debate this legislation, there are several communities in my riding dealing with very high suicide rates. Makwa Sahgaiehcan First Nation, a community of about a thousand people, has over 100 community members currently on suicide watch.

There are long-term care home and palliative care shortages across the country, but this is even more true in northern and remote communities. We need to consider what message we, as legislators, are sending to these vulnerable communities when we go way beyond the Supreme Court of Canada's Carter decision by removing safeguards that would protect Canada's most vulnerable.

The government is now seeking to play an active role rather than a passive role in the end of Canadians' lives. I find this extremely troubling and implore my colleagues on the other side of the aisle to allow the necessary time to consider the truly long-term ramifications of the legislation and to listen to all the voices speaking out on it. This does not need to be done with unnecessary hurry.

There are two main topics I want to address when it comes to Bill C-7. Number one is the impact passing the legislation will have on indigenous communities, and number two is the importance of safeguards to protect Canada's most vulnerable.

I do not stand here pretending for one moment to speak on behalf of indigenous people in Canada. However, over my lifetime I have developed relationships with many first nations and Métis people in northern Saskatchewan and over the year I have discussed this issue of assisted dying with many of them. There is a great worry among the leadership of these nations that legitimizing suicide in our culture will have grave impacts on their younger generations as well as those who are nearing the end of their lives.

These concerns were actually raised during debate in the last Parliament by Liberal MP Robert-Falcon Ouellette during his speech on what was then Bill C-14. He said:

In the indigenous world view, everything is interconnected. It is holistic, meaning that when a change is made in one place, the impact will be felt elsewhere, and the two cannot be separated. In the western world view, often we compartmentalize things. We believe that we can play, that we can control certain situations, that we can effect change here and not see change in other places. Above all, we have come to believe ourselves able to predict and control all, to control the future. This does not mean, though, that we should not take action.

The impact of this bill on people in Toronto may be very different than on the people in Nunavik or Attawapiskat. Our role as parliamentarians is to place ourselves in the moccasins of others, to place ourselves outside of our own experiences, to see the world through another cosmology and other world view, and to see the impact that our decisions may have on others.

We are making profound changes in concepts surrounding life, which cannot be undone in the future. In the indigenous tradition and philosophy, we are required to think seven generations into the future. If I am wrong and there is no connection between Attawapiskat and physician-assisted dying or suicide, if the average person does not see a connection and communities do not see a greater stress, then I will gladly say I was wrong; but if there is an impact, which is caused by the valorization of suicide, then what?

Mr. Ouellette then goes on to share a very personal and difficult story of hardship he and his siblings faced as young children, which led him to nearly take his own life. He goes on to say:

If in my life I had seen, or I had known, that my grandmother had somehow used physician-assisted dying or physician-assisted suicide, or others in my family had completed the irreparable act, then it would have made it much more difficult for me to continue.

We might not think the impact will be there, but we do not know. We assume we know these things. We are deciding the future of a few for the end of a few.

Speaking to CBC during the debate on Bill C-14, Senator Murray Sinclair shared similar views. He said:

From the indigenous perspective, ending one’s own life was not encouraged, in fact it was discouraged and there are teachings in my community, Ojibwa teachings, around whether or not you will be able to travel to the spirit world in the proper way or a ceremony could be done for you if you make the decision to end your life without good reason.

In speaking to his colleagues in the Senate, Senator Sinclair, speaking about younger people, said:

It will not take much for a young, vulnerable person to believe that their situation is intolerable to them and, therefore, we need to ensure the message we send to the Canadian public with this legislation is that this is not a right that should be easily exercised or that we are embracing.

First nations people in northern Saskatchewan, Mr. Ouellette from Manitoba and Senator Murray Sinclair are not alone. Tyler White, chief executive officer for the Siksika Health Services, as well as Dr. Thomas Fung, a lead physician of the same nation, are sounding alarms in response to the legislation. During an interview with CTV, Mr. White said, “The expansion of MAID sends a contradictory message to our peoples that some individuals should receive suicide prevention, while others suicide assistance.”

