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

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

Madam Speaker, I think it is unfortunate and inaccurate to conflate the idea of discrimination in this context.

First, the charter of rights requires that persons with disabilities be able to make the exact same decisions about their body and their passing as persons with ability, which is what the Truchon decision references.

Second, there is reference to conscience protection rights in the Carter decision, and I have already referenced that. Also, there is a reference to it in the preamble of the previous bill, Bill C-14, and I referenced that. Out of an abundance of caution after amendments that, I believe, were moved by the member for St. Albert—Edmonton in the last Parliament for further clarity, a further amendment was made with respect to conscience rights in Bill C-14. To purport that conscience rights are not protected in this legislative scheme is categorically false.

There have been assertions of a culture of coercion or encouragement towards accessing MAID on the part of practitioners. Is the member aware of any instances, not just in her province but anywhere in this country, where such instances of coercive behaviour of medical practitioners have resulted in a prosecution under the Criminal Code?

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

Madam Speaker, as a point of clarification, there are four protections for conscience rights in this regime: the preamble, section 9 of the former Bill C-14, section 2 of the Charter and paragraph 132 of the Carter decision.

In terms of persons with disabilities and respecting their autonomy, I refer the member opposite to the comments of Senator Petitclerc, former Conservative minister Steven Fletcher, and many others who have indicated that there is a heterogeneity of views among the disability community.

Last, the question I would put to the member opposite comes from the Truchon decision at paragraph 678. The court addressed the issue of the competence and dignity of persons with disabilities and said:

Where natural death is not reasonably foreseeable, the consent and suffering of the disabled are worthy only of the sympathy of Parliament, which has adopted a protectionist policy towards every such person, regardless of his or her personal situation. As soon as death approaches, however, the state is prepared to recognize the right to autonomy. This is a flagrant contradiction of the fundamental principles concerning respect for the autonomy of competent people, and it is this unequal recognition of the right to autonomy and dignity that is discriminatory in this case.

That is the court in Truchon disavowing the previous regime and requiring this Parliament to extend the regime to ensure the competence, dignity and autonomy of persons with disabilities.

I was wondering if the member opposite would care to comment on that paragraph.

Motions in amendment

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, as the saying goes, never two without three.

I rise today in the House of Commons to speak once again to the issue of medical assistance in dying as it pertains to Bill C-7, an act to amend the Criminal Code. However, this time we have a deadline set by Justice Baudouin, namely December 18, 2020, so there is a sense of urgency now.

I am likely repeating myself today, but many people here have had unique experiences involving the end of a loved one's life. I am thinking in particular of one of my old friends, Stéphane, who died in palliative care at a very young age, in his twenties. He was supported by the excellent Maison Au Diapason. He was one of the youngest patients to die there and one of the first as well. This type of assistance is essential and useful.

As the Bloc Québécois critic for the status of women and seniors, I naturally took a special interest in this bill. In this speech, I will be reminding everyone of all the work that my party has done on this important issue, while emphasizing the great sensitivity of Quebeckers when it comes to medical assistance in dying. I will conclude with the position that certain seniors' and women's groups have taken on this issue and the recommendations they made that are extremely useful, but that are already several years old. They too are starting to get impatient.

First, let's talk about the reason for this debate. In September 2019, the Superior Court of Quebec ruled in favour of Nicole Gladu and Jean Truchon, both of whom had incurable degenerative diseases. The court stated that one of the eligibility criteria for medical assistance in dying was too restrictive, both in the federal legislation covering MAID and in Quebec's Act respecting end-of-life care.

These two brave individuals, with whom I have mutual acquaintances, simply asked to be able to die with dignity, without needlessly prolonging their suffering. Mr. Truchon, who had cerebral palsy, had lost the use of all four limbs and had difficulty speaking. Ms. Gladu, who has post-polio syndrome, is not able to control her pain with medication and cannot stay in the same position for too long because of the constant pain. She has said that she loves life too much to settle for mere existence. That is what she said.

What we are talking about here is the criterion of a reasonably foreseeable death. Justice Christine Baudouin said it well in her ruling:

The Court has no hesitation in concluding that the reasonably foreseeable natural death requirement infringes Mr. Truchon and Ms. Gladu's rights to liberty and security, protected by section 7 of the Charter.

