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

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

Madam Speaker, I consider it an honour to speak for a third time on Bill C-7 as the bill would dramatically expand access to assisted death in our country.

I rise again to represent the thousands of voices across the country who feel that the bill puts them in crosshairs. I am referring to vulnerable Canadians living with disabilities and disabling conditions who believe they have been targeted. They have told us that this legislation singles them out by providing them with a special path to assisted death. They want us in this place to know their lives matter. This is the last opportunity for members of the House to legislate Bill C-7 to ensure their best interests are considered.

I want to use my time today to reiterate what has been a common theme throughout my interventions on Bill C-7. The Liberals are moving to impose sweeping consequential legislation despite what they have been clearly told by Parliament and Canadians. Yes, they have even ignored their own legislation.

The government should not have moved to implement the bill before the parliamentary review of Bill C-14, which was slated to take place before the end of June next year. It should have done that first. We do not yet have a clear enough picture of the impact a Canada-wide MAID regime has had on our country. Five years is not remotely enough time to take stock of trends, abuse and the impact of MAID on charter-protected conscience rights.

I remember the words of the former member for Winnipeg Centre, Robert-Falcon Ouellette, during debate on Bill C-14. In his view, the Liberals should have delayed the implementation of the Canada-wide MAID regime for at least five to 10 years until it could be adequately determined what the impact of assisted death would be in all communities across our vast and diverse country. Mr. Ouellette spoke against adding fuel to the suicide crisis that had taken such a heartbreaking toll on reserves.

Tyler White, CEO of Siksika Health Services, said recently that Bill C-7 ran the risk of undoing the work that indigenous elders had done to curb the frequency of suicides among indigenous youth. What message does Bill C-7 send these young people? If indigenous advocates believe that Bill C-14 was a step in the wrong direction, why is the government taking things even further with Bill C-7? What is the purpose of rushing this?

I also remember the elements of the Bill C-14 debate pertaining to instances of MAID abuse in other parts of the world. This is key. The Belgian model, which Bill C-14 was modelled after, is known for its abuse. In Belgium and the Netherlands, MAID laws, once limited to mentally competent, terminally ill adults, now include adults and children with mental deficiencies, severely disabled individuals and even those with treatable psychiatric conditions, such as anorexia and depression. Between 2012 and 2017, the Netherlands alone saw a 600% increase in euthanasia, which was sought to address psychiatric conditions.

When was the government planning to take a hard look at Canada's MAID regime and how we could prevent this kind of abuse in the future? The Minister of Justice says that it is in the works and part of the plan. Why was it not done first? This is the cart before the horse. It is the tail wagging the dog.

By ignoring a five-year review, the government has also cast aside the concerns of physicians. We cannot ignore the monumental importance medical professionals place on their Hippocratic oath, such is true of Dr. Ramona Coelho, a champion of conscience rights in her field. She told former MP David Anderson at the end of the Parliament, “Doctors know the importance of conscience rights to protect themselves and their patients...people like me who are being pressured to leave family medicine. I know palliative care doctors in Ontario who have stopped practising. I know nurses in institutions who are feeling bullied…shift their focus, or retire early ...The pressure is there, and we are looking for relief.”

It saddens me that the government has yet to establish conscience protections for medical practitioners who do not wish to violate their conscience while at a patient's beside. This bill is asking doctors to go far beyond what Bill C-14 even asked them to do. In Dr. Coelho's words, “it is my conscience that pushes me to go the extra mile, and I think patient care will suffer if doctors are not allowed to live with integrity and follow their conscience.”

It is because of this risk of abuse on many fronts that many of us on this side of the House walked away from the Bill C-14 debate with an unpleasant feeling in our gut, one that suggested that the implementation of the MAID regime had started Canada down a very slippery slope to a culture of death on demand. We are at Bill C-7 today.

However, there was an ever-present light at the end of the tunnel with Bill C-14. The five-year review was important to members of the House and indeed to all Canadians. It is shameful we find ourselves ramming through this legislation before this review is even started.

On that note, I realize that the Liberals are frustrated that my colleagues and I have been so diligent in vocalizing the outpouring of concern from disabled Canadians, concerned medical professionals and those whose personal beliefs conflict with the bill. That is our responsibility.

The Liberals desperately want to speed up the passage of this life and death legislation. They want to meet the deadline imposed by the Quebec Superior Court, a deadline they could have met comfortably if the House had sat in May and June and the Prime Minister had not prorogued Parliament in August.

In a way, this is beside the point. The December 18 deadline is arbitrary, as was the deadline for Bill C-14. As legislators, our mandate is to pass the best legislation possible for all Canadians. I underscore the words “all Canadians”.

The bill has barely been studied as the Standing Committee on Justice and Human Rights only held four meetings of hearings. Many witnesses and briefs were denied a voice because of this. Of course, the Liberals certainly could have, should have and still could appeal the Quebec Superior Court decision. We could have struck a balance in good faith of what Canadians actually wanted when it came to end-of-life decisions.

As I said in a previous debate, four years since the passage of Bill C-14 has allowed Canadians to further process the idea of assisted death. Almost 80% of Canadians believe it should be easier to make end-of-life decisions for themselves. That number is seven points higher than it was four years ago upon the passage of Bill C-14.

At the same time, Canadians are unwavering in their support of strong safeguards for the most vulnerable in our society as well as conscience protections for medical professionals. They are unwavering. According to an Angus Reid Institute poll released last month, the same majority of Canadians who desire empowerment in their end-of-life decisions want Parliament to weigh the risks of MAID for those living with mental health issues such as depression.

Sixty-nine per cent of Canadians fear depressed individuals could see MAID as a means to escape dealing with the underlying cause of their condition. Of those surveyed, 65% want Parliament and the courts to consider MAID's impact on the elderly and those with disabilities. They fear death-on-demand could encourage these Canadians to seek it as a means of ending their perceived burden on others. This perceived feeling is being encouraged and more research needs to be done.

Sixty-two per cent of Canadians want Parliament and the courts to examine the potential impact of MAID on our health care system. There is a danger that increased reliance on assisted death will lead policy-makers to begin neglecting long-term and palliative care. I am being gracious in saying “begin”, because, in my view, we can see this discouraging trend unfolding already.

Seventy per cent of Canadians continue to live without access to palliative care, while the government has failed to invest the $3 billion it promised to help in closing that gap. Clearly there is a discrepancy.

Canadians are equally as outspoken when it comes to conscience protection for doctors or those whose faith bars their participation in MAID. Fifty-seven per cent agree that nursing homes and hospices with conscientious objections should be able to deny MAID to those who request it. The Canadian Medical Association has indicated that 23,000 doctors are available to provide this service, which is more than enough across Canada. We need to protect our conscience protections.

Canadians want to see reasonable safeguards maintained in Bill C-7. They want to see Parliament legislate with their interests in mind, their interests, not those of the courts. They want to see the House continue to give credence to the views of medical professionals and those with disabilities.

Regrettably, judging by what we have seen through debate, Bill C-7 is another example of the government allowing the courts to legislate for Canadians. This bill is not reflective of what Canadians hold dear: Care and compassion for all, regardless of age, disabilities or religious beliefs.

Public health and economic safeguards have been the highest priority of the House throughout the pandemic. That is why so many in this place and across the country find Bill C-7's attack on end-of-life safeguards so painfully ironic and troubling. It is for this reason I cannot and will not support the bill.

[René Arseneault, Liberal, Parliamentary Secretary to the Minister of Economic Development and Official Languages (Atlantic Canada Opportunities Agency and Official Languages)]

Madam Speaker, I have listened with great interest to the debate on Bill C-7, having myself been a member of the joint committee behind Bill C-14.

I heard my colleague say that he has the utmost respect for the Supreme Court of Canada. I would remind him that we cannot talk about Bill C-7 without first talking about Bill C-14, since Bill C-7 is the logical and natural continuation of Bill C-14. On top of that, the Supreme Court of Canada, in which my colleague has great confidence, issued a unanimous ruling in Carter.

Is it not entirely reasonable to keep to the Carter decision, for example, since the Truchon decision addresses in some ways the gaps in Bill C-14, to accept that Bill C-7 finally closes the loop of the Carter case and Bill C-14?

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Madam Speaker, I will be sharing my time with the member for Cypress Hills—Grasslands.

Here we are on December 8, 2020, only 10 days away from a deadline imposed on Parliament by the Quebec Superior Court from the Truchon decision. The Liberal side of the House is suggesting that perhaps it is the fault of members of the Conservative Party for delaying progress on this very important topic. I take exception to that.

How did we come to this point in the first place? Our leader spoke this morning and he raised this topic, and so I am just going to repeat some of what he said. First of all, there was the failure of the current Attorney General to appeal this decision of the Quebec Superior Court. It is a lower court. In my opinion it was a wrong decision, and it should have been appealed, first of all, to the Quebec Court of Appeal. We would have had the benefit of the wisdom of that bench. Subsequently it should have been appealed, like all important constitutional issues, at the Supreme Court of Canada. I have the deepest respect for the Supreme Court of Canada and the constitutional expertise and scholarship that has come out of that court. The Attorney General has missed that opportunity to be able to engage the Supreme Court of Canada in the discussion on this very important topic.

Parliament, as our leader said, is the top court of the land. We are sovereign. We can make and unmake any laws that we want, provided that they are within the four walls of the Constitution of this country. That is the dialogue that we should have had with the Supreme Court of Canada. That, sadly, will not be happening on this topic.

The second very important point is prorogation. We had been making good progress on Bill C-7. We were talking about this back in February and March already. Prorogation happened, and the debate had to go right back to square one. How is that our fault? Why did the Liberal government decide on prorogation? It was not for any good policy considerations. It was strictly for political considerations, so we are not going to wear that. The Liberal government is going to wear that.

Another point that I would like to raise is that if Bill C-7 reacted in the narrow way that the Truchon decision required, this debate would be much shorter and faster, but the government has decided to take the opportunity to expand the debate. The Liberals are suggesting that we are disrespecting the Truchon decision and the Quebec Superior Court by raising these issues. We are not the ones who are raising the additional issues; it is the government in its Bill C-7 that is doing so. If Bill C-7 was just about the Truchon decision, then it would not be talking about removing the 10-day reflection period. The “First Annual Report on Medical Assistance in Dying in Canada, 2019”, just recently published by Health Canada, has told us that, of the 7,336 MAID applications in 2019, 236 of the applicants changed their minds during the 10-day reflection period. Obviously, that 10-day reflection is there for a purpose. It is serving that purpose very well. Why would we be removing that?

Furthermore, Bill C-7 has introduced the concept of advance directives and, consequently, the elimination of contemporaneous consent by the person who is asking for the medical assistance in dying. That would be shifting the final decision away from the person receiving medical assistance in dying to the person who would now be going to apply it. We are no further ahead. I do not think that is an improvement.

Then, there is the other requirement, removing the second witness. What is that about? Why is that so important? There are so many legal documents that require two witnesses, wills for example, to make sure that there is not coercion on the part of people who might benefit. In the case of wills, the beneficiaries of the will might benefit. It is a long-standing legal principle that two witnesses be required. These changes are significant, and disability groups across the country have told us so loudly and clearly.

Of the many groups that appeared before the committee hearings, not one of the disability groups was in favour of Bill C-7 and the removal of these protections. That is why we are at an impasse in this eleventh hour.

