This bill is from the 42nd Parliament, 1st session, which ended in September 2019.
Jody Wilson-Raybould Liberal
This bill has received Royal Assent and is now law.
This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.
This enactment amends the Criminal Code to, among other things,
(a) create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process;
(b) specify the eligibility criteria and the safeguards that must be respected before medical assistance in dying may be provided to a person;
(c) require that medical practitioners and nurse practitioners who receive requests for, and pharmacists who dispense substances in connection with the provision of, medical assistance in dying provide information for the purpose of permitting the monitoring of medical assistance in dying, and authorize the Minister of Health to make regulations respecting that information; and
(d) create new offences for failing to comply with the safeguards, for forging or destroying documents related to medical assistance in dying, for failing to provide the required information and for contravening the regulations.
This enactment also makes related amendments to other Acts to ensure that recourse to medical assistance in dying does not result in the loss of a pension under the Pension Act or benefits under the Canadian Forces Members and Veterans Re-establishment and Compensation Act. It amends the Corrections and Conditional Release Act to ensure that no investigation need be conducted under section 19 of that Act in the case of an inmate who receives medical assistance in dying.
This enactment provides for one or more independent reviews relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.
Lastly, this enactment provides for a parliamentary review of its provisions and of the state of palliative care in Canada to commence at the start of the fifth year following the day on which it receives royal assent.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from Parliament. You can also read the full text of the bill.
Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-14s:
David Graham Liberal Laurentides—Labelle, QC
Madam Speaker, the member made reference to the notwithstanding clause. I am always a little nervous about telling someone that their rights temporarily do not matter. It is something that I do not find terribly helpful.
The member said that he wants to make sure that anything that happens is safe from future Supreme Court decisions. I wonder why he thinks that matters, if he is willing to use the notwithstanding clause in the first place.
Bob Zimmer Conservative Prince George—Peace River—Northern Rockies, BC
Madam Speaker, it is simply two different situations.
We have a law that was sufficient all the way up until last year when the Supreme Court decided that it was not. That was the premise at the start of my conversation.
The following three points were made, that if the government is going to proceed without going through the notwithstanding clause process, then we would go through the rest.
I will just inform the member across the way that on a plane ride home from Ottawa to Vancouver, I sat next to a Supreme Court justice of the appellate court. I asked how we could have a check on them. Canadians have a check on us through elections and feedback letters. He said that there is a mechanism to check on them, and it is called the notwithstanding clause.
Clearly that is our way to check the courts, and to have our say in that body. We need to seriously consider it in this matter.
Kellie Leitch Conservative Simcoe—Grey, ON
Madam Speaker, as the member mentioned, I think there are grave concerns among health care professionals, not just physicians, but nurses, young residents, and others who would be compelled and quite frankly, ordered on an order paper to participate in this act.
Currently the legislation as outlined really does not provide protection for those who choose not to participate and that is not just about physicians. It is about nurses, young Canadians who have become residents, and Canadians who are participating in the health care field.
I would like the member's thoughts on how those individuals could be protected, because right now the legislation protects one group of health care professionals, but does not treat the other groups fairly.
Bob Zimmer Conservative Prince George—Peace River—Northern Rockies, BC
Madam Speaker, absolutely, as I referred to, an amendment was put forward by one of our colleagues, with respect to proposed subsections (7.1) and (7.2). Some of these positions are not protected, as the member stated. We are talking about not just medical practitioners, but we are talking about pharmacists and any kind of health institution that would allow this act to be performed within it, faith-based health care providers.
It is a wide-open door as to who can be drawn into this situation. Without sufficient protections, I am deeply concerned that all of these groups will be wrapped up into this legislation and be forced to do something against their beliefs.
Anthony Housefather Liberal Mount Royal, QC
Madam Speaker, I want to talk about my colleague's conclusion that Parliament should use the notwithstanding clause. I come from the province of Quebec. When I was 18 years old, the province of Quebec used the notwithstanding clause to ban English from commercial signs and it enraged me and it enraged our community.
For me, no matter how passionately the hon. member feels about a subject, the use of the notwithstanding clause to tell a group of people who feel that their rights have been vindicated by the Supreme Court that suddenly they no longer have that right is not what the hon. member really should consider to be a fair and just solution.
Could the hon. member look at that in light of the experience that I lived in Quebec and please reconsider his views?
Bob Zimmer Conservative Prince George—Peace River—Northern Rockies, BC
Madam Speaker, I will clarify one thing. I finished with talking about a free vote from the government. That was my conclusion. The opposite side talks about open and accountable government and a new way of doing business here in Ottawa. I question whether free votes are really occurring on the other side, just by the numbers that oppose any government legislation. Usually on our side we have anywhere from one to 15 honest free votes in the House. I would challenge the other side to have a free vote on this on their side—
Criminal CodeGovernment Orders
An hon. member
On charter rights he said you would vote as a caucus.