That is the crux of our debate. These advocates had been denied medical assistance in dying because their death was not reasonably foreseeable, even though they had legitimately demonstrated their desire to stop suffering. Jean Truchon had chosen to die in June 2020, but he moved up the date because of the pandemic. Nicole Gladu is still living, and I commend her for her courage and determination.

The Bloc Québécois's position on this ethical issue is very clear, and I want to thank the member for Montcalm for his excellent work. I will not be as technical as him, but he showed us that we are capable of working together, and I thank him for all of the improvements that he made to this bill.

As many members have already pointed out, legislators did not do their job properly with the former Bill C-14. As a result, issues of a social and political nature are being brought before the courts. We need to make sure that people who have irreversible illnesses are not forced to go to court to access MAID. Do we really want to inflict more suffering on people who are already suffering greatly by forcing them to go to court for the right to make the very personal decision about their end of life? This will inevitably happen if we cannot figure out a way to cover cognitive degenerative diseases.

Obviously, we agree that we need to proceed with caution before including mental health issues, but that is not the issue today, since MAID in mental health-related cases was excluded from the bill. Once again, this matter was brought before the Standing Committee on Health via a motion moved by my colleague from Montcalm.

Second, I want to talk about how important Quebec is in this context. Quebec enacted the country's first legislation on this subject. Wanda Morris, a member of a B.C. group that advocates for the right to die with dignity, talked about how a committee that got the unanimous support of all parties in the National Assembly was a model for the rest of Canada. She said it was reassuring to see how it was working in Quebec and that people were happy to have the option to die with dignity.

However, it is important to know that this bill was first introduced by Véronique Hivon and that it was the fruit of many years of research and consultations with individuals, doctors, ethicists and patients. Whereas 79% of Quebeckers are in favour of medical assistance in dying, only 68% of people in the rest of Canada are. Those numbers are worth knowing and mentioning.

In 2015, when all parties in Quebec's National Assembly unanimously welcomed the Supreme Court's ruling on medical assistance in dying, Véronique Hivon had this to say:

Today is truly a great day for people who are ill, for people who are at the end of their lives...for Quebec and for all Quebeckers who participated in this democratic debate...that the National Assembly had the courage to initiate in 2009.

I believe that, collectively, Quebec has really paved the way, and we have done so in the best possible way, in a non-partisan, totally democratic way.

For the third part of my speech, I would like to tell you about a meeting I had with the Association féminine d'éducation et d'action sociale in my role as the Bloc Québécois critic for status of women, gender equality and seniors. At this meeting, these brave women shared with me their concerns about this issue.

I will quote the AFEAS 2018-19 issue guide:

Is medical assistance in dying a quality of life issue? For those individuals who can no longer endure life and who meet the many criteria for obtaining this assistance, the opportunity to express their last wishes is undoubtedly welcome. This glimmer of autonomy can be reassuring and make it possible to face death more calmly. ... As the process for obtaining medical assistance in dying is very restrictive, those who use it probably do so for a very simple reason: they have lost all hope. ... This process cannot be accessed by individuals who are not at the end of life. ... People with degenerative diseases, who are suffering physically and mentally, do not have access to medical assistance in dying.

A brief submitted in 2010, or 10 years ago, to the Select Committee on Dying with Dignity, explained that the last moments are not always difficult because there are standards to guide medical practice and medical advances help relieve pain. However, despite everyone's goodwill, some people do have unfortunate experiences. Consequently, to prevent prolonged agony from depriving some people of their dignity and control over their lives, there are those calling for as a last resort the right to die with dignity, or the right to die at a time of one's choosing with assistance in this last stage.

Another brief pointed out that there have been four separate attempts to introduce similar legislation, specifically in 1994, 2005, 2008 and 2009, but these bills have never gone further than first reading. This needs to pass.

I will now read the conclusion from the AFEAS brief, as it is really powerful:

Over the next few months, AFEAS members will continue to reflect on the framework in which individuals losing their autonomy or suffering from an incurable, disabling illness, or experiencing acute physical or mental pain without any prospect of relief will be able to clearly and unequivocally express their desire to stop fighting to live and seek assistance to die.