In a letter shared with my office, Mr. White and Dr. Fung told the story of a patient who suffers from a lung disease that causes him to become easily short of breath, even when doing simple household tasks. This patient uses a walker but cannot walk for more than a couple of minutes without gasping for breath. While the man's condition is incurable, he could certainly have an improved quality of life if he had access to funding to support his home oxygen, but he was just out of the range of being approved for funding. Dr. Fung concluded by writing that under Bill C-7, this patient would have qualified for assisted death when it should be clear to all that there are other ways to relieve this man's suffering and improve his quality of life. Patients like Dr. Fung's deserve better.

In a country as developed and resourceful as Canada, we cannot allow ourselves to abandon people like this. Our health care system is the pride of many Canadians, but that is because of universality of access to life-saving treatments, not the universal admissibility to a physician-administered death.

I want to talk for a minute about the safeguards for vulnerable Canadians and how the legislation would fail to provide them. I am not a lawyer, but thankfully the Leader of the Opposition is. We are probably all glad that is the case, that I am not the lawyer. I was glad to be in the House during this speech on Bill C-7 this morning.

Leaning on his legal expertise, allow me to repeat some of what he said regarding previous litigation surrounding assisted death, because it struck me as very important. He said, “All of them talked about the role of the state in protecting the decisionally vulnerable, as they were called, people who could be pushed into end-of-life treatment because they felt they were a burden. This has been talked about since the 1990s, and this Attorney General is removing the safeguards from our regime. Every ounce of case law on the issue of assisted dying, euthanasia or assisted suicide talks about protecting those vulnerable.”

Speaking of protecting the vulnerable, the leader also said, “All major disability groups in Canada agree with the compassionate and reasonable position being presented by my Conservative colleagues. I am very proud of the advocacy we have shown. We have also been joined by legal scholars, indigenous leaders and people working with people with mental health issues.” I wholeheartedly echo the comments made by my hon. friend this morning and repeat the need for the government to step back from its repealing of the provisions that would ensure a 10-day waiting period, as well as two witnesses.

As a matter of fact, regarding the 10-day waiting period, a senior employee of the AFN shared on Twitter recently, “This ten day period literally saved a member of family’s life. MAID must be accessible but also account for clear and thoughtful consent. The Liberals should rethink this.”

In closing, I want to completely acknowledge that both sides of this debate are coming from a point of view of compassion. I understand that the government has approached the drafting of the legislation in good faith, but the reality is that it has fallen short of its duty to Canadians. That is why I will be voting against this dangerous bill and I hope that my colleagues on the other side of the aisle will reconsider their support for it as well.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I am pleased to rise once again to speak to Bill C-7, the government's medical assistance in dying legislation. I do acknowledge that this is an incredibly complex subject matter for which there are many diverse views.

With that said, the way in which the government and the Attorney General have handled the legislation is a lesson in what not to do, having regard for the gravity of the legislation. I say that having full respect for the Minister of Justice and Attorney General. I believe he is a sincere and intelligent individual who is compassionate and does want to do what he believes to be right.

That said, when the Minister of Justice spoke in the House at second reading, he indicated that there were widespread consultations and that out of those consultations there was a consensus. Neither is true.

The consultations that the minister spoke about were largely over the course of one month in January of this year. They were online consultations that excluded vulnerable segments of the population, including persons with mobility, cognitive or visual impairments, persons without access to the Internet and persons living in remote and northern communities. Their voices were not heard or were not heard as easily as a result of the online consultation process that started and ended within roughly a period of one month.

Not only that, but the consultations were said to have had a predetermined outcome. In other words, the minister had an idea of the legislation that he sought to craft and he used the process as a way of getting the answers that he had hoped to receive.