Mr. Neil Belanger, executive director of the British Columbia Aboriginal Network on Disability Society, commented on a newly released document entitled “In Plain Sight”, commissioned by British Columbia's minister of health, the Hon. Adrian Dix, to review indigenous-specific racism in British Columbia's health care system. Although it is a review of B.C.'s health care system, the principles in it would apply right across Canada. Mr. Belanger and the group that he represents are concerned about the proposed removal of safeguards. He said:

There is no debating the systemic racism and discrimination within Canada’s health systems, and the experiences and deaths of Indigenous peoples when seeking care. We all would be remiss to believe that this somehow would not permeate into MAID.

He went on to say in his testimony before the Senate committee that:

...the Government of Canada has failed to engage the Indigenous peoples of Canada living with disabilities, Elders, and Indigenous Leadership in relation to MAID on any tangible level. This lack of engagement is contrary to the government’s stated commitment to reconciliation, UNDRIP, and the CRPD.

Other disability groups are saying the same, yet this government is refusing to listen. Mr. Belanger takes this a step further. He and the organization for which he speaks advocate sticking with the end-of-life criteria already in place after the Carter decision and after Bill C-14, which was the well-considered opinion of Parliament just four and a half years ago.

Recently, when Mr. Belanger's organization presented to the Senate committee on legal and constitutional affairs on Bill C-7, he said that:

[BCANDS]...stands with our sister disability organizations and countless others across Canada in calling for the removal of Track 2 in the proposal changes to Bill C-7, and limiting access to MAID to the end of life criteria...

Track 2 is medical assistance for those people whose death is not reasonably foreseeable.

People may state the obvious: that this is all water under the bridge and that the Truchon decision said that it is unconstitutional. To go back to my original comments, that decision should have been appealed, and it was not. I am going to have to tell Mr. Belanger that the debate has been had already. This government has sadly treated as a settled constitutional principle that it is unconstitutional for any law of this country to refuse medical assistance in dying to those who meet all the other criteria, but are not dying.

This is a fundamental shift that was not debated. This government has stated on many occasions that it had broad consultations and 300,000 people responded, but the one question it never asked was if people agreed that medical assistance in dying should be given to those whose death was not reasonably foreseeable. The fundamental question was never asked. That is not a true consultation, in my opinion. It is a pretext for advancing a legislative agenda that had been preconceived. It has been said on several occasions in the House during this debate that the current Attorney General voted against Bill C-14 four years ago because it did not address that, and did not expand MAID to that point. This is the current Attorney General imposing his will on Parliament and forestalling that very important debate.

The first report by Health Canada on the state of medical assistance in dying stated that roughly 2% of Canadians in 2019 used medical assistance to die. That is the average across the country, but it is much lower in some provinces. It is the average in Quebec and far above the average in British Columbia.

Why is that? Is it because there are more sick people or old people—

[Ed Fast, Conservative, Abbotsford, BC]

Madam Speaker, I am thankful for the opportunity to again speak to the bill. There were a lot of things that I wanted to say the first time around at report stage that I could not share because we ran out of time, but hopefully I will be able to conclude my remarks today.

I am splitting my time with the member for Northumberland—Peterborough South.

The Leader of the Opposition spoke in the House earlier today and talked about how Bill C-7 is moving our country from a regime of assisted death to a regime of assisted suicide. We presently have in place former Bill C-14, which was brought in as a response to the Carter decision. That bill recognized the fact that the Supreme Court said that medically assisted death was a right but needed to be surrounded by guardrails, by safeguards that would ensure that the most vulnerable in Canada do not end up dying when they have an opportunity to live a productive life.

The Carter decision resulted in legislation that imposed a requirement that death needed to be reasonably foreseeable. The legislation before us eliminates that and a whole bunch of other safeguards that the original legislation was intended to keep in place.

Why are we at this place in the first place? Members in the House know that a lower court from Quebec, one single judge, ruled in the Truchon case that the reasonable foreseeability aspect of Bill C-14 violated the Charter of Rights. It was unconstitutional. This is a lower court from Quebec, one single judge, making a life and death decision for Canadians across the country.

One would expect, from a Liberal government that takes veterans to court and takes first nations to the Supreme Court of Canada, that this life and death decision would be appealed. The Truchon case would be appealed through to the Supreme Court so that we could have the Supreme Court, which articulated the Carter decision, comment on whether reasonable foreseeability was in fact constitutional.

Instead the Liberal government said, no, it was not going to appeal and in fact it would simply respond to the Truchon case and do exactly as that single judge of a lower court asked it to do. The Liberals eliminated reasonable foreseeability from Canada's medical assistance in dying regime. That is why we are here.

Members may recall, when C-14 first came forward, when the Carter decision had to be responded to, that parliamentarians noted the fact that this represented the crest of a steep, slippery slope toward making assisted suicide available to a broader and broader group of vulnerable Canadians. That was the concern that we expressed at the time and, quite frankly, some people mocked us. They said we were fearmongering. They pooh-poohed our concerns. Today, here we are and our concerns have been borne out.

Last time I did not get a chance to read into the record a letter from a doctor in my community of Abbotsford, Dr. James Warkentin, who expressed his concerns about the legislation. He says, “I appreciate your invitation to write to you regarding C-7. As a family physician, the decriminalization of medical assistance in dying in 2016 struck me at my core. How could killing someone one day cost me my licence and send me to jail, and the next day be expected of me to provide? Furthermore, how could our most vulnerable be protected from the pressure to end their life one day and then have state-sanctioned avenues the next?” He went on to reference the six reasons why over 1,000 Canadian physicians have signed a letter opposing Bill C-7.

In a moment I am going to read that letter into the record, because I believe those judges would appreciate having that letter on the record so it is very clear that many medical professionals across the country oppose Bill C-7, which would remove many of the safeguards, the guardrails, the protections for the vulnerable which were originally intended under the Carter decision.

The letter begins like this:

This bill, expanding “medical assistance in dying” (MAiD) to virtually everyone who is sick and suffering in Canada, will, if passed in its current form, make our country the world leader in administering death.

As medical doctors, we feel compelled to voice our dismay at how individuals who have little lived experience of the realities involved in the everyday practice of medicine suddenly and fundamentally changed the nature of medicine by decriminalizing euthanasia and assisted suicide.

As a side note, when they refer to “individuals who have little lived experience of the realities involved in the everyday practice of medicine”, they are referring to us, the parliamentarians in the House. It goes on:

Unfortunately, our patients are the ones who suffer the most from the consequences of this ill-devised scheme. The shock of a sudden illness, or an accident resulting in disability, can lead patients into feelings of anger, depression, and guilt for requiring care - emotions that, with proper support and attention, can resolve over time. The care and encouragement shown by physicians may be the most powerful force in overcoming despair and providing hope. Unfortunately, patients can no longer unconditionally trust their medical professional to advocate for their life when they are at their weakest and most vulnerable. Suddenly, a lethal injection becomes part of a repertoire of interventions offered to end their pain and suffering.

Bill C-7 would allow those who are not dying to end their lives by a lethal injection at the hands of a doctor or nurse practitioner. Shockingly, most of the safeguards that Parliament deemed necessary in 2016 to protect the lives of vulnerable individuals from a wrongful death are being removed. Under the new bill, an individual whose natural death is considered to be “reasonably foreseeable” could be diagnosed, assessed and euthanized all in one day. We are very concerned that removing the 10- day reflection period and other safeguards will lead to an increase in coerced or tragically unconsidered deaths.

The reckless removal of safeguards previously deemed essential will place desperately vulnerable patients directly in harm’s way and may cost them their very lives....

Our profession has been coerced into facilitating suicide rather than preventing it, for ever-increasing numbers of citizens. We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws.

That is an excerpt from a letter from over 1,000 physicians in Canada. It does go on, but I do not have time to complete it.

That is the perspective coming from our medical profession across the country and it is the disability groups, medical professionals, faith groups, palliative care advocates and first nations that are all calling for more caution before expanding assisted suicide, yet the government has refused to listen to those concerns.

At the committee, our Conservative opposition members brought forward numerous amendments that would have addressed some of the failings of the legislation, that would have reinstated the protections for which the vulnerable within our country have called. Seventy-two disability groups oppose this legislation. They want more protections, yet they are not there.

I encourage my colleagues across the way to please give this legislation more time. Give us an opportunity to get this right.

[Gérard Deltell, Conservative, Louis-Saint-Laurent, QC]

Madam Speaker, it is with a great deal of emotion that I rise again in the House to speak to this extremely sensitive issue, medical assistance in dying.

In this speech I will highlight the parliamentary and judicial reality. As the House leader of the official opposition, I have a thing or two to say about that. In fact, I have quite a few things to say about that. I will talk about the reasons why we are gathered today to talk about Bill C-7 at third reading stage. I will also address the substance of the issue, that is, my position and that of my colleagues.

Before I begin, I would like to make certain things clear: this is a topic that leaves no room for partisanship. On this file there are no good guys or bad guys, good positions or bad positions, good votes or bad votes. There are just positions that we are comfortable with, that we believe in and are prepared to defend personally as individuals. This topic may be terribly divisive, just as it may be a golden opportunity to have an intelligent conversation that is above all respectful of differing opinions.

As you well know, Madam Speaker, I do really enjoy political battles. I do not hate the arguments and the counter-arguments. On the contrary, it is part of politics. However, there are issues that do not lend themselves to this.

As far as I am concerned, when we talk about assisted dying situations, the issue is not a partisan one. There are no bad guys and good guys. There are no good votes or bad votes. There are only votes and positions in which we are comfortable. Where we stand firm on that is being respectful to our counterparts. This is the issue, and this is why I want to address it. While sometimes, the House knows, I like to be a little aggressive in my comments, in this case I will try to do my best to be modest, because I want to be respectful to each and every position.

Bill C-7 responds to a decision of the Quebec Superior Court. However, this is not the first time that medical assistance in dying has been addressed.

Members will recall that the Province of Quebec was the first to begin working on this issue, which led to the passage of a law on medical assistance in dying. Unfortunately, or fortunately, I know what I am talking about because I was a member of the National Assembly of Quebec. In passing, I was elected for the first time 12 years ago on this day. As a provincial representative, I worked for six years on this sensitive issue under three ministers and three different governments.

I want to be clear. This issue can be dealt with in a non-partisan way, and the proof is that three premiers—Premier Charest, Premier Marois and Premier Couillard—in two different political parties led the parliamentary work that resulted in the adoption of the first provincial law on medical assistance in dying in Canada. I would like to point out that this was done under the leadership of a premier who was a physician, Dr. Philippe Couillard. I was there.

Then came the Supreme Court of Canada's decision in Carter, again, on medical assistance in dying. The federal government had to decide how to define and set the federal criteria for medical assistance in dying. Prime minister Stephen Harper, recognizing that the federal government was on the verge of an election campaign, rightly decided, with the support of the other political parties, not to address this issue. That was the right thing to do.

As I said earlier, this issue is not a partisan one. That is why former prime minister Harper did the right thing and put it aside during the campaign in 2015. Then the new government elected, which could have been Conservative, NDP or Liberal, would table a new bill. I have been part of that discussion. I have been part of that committee.

The government was well advised to create a cross-party and, more importantly, joint parliamentary committee, which had both senators and members of Parliament as members.

I had the honour of sitting on that committee, at the request of my then leader, the Hon. Rosa Ambrose. I had the privilege of having very interesting and fascinating conversations with Canadians across the country who had different points of view. We came to a consensus in the form of Bill C-14. I want to be clear about the use of “consensus”, because the way democracy works, and this is a good thing, means that some people are in favour while others are against.

Bill C-14 was passed in the House of Commons five years ago. This bill included a clause that could be considered a sunset clause, since it required that parliamentarians review the legislation.