The House resumed consideration of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), as reported (with amendment) from the committee, and of the motions in Group No. 1.
Kamal Khera LiberalParliamentary Secretary to the Minister of Health
Mr. Speaker, it is an honour for me to rise today to speak in support of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).
I would like to start off by first acknowledging that medical assistance in dying is a deeply personal issue for all Canadians, which is tied to both their life experiences and personal beliefs. My background as a registered nurse in an oncology unit helped shape my thoughts and opinions on this matter.
Understanding that this is a very sensitive issue, with proponents on all sides of the debate, within days of this new Parliament, the now-government caucus moved swiftly to strike a joint committee to study the matter and make recommendations, which heard from many Canadians and experts on this issue. After working several days, sometimes well into the evening, the committee made its recommendations to Parliament.
Before I continue, I would like to thank all my hon. colleagues on both sides of the House, and in the Senate, who participated in the special committee and the justice committee for their contributions.
I also know that our minister has worked very hard to craft legislation that would ensure that the priorities of Canadians were met when it came to the issue of medical assistance in dying.
I strongly believe that the proposed legislation finds the perfect balance by reconciling the issue of autonomy of competent adults with the protection of vulnerable people through a thoughtful tailoring of the eligibility criteria and robust safeguards that are essential to preventing error and abuse. It also strikes the right balance by ensuring that conscience rights of physicians and nurse practitioners are protected, and commits to continuing to work with the provinces and territories regarding coordination and jurisdictional issues.
I want to assure members that our government is committed to continued discussions with the provinces and territories on a range of issues, not only related to medical assistance in dying but also to a full range of end-of-life options, including palliative care.
In various testimony given before the House committee, witnesses discussed other regimes where medical assistance in dying has been implemented. In Europe, for example, three countries have legislated access to medical assistance in dying, which is Belgium, the Netherlands, and Luxembourg. In the United States, four states have legislated access.
However, where Canada is unique is in the jurisdictional complexities that we face. In Canada, the federal government has exclusive jurisdiction over criminal law, and health is a shared jurisdiction between the federal, provincial, and territorial governments. Primary responsibility for the provision and delivery of health care services rests with individual jurisdictions. This is why our government has proposed legislation that will be applied across all provinces and territories but at the same time will respect and allow flexibility for jurisdictional roles and responsibilities in the areas of health care.
This brings me to another important issue that cannot be ignored or put aside when talking about enabling access to medical assistance in dying when one is approaching end-of-life care, and that is access to quality palliative care. It is very clear that Canadians are looking to their government for leadership to advance the availability and quality of palliative care within the broader scope of how we address Canadians' needs at the end of their life.
We know that most people at the end of life wish to remain at home as long as possible, as long as they are well supported by the services they need. This is why the federal government is committed to improving palliative care as part of a new health accord, supported by a long-term investment of $3 billion over four years.
Recently, federal, provincial, and territorial ministers of health agreed to work individually and collectively on improving home care to better meet the needs of patients closer to home. However, an agreement must still be reached on how funds will be used to strengthen and transform the health care system. We know that all jurisdictions are working diligently to meet the growing home and palliative care needs of their aging populations. However, we also know that jurisdictions are at different points. Some are well advanced in their efforts, and others are at a more moderate stage. By continuing to work with provinces, territories, and stakeholders, we will bolster each other's efforts for the benefit of all Canadians.
Another aspect that I would like to address when we talk about providing Canadians with that full range of options at the end of life is access. The government is very clear in its commitment to facilitate access to these services and to those providing it. This includes access to this new service of medical assistance in dying.
Our government is committed to respecting the autonomy of Canadians suffering from grievous and irremediable medical conditions. Access to medical assistance in dying would only be available for those who meet the following conditions: be a mentally competent adult who is in an advanced state of irreversible decline in capability; have a serious an incurable illness, disease, or disability, and are experiencing, enduring an intolerable suffering; and whose deaths are reasonably foreseeable.
It will also remain a crime to assist a person either in dying or in causing a person's death in situations other than lawful medical assistance in dying.
With regard to Bill C-14, our government is also committed to protecting the exercise of conscience rights as the proposed legislation also provides exemptions for both physicians and nurse practitioners from having to provide medical assistance in dying. Over the course of this national dialogue, we have seen that the protection of conscience rights for these providers is clearly an issue for many Canadians. Our government has listened and made Bill C-14 more explicit on this issue, and therefore more appropriate for the diversity within Canada.
The bill now reads as follows:
For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.
We trust that this helps to address the concerns some of members may have either personally and/or on behalf of their constituents on the issue of the protection of conscience rights.
Our government is also proposing to work with provinces and territories to create an end-of-life care coordination system. This would have a dual function. It would respect the conscience rights of health care providers, while facilitating access for Canadians to not only medical assistance in dying but a full range of end-of-life options, including palliative care.
The federal government would be prepared to collaborate on developing such a system should provinces and territories wish to participate, so that all Canadians have access to the care they need and deserve. We could also start on this by reviewing the information that we have on assisted dying regimes in other countries to see what they have done, and assessing their applicability to Canada.
Working in the health care field and especially in oncology, I know that health care is about connecting and helping people during their most vulnerable times. This means that we need accountable and transparent regulations to monitor and instill confidence in the appropriate implementation of medical assistance in dying.
This will protect vulnerable patients when they may not be able to do so themselves and help Canadians understand the number of requests for medical assistance in dying, the types of medical conditions that lead to requests, and whether the procedural safeguards in the law are working as intended. It will also work to ensure that high-quality, comparable Canadian data is generated so that any future discussions about changes to the medical assistance in dying system can be based on the best possible evidence.
Therefore, Bill C-14 creates legal obligations for physicians, nurse practitioners, and pharmacists to report certain information for the purpose of monitoring. Regulations will be put in place to guide the information to be provided, to whom, and within what time frame. In the short term, Health Canada is working with our counterparts in the provinces and territories to establish an interim system should the bill be passed on June 6, until a permanent process is in place.
In closing, I would like to once again reaffirm my support for Bill C-14, which I believe is the right approach for medical assistance in dying. It will support and facilitate access for those seeking it, protect our most vulnerable, and protect conscience rights. We know that no one solution can reconcile the diverse perspectives on medical assistance in dying, but we believe we are moving forward together with a balanced approach that is appropriate for Canada at this time.
I thank the Speaker for giving me the opportunity to speak on this very important piece of legislation.
Michael Cooper Conservative St. Albert—Edmonton, AB
Mr. Speaker, I want to ask the member a question about the deadline of June 6.
Right now, it looks like the earliest that the legislation will get to the Senate is mid-week during the week that we return. The expiration of the stay on the declaration of constitutional invalidity expires on the following Monday. It looks like it is now virtually impossible to meet the June 6 deadline.
In the face of that fact, would the hon. member agree that the Minister of Justice should apply to the Supreme Court to ask for a further extension, not a six-month extension, not a four-month extension, perhaps a one month or six-week extension, so that we can get legislation passed without there being a void in which there would be an absence of certainty and an absence of protections for vulnerable Canadians?
Kamal Khera Liberal Brampton West, ON
Mr. Speaker, I would like to thank the hon. member for his question and for all his hard work on the special committee and the justice committee.
What he said, again, reinforces how important it is for us to pass the legislation by June 6. As members know, if the legislation is not in place by June 6, the court's ruling would come into effect, meaning that medical assistance in dying would be lawful where it is in accordance with the parameters set by the Carter ruling.
We know if the bill does not pass there will be a vacuum. I know this is something that my hon. colleague has said before in the House as well. People who are suffering incurable and irremediable conditions will be left with no access to medical assistance in dying because no medical practitioner will be at all comfortable assisting anyone in dying without any legal framework.
On the other side, we will be putting our most vulnerable population at risk with absolutely no safeguards, and we know how disastrous that could be.
Again, this just shows how important it is for us, as parliamentarians and as Canadians, to pass the legislation by June 6.
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Mr. Speaker, I, too, would like to thank the Parliamentary Secretary to the Minister of Health for her very thoughtful remarks on the bill.
My question for her is about process. I am one of the people who did not get an opportunity to speak to the bill at second reading. Under the time allocation motion, we now, today, will have 10 amendments on the bill before us and we will have only nine speakers. We actually have more amendments than speakers on the bill.
I wonder how she feels or why she feels the government is unwilling to accept the proposal that was just made that would allow this debate to continue on Monday and allow many more members of Parliament to participate in the debate at report stage, because we are going to have less than 10% of the members of Parliament actually participating at this stage.
Kamal Khera Liberal Brampton West, ON
Mr. Speaker, for all Canadians, this is an extremely difficult and deeply personal issue, tied to their life experiences and personal beliefs.
As we know, it is a very diversified situation. For some, medical assistance in dying would be very troubling, and for others, the legislation would not go far enough. We believe that the legislation is the best approach to ensure that dying patients who are suffering unbearable pain have the choice of a peaceful death, and that the vulnerable are protected.
The Supreme Court of Canada decided that Canadians suffering intolerably have the right to request assistance to end their suffering, and we respect that decision.