Do not take my word for that. Take the words of the persons who were involved in the consultation process, including Heidi Janz of the Council of Canadians with Disabilities, or Dr. Catherine Frazee, the former chief commissioner of the Ontario Human Rights Commission and a leading advocate for persons with disabilities. They said that the consultations were predetermined when they appeared before the justice committee.

What about the consensus that supposedly arose out of these so-called extensive consultations that simply were not so? We know that out of those consultations just about every national disability rights organization opposes this bill. As we speak, they are calling on the minister and the government to put this bill on pause. We know that more than 1,100 physicians have penned a letter expressing their opposition. Concerns were expressed by the U.N. Special Rapporteur on the rights of persons with disabilities.

Just about every witness, if not every witness other than the minister himself, who appeared before the Senate legal and constitutional affairs committee that held hearings the last couple of weeks, panned the bill. No one, it seems, is happy with the bill. So much for the minister's assertion at second reading in the House that there was a consensus. There was no consensus, because there was no meaningful consultation, and there was a predetermined result that has resulted in legislation that just about everyone in one way, shape or form has been highly critical of.

I heard over the course of the debate members of the government and other parties talk about this issue in a context as if there were no risks, “Get out of the way, let the patients make their choice and throw out safeguards, because otherwise one is infringing on individual autonomy.” The Supreme Court of Canada recognized in Carter that “there are risks, to be sure”, at paragraph 105 of the Carter decision, and the court talked about how those risks can be “'very substantially minimized through a carefully-designed system' that imposes strict limits that are scrupulously monitored and enforced”. That is what the Supreme Court of Canada said.

When we talk about those risks, one need look no further than the case of Roger Foley, who is severely disabled, requires 24-hour care and is in a hospital facility in London, Ontario. I will read what he said about his experience, because it really is quite shocking. When he came before the justice committee, he talked about what can happen when there are insufficient safeguards, and we are talking about safeguards that are in Bill C-14 which are now being further removed by Bill C-7. He said:

I have been coerced into assisted death by abuse, neglect, lack of care and threats. For example, at a time when I was advocating for assistance to live and for self-directed home care, the hospital ethicist and nurses were trying to coerce me into an assisted death by threatening to charge me $1,800 per day or force-discharge me without the care I needed to live. I felt pressured by these staff raising assisted dying rather than relieving my suffering with dignified and compassionate care.

In the face of that, we put forward an amendment to say that this must patient-initiated. The minister responsible for disability inclusion said that she had grave concerns about what happened to Roger Foley, and she has heard about this regularly. Yet, even in the face of that evidence, the government rejected that very common-sense amendment, rejected other amendments and instead moved recklessly ahead. We are now in this untenable situation where the most vulnerable persons in our society could be put at risk. It really is unfortunate that it has panned out this way. I can only hope that the Senate will bring forward substantive amendments to this deeply flawed legislation.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Madam Speaker, it gives me no pleasure to rise yet again to oppose this deeply flawed and dangerous legislation, Bill C-7. The Liberals have been complaining in the media that they think the Conservatives are holding up the legislation and that they are going to miss their court-imposed deadline of December 18, but they really have no one but themselves to blame. Conservatives are doing our constitutionally mandated job to hold the Liberal government accountable on its legislation.

Looking at the record over these past eight months, it is clear that my party has bent over backwards to give the Liberals the breathing room to implement emergency economic aid and other COVID-related measures. We have been very co-operative. We have also seen a great deal of government legislation move fairly quickly through the House just this fall, and in a minority Parliament at that.

Let us look at the Liberal record on moving the legislation forward. From the very beginning, the government really made its own bed on this one when it refused to defend its own legislation, Bill C-14, which was just passed in the last Parliament. Even some of its own members said on Twitter that the legislation was unconstitutional, admitting they felt it was unconstitutional even when they were voting for it, but they did not use the opportunity to appeal the legislation to the Supreme Court. That shows me that it was the government's intent to use the courts to circumvent Parliament.