It was inevitable that this issue would end up before the courts, and it did. A Quebec Superior Court judge issued a decision in Truchon v. Attorney General of Canada on September 11, 2019.

Through the Minister of Justice, the federal government immediately reviewed the decision, decided to hold an online consultation and introduced a bill in the House of Commons in February. As we see it, that was the first major mistake. I have nothing against the judge or the Quebec Superior Court. Every court has its own responsibilities and makes its own decisions. The judge was appointed to that court in 2017, which was a good thing, and she was appointed to the Court of Appeal on November 20, which was a very good thing.

Every aspect of this issue is sensitive. No matter which law we pass, there will be legal challenges. The better approach, the more responsible, respectful, reasonable approach, would have been for the government to appeal the ruling and then take it to the Supreme Court. As my colleague from Alberta quite rightly said earlier, the Constitution says that every province has a superior court and a court of appeal before cases reach the Supreme Court.

For that purpose, we need to have the highest degree of evaluation. In that specific case, the Superior Court of Quebec is good, but it is not enough. We need to be sure of our judgment on that. That is why the government should have appealed the decision and then let the Supreme Court judges decide what is good and right based on the law, based on our Constitution and based on our Canadian history that we are proud of. That is how it works.

However, that is not how it went. The government decided to call the shots right now. I heard my colleague from Winnipeg North. He is always articulate and always passionate, but with all due respect, I do not agree with him. Just because we are appealing this decision to the appeal court and then the Supreme Court, that does not mean we pay no respect to the Superior Court of Quebec.

It is simply a matter of respecting the judicial process as it is set out in our Constitution, particularly when it comes to an issue as sensitive as medical assistance in dying. Regardless of the law that is passed here, we can expect it to be challenged.

It would have been far better to draft legislation based on a Supreme Court decision, as we did five years ago, rather than on a Superior Court decision. I say that with all due respect for Justice Baudouin, who was just recently appointed to the appeal court by the Liberal minister, and for the Quebec Superior Court, which plays an important, essential and extremely serious role in our justice system.

A debate took place in the House of Commons. This was well before COVID-19, before the words “in-person meeting” became part of our everyday vocabulary and at a time when the word “zoom” referred to a camera lens and not to a way of holding meetings. In short, we have adopted a lot of new concepts in 2020.

Getting back to what I was saying, Bill C-7 was introduced in the House of Commons on February 24 following the decision rendered on September 11, 2019, and the subsequent government consultations. On February 26 and 27, we began debate at second reading. We followed the usual regular, rigorous process. Discussions were held. Things were being done in a reasonable manner, even though it would have been preferable if this matter had been brought before the Supreme Court.

Then COVID-19 happened. The government did what it had to do, that is, it postponed the study of this bill and sought an extension from the court because of the delay. The court agreed. Parliament resumed in September, and that is when the government made a serious mistake. I will come back to that later.

Now let's get to the substance of Bill C-7. As I said earlier, there will not be unanimity on this bill because society is not unanimous. That is the very foundation of democracy. That is why we are here in the House of Commons. Some people are for, and some are against. Some people are right-leaning, and some are left-leaning. Some people are sovereignists, and some are federalists. Society is not a monolithic block. The beauty of society lies in all its different textures. That is the democracy that we must preserve. That is why we need to have intelligent debates in the House of Commons.

That is why, during the analysis, our party proposed two amendments that are entirely respectful and reasonable and that seek to protect the most vulnerable people in our society. The amendments essentially call for the 10-day reflection period to be restored when death is reasonably foreseeable, and for the 90-day reflection period to be increased to 120 days when death is not reasonably foreseeable. The purpose of those amendments is to ensure that individuals who choose to act have enough time to look into their hearts and make the decision that feels right.

That is why prestigious organizations have spoken out against Bill C-7. The Canadian Psychiatric Association has expressed very serious reservations. The Canadian Bar Association has said that it has conditional reservations about this bill. The Council of Canadians with Disabilities opposed the bill. Groups like Living with Dignity, a Quebec-based network, and Inclusion Canada have spoken out against the bill. Indigenous spiritual leaders have expressed very serious reservations. In short, society has spoken, and that is what makes for an interesting debate.

We needed to have a proper debate, with people on both sides of the issue. That is why we would have liked the debate to run its course, without the very heavy influence of the deadline imposed by the Quebec Superior Court.

I will now talk about our work in Parliament, which is essential. I mentioned that Bill C-7 was introduced in February, before COVID-19 and the return of the House. However, the government decided to prorogue Parliament. We know that the Prime Minister made this decision because he was not pleased with the work being done by our MPs on the parliamentary committees studying ethics and WE Charity. The more the work progressed, the more things were heating up for the Prime Minister. He therefore decided to prorogue Parliament.

This prorogation put an end to all committee and House work, and the study of Bill C-7 had to start all over again. As a result, we lost 24 days of parliamentary time. Had we not had this prorogation, we would have resumed on September 21, not on September 23 with the throne speech. Furthermore, had we started on September 21, we would not have lost all the work that had already been done so far on the bill, which adds up to 24 additional sitting days.

The government has the power to prorogue Parliament. Even if I accept the prorogation, why did the government wait so long to introduce Bill C-7? Today we are being told that the Superior Court's December 18 deadline is fast approaching and that we need to hurry up so the Senate can pass the bill in time.

The government presented its throne speech on September 23. When was Bill C-7 introduced? It could have been introduced on September 24, like Bill C-2 was. It could have been introduced on September 25, like Bill C-3, the bill on judges, was. However, this bill was introduced on October 5, costing us seven parliamentary sitting days.

Now, the government is lecturing us, claiming that the Conservatives will not stop talking for talking's sake and that we are wasting time. No. The government has full control over the agenda, and it is the one that decided to prorogue Parliament, wasting 24 days of parliamentary time. On top of the prorogation, this government wasted seven sitting days before introducing this bill, even though it knew full well that everything had to be finished by the Superior Court's December 18 deadline.

Consequently, I will never accept responsibility for the fact that we are still not done, a week and a half out from the December 18 deadline set by the Quebec Superior Court. The government is entirely responsible for this situation, and I will never allow it to accuse us of causing delays.

Not once have Conservative members acted petty, not at second reading, not in committee, not at report stage and not at third reading. Some members support this issue and others oppose it, but we have always expressed our opinions in an appropriate, respectful way.

We never used filibusters or any other rule to be sure that we would let it go, without any decision made. We were respectful, because this issue calls for being respectful. We did it correctly. I am very proud to be the House Leader of the Official Opposition, because members on this side of the House, the official opposition, did a tremendous job at each and every stage. Conservative members were very serious; they were very parliamentary; they did it correctly.

That is the opposite of what the Liberals did at the Standing Committee on Finance, where they engaged in systematic obstruction for over 16 hours to prevent the committee from studying ethics scandals, and at the Standing Committee on Access to Information, Privacy and Ethics, where the Liberals engaged in almost 40 hours of obstruction over the course of 10 meetings. That is what I call wasting time. We have done serious, diligent work here, and we are very proud of that.

As I said, the government that is being held hostage by that date, December 18. If ever this bill were not passed by Canada's Parliament, including the Senate, by December 18, what would happen? Bill C-14 will continue to apply, and the Truchon ruling will apply in Quebec.

Basically, the regime proposed in Bill C-7 would not apply, but life would go on, no pun intended. People will keep doing what needs to be done, as they have done from the start, except that the Truchon decision will apply in Quebec and Bill C-14 will apply in the rest of Canada.

I would like to talk about one final, but critical, issue.

With regard to freedom of speech and freedom of vote, I am very proud to be the House Leader of the Conservative Party. On this issue, each and every Conservative member has the right to vote on his or own belief. The best proof of that is that my leader, the future prime minister of Canada, the member of Parliament for Durham, voted against and I did for. This is what democracy is all about.

In our party, we have people who are against, like my leader, and there is me, the official opposition House leader, who voted for. That is what democracy is all about. We should fight for that. Even if I disagree with some of my colleagues and even if all my colleagues behind are not pleased to see that I will vote in favour, so what?

We are the only party to preserve that tool that is so important, that tool that can fight cynicism in politics. I am proud to be part of that team.

During the vote on the amendment, there were even Conservative members who voted against the entirely reasonable amendments that we proposed. When it came time to vote on the report, 13 Conservative members voted with the government on this bill. I was one of those members. There were six Quebeckers, seven members from outside Quebec, anglophones, francophones, people from the east and west and even neighbours. I voted in favour, but my neighbour from Portneuf—Jacques-Cartier, who is right next to me, voted against.

Let us celebrate this democracy. Let us celebrate this parliamentary system. Let us celebrate full freedom of conscience when it comes time to vote on these issues. Most of all, let us rightly stand up for the work of parliamentarians and vigorously condemn the fact that this government has been dragging its feet, which is why we ended up here with little time to spare.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, the bulk of the original criteria under Bill C-14, I believe, remain under Bill C-7.

In order to pursue a medically assisted death, a person must satisfy the following eligibility criteria: They must be, of course, of majority age. They must be able to make health care decisions for themselves. They must make a voluntary request for MAID that is not the result of external pressure, for example, from a health care professional or a family member. They must give informed consent after they have received all of the information they need to make their decision, including a medical diagnosis, available forms of treatment and available options to relieve suffering including palliative care. They must have a grievous and irremediable medical condition, meaning that the person has a serious and incurable illness, disease or disability, is in an advanced state of decline in capabilities that cannot be reversed, and experiences unbearable physical or physiological suffering from an illness, disease or state of decline that cannot be relieved under conditions that the person considers acceptable.

Does my hon. colleague support the ability to access medical assistance in dying for people who fulfill those criteria?

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

Madam Speaker, we are now at the third reading stage of C-7. This means all the amendments that will be considered by the House have now been considered, and we must now pronounce on the final version of the bill and its effects.

Before I speak about this bill in final form, I want to respond directly to what I see as the government's principal argument for this legislation and other similar legislation. It tells us this is all about choice: the choice of individuals to live as they choose and die as they choose. The idea is that moral judgments about good living and good dying ought to be made by the person doing the living and dying, as opposed to by someone else, because the individual is uniquely qualified to make judgments about their own happiness and someone outside their skin simply cannot make those judgments as well.

This is the one serious argument people use to advance this bill and others like it. We should of course appreciate the existence of other unserious arguments, such as the assertion that, “The courts told us to,” or, “This is what people we have consulted told us to do.”

A small part of this bill responds to a lower court decision, but most of it has been invented, out of thin air, by the government and whoever it consulted or did not consult. Over a thousand physicians have signed a letter opposing this bill, and every single disability rights organization that has spoken out about this bill has spoken in opposition to it. These are unserious arguments stemming from unserious readings of court decisions and unserious consultation.

The serious argument made in support of this bill, as I have stated, is that people ought to have the choice to make decisions about their living and dying because they know what will lead to their happiness better than anyone else. This is the argument, but we should also notice how those who use this argument ultimately choose to apply it selectively. Even while suggesting it is all about choice, they insist on changing the words we use to describe the choice in order to make us feel better about it.

The phrase “medical assistance in dying” was invented at the time Bill C-14 was proposed, and is not a phrase used in other countries to describe the phenomenon of doctors killing their patients. If this is really about choice, why do we have to invent new pseudo-terms to make ourselves feel better about that choice?

If I asked members point-blank whether they think a person should be able to commit suicide, I am sure many would respond that this is not suicide. It is completely different, as it is medical assistance in dying. Formally, what is meant by medical assistance in dying is facilitated suicide, or killing in a medical context. We claim to be focused on choice, but we still are uncomfortable enough with the choice that we have to invent new words to describe it.