Establishing the framework in which these decisions are made will be critical to ensuring that abuse cannot occur. The guidelines must be clear and precise so that all individuals can freely express their own choices, without any constraints and with full knowledge of all available options. It will be essential that all end-of-life services, including palliative care, be available and effective throughout Quebec so that patients have a real choice and do not feel forced to accept a “default” option because of a lack of adequate services or undue pressure from others.

I will also close now, in the hope that all of these comments and the lived experiences of the people in Quebec who made the request and wanted to die with dignity will afford Bill C-7 the same unanimous support from all members of the House of Commons so that we may all freely choose when we die. Let's take action.

[Arif Virani, Liberal, Parkdale—High Park, ON]

Madam Speaker, I thank the member for his contributions today and in this Parliament. I offer my sympathies to him for the loss within his family.

The point I was making earlier in this debate was simply to reflect what we heard during the consultations. The 10-day reflection period is entrenched in the old Bill C-14. When Canada was embarking on this for the first time in its history, it was deemed necessary to do the work of ensuring that consideration and time for reflection was available.

What we have found four years after the fact, after extensive consultations, is that the goal of that 10-day reflection period was not actually doing what it was intended to do. As an unintended consequence it was actually prolonging suffering.

The point underscoring this difference in views on either side of the House is that when people get to the stage of asking for medical assistance in dying, they have already reflected upon it. They have already considered it and have gotten to that point after very appropriate and measured determination.

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

Madam Speaker, I would note that Madam Justice Baudouin, in rendering her decision and finding that the reasonably foreseeable criteria contravened section 7 and section 15 of the charter, based her analysis on only one objective of Bill C-14, namely to protect vulnerable persons from being induced in a moment of weakness to ending their lives.

The justice ignored other objectives of law, including the sanctity of life, dignity of the elderly and disabled, and suicide prevention. On that basis alone, the decision should have been appealed.

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

moved:

Motion No. 2

That Bill C-7, in Clause 1, be amended by deleting lines 25 to 31 on page 3.

Motion No. 3

That Bill C-7, in Clause 1, be amended by replacing line 8 on page 5 with the following:

“(i) ensure that there are at least 120 clear days between”.

Madam Speaker, I am pleased to rise to speak at report stage of Bill C-7 and, in particular, with respect to the two very modest amendments that we in the official opposition have put forward to the legislation, namely, to maintain a 10-day reflection period and to extend the reflection period of 90 days to 100 days where death is not reasonably foreseeable. Both of these amendments are supported by the evidence that was heard at the justice committee in what was otherwise a very rushed process. It need not have been this way and it should not have been this way.

One year ago, the Attorney General should have done what we on this side of the House called on the Attorney General to do, and that was to appeal the Truchon decision. That would have provided clarity in the law and it would have provided Parliament with time to appropriately respond legislatively if necessary, but the Attorney General did not do that. Instead, he rushed ahead with legislation purportedly aimed at responding to the Truchon decision, legislation, I might add, that was introduced with very little consultation.

The legislation went well beyond responding to the Truchon decision. The legislation fundamentally changes the medical assistance in dying regime that was passed in this Parliament a mere four and a half years ago and in so doing, the Attorney General and the government pre-empted a legislative review that was mandated by Bill C-14.

As a result, what we have is a rushed process to deal with a shoddy piece of legislation that recklessly puts vulnerable Canadians at risk. It is why virtually every disability rights organization in Canada opposes this bill. Indeed, 72 national disability rights organizations wrote to the Attorney General and pleaded with him to appeal the Truchon decision. Those pleas fell on deaf ears.

More than 1,000 physicians have penned a letter to the Attorney General opposing this bill. The UN Special Rapporteur on the rights of persons with disabilities expressed concern about Canada's medical assistance in dying regime and questioned whether Canada in fact was living up to its international obligations under the Convention on the Rights of Persons with Disabilities.

I will quote Krista Carr, the executive vice-president of Inclusion Canada, an organization that represents the rights of persons with disabilities, who said this of Bill C-7, “Bill C-7 is our worst nightmare.”