Parliament was mandated, under Bill C-14, to conduct a thorough review of medical assistance in dying and that review was to occur next year. It is important to have these sorts of reviews built into legislation because when we talk about something as serious as medical assistance in dying, which is a novel legislation, a new innovation in our social fabric, Canadian people really have not had adequate time to digest how they feel about the legislation and to examine their lived experiences.

A five-year review was a very adequate provision to give Canadians a bit of time to assess the bill and then have Parliament make recommendations and possibly changes to the legislation so that we could fix the bill, whether that meant tightening up some things that were prone to abuse or maybe loosening up the legislation in cases where it was needed. However, with the Liberal government's desire to short-circuit the legislative process and the will of the previous Parliament, it chose to fast-track the legislation by not choosing to appeal it to the Supreme Court. I believe this was done very purposely to ensure the legislation would pass before a review took place.

If the review had gone forward, as we have seen from the Council of Canadian Academies, there are a lot of questions about the practice of the legislation and how it has been carried out over the past few years. Abuses have been raised in committee and in the House repeatedly, yet in the legislation the government has taken no efforts to take those experiences and make this a safer piece of legislation for vulnerable people.

Going to the next example of why the government's problem is one it made itself, with the COVID-19 pandemic, which I agree was not the government's fault, it was required to request several extensions of the bill. The courts were willing to approve those extensions and, in late summer, Liberals chose to prorogue Parliament. By proroguing Parliament, they made the choice to clear the decks of all of their legislation, start from the beginning and send us back to the drawing board. By doing that, they delayed the legislation further. For the Liberal government to claim that Conservatives are holding up the bill when what we are doing is our constitutionally mandated job, especially on an issue as important as life and death, it does not ring true.

Another example is that if the bill was so important for the government to get passed so quickly, why was it not the first justice bill it put forward? Bill C-3 was passed in a very expeditious manner with all parties' support in the House. It was passed, largely, with the support of committee and minimal amendments. Even in that expedited manner, that delayed the government's legislation by weeks. The Liberals are talking and complaining about how Conservatives are allegedly delaying the legislation, but it was their own choices that resulted in the delay of the legislation.

We are left today with the government complaining that the Conservatives are doing their job. We are doing our job by criticizing the Liberals' legislation. We are holding them to account. We are championing the rights of vulnerable people. We will never apologize for doing what our constituents have sent us here to do, which is to stand up for their deeply held beliefs, to stand up for their concerns and to stand up for vulnerable people.

Vulnerable Canadians made their desires known and their concerns known very loudly and clearly at the committee. I am pleased to see that the other place has had more time to hear from witnesses. I believe it has heard from over 80 witnesses, the vast majority of whom are opposed to the legislation. Frankly, in the House, we only had four committee meetings for this very important legislation, so I am pleased that the Senate is taking its responsibility seriously and thoroughly examining the bill and hearing from vulnerable people and others who are concerned about the legislation.

The members of these communities were afraid of Bill C-14. They were assured by the government that they would be protected and that there were protections for people with mental illnesses from accessing it. There were protections for children. There was the reasonably foreseeable death requirement, which was touted as a great protection for the disabled community. I can tell members that what they are saying is that they are terrified by what they see in this bill from the Liberal government.

I read today on CBC that the Minister of Justice appears to be in a showdown with disabled groups who are demanding a halt to the bill. The idea that the Minister of Justice, whose role is to uphold the Charter of Rights and Freedoms for Canadians, is fighting and ignoring the pleas of disabled and other vulnerable Canadians is just plain wrong.

Conservatives have been listening and we have been fighting for these vulnerable Canadians. It appears that nobody else is willing to fight for them. That is what we will do. We are fighting for these vulnerable Canadians. We are not being intransigent about this bill. Conservatives have a wide range of perspectives on this issue. We have put forward, as a party, some very common-sense amendments that do not undermine the legality of medical assistance in dying as a general practice but will do a lot to assuage the fears of vulnerable Canadians.