Some members do not like the use of the word “euthanasia” to describe the phenomenon of doctors and nurses killing their patients after being asked to do so. The Minister of Health told the Standing Committee on Justice and Human Rights that phrases “referring to this bill as 'euthanasia' legislation, which I have heard in the House of Commons, are incredibly demeaning to the dignity of people”.

The health minister may be interested to know the word euthanasia actually comes from two Greek words: “eu”, meaning well, and “thanatos”, meaning death. The term euthanasia means “good death”, and is itself a sanitization of the concept of killing. If the term is misleading, it is not because it is too harsh but because it is too gentle. As we have heard, not all cases of assisted suicide can reasonably be called good deaths by any definition.

Notice that the word euthanasia is never used to describe the administration of the death penalty. The term was invented in order to sanitize the idea of the medicalized killing of a consenting person. It is instructive that a sanitized term for this practice, once people had a full social awareness of its meaning and reality, had to be replaced by a new sanitized term to further obscure the true nature of what is taking place.

No doubt, in 20 or 30 years, the term MAID will be thought gauche and replaced with another, more up-to-date sanitization of a term that no longer makes us feel better about something we naturally feel uncomfortable about. The point is that if this all about choice, and if we are comfortable with this choice, why are we not comfortable speaking plainly about sick people committing suicide and about doctors killing their patients when asked to do so? Would that not be a more plain and accurate description of the choice that many wish to defend?

If there is a practice or activity that people are uncomfortable seeing depicted or hearing described accurately, perhaps we should ask ourselves why we feel uncomfortable instead of demanding that the images and descriptions be put aside.

Members should observe as well that the idea of a choice to die, or a right to die, is being advocated for selectively. Some people have a right to die and some people do not, apparently, so we have to ask why this principle is being selectively applied.

Suppose that I, an able-bodied healthy white man, experienced some great personal tragedy such as the death of a child or the breakup of my marriage. It is possible that following such an event I might start to experience extreme existential pain and suicidal ideation. If I then went to a doctor to share the feelings I was experiencing, I would not be presented with MAID as a way out of the challenges I was facing. The way I look, my health status and other characteristics I have would signal to the doctor that my life was worth living. We know it to be true that when a young, able-bodied person chooses to die, those around them will say, “What a tragedy. He had so much to live for.”

The argument for a choice to die does not apply to those who society believes should not choose to die, even if such people are sincere in their expression of pain, in their sense that their pain is irremediable and in their desire not to continue living, but what if a person who is older, who is disabled, who does not fit the stereotypical social mould of someone who has a lot to live for, presents themself to the health care system experiencing existential pain and suicidal ideation?

We know from testimony from the justice committee that people in this situation are offered and even pressured to opt for MAID. People who are elderly or living with disabilities are often offered and pushed to take MAID without asking for it. This is the testimony given over and over again at the justice committee and confirmed by the minister responsible for disability inclusion, who acknowledged how concerned she is about people with disabilities being regularly and proactively offered MAID that they do not want.

We see here an important and revealing contradiction in the application of the principle of choice. For some in society, death is seen as an unreasonable choice and is actively discouraged. For others, death is seen as a desirable choice and is actively encouraged. This is not just a debate about choice, therefore. Rather, it is a debate about how the architecture of choice is set up differently for different people, based on whether others assess their lives as being worth living.

This is what leaders in the disability community are deeply concerned about: how this legislation includes them and only them in the additional category of those for whom we think death is a reasonable course of action.

Suppose that of my four children one had a disability and suppose that I taught three of my children to always press on because life is beautiful, but I told the fourth child that they should consider death if they ever faced circumstance that they could not handle. Do colleagues think that situation would make my fourth child feel privileged by the special offer of choice or do colleagues think she would feel devalued by the fact that I thought death was uniquely an option for her, based on the presumption that her life was not worth living?

Choices do not exist in a social vacuum. When we speak about choice, we recognize that people are making choices between available options and the nature of those available options is constructed by the society in which they live.

I used to think that people were always better off with more options, that just like a menu at a restaurant, we are always better off with more options available to us: the longer the menu, the better. If I do not like any of the new options available, then no problem. I do not have to choose them, but I should not begrudge other people the opportunity to have more choices available to them, even if I do not like those choices. Nobody is made worse off by the lengthening of the menu. Then I realized that it was not that simple. If I am in a restaurant and the only options available are chicken or beef then, arguably, yes, I am better off with the addition of more items on the menu; a fish option, a vegetarian dish, etc., but there is also a case in which the existence of certain options on the menu fundamentally changes the nature of the experience.

Suppose that while travelling, I encounter a restaurant that offers a human flesh sandwich in addition to the usual fare. It is fairly safe that I would not stay and order in that restaurant even if I had no intention of ordering the human flesh sandwich. It is unlikely that any members of this House would feel comfortable eating in such a restaurant, even if all they planned to eat was the filet mignon. That example illustrates the way that the offer of an additional option can actually change one's entire experience of a place or environment. A person with a disability who is offered death has a very different experience of health care from a person who is consistently offered life-affirming care.

The fact that people are offered or encouraged toward certain choices, and that some people are offered those choices and others are not, changes the entire experience of health care for many people. Part of the response to this brave new world of so-called medical assistance in dying is that people are seeking safe spaces where they can receive care that is life-affirming. There are still many people in this country who have about as much interest in receiving care in an environment where death is being offered as they do in eating at a restaurant where cannibalism is offered. Such people should be free to receive care in a hospice where life is the only choice and where they feel safe from the possibility of pressure of a momentary weakness or from the sense that they are an unnecessary burden. Some are still looking for care that is animated by the conviction that all lives are always worth living, but perversely, those who claim to champion choice are actually attacking these safe spaces. With the absence of conscience protection in this or any other legislation like it, doctors are being forced out of their profession and life-affirming hospice care is being shut down.

We wonder why we have a crisis in long-term care in this country. Maybe it has something to do with the fact that so many of the people in organizations that have historically operated in this space are being pushed out because of a lack of conscience protection. Protecting the conscience rights of physicians and institutions is not just about the rights of providers. It is about the right, indeed the choice, of patients to receive care in a certain kind of environment if that is their desire.

I know from the many conversations that I have had with constituents, including those who are very supportive of the expansion of MAID, that the present realities of the social architecture of choice are top of mind for them during their advocacy. In other words, they want more euthanasia because they find the alternative intolerable. An absence of good care, an absence of effective pain management, an absence of support to live in a way that accords with their sense of dignity and a sense of resignation about these realities leaves them to want to be able to end it all, rather than endure under undesirable conditions, but those conditions could themselves be changed. The expansion of euthanasia, along with continuing pressure on all health care institutions to offer it, will further erode the life-affirming nature of care that people receive.

I remember once having a long conversation with a constituent who explained to me her reasons for advocating for expanded euthanasia. She emphasized the classic arguments about choice and control, and then shared with me a story of being in a care situation and struggling to have a bowel movement unaided. She went to the nursing station for help, and unfortunately was met with a gruff and unempathetic response. Her memory of the sense of indignity she felt, struggling for a long time on her own, and then seeking the help of a person who seemed uncaring and disgusted, was clearly a part of her thought process about the circumstances under which she would want to die.

While I can identify with her feelings in the moment, I think the solution is to give people the choice of compassionate care. It is a tragedy that people are considering death because of moments of perceived indignity that can be quite directly resolved.

Many older people who are considering death say that they do not want to be a burden on others. This is expressed as a matter of choice, but it is also revealing about the architecture of choice. It is generally unheard of for children to insist on paying rent to their parents or living independently because they do not want to be a burden. Certainly, I have never heard such sentiments from my children.

Why are elderly people made to feel like they might be a burden, while children are not? Again, this is an issue of social context. If children were constantly told from a young age that they were a great burden to their parents, that they were costing them money that could be spent on other things, and that they were interrupting their social lives, then children would likely start to worry about being a burden.

Conversely, if seniors and people with disabilities were constantly affirmed for their value and their ability to contribute to society, constantly told that they hold the key to our future rather than constantly being told about the burden they impose, then of course they would be more likely to choose life instead of death.

This is not just a question of choice. It is a question of the social architecture of choice that leads people to make different choices in different kinds of situations based on the limited options in front of them and based on the way that different options impact each other.

To underline this with one further point, it should not escape the notice of members that the government's Bill C-6, the proposed ban on conversion therapy, is built on the premise that people cannot consent to something that is contrary to their human dignity. Although I have concerns about the text of Bill C-6 as written, I agree with the principle that conversion therapy is wrong and should not be allowed.

In light of both Bill C-6 and Bill C-7, it remains unclear to me what the government's view is on the ability of a person to consent to harm. Is it the view of the government that people should be able to voluntarily consent to things that harm them? Looking at these bills together, we might conclude the government finds it okay for people to consent to death but not okay for people to consent to certain things that are deemed worse than death. However, this subjective categorization of certain harms as being worse than others clearly may contradict an individual's own subjective sense of what things are more harmful than others.

It is time for us, as parliamentarians, to talk about the choices that elderly people and people living with disabilities have in front of them, and to give them options besides death, to move from a narrow focus on questions of choice to a discussion of the architecture of choice that puts people in impossible and painful situations. A good society is not just one that gives people the formal right to make choices between different alternatives. It is one that ensures that those alternatives are sufficiently robust so that individuals are able to make choices that truly lead to happiness. Of course not all choices lead to happiness.

People can make choices that they think will lead to happiness, but do not. This is especially serious when a decision is final and irreversible. The wider community has a reasonable interest in ensuring that a person making that choice has at least all of the information in front of them, taking into consideration the fact that people can and often do adapt to new circumstances over time. A belief in the pursuit of happiness entails a belief in freedom but also a belief in the value of encouraging the considered use of freedom through due reflection.

Having reflected on the application of the concept of choice in this context, I would now like to make a few additional comments about the provisions of this bill and the timing of it. This bill proposes to eliminate the requirement that death be reasonably foreseeable for those seeking euthanasia and puts those for whom death is not reasonably foreseeable on a second track with some distinct requirements. The reconsideration of the question of reasonable foreseeability was provoked by a court decision in Quebec, the Truchon decision, which the government could have chosen to appeal but did not.

This bill deals with more than this question. It also arbitrarily eliminates a number of safeguards that have nothing to do with the Truchon decision. It eliminates the 10-day reflection period. It reduces the required number of witnesses. It eliminates the requirement for contemporaneous consent. The removal of the 10-day reflection period in particular has led experts to point out that this opens the door to same-day death, to a situation where a patient could request and receive euthanasia on the same day.

Some members of this House have strenuously objected to the use of this term. Same-day death is a jarring idea that someone's worst day could be their last, and that temporary suicidal ideation could lead to immediate death. However, those who find this term uncomfortable must face up to the fact that the legislation as written contains no parameters for those for whom death is deemed reasonably foreseeable.

If members believe that time parameters exist, then they should point to where they exist in law. If members believe that time parameters should exist, then they should have supported their reintroduction into the bill. As the law stands before us now, there are no legislated requirements around timelines for those for whom death is reasonably foreseeable.

At third reading, members must choose whether or not they will vote for same-day death in Canada. As Wilberforce said:

You may choose to look the other way but you can never say again that you did not know.

The Conservatives have proposed reasonable amendments to reintroduce the reflection period, introduce a shorter reflection period and reintroduce requirements around contemporaneous consent and independent witnesses, in particular, recognizing the different experiences people with disabilities have reported with respect to the health care system. We also introduced a requirement that health care practitioners only discuss euthanasia if it is brought up by the patient first. These safeguards matter and would protect vulnerable people by reducing their risk of being rushed and pressured into vulnerable situations.

In response to our call for safeguards, the government said it trusts health care practitioners and these rules are not required. The purpose of a safeguard is not to respond to what may be the average case, but to establish a minimum standard. We are talking about 100,000 people in this country whose professional qualifications would allow them to administer euthanasia. Are those 100,000 so uniquely virtuous or trustworthy they do not need laws to regulate their behaviour while the rest of us do? I believe most people in medicine are doing their best to selflessly serve others, but one needs only listen to the testimony at the justice committee to realize some of those who are providing health care have fallen short of that call. All of us need laws to regulate our behaviour to some extent. If we need regulations, then how can we expect those 100,000 people to be different? Are there no bad apples? I am not arguing they should be subject to unique suspicion, but that they simply need rules and laws to guide their actions like the rest of us do. People charged with taking another person's life should do so within strictly defined parameters for their own good and that of everyone else. I trust doctors just as I trust police officers, but they still need regulations and oversight. We recognize there are some bad apples on our police forces and if we need safeguards for police officers in light of their power to take life, then we also need safeguards for those in power to take life in a medical context.

The government has been working very hard to push the narrative about timing, claiming the Conservatives are responsible for delaying this bill. It should stand to reason that if the government wants us to invest in rapidly passing its bill, it must proceed to persuade us that it is a good bill, which it has not done. The Truchon decision requires a response, but matters would be much simpler if the bill only focused on a response to Truchon instead of a variety of other changes. As it is, we are forced to consider all of the elements together, not just the narrow part that responds to Truchon. This is the government's choice, not ours.

Let us also take stock of how we have come so close to the court deadline. This legislation was presented in February. In May and June, the Conservatives wanted the House to sit in a modified form, but the government refused to allow it. Then it killed its own bill by proroguing in August. All of these moves pushed us into the mid-fall before the bill was considered. It then received a mere four meetings of witness testimony at the justice committee. The government's approach to this legislation has been to delay until the last minute and then demand urgency instead of a considered review. Let us be clear that this is a political tactic designed to subject these radical changes to as little debate as possible.

As a high school student, I had the honour of participating in a special MLA for a Day program at the Alberta legislature. At one of our meetings, a seasoned Progressive Conservative minister explained to us how legislation was passed. Students were surprised by the length and complexity of the process. They asked why it took so long and could the process not be shortened a bit. The minister told us he was glad it took so long because one of the fastest pieces of legislation to ever pass in the Alberta legislature was the Sexual Sterilization Act of 1928, which allowed the government to sterilize people with disabilities against their will based on the analysis that they imposed an undue burden on society. Legislators at that time should have taken more time to listen to people with disabilities and considered the implications of what they were doing. The point that when we are in too much of a hurry to make decisions we risk undermining the fundamental rights of our fellow human beings, in particular, those living with disabilities, has stuck with me to this day.

Those of us on this side of the House who are raising concerns and demanding that time be taken to consider this bill and appropriate safeguards be put in place are on the right side of history. As was the case with the Sexual Sterilization Act of 1928, when this bill is repealed in five or 50 years, I will proudly tell my grandchildren that I took a stand for the universal immutable dignity of every human being.

Justice

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

Madam Speaker, the Liberals are frustrated that my colleagues and I have been so diligent in vocalizing the concerns of disabled Canadians and medical professionals in regard to Bill C-7. However, the Liberal government ignored its own legislation to review Bill C-14; held the House hostage in May and June; prorogued Parliament in August; limited the justice committee to four hearings, blocking written submissions; and chose not to appeal the deadline imposed by the Quebec superior court.

Why does the Prime Minister not want to create legislation that shows compassion for all Canadians?

Criminal Code

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, there are few, if any, issues that have come before Parliament that more clearly touch on our fundamental values as Canadians than medical assistance in dying.

Let me start today by restating what I said at the beginning of my speech in favour of Bill C-7 at second reading. When it comes to medical assistance in dying, the priority for New Democrats has always been, and remains, avoiding unnecessary suffering being inflicted on those who are already afflicted with terminal illnesses, and at the same time also avoiding prolonging suffering for the families who must bear witness to the suffering of their loved ones.

Here we are in late December, up against the deadline set by the Superior Court of Québec in the Truchon case. It does not really matter whose fault that is. Some of this delay was obviously due to COVID, but a good measure of the delay was due to the Liberals proroguing Parliament.

To me, it is manifestly unacceptable to hear some members arguing that we do not have to meet the deadline because it would “only affect Quebec.” In any case, the time has come for the House to act on Bill C-7. It is also time to act on another task as well. Not only has our consideration of the bill been delayed, but equally important, the five-year statutory review of the original medical assistance in dying legislation, Bill C-14, is now long overdue.

Members will know that some of us called on the government to get this review under way much earlier this year, so that it could have helped guide the consideration of Bill C-7. Again, COVID and prorogation intervened.

When it comes to medical assistance in dying, Parliament had two tasks before us. One was the need to amend the MAID legislation to conform with the charter as required by the Superior Court of Québec ruling. This ruling found the current law too restrictive, and that was in fact the very reason New Democrats voted against Bill C-14 at the original vote.

Making MAID laws conform to this ruling is, of course, the central purpose of Bill C-7. However, as I said, the second task with regard to medical assistance in dying was to conduct that statutory review of the broader issues, having had four years of experience with it.

As a result of growing increasingly concerned while waiting for the government to get the review under way, on October 8, I introduced Motion No. 51. My motion called for the creation of a special committee of the House of Commons to conduct this review. Special committees have some advantages when it comes to reviews of this kind. They are granted comparatively unlimited resources by the House and are not bound by the four hours per week schedule specified for standing committees, like the justice committee.

They are mandated to work on a single task, so they are not subject to the kinds of delays that can occur in standing committees, like the justice committee, where dealing with legislation must always, necessarily, take precedence over studies. Of course, special committees can make recommendations for actions needed beyond the confines of Bill C-7 or beyond the narrow court decisions.

Indeed, it was a special committee that made the original recommendations to the House that became Bill C-14. To be clear, this broader legislative review of issues arising out of medical assistance in dying was mandated in the original legislation and was supposed to start last June at the latest. It should have taken place, and would have taken place, whether or not there was a court decision in Quebec.

Bill C-14 required that the review specifically look at the question of advance requests or advance directives, requests from mature minors and requests where mental illness is the sole underlying condition. However, New Democrats have argued from the beginning that the mandate of that statutory review was missing a key element. That is why my motion called for a special committee with an expanded mandate to include the question of whether the safeguards in our medical assistance in dying legislation are adequate to protect the most vulnerable among us.

I am happy to say that I believe all parties now seem to agree that the mandate should be expanded to include this question. I am still not sure why the government is so averse to a special committee, but I think it will find that members of the justice committee would reluctantly agree to the justice committee undertaking this review, as long as it had the expanded mandate. Though, of course, I will still worry that time, resources and the agenda of the standing committee may be too limited to do justice to the task.

Previously I have spoken about the issues of medical assistance in dying on very personal and very practical terms. I have spoken about my mother's fears of being trapped in a hospital bed while suffering and no longer knowing her family. I have spoken of a friend who chose medical assistance in dying much earlier than she might otherwise have done out of fear of losing her capacity to give final consent because of her growing brain tumour.

Now, in addition to these personal experiences, as a member of the justice committee I have had the privilege of talking to dozens of Canadians over Zoom, of hearing dozens of witnesses in committee and of reading even more briefs on medical assistance in dying.

I have been particularly and equally touched by the stories of families whose loved ones chose medical assistance in dying over prolonged suffering and the stories from those medical practitioners who provide that medical assistance in dying. My conversations with these families and with these doctors helped me understand how medical assistance in dying operates in real life. These conversations have made it clear to me that the current legislation has some unintended and cruel consequences. This was evident even before the Quebec court ruling.

Those who listened carefully to the terminally ill, their families and the practitioners providing medical assistance knew well that our current law often inflicts and prolongs unnecessary suffering. Bill C-7 addresses three of those cases of unnecessary and prolonged suffering. While it was not strictly required to do so by the Truchon decision, I rightly think the bill does take on that task of reducing suffering.

Most important to me, Bill C-7 will end the spectre of patients like Audrey Parker of Nova Scotia, who felt she had to leave early and choose an earlier date for receiving medical assistance in dying because of her fear of losing the competence required to give consent at the moment the assistance is rendered. Audrey Parker felt she had no choice but to miss one last Christmas with her family. I think we all owe her thanks for making her personal struggle public so that others would not have to face the same awful choice.

Bill C-7 will fix this by waiving the requirement for final consent for those already assessed and approved for medical assistance in dying. This waiver of final consent takes away that need for any person, and let me stress this again, who has already decided to request medical assistance in dying and has already been assessed and approved for that assistance. It will prevent them from having to go early in order to avoid the loss of competence that would prevent them from receiving the end to their suffering and the end to their family's suffering that they desire.

Whether one supports waiving the requirement of consent at the moment assisted dying is provided or does not support that, Bill C-7 does not open the door wide to advance consent or advance directive. It is simply providing that waiver of final consent for those already assessed and approved. The topic of advance requests remains part of the mandate of the special committee I would like to see doing the statutory review.

This is a question of great concern to many of my constituents. In fact, it is the single thing I have heard the most about from my constituents. They are concerned about maintaining their autonomy and decision-making over how their end of life takes place. They want to make sure that their wishes are respected. I have to say that my discussions with practitioners providing medical assistance in dying have persuaded me that this question is not so simple as it appears on first look. As I have said, this will remain an important question for a statutory review to address, but it is not part of Bill C-7.

A second cause of unnecessary suffering that Bill C-7 will also eliminate is the mandatory 10-day waiting or, as it is sometimes called, reflection period. The evidence provided in the report of the Association of Medical Assistance in Dying Assessors and Providers shows that nearly half the patients receiving medical assistance in dying chose to do so on or about the 11th day. What does that tell us? It tells us that their suffering was prolonged simply to meet that statutory waiting period of 10 days.

I know concerns have been raised by members of Parliament about people changing their minds, but the statistics on people changing their minds about medical assistance in dying show that people do that during the assessment period, before they are actually approved. What the waiting period does is it makes patients hold out for days longer on what has already been assessed as intolerable suffering just to meet the statutory requirements. All patients are made to spend this time suffering and few if any are actually reflecting on the situation, because at this point to relieve the pain they are heavily sedated. If we truly respect the agency of patients who are terminal and suffering, then we ought not to impose a cruel waiting period.

Let me say as an aside how disappointed I have been to hear some members of Parliament alleging that Bill C-7 somehow creates the possibility of what they call “same-day dying”. It does nothing of the kind.

That would only be possible if the medical professionals involved skipped their duties and their professional responsibilities as prescribed in law and in their own professional codes of conduct. That is what it would take to produce such a result. Making this false allegation is insulting to the patients and the medical practitioners who provide this service. It demonstrates how little those who use that term know about the actual process of medical assistance in dying.

Another misleading “fact” that has often been cited in this debate occurs when members ask how can anyone support Bill C-7 when “doctors oppose it”. What those members are referring to is a petition submitted to the justice committee, a petition signed by more than 700 physicians. What this selective siding ignores is that the Canadian Medical Association, which represents more than 70,000 doctors, has come out squarely in favour of Bill C-7. That is nearly 100 times as many doctors as those who signed the petition.

Let me point to another positive change in Bill C-7 that reduces suffering, which has been willfully misconstrued: the reduction of the requirement that two independent people witness the signature of the patient requesting medical assistance in dying.

This change was suggested by practitioners as a result of the experience they have already had with Bill C-14. Clinicians and families often found the process of identifying a second independent witness was difficult, especially in rural and remote areas, because of the requirement of independence. It often also raised privacy concerns, as it involved an extra person in this process.

We must remember that the purpose of witnesses is only to verify the identity of the person making the request. Two independent medical assessors have already been involved each and every step of the way throughout the process. They have already had to certify the patient's eligibility for MAID. Practitioners have said this second witness provision is unduly restrictive and, again, often only ends up unnecessarily prolonging suffering.

At this point, I want to turn to some of the specific concerns about Bill C-7 that were raised at the justice committee.

The first concern is about the removal of the requirement that death be reasonably foreseeable in order for someone to proceed with medical assistance in dying. Of course, this provision was removed by the Quebec court decision, not by Bill C-7.

Bill C-7 makes sure that medical assistance in dying legislation conforms with the decision of the court. It said limiting medical assistance in dying to cases where death was imminent was a violation of the Charter rights of patients whose death might not be on the immediate horizon but whose condition left them in intolerable suffering.

Bill C-7 creates a second track for those whose death is not imminent and specifies a second set of requirements and safeguards appropriate for the second track. The decision about whether the reasonably foreseeable provision should be removed is not made by Bill C-7. It is a decision made by the Quebec courts. I believe this is consistent with the Carter decision.

I want to take a moment to address those who say there is no need to meet the deadline opposed by the Quebec Superior Court. I remind them that without Bill C-7, those whose death is not reasonably foreseeable will come under the existing requirements immediately and will be without any of the conditions specified in Bill C-7 as appropriate for the second track. Regardless of whether people believe the safeguards are adequate, I ask them to understand that if we do not meet the deadline, there are no safeguards in the second track at all.

I believe most of us accept that there are good reasons to differentiate between the two tracks and to have additional requirements appropriate for those whose death is not imminent. Bill C-7 rightly sets out a more restrictive process and therefore requires more time for assessment and decision-making for the second track.

In addition, it does not set a reflection period of 90 days. It sets an assessment period of 90 days. That is an important distinction. It is not a maximum of 90 days; it is a minimum of 90 days. I do not think we should get confused on that point.

The second concern I want to address is a very important concern of the disability advocates: with the removal of the requirement that death be imminent, there will be pressure on the vulnerable in our society to choose medical assistance in dying.

Nothing in Bill C-7 changes the very high standards set in the original Bill C-14 for receiving medical assistance in dying. To receive this assistance, patients must have a condition that is incurable, must be in an advanced state of irreversible decline and must face intolerable suffering. This means Bill C-7 does not open the door wide, as some have suggested.

However, let me be clear here. I do not, in any way, wish to dismiss the concerns of the disability community over their vulnerability. That is why I have been calling for an expanded mandate of the statutory review so that we require it to consider the question of whether safeguards to protect the vulnerable in our medical assistance in dying legislation are adequate. Again, this may require us to look beyond the narrow confines of the medical assistance in dying legislation to other health legislation and other social support legislation.

That is why my colleague, the member for Elmwood—Transcona, and I have just delivered today a joint letter to the Minister of Disability Inclusion calling for a new national income support program, set at $2,200 per month, for all persons with disabilities. This would be a single, national program to replace the patchwork of provincial programs that rarely come close to the amount that we have all now acknowledged with CERB as the minimum necessary. Providing such a benefit would be an important step toward a guaranteed basic income for all Canadians. More importantly, in the context of the bill, this would provide support at a level that would help avoid placing persons with disabilities in a position where dying looks like a better option than living without the supports they need.

Failure to provide the necessary resources to ensure that everyone can enjoy full and equal participation in life is a long-standing and ongoing black mark on the federal Parliament and all provincial parliaments. We have only to look at the failure to deliver additional assistance promptly to persons with disabilities during this pandemic to remind ourselves how often we forget about those living with disabilities.

As we consider how to recover from the pandemic, I hope we can adopt this proposed federal program that would provide all people with disabilities the equivalent of a living wage. This would be an important step toward relieving the fears about having to make a terrible choice eventually with medical assistance in dying.

Given the speeches from all parties stressing the need to take the situation of people with disabilities seriously, and in light of the Quebec Superior Court decision, I believe we should be able to marshal immediate support for this proposal in a minority Parliament. It would be an important step in mending the gaps in our social safety net that COVID has revealed. COVID has taught us that we can roll out income support programs quickly when we really want to do so.

As I near the end of my time, let me take a moment to address one last phenomena I observed in our committee discussions and one that I found very disturbing. It was the tendency of some members to mix together issues of suicide and medical assistance in dying. These are two completely different issues, distinct both medically and morally.

Medical assistance in dying does not provide a way to take one's own life. The testimony from physicians and families involved in medical assistance in dying told us very clearly that no one involved in medical assistance in dying wants anyone to die: not the families, not the physicians and certainly not the patients themselves. Medical assistance in dying is about those who are already dying and are far along that path and in intolerable suffering. It is about them being able to have control about how their life ends and when that suffering for them and their family will come to an end. It is not about choosing to die.

The New Democrats continue to support Bill C-7, as it contains significant measures that will help bring an end to unnecessary suffering and provide the necessary safeguards in the second track for those whose death is not reasonably foreseeable. It will do so in time to meet the deadline hopefully imposed in the Truchon decision.

We will continue to demand that we get started on the statutory review, which should already have begun. Proceeding with Bill C-7 without proceeding with the review is only getting half the job done on medical assistance in dying. At the same time, it potentially undermines public support for medical assistance in dying, which so far has only continued to grow.

In conclusion, I want to say again that I believe as a society we must do a better job of providing for the most vulnerable among us and those who are differently abled. In the case of the tragic deficiencies in end-of-life care and in the lived experiences of people with disabilities, COVID has taught us how much further we have to go toward a fully compassionate and fully equal society. I urge all parliamentarians not to ignore those lessons.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, this is the last stage of debate before Bill C-7 is passed.

I would like to remind members of the first thing I said when we began the clause-by-clause study of the bill. I said that we must not forget that while we are debating, people are suffering and are waiting for the results of our efforts. Today, I would say that they want to know whether we will take care of them and listen to their voices, or whether they will once again have to bear the burden of going before the courts to have their final wishes heard.

I also said that I was certain, from the start of the debate on Bill C-7, that all parliamentarians in the House were caring and compassionate, but that we could not be caring and compassionate if we infringed on the autonomy of a person who is dying or suffering and has reached their breaking point.

I have to say that I am disappointed by the Conservatives' attitude. It is one thing to want to make a point, but it is another to engage in what amounts to filibustering. However, what bothers me even more is that they seem to be claiming that they know better than the person who is dying what is best for them. I cannot make such a claim. I prefer to give the person the choice, and my role as a legislator is to preserve that choice.

Unfortunately, the Conservatives are practising government-imposed moral paternalism, which is odd because they are economic libertarians. That means they want less government intervention in the economy, yet they also want full government intervention in a matter as intimate as our own death.

The Conservatives are practising government paternalism, but they are not alone, because we have heard some practitioners say and demonstrate that in 2020, they still apply a medical paternalism that I would describe as appalling. Why on earth are these omniscient practitioners doing that? How are they better equipped than a person who is dying or a suffering patient who has reached their threshold of tolerance to know what is best for them? Only God knows, but they do not mention that.

Those few medical practitioners continue to frustrate us to this day because they practise in Quebec. Five years after Quebec's Act Respecting End-of-Life Care was passed, they consider palliative care and medical assistance in dying to be mutually exclusive, when they are and should be complementary, since medical assistance in dying is part of the care continuum under Quebec's end-of-life care legislation. However, that is still not enough. They believe that the patient must change their mind if they request medical assistance in dying, and they say they manage to make them change their minds. They have no qualms about saying that they would not want to refer the request for medical assistance in dying to a doctor who can perform the procedure, even though that is enshrined in Quebec law. They say they are obviously doing it for the good of the patient, even though they refuse to listen to the patient and heed their wishes.

That is the testimony that provides the basis for the Conservatives' filibustering. They claim to know better than the dying patient what is best for them. That is not caring. That is a violation of the principle of self-determination.

I will let the 88% of Quebeckers who support the freedom to choose medical assistance in dying judge the Conservative Party's position and attitude. However, what I heard in committee worries me, because five years after Quebec adopted its end-of-life care legislation, some institutions can and do circumvent the law, as was the case before the Morgentaler decision, to hinder someone from receiving medical assistance in dying. I was shocked to hear that.

If a patient is no longer receiving aggressive treatment and has finally been given the right to die, which is known as palliative care, I hope that this patient will not be subjected to aggressive palliative care.

Dying with dignity implies respect for human dignity. It is not an intellectual conceit; it is intrinsic. Treating people as ends in themselves and not as mere means involves respecting a person's capacity for self-determination, free will and freedom to choose. A person must never be subjected to an analysis or an ideology, religious or otherwise. A person is the master of their own destiny.

Furthermore, self-determination is enshrined in law. No one can undermine our intellectual or bodily integrity or our self-determination without our free and informed consent, even in an emergency.

That means that when a sick patient is at their most vulnerable, when they are suffering and dying and have reached the point where they can bear no more, the person at their bedside must not impose their own ideology on that person, be it religious or otherwise.

That is why they say in clinical ethics that the patient comes first. The patient's wishes, which are based on how much they are suffering, need to be heard. Palliative care providers should not see medical assistance in dying as a failure. If a palliative care patient, who is irreversibly committed to dying, wakes up one morning completely at peace and ready to let go, then the palliative care provider should not see that patient's request for medical assistance in dying as a failure.

I have said it before and I will say it again: I hope that, when they are on the threshold of death, all my parliamentary colleagues will be able to feel that peace and let go with a clear conscience. That is the best we can hope for for any human being.

Bill C-7 responds to the Gladu-Truchon ruling. The courts determined the appropriate response by examining the limits of the government's power to intervene in end-of-life decisions in Carter and Gladu-Truchon. The courts told us that the provisions of the Criminal Code infringed on the right to life, liberty and security of the person.

They infringe on the right to life—that says a lot—because they cause people who are suffering to shorten their lives through suicide, which is decriminalized in Canada, rather than waiting for the moment when their threshold of tolerance is reached. This is significant.

During the committee deliberations, I heard people say that 90 days is not long enough. In saying that, they were assuming that someone who has a degenerative disease of any sort might wake up one morning and suddenly decide they want medical assistance in dying, without having ever discussed it with their doctor or health care professionals throughout their care process. It is as though they thought this all came out of a Cracker Jack box one morning and the person was wondering whether they could access medical assistance in dying that very moment or whether 90 days was enough time to be sure of that decision. That is not how it happens in real life.

The right to life is not something to be cast aside lightly. People want to live as long as possible. People want to live, and when they receive a diagnosis and are in a suicidal state, they can be treated to reverse that state. When someone finds out that they have cancer they are not going to tell their doctor that they want medical assistance in dying. They are going to ask what can be done to help and when their treatment will begin. Sometimes it takes 15 or 20 years, and other times the cancer is more aggressive, but there comes a point when the doctor announces that all treatments have been exhausted and it is time to begin the palliative stage. In any case, this does not happen overnight.

If someone who receives such a diagnosis tells their doctor they want medical assistance in dying, the doctor will prescribe anti-depressants and tell the patient that they will take care of them. They will tell the patient to get their affairs in order and talk to the family. They are not going to provide medical assistance in dying. That is not how it works. Sometimes in committee I would hear people describe catastrophic scenarios out of some sort of house of horrors, as if that were how things happened.

Bill C-7 is based on principles the Bloc Québécois believes in. Who can dispute the fact that death is the most intimate moment in a human being's life? Neither the state nor my neighbour will die in my place. The decision can only be made by the person requesting it, not by the family or anyone else.

The criteria must of course be met. We in the Bloc Québécois have confidence in our health workers. We have confidence in our health professionals. There is something that I find rather perplexing. Just this Tuesday, the Conservatives supported our motion that commended the work, dedication, care and concern of health workers and health professionals. However, when it comes to the most intimate decision a human being can make, to decide one's own death and not to suffer, and when it comes to respecting a person's right to self-determination, the Conservatives no longer have confidence in them. They believe that there are people who may have bad intentions.

If there are people who are not well intentioned or caring in the health system, let us show them the door right away. I would also say that if there are any health professionals who claim to know better than the patient who is at the end of the process and who has made the choice that is right for them, it is time they reflected or took a course on respect for human dignity.

Throughout this debate, I have gotten the sense that some people are against freedom of choice. When people support freedom of choice, that does not mean they want to get rid of palliative care and go around signing all kinds of people up for MAID. What we are saying is that an individual who wants to die at the end of the process should be able to do so. MAID should apply to people whose suffering is intolerable and cannot be alleviated.

Yes, Bill C-7 leaves a number of things unresolved. There are two main elements here. One major improvement is that Bill C-7 tossed out the reasonably foreseeable natural death criterion, which is not a medically valid criterion. That is understandable. However, it was retained for use in defining two safeguards. I would have liked to see a more specific definition of “reasonably foreseeable death”.

For terminally ill people, there is a safeguard of up to 10 days, and a second consent may not be necessary. In cases like Ms. Gladu's, Mr. Truchon's and Ms. Carter's, where death is not reasonably foreseeable, it is supposed to be 90 days. I would have liked some clarification on this criterion because doctors need things to be clear and specific. I do not know why this criterion was brought back. There is always room for improvement.

The bill removes the need for second consent to put an end to people's suffering when palliative care no longer eases their pain, when death is irreversible and the process has already begun. That seems like a good thing to me.

Bill C-7 obviously excludes mental illness as an eligible reason when it is the sole underlying medical condition. It also does not cover all of the issues associated with advance requests, particularly in the case of neurodegenerative diseases, or the issue of mature minors.

Under Bill C-14, a parliamentary committee was to examine those provisions and the matter of palliative care last summer. Today, the Bloc Québécois is calling for that review to begin as soon as possible, not in five years or even one year, because there are people who are suffering. What is more, this time, we must not make them bear the burden of having to go to court to be heard. Who is more vulnerable than a person who is enduring unbearable pain, who has reached or is about to reach the limit of what they can endure and who has to decide to go before the courts to make their voice heard?

It is time for us as legislators to take up the torch, show some leadership and do our job. The courts can issue orders for us to do something, but obviously when they do there is a fixed timeline. Right now, we have a deadline to meet, December 18. I really hope that we can pass this bill and begin the review process so that we can deal with the sensitive issues that are not addressed by Bill C-7.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, I come at it from the very same position as my hon. colleague from Brantford—Brant. I am choking up. I know both sides of it. Right next door to me, my father-in-law is in palliative care. We have been looking after him for six months. I also have a 32-year-old daughter who lives with a cognitive disability, and we worry every day. We worry every day that they go outside. We worry every day, when I go to work, that somehow someone is going to take advantage of them, and that we will not be there to protect them.

I wonder if I could get my hon. colleague to expand a bit on the fear that parents have and the fact that we are not always there. There will come a day when we are not there, so we have to do everything in our power. I said in the last session that Bill C-14 was perhaps the most important piece of legislation in our lifetime and our generation, but as a parent of somebody with a disability this is so important.

I ask my colleague to expand a bit more on the fear that we have for our children.

[René Arseneault, Liberal, Parliamentary Secretary to the Minister of Economic Development and Official Languages (Atlantic Canada Opportunities Agency and Official Languages)]

Mr. Speaker, I want to thank our friend from Brantford—Brant for sharing his own experience.

I was one of the original members of the joint committee behind Bill C-14. Allow me to share a little background.

Bill C-14 was introduced in response to the unanimous ruling of the Supreme Court of Canada handed down in February 2014, when the Harper government was in power. The court gave the government 12 months to comply with the ruling. The Harper government, knowing that an election was coming in the spring of 2015, essentially did nothing. The Liberals won the 2015 election. We lost 10 precious months before cabinet was appointed as a result of the Conservative Party's inaction.

Politicians are often called upon to make decisions, and it is not always easy. The majority of members on our committee who opposed this bill said they were doing so to protect vulnerable people, which is something everyone wants to do.

Could my esteemed colleague tell us where in Bill C-14 or in Bill C-7, which we are debating today, it says that a minor with a head injury, cerebral palsy or Down's syndrome could request medical assistance in dying? I do not see that anywhere.

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

Mr. Speaker, I am thankful for this time to speak on this incredibly important issue to all Canadians.

As I was leading into this speech, I reflected back on the debates on Bill C-14. On May 3, 2016, the House was debating the creation of a euthanasia and assisted suicide bill. At the time I spoke in the evening on May 3, I mentioned how this would probably be, in my career as a politician, a member of Parliament, having at that time served eight years and now in my 13th year, perhaps the most important speech that I would ever make.

When I look back on that speech today, I think I was wrong. I think perhaps this is the more important speech because at that time Parliament was faced with a court deadline as well to put into place legislation for euthanasia and assisted suicide. Like many countries around the world that have these bills, going back to the first legislation in the Netherlands in 2002 until today, I have seen the progression of what has happened in these countries as an example of what will happen on the slippery slope of this legislation.

I should say as well, as I did in 2016, I come at this with a very biased approach and that is because I am the father of a 34-year-old intellectually disabled son. My son was brain damaged at age two. He suffered irreversible damage that has caused him to lead a life with his parents as his caregivers his entire life. When the people and organizations that represent persons with disabilities speak, and they have spoken loudly, to the particular changes and amendments that the government is bringing forward in Bill C-7, they have said this is the worst possible scenario.

I interpret that from my lens as a parent in terms of protection for my son. Frankly, it causes me to reflect on what we are currently experiencing: the COVID-19 crisis. Just about every piece of communication that I receive, email, text, telephone call, whatever, usually starts with a sentence where that person says to me or I say to them, “I hope your family is safe”. Generally speaking, the salutation at the end of those communications is, “Stay safe”. I believe all parliamentarians have probably experienced the exact same thing.

One of the concerns of the disability community is this. What will happen to our children in their latter lives when we are no longer with them, when we can no longer care for and protect them? Therefore, the theme of my speech today is “Stay safe, my son”.

Let us look at the evolution of these laws across the world. I will read a few recent headlines that I found through my research coming into this today. “'What kind of society do you want to live in?': Inside the country where Down syndrome is disappearing”. This headline is from the BBC on October 14, “Netherlands backs euthanasia for terminally ill children under-12”.

Let me read a couple of excerpts from this article, which are fairly poignant considering today's discussion. The article begins, “The Dutch government has approved plans to allow euthanasia for terminally ill children aged between one and 12." Of the current law, it goes on to mention, “It is also legal for babies up to a year old [to be euthanized] with parental consent.

I could go on with more headlines, but I choose not to because I think members get the point. The point is this: Where do we stop? With Bill C-14 in its original form, the preamble said it all, which was, and I am sure the committee heard this, that there are many in society who say this bill does not go far enough and does not satisfy those who want wide open death-upon-request euthanasia laws. When we look at this, we must look at it from both sides, because both sides of this issue require our compassion.

I have spent time with three significant people in my life at the end of their lives. One is my mother, who was in extreme pain for a long period of time. I held her hand upon her death. I also watched a very good friend deteriorate from age 39 to age 41 before his death. As well, lately, a very good friend, who is choosing to end her life early, and who I had quite a frank conversation with out of total respect. All of them had been, or are in, the final stages of a terminal illness.

Compassion must go to people who are in situations that are unbearable. Fortunately, there are other alternatives. I happen to live in Brantford, Ontario, and we have one of the finest palliative care units in all of the country. People come to study it and look at it. They come to see it as an alternative. If we were to focus on something going forward that a government could do, but that it would perhaps not see as a priority, it could be to give people the resources to make a choice.

Let me get back to this discussion of the most vulnerable. They are persons with disabilities, and to name a few, they are autistic children, autistic adults and persons with brain damage, like my son. These are not mental illnesses, by the way. Some of these are genetic, such as Down Syndrome. There are some who have met a person with Down Syndrome who just lights up their life because of their complete innocence and their complete love, not only for others, but also for their own lives. There are many others who the disability community speaks for.

Bill C-7 undermines their precarious position. It takes and diminishes the few protections that existed in Bill C-14, and of course, this is what is being chosen, as per the votes up to this point, on this issue by the majority of members of Parliament.

To my son, I say, “Stay safe.” To the constituents of Charlottetown, I say, “Stay safe.” To the constituents with disabilities in Scarborough—Agincourt, I say, “Stay safe.” To all Canadians, I say, “Stay safe.”

The trajectory of where we are heading, and it is in that preamble to the legislation, is what is happening around the world. It is happening in society. People in legislatures are making the decisions for the rest of the country as to what the future will look like.

This is a critical moment. It was a critical moment back in 2016. Again, we are faced with a critical moment. The priority has become a deadline set by a court, instead of the fullness of all voices being heard.

The parliamentary secretary can articulate the numbers. He can articulate the fact that there were so many submissions and individuals we were able to listen to. At this point in time, the people who represent the vast number of persons with disabilities and their families in this country are dead against this legislation. Let us be clear about that. Let us not try to sugar-coat this. This is where we are today.

What kind of society do we want? Where this leads to, frankly, is one of those headlines. As we take away the protections for individuals with disabilities, as this law does, we eventually lead society into the normal course of accepting that assisted suicide and euthanasia are natural things. We move toward being a society that starts to look at individuals as either being healthy in society's mind, and living fulfilling lives, or beings one of those who have been brought into this world, or has had something happen to them in this world, that puts them in this very precarious situation.

Is life easy for persons with disabilities and their caregivers? In most cases, it is not easy. We can attest to that. We have three healthy children, as well as our special needs son with disabilities. Part of the richness of life is the fact that the child who many would see as imperfect is the one who brings the most joy to life. They are the ones we must protect at all costs.

Why do we not spend the time to get this legislation right and make it airtight so their lives are never at risk? I do not believe this legislation does immediately put them at risk. Some would say this legislation is quite to the contrary, but looking to five, 10, or 20 years from now, when most of us here will no longer be in Parliament, it will be a new group of elected representatives looking to make changes down the road.

Is there anything in the international experience to tell us that this is not a continual, gradual and incremental deterioration of the protections for those who are the most vulnerable?

The other point that needs to be made is that persons with disabilities are a minority in our country. Over the 13 years I have been in Parliament, more time has been spent on legislation, members' statements, just name it, than communications from government about protecting minorities. This is a vulnerable, if not the most vulnerable, minority in society. It is definitely in the top grouping of the most vulnerable.