Catherine Frazee, professor at Ryerson University, former chief commissioner of the Ontario Human Rights Commission and a leading advocate for the rights of persons with disabilities, said “our equality is, right now, on the line” with respect to Bill C-7. She noted that the careful balance between individual autonomy and equality carved out in Bill C-14 had been upended in Bill C-7.

Dr. Heidi Janz of the Council of Canadians with Disabilities said:

Bill C-7 would enshrine a legal form of ableism into Canadian law by making medical assistance in dying a legally sanctioned substitute for the provision of community-based supports to assist people with disabilities to live.

You must ensure that MAID does not weaponize systemic ableism in Canada.

In the face of those concerns right across the spectrum from physicians and experts to persons with disabilities and their advocates, we, on this side, thought it appropriate we proceed in a cautious and deliberate way, having regard for the complexity of the issue, the lack of consultation and the very short time frame before us to consider the radical changes brought forward by the government in Bill C-7.

Therefore, at the Standing Committee on Justice and Human Rights we put forward reasonable amendments, including maintaining a 10-day reflection period, having regard for the fact that people do change their minds and having regard for the feedback that was provided.

We put forward an amendment to ensure there be two independent witnesses. When one executes a will, one needs two witnesses. One would expect that at the very least there would be a safeguard at least as robust as in the case of executing a will when we are talking about ending one's life, but no, the government removed that safeguard.

We put forward an amendment to extend the reflection period where death is not reasonably foreseeable from 90 days to 120 days, having regard for the fact it is often not even possible to access palliative care or other supports within 90 days. What good is a reflection period of 90 days if one does not have access to alternatives within such a time frame? That amendment was rejected by the government.

Consistent with what the Minister of Disability Inclusion said, and having regard for the horrific evidence we heard of Roger Foley, who was coerced into making a request for medical assistance in dying, which he recorded, this should always be patient-initiated so coercion is limited and to guard against that.

In closing, let me just say that what we have is a piece of legislation that does the opposite of what the Supreme Court called on Parliament to do in Carter, namely, to provide for a carefully designed and monitored system of safeguards. This legislation eviscerates those safeguards, and on that basis, is unsupportable. It needs to be defeated out of hand.

Criminal Code

[Mel Arnold, Conservative, North Okanagan—Shuswap, BC]

Mr. Speaker, I certainly agree with the member that the review of the original Bill C-14, medical assistance in dying, needs to take place so there is a proper review of what has been happening since 2016 when it passed. As we move forward with this bill, we certainly need to be cautious and review it, because what we are dealing with here as legislators is the life and death of other people.

[Mel Arnold, Conservative, North Okanagan—Shuswap, BC]

Mr. Speaker, it is an honour to rise and speak in this House on Bill C-7, an act to amend the Criminal Code, medical assistance in dying.

Each and every time that I speak in this House, I am reminded that the opportunity has been entrusted to me by the citizens of North Okanagan—Shuswap, first in 2015, and again in 2019. It is roughly five years now since I arrived in this place for the first time and I still remember the anticipation I experienced as I approached my work as a member of Parliament. I still carry great appreciation for the opportunity to serve the people of North Okanagan—Shuswap and, indeed, all Canadians.

Each and every member of this House has been entrusted by their constituents to represent all constituents, and this is a responsibility that I hope all members keep as a guiding principle as we undertake our work. I do not think anyone could be fully prepared for what the role of being an MP entails and the unexpected situations that arise, but I will say that I came here with an open mind, eager to listen and committed to doing my very best to represent the constituents of North Okanagan—Shuswap.

Shortly after the 2015 federal election, Bill C-14 on medical assistance in dying was introduced to the 42nd Parliament. In fairly short order, Bill C-14 was debated and passed. As members will recall, Bill C-14 was passed in response to the Supreme Court decision that ruled that adults with grievous and irremediable medical conditions are entitled to physician-assisted suicide, as it was termed at the time.

Over the time that was allotted for debate and committee study of the original Bill C-14 legislation, I took the opportunity to hear from constituents and took what I heard at that time to form my position on the legislation at hand. Since then, I have continued to listen to constituents on all sides of this debate in an effort to ensure that I am aware of their many differing viewpoints. I have heard from many who believe in the sanctity of all human life and believe the time of life and death is to be decided by a greater power than any of us possess. I have also heard from others with various incurable health conditions who want the ability to choose an appropriate time so that they are able to pass with dignity, and the ability to choose when to say a final goodbye.