Some of these common-sense amendments proposed at committee included protecting patients from undue coercion. By coercion, people immediately draw up images of doctors in deeply immoral situations pushing medical assistance in dying on vulnerable people who are isolated from loved ones and family members. I am not trying to say that is happening. Frankly, I think what we have seen is that it is a lot more benign than that. It is not doctors aggressively pushing medical assistance in dying on people.

Someone may be in a situation where there is a power imbalance, and as a disabled person, other vulnerable person or a person who is older, they might not have family members or access to supports like social workers and psychologists. In this situation, they trust their doctors and that is a good thing because our doctors work very hard and they are very professional. However, if someone has that trust relationship with their doctor and the doctor comes and asks if they have considered medical assistance in dying, that could seem very benign for an average person. If I was in a situation like that and the doctor came to me, I would say no thanks, but we never know what someone else is going through and what challenges they are facing.

If they do not have someone to turn to, they can feel like the doctor is looking out for their best interests and the doctor is suggesting that they consider medical assistance in dying, so maybe the doctor is right and maybe that person should consider it. In this case, we recognize there is a power imbalance. At committee, we suggested putting forward some very strong protections to say that health care professionals should in no way be presenting medical assistance in dying as an option to patients. This is a basic protection.

This is something we talked about with the last bill. I was actually very disturbed, during debate at second reading, when a Liberal member stood up and talked about a couple they knew who had not ever considered medical assistance in dying. It was a very touching story. The member nonchalantly said that the doctor came in, passed them a brochure and asked if they had ever considered medical assistance in dying. The member, I think, thought that this was an innocuous and benign situation, but for me and for people in disabled and vulnerable communities, it was very scary that they could be put into this situation without adequate supports. They might feel like they were being coerced into a decision.

We also wanted to put in some stronger protections around a period of reflection. I think the period of reflection is key because, even in the government's own reports on medical assistance in dying, there were many cases in which people did not receive disability supports, and they received MAID while still not receiving disability supports. There were people waiting to get palliative care who had not received access to palliative care who also received medical assistance in dying.

It clearly illustrates that the government is not putting the resources in to help disabled Canadians, or to help Canadians who need palliative care. If we shorten the timeline or eliminate the timeline altogether, we are really losing an opportunity for people to access these wonderful services that can make the end of life much more peaceful.

One of the sad things about debating this bill today is that I feel like I am being forced to defend the status quo, implemented in the last Parliament under Bill C-14. I was not a big fan of Bill C-14, and as legislation it has proven time and again to fail to protect vulnerable people. It certainly did not protect the prisoners who underwent medical assistance in dying.

This issue was raised by the Office of the Correctional Investigator, and it has deep moral and ethical problems. Prisoners really have no power. He raised a case in which a prisoner was coming close to the end of life and wanted to die peacefully in the community with access to palliative care. They were denied the opportunity to do so, and then chose MAID instead. I think the correctional investigator was very astute in bringing that up. In situations where somebody does not have a right to determine their own manner of death or the manner that leads up to their death, how can they be given a choice to access medical assistance in dying? That raises some big issues.

In numerous cases, people were largely not sick with anything. In one case in the Globe and Mail a number of years ago, an elderly couple in their nineties wanted to die together. According to the article, they were not suffering from any pre-existing conditions, except arthritis, but it was ruled that because they were so old their deaths were reasonably foreseeable. That is really troubling. Medical professionals have raised the point that a reasonably foreseeable death is not actually defined in any medical journal. There is no definition of “reasonably foreseeable.” It is so subjective. One thing that I would have liked to see with this legislation was for the government to come forward with an actual medical definition of “reasonably foreseeable.” Instead, it has chosen to eliminate this language altogether, which waters down the protections.