Disability knows no boundaries. We are involved with groups of people, and I represent the Six Nations of the Grand River, the largest first nation in Canada. We are helping aboriginal individuals from Six Nations who have children with disabilities. They feel very strongly about the fact that the few protections that exist need to not only be kept in place, but also enhanced and made airtight for their children.

In those debates in 2016, the member for Calgary Nose Hill said in her opening statement that this is about, “the sanctity of human life” and “defining the morality of our country.” I could not agree more wholeheartedly with those words.

I will finish my remarks by saying, “Stay safe, my son.”

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I am pleased to add my voice to the debate on Bill C-7, an act to amend the Criminal Code with respect to medical assistance in dying.

I want to start by reminding all members that this is important legislation. We as parliamentarians have a court-imposed deadline of December 18 to pass this legislation. This legislation would help prevent the suffering of Canadians. Even if there were no court-imposed deadline, we would have a moral obligation to see it passed.

I am really disappointed, to be frank, to see my colleagues across the aisle delaying the bill, increasing the chances that the government misses the court-imposed deadline and prolongs the suffering of Canadians in denying them the autonomy to choose medical assistance in dying.

I am very disheartened to see members of the Conservative Party of Canada continue their delay tactics to slow this legislation. I saw it at the justice committee and we are seeing it again now. We know that the majority of Canadians believe that MAID is a basic human right. More than 300,000 people participated in consultations earlier this year.

The Quebec Superior Court's deadline is now two weeks away as of today. Conservatives are now trying to undermine the urgency of the situation. They are ignoring the very real consequences that their inaction could have on those who are suffering in this country. I think it is also important to remind members where the content of this legislation came from and the process the government went through in January in developing this legislation.

Bill C-7 was informed by the Truchon decision itself, Canadian and international reports, the experience of existing international regimes, and the government's consultations on MAID held in January and February of this year.

I had the opportunity to participate in some of these round tables that were hosted across the country including in my home of Toronto, where I am speaking from, and in Winnipeg. In these consultations, our team spoke with 125 stakeholders including regulatory bodies, legal experts, doctors, nurse practitioners, representatives of the disability community, and indigenous persons and their representatives. They shared their experiences and insights into MAID and its implementation in Canada over the last four years.

In order to get a broader public perspective, the government also hosted an online public survey. It received over 300,000 responses from people across the country. The summary of the consultations was released in March as a “what we heard” report. Our government did its homework in the creation of this legislation.

I would like to take the time to explain to all hon. colleagues what Bill C-7 proposes to change in our MAID regime so that we all start from the same common understanding of the legislation before us.

There are four main aspects to the bill. The first aspect concerns eligibility criteria and these changes are fairly straightforward. The eligibility criterion requiring a reasonably foreseeable natural death would be repealed. As I have already described, this change would in effect adopt the outcome of the Truchon decision for the whole of Canada.

This eligibility criterion makes Canada's current end-of-life regime available only when a practitioner can determine with confidence that a temporal connection to death exists, with some flexibility. In Truchon, the Quebec Superior Court told us that this criterion violated the charter rights of people whose death was not reasonably foreseeable, people like Mr. Truchon and Ms. Gladu.

To avoid prolonging the suffering of the applicants and other Canadians in similar situations, our government decided to accept the decision and amend the act for all of Canada.

The legislation would continue to require a voluntary request and informed consent from a person with decision-making capacity. These cornerstones of autonomy would ensure that MAID could be safely provided to Canadians who deem it to be the solution to their suffering, while guarding against persons being pressured into seeking MAID. We trust that individuals know best for themselves when they can no longer endure suffering, regardless of whether their natural death is reasonably foreseeable. We are committed to respecting this very personal choice of Canadians.

The second aspect of the bill is the safeguards. The bill would use the criterion of reasonably foreseeable natural death to create a two-track system. Those whose death is reasonably foreseeable would continue to benefit from the current safeguards with two changes. First, the 10-day reflection period would be repealed and a person would only need one independent witness to sign a MAID request instead of two. That independent witness would be someone who is paid to provide health and personal care services to the person requesting MAID. These changes are intended to alleviate barriers to access and to reduce suffering.

We heard from medical practitioners that these did not serve as safeguards, but only unnecessarily prolonged suffering for individuals who had made up their mind. It also created issues of accessing MAID in rural and remote areas.

Those people whose death is not reasonably foreseeable would benefit from an enhanced set of safeguards. In addition to those safeguards required where death is reasonably foreseeable, practitioners would have to assess a person's MAID request over a minimum assessment period of 90 days. If neither of those two MAID assessors has expertise in the condition that is causing the person's suffering, they would have to consult a practitioner who does. That is pursuant to the amendment that was helpfully proposed by the NDP member for Esquimalt—Saanich—Sooke at committee. The person requesting MAID must be informed of the means available to relieve their suffering, including mental health and disability support services, and be offered consultations with professionals who provide those services. Both practitioners have to discuss those means of relieving suffering with the person and be of the view that the person has seriously considered those means.

In terms of the broad approach to the bill, the third aspect of Bill C-7 is that of the limited change around advance consent. This one is unrelated to changes in eligibility criteria, but instead seeks to address an unfair situation that arises when a person is approved for MAID but loses decision-making capacity and cannot consent to the MAID procedure immediately before it would be provided, despite the request having been approved and the procedure already planned. Members probably know the reason for this amendment best through the story of Audrey Parker, the Canadian woman whose case we heard so much about a bit more than a year ago who had to schedule her MAID procedure earlier than she would have wanted, out of fear of losing decision-making capacity before her preferred date to receive MAID.

In my view, Bill C-7 takes the right approach by proposing to allow the waiver of final consent only in cases where the person's death is reasonably foreseeable and only when he or she has already been found eligible for medical assistance in dying and is waiting for the procedure to take place, but risks losing the capacity to provide final consent.

According to practitioners and people like Audrey Parker, this is exactly the kind of situation that forces people to make a cruel choice if they risk losing their capacity to give consent before receiving medical assistance in dying. That is the one, very specific scenario this bill proposes to address, since it presents the least amount of uncertainty in terms of patients' autonomous choices and the least ethical and practical complexity.

I know this is an important issue for Canadians, and I am committed to working with all parliamentarians to begin the parliamentary review of the medical assistance in dying regime as soon as possible after Bill C-7 has made its way through the parliamentary process. I have no doubt that the issue of advance requests will be an important part of that review.

The fourth and final category of amendments that the bill proposes targets the monitoring regime. The changes would allow the collection of information in a wider range of circumstances, including information about preliminary assessments that might be undertaken before a request is put in writing. Consultations will take place before these regulations are amended. An amendment at committee based on an amendment proposed by the hon. member for Nanaimo—Ladysmith of the Green Party would require that the Minister of Health consult with the minister responsible for the status of persons with disabilities in carrying out their reporting obligations; again, another helpful amendment that was proposed at the committee stage.

Medical assistance in dying has always been a very difficult issue that generates a variety of opinions on all sides of the issue. It strikes deeply to all Canadians' personal morals and sensibilities. We understand this. As such, it requires different interests to be considered. I firmly believe that Bill C-7 does exactly that. The law will 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 where the person's natural death is not reasonably foreseeable. These safeguards 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. We believe such a regime can work safely by guarding against overt and subtle pressures to seek MAID, while providing autonomy to a greater number of Canadians to make this important choice for themselves.

I would like to return for a moment to the topic of safeguards, specifically when it comes to those whose death is not reasonably foreseeable. It is very important to remind members of this House what these safeguards are and why we believe that they are adequate.

This legislation proposes a distinct set of procedural safeguards that are tailored to the risks associated with assistance in dying for persons whose death is not reasonably foreseeable. Ending the lives of those whose suffering is based on their experience of their quality of life is different from offering a peaceful death when the dying process would otherwise be painful or prolonged, or would erode a person's sense of their own dignity. Bill C-7 therefore proposes a more robust set of safeguards where natural death is not reasonably foreseeable. Safeguards for those whose death is not reasonably foreseeable would be built around the existing safeguards, but contain enhancements over the previous Bill C-14, which was passed in the 42nd Parliament. Importantly, the medical assessments of a person's eligibility must span at least 90 days.

I mentioned this earlier, but I want to emphasize, as there appeared to be some confusion around this at the Standing Committee on Justice and Human Rights, and elsewhere. This period of 90 days is not a waiting period or a reflection period. This is not a requirement that the person wait 90 days after they are approved. Rather, it is a stipulation that practitioners must, over at least a period of three full months, fully explore the person's medical condition and the nature and causes of their suffering, and work with them to identify reasonable treatment or other support options they must discuss with the person. The person seeking MAID is not required to undergo any treatments. It would be an intrusion into the individual's autonomy to force them into any sort of treatment, but as we embark on this new expansion of the MAID regime, we believe we can collectively move forward safely, if we can be satisfied that available options have been brought to the person's attention and given serious consideration.

All of these safeguards reflect the irreversible nature of ending someone's life and the very serious nature of medical assistance in dying, which needs to continue to be strictly regulated, especially given the broadening of the regime. As stated by the Canadian Medical Association, which welcomed our government's staged approach, the proposed MAID amendments are “a prudent step forward”. Bill C-7 proposes to further support individual autonomy while also protecting vulnerable persons and ensuring that careful consideration will be given to those challenging issues. For these reasons, among others, I strongly encourage members of this House to support this legislation and to support its passage through this House and Parliament to meet the court deadline of December 18.

I also want to remind members of the upcoming parliamentary review. Through the course of the consultations, and then through the committee process, we did hear of a number of issues that need to be reviewed and addressed, but need more thorough study than could be done in the time required to meet the court-imposed deadline. Parliament will have ample time to review all of these issues, and I think it is important that we do so, but we need to get this legislation passed as well.

Bill C-14, from the previous Parliament, called for Parliament to conduct a review and specifically mentions the state of palliative care. We expect this review will also include important issues such as mature minors, mental illness as the sole underlying condition and advance requests. By no means would I expect this to be a closed list, either. This is a broad issue and we would hope to hear from many Canadians on a wide variety of subjects relating to MAID. Having heard from many witnesses and spoken to many Canadians on Bill C-7, I know there are diverse views on this issue. They are all difficult issues, and I look forward to the parliamentary review and hearing from many more Canadians on the subject and seeing what the review has to say.

As I said at the beginning of my speech, I am very disappointed and concerned by my colleagues across the way and their lack of respect for the court deadline imposed on us by the Superior Court of Quebec to pass this legislation. I believe we have an obligation as parliamentarians to do everything we can to try to meet the deadline of the court. Canadians want this legislation. Quebeckers want this legislation. I am really unclear on why my colleagues across the way are showing disrespect for the will not only of the court, but of all Canadians. They have been slowing and delaying debate unnecessarily, and I am very concerned by what this says about how much they value the rule of law and the will of Canadians.

I want to thank my colleagues who serve with me on the justice committee for their work on helping us in a smooth and efficient committee process on this legislation. I look forward to this House giving the same consideration to the legislation. Again, I want to emphasize to my colleagues the importance of moving quickly. I look forward to continuing the debate on Bill C-7, but also to its ultimate passage in time for Parliament to meet the court-imposed obligation.

Sitting Resumed

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, that is exactly the point of a 10-day reflection period or any reflection period. It is for the person who just signed the document to give deep reflection to the document that he or she has just signed as to whether this is the right thing. It might have been the right thing at the time. It could very well be that within the reflection period they could change their mind. It was a good safeguard that was put in place in Bill C-14, a well-considered opinion of this Parliament, and it should be maintained. There is absolutely no reason to eliminate it, if the purpose is to comply with the Truchon decision.