While listening to and pondering the various personal beliefs and scenarios shared by constituents, I have also reflected on my own personal experience and how fortunate many of us are that we have not had to make the very difficult, personal decision that many Canadians face every day.

I would like to share what weighed heavily on my mind during the debate and considerations, back in 2016, and remains with me today as we revisit this topic in the legislature. My mother had developed dementia over a period of years before her passing. At first, we did not recognize the symptoms or maybe we did not want to actually acknowledge that they were there, but as time went on Mom became more forgetful. At first it was just that she would end up with multiple jugs of milk in the fridge because each time she went to the grocery store she simply remembered that she needed milk and not the fact that she had just bought some the day before.

As time progressed, her memory got worse and eventually she moved into a full-care home where she was safe and cared for. Initially it was only her short-term memory that faded away and she could still remember many things from earlier in her life and about her family, but that gradually changed. One thing we did notice in the last few months of her life was that she no longer used the telephone. It would ring but she was not able to put the pieces together to pick it up and talk to whoever was calling. The phone had been a big part of her life as she would always call all of her children, grandchildren and great-grandchildren on our birthdays, but for a number of months she was no longer able to remember phone numbers, what the telephone was for, or how to start a conversation.

At the time of what turned out to be her last Christmas, we made plans to have her home for Christmas dinner and we all looked forward to the day. Then on Christmas morning, we got a call from the care home. They said she had come down with the flu and would not be able to go out. We managed to get through Christmas Day but were concerned the illness was more than she could take in her frail condition.

The next day we were surprised when the care home called and said my mom was doing much better that day and asked if we wanted to come for a visit. We headed out, knowing that mom might not be looking or feeling her best because she had been ill.

We walked into the room that day and were totally taken aback. She was sitting up, fully articulate and waiting for us. We were shocked when she started conversations like someone had turned back the clock two years on her dementia. She told us how she felt bad she had not been able to go out and do any Christmas shopping for the grandchildren and many other things she had not been able to communicate for months.

When we returned home later that day, our answering machine was full of messages from my five siblings all wondering what was going on with mom. She had picked up the phone and called each of them from the numbers in her head and had extensive conversations with each of them.

We were all in shock from this remarkable recovery of her memory and the restoration of her mental function from what had been considered incurable. Unfortunately, the recovery was temporary and only lasted about 24 hours, but nonetheless it was a complete reversal of her dementia for that period of time. To this day, no one has been able to explain how or why this happened. We wondered, at the time, and still wonder today if there may be a cure just around the corner.

This is only one scenario, and in the time since medical assistance in dying became legal, I have heard from constituents and observed cases where family members have been quite open about their aging parent or terminally ill family member. They have been open about how, at some point, the parent or family member is no longer the person they once were and no longer wants to carry on. I have heard how they want to be able to make the choice and should not be denied that choice.

In considering the legislation before us today, we must consider all of the people and lives that will be affected by our decision. It is a very difficult task when we are not able to hear all of the different scenarios, learn the details about symptoms and reasons for personal choices.

That is why I urge all members to consider what safeguards should be in place and if safeguards are not in the current text of the bill, can it be amended so that our decision respects the needs and rights of our constituents and Canadians.

I will continue to open my mind and listen to what I hear from my constituents. I expect I might hear cases like mine where we were fortunate that when mom passed peacefully in her sleep a few months later, we did not have to make those difficult decisions. There are cases where a cure might be found soon for someone who is incurable today. There are cases where there is no hope for recovery and someone wants to ensure dignity is retained.

There are many other personal situations out there and as legislators, we must remember that. We have a duty to consider more than just our own personal opinions or those of the people close to us. We must be considerate of those who will be tasked with carrying out what we legislate. We must guard against any loophole or opportunity for this legislation to be exploited or abused, because we are literally legislating on matters of life and death here. Let us consider all of that in our deliberations.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Mr. Speaker, before getting into the details of the proposed legislation in front of us, I first want to make sure that in the House we avoid a common misunderstanding that seems to come up whenever people strongly disagree with assisted suicide or related issues. Quite often, someone in favour of allowing assisted suicide or removing safeguards will express compassion and empathy for those who are suffering. In saying this, I am not questioning their feelings or their sincerity; nobody wants to suffer or watch their loved ones go through terrible pain. What I am saying here, for everyone's benefit, is that those who are opposed to it or who want to support safeguards have a deep sense of compassion and empathy for those who are suffering. In other words, our human feelings of compassion by themselves do not automatically lead to one position or another.

Along with my wife, I have watched four grandparents pass away, and at present we have another one who is living in palliative care. Each time I have witnessed and cared for family members as they go through difficult health problems, I am reminded of the importance of always affirming a dying person's dignity while they live out the last part of their life.

For the past year, we have had widespread awareness of and concern for how the spread of COVID-19 could devastate seniors and others who are more vulnerable because of medical conditions. For the most part, these are the same people who are at risk and would be even more so under this new law. Along with everything else we could learn from 2020, I hope we can improve our medical practices and strengthen safeguards for the most vulnerable in every area, including this one.

As we continue to debate Bill C-7, it is important for all of us to take a moment to carefully consider its wider impact and unintended consequences. If passed, the new law will significantly expand the number of Canadians who will be eligible for assisted suicide. Whether we agree with these changes or not, it is clear that they are major and fundamental.

It was only a few years ago that Parliament passed Bill C-14, which created the legal framework for what it called “medical assistance in dying”. Previously, the Criminal Code had considered it a serious crime to either kill a patient or participate in a patient's suicide. While amending the section on culpable homicide and defining eligibility, it presented MAID as the narrow exception.

At the time, the former justice minister, with the same sense of transparency for which she later fell out of favour with the Liberal government, publicly stated, “We recognize that medical assistance in dying will in many respects fundamentally change our medical culture and our society.” It was true for what happened back then, and now we are adding some more major changes before the last ones were ever properly reviewed. There was supposed to be an official review of the MAID system, but that has not happened.

Without having a thorough and careful review, we are supposed to proceed with Bill C-7 anyway. So far, in the current session, we have started debating this bill for part of only four days. I hope there will be much more time than this for considering this bill at every stage, especially when it is studied by the justice committee. There is so much that should be said, and the amount of time we all have to work with is too limited.

I share the deep concern of many Canadians who recognize that this bill undermines our country's commitment to upholding and protecting the equal value of each human life. More particularly, there needs to be even more attention given to how assisted suicide, especially in the way this bill handles it, affects the lives and social well-being of people with disabilities.

Over the past year, the idea of systemic discrimination has come to the forefront of our public discourse in Canada, in the U.S. and around the world. To help us better reflect on how it can relate to this discussion, we can look to the work of Dr. Laverne Jacobs. Dr. Jacobs is a law professor at the University of Windsor. She has approached the issue with her legal expertise and speaks from her experience as a Black woman living with disabilities in Canada.

As part of a longer presentation about MAID back in January, she compared and related the experiences of minority communities. She said, “What's particularly troubling about any system or any structure of systemic discrimination is that once ideas that are harmful to a minority group have been legislated into law, it is very difficult to convince the general public that they are not stigma-inducing or ultimately discriminatory. So in both cases, in both the case of racial inequality in the U.S. and the case of MAID here in Canada, we're dealing with the stigmatization of a historically disadvantaged group.”

In an article on the subject of MAID, Dr. Jacobs wrote:

More explicitly, while the MAID law indeed requires consent, these irreversible choices about ending a life are made in a complex social, cultural and health-care context, where lack of access to adequate care, lack of social support and overall ableist stigma have an impact on the choices people with disabilities may have.

In the same article, she also said:

There are also concerns, fuelled by developments in the few countries that provide access to MAID outside the end-of-life context, that being elderly and fragile is increasingly accepted as a reason for a physician-assisted death and that this may create subtle pressure.

This is a small sample of her work, and Parliament would do well to take a closer look at the rest of her comments.

Loss, especially one of this nature, directs and shapes people's actions and attitudes. We cannot say that people with disabilities and other vulnerable populations have not told us this and explained how this bill will inevitably hurt them. Many other advocates and members of the disability community have been speaking out with similar fears, but they were not heard when they called for the government to appeal the Quebec Superior Court ruling. They have also been ignored when it comes to the problems in Bill C-7.

Bill C-7 has to do with life and death, which are ultimate realities. It is reasonable to expect that altering the way our institutions and culture approach the most consequential matters will have wide-ranging effects across all of society. It is hard, if not impossible, to imagine where we will end up if we follow this path.

In my remaining time, I want to highlight some of these problems.

Most notably, Bill C-7 removes the reasonably foreseeable natural death criterion, which is very concerning to me. I am concerned that removing it will normalize suicide over time. Without appealing the decision, the government is going beyond what the Quebec Superior Court ruled.

As one example, the government wants to allow for advance directives. As I have said before, there has been no thorough review of MAID as it currently operates. I am also not aware of any specific study about the risks and problems associated with a process for advance directives. That should happen well before we ever consider enacting it.

Advance requests raise difficult questions. For example, I have to wonder: Could someone consent in advance to be killed once they reach a state they fear but have never experienced, like living with advanced dementia? Further, once someone has signed an advance request and lost the capacity to consent to medical treatment, at what point exactly would their life be terminated? More alarming to me is this: If a non-capable person seems to resist a lethal injection, can the physician still proceed with the injection if the physician believes that the resistance is not due to any understanding on the patients' part that the injection will kill them? Bill C-7 states that apparent resistance means a doctor must not proceed but clarifies that involuntary responses to contact is not resistance. This raises another question. How does a doctor determine if the response to contact is involuntary?

Given that advance requests raise serious ethical issues, oversight challenges and safety risks, legalizing advance directives in the way that Bill C-7 would is irresponsible. This is the position we are left with when we are not trying to create effective accountability mechanisms and when we have insufficient data.

I am also troubled that Bill C-7 would remove the 10-day waiting period. Frankly, I find this disturbing. The 10-day waiting period in Bill C-14 already had a built-in exemption for those whose death or loss of capacity to consent was imminent, and as such, I cannot understand why the removal of this waiting period is necessary or prudent. On the contrary, I find it negligent.

It is well established that the desire to die is often transient. Suffering individuals have ups and downs throughout the day, throughout the week and throughout the year. No one should be able to make a death or life decision when at their most vulnerable point. The 10-day waiting period effectively allows a patient to reconsider their decision and take the time to speak with loved ones. This is critical.

Finally, I want to add that I believe the bill should add a provision that prohibits medical practitioners from discussing MAID unless the patient explicitly asks. We must not underestimate the power of pressure and suggestion, no matter how subtle, especially when it is combined with social stigma, as I mentioned before.

Journalist Ben Mattlin, who suffers from spinal muscular atrophy, wrote this in the New York Times:

I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless—to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”

Perhaps, as advocates contend, you can’t understand why anyone would push for assisted-suicide legislation until you’ve seen a loved one suffer. But you also can’t truly conceive of the many subtle forces—invariably well meaning, kindhearted, even gentle, yet as persuasive as a tsunami—that emerge when your physical autonomy is hopelessly compromised.

Despite Mattlin's significant physical disability, he is a father, husband, author and journalist. He has a successful life and knows what he wants. He is less vulnerable than others who might be more easily persuaded that MAID is their best option. In this way, voluntary MAID is the start of a slippery slope that leads to involuntary MAID.

[Chris Lewis, Conservative, Essex, ON]

Mr. Speaker, I rise today to speak to Bill C-7, which proposes to remove safeguards contained in the existing Criminal Code provisions for medical assistance in dying, as well as to expand eligibility. This is a grave matter and one that should not be treated lightly. Its impacts will be significant, especially for vulnerable Canadians. It is important that we get this right.

Before I get into the substantive issues contained in this bill, I would like to add my voice to those of the people who previously urged the Minister of Justice to appeal the Quebec Superior Court's ruling to the Supreme Court. One month after the Quebec Superior Court decision, 72 organizations that help Canadians with disabilities wrote to the minister, calling on him to appeal the decision. Less than a week later, 300 physicians signed a similar letter and since then, many others have voiced their concerns as well.

Referring it to the Supreme Court would have been the more prudent course of action, as it would have provided Parliament with a framework within which it could legislate. Alas, those many voices, as well as those of my Conservative colleagues in the House, went unheeded.

Further, when Parliament passed Bill C-14 in 2016, the legislation required a parliamentary review of its provisions to commence at the start of the fifth year following royal assent. That review, which was also to include a study of the state of palliative care in Canada, could have taken place this past summer but, instead, the government opted to shut down Parliament. That was time squandered.

There was much wisdom in including a mandatory review when Bill C-14 was adopted. Now, instead of giving this matter the thorough attention benefiting its gravity, parliamentarians are being asked to rush legislation through to meet the judicial deadline of December 18, unless, of course, a third extension is sought and granted. We call that putting the cart before the horse. It is therefore vital, in the short time we have to review these changes to the MAID clauses in the Criminal Code, that we hear from as many Canadians as possible from all walks of life, and especially those likely to be most impacted by any expansion of the current laws.

There are two changes to the existing law that are most troubling. The first is the repeal of the provision that requires that a person's natural death be reasonably foreseeable and its replacement with the words “grievous” and “irremediable”. The other is the elimination of the clause requiring a 10-day waiting period between when MAID is requested and when it can be administered. These changes need careful study. What will the unintended consequences be?

Moving forward, the priority of the Conservative Party is ensuring this type of legislation includes safeguards for the most vulnerable in our society, as well as for the conscience rights of physicians and all other health care professionals. One concern in that regard is ensuring adequate safeguards to protect those who may not have the ability to consent. Many of those involved in the care and advocacy for citizens with disabilities are sounding the alarm. We would be well advised to heed them.

I would like to quote from the letter from 72 advocacy groups written to the Minister of Justice just last fall. They were among those who urged the minister to appeal the Quebec Superior Court's decision in Truchon and Gladu. These are their words:

When the original medical assistance in dying legislation was debated in Parliament, there was a clear understanding that MAiD must have limits; that individual rights must be balanced with protections not only for our most vulnerable citizens, but for our society as well. One of the most important foundations of our Canadian identity is that we are a caring, compassionate country. We...place a high premium on being inclusive and tolerant while working hard toward the accommodation and integration of minority members of our communities. And yet, if the Quebec decision is allowed to stand [or as it stands now codified in the law], we will be in serious danger of losing this fundamental element of our Canadian identity. Our neighbours and our loved ones living with disabilities already continually experience the devaluation of their lives. They are frequently told—often bluntly—that they would be “better off dead.”

The letter makes the point that the unintended consequences would be to “...erode provincial health responsibilities for expert clinical care and social support of citizens who are fragile.”

It is crucial that adequate safeguards are included in Bill C-7, and that will be one of my highest priorities. Another concern worth repeating is removal of the end-of-life criterion. As the Council of Canadians with Disabilities stated in its October 2000 letter to the Minister of Justice, “Without the equalizing effect of the end-of-life criterion, which guarantees that the common thread between all persons who access an assisted death in Canada is that they are all dying,” with the proposed changes, “...persons with disabilities will be able to gain access ultimately because they have a disability.”

A worse stereotype could not be institutionalized in law: that disability-related suffering, largely caused by a lack of support and equality, justifies the termination of a person's life.

I now want to take some time to address the need for palliative care in Canada and the importance of such end-of-life care. As mentioned previously, a study of palliative care was to be included in a mandated parliamentary review. This should have happened before Parliament took action to expand the current Criminal Code provisions. Again, I would like to turn to the experts on this: the doctors and other health care professionals who provide end-of-life care and face these life-and-death decisions every day.

The Canadian Society of Palliative Care Physicians strongly advocates for the prioritization of adequate investment in, and enhancement of, palliative care services. Without access to high quality palliative care, some patients who are suffering may feel that MAID is their only option because their suffering has been inadequately addressed, or they perceive that their families or social supports must carry an excessive burden. Data regarding availability, access, quality and types of special palliative care, for example, are essential not only for those requesting or receiving MAID, but in general in order to better inform areas for improvement. Palliative care should remain distinct from MAID to ensure clarity, and to avoid