Bill C-14 did not save people who were suffering from mental illness from receiving medical assistance in dying. There was a case in Chilliwack where somebody who had a history of depression was able to access medical assistance in dying in an expedited manner. Their family was not informed until very late into the process and they were not able to intervene and explain that this person, while they did have a reasonably foreseeable condition, also suffered from depression and other challenges and that maybe, with a social worker or a psychologist, those things could have been worked out and medical assistance in dying could have been avoided.

It is clear to me that we are removing even the barest of protections. We are removing this adequate reflection period and making this legislation, which is already prone to abuses, even more open with this new legislation.

The government claims this new bill is safe because it is explicitly denying people who are suffering exclusively from a mental illness from receiving MAID. When the previous legislation was brought in, even though I was not a member of the House at the time, I sat in on a lot of meetings. It is interesting that, in committee appearances and at the joint special committee, Dr. Sonu Gaind from the Canadian Psychiatric Association was very hesitant to endorse medical assistance in dying for people suffering from mental illnesses, especially exclusively mental illnesses. Their testimony said that they do not treat any mental illness as if it is untreatable. There is always a treatment. Sometimes it is a very difficult treatment or an ongoing treatment, but society must never accept that there is not a way to treat mental illness. The alternative is that we stop helping people and that they seek medical assistance in dying.

It is tricky when the government talks about excluding MAID for people with exclusively mental illness, but we are seeing that too many people who might qualify for medical assistance in dying because they have a physical condition and a reasonably foreseeable death also have a mental illness.

Where doctors are involved, they are very well educated but they are not necessarily educated in all aspects of health. Not every doctor is a psychologist or qualified to make mental illness determinations. How do we know that somebody who might have a reasonably foreseeable death, and who might have a previous condition, is not depressed and seeking medical assistance in dying for the purpose of their mental illness?

Under this legislation, there is no protection for those people seeking medical assistance in dying. While the government may say they qualify because they have a grievous and irremediable condition, we need to have more protections to ensure that people with mental illnesses are not seeking medical assistance in dying in the heat of the moment. Maybe they have had an incident that has led them to want it, and given more time to reflect maybe they could be dissuaded from seeking it.

There are no mechanisms, as I said. I am not going to just criticize, I am going to put forward actual, concrete ways I think we could make this legislation better. Unfortunately, it does not seem the government is in the mood to accept too many amendments from the Conservative side, but I will go ahead and say them anyway. We should require social workers and psychologists to be involved with decisions where underlying mental health issues, or issues related to access to income supports or to poverty, might be identified.

I was very disturbed to read in Maclean's magazine that some people are seeking medical assistance in dying because they are living in poverty. That was never written in the legislation. That was never intended as a purpose for medical assistance in dying. By including these important medical professionals, we could make it much more difficult for people to get medical assistance in dying who might not make that decision if it was between them and a doctor.

That leads me to one of my final points. The government is removing some of the witness requirements. Under the previous legislation, an independent witness who was apart from the medical process was required to be involved. That would provide accountability to ensure that doctors and health care professionals were crossing all their t's and dotting all their i's to make sure that this was a completely kosher procedure. By removing the independent witness requirement, it is leaving the decision up to a doctor and the patient.

I am going to be opposing this legislation. I look forward to the other place coming back with some very strong amendments. I look forward to debating those amendments again, and getting the best possible legislation that will protect vulnerable people in this country.

[Ed Fast, Conservative, Abbotsford, BC]

Madam Speaker, my colleague from Yorkton—Melville has referenced the issue of the steep slippery slope on which we find ourselves. Back when Bill C-14 was being debated in the House, many of us had concerns it was indeed a slippery slope and we were generally mocked and accused of fearmongering. Today, here we are. In fact, it is very clear it was a steep slippery slope.

It is the vulnerable in Canada who are being exposed to medically assisted death. I would ask the member to comment on the assurances from the government that those with mental health issues, children and other vulnerable Canadians will not be exposed to this in the future and that they will be fully protected under the legislation.

I would like her comments on whether she takes those words at face value or questions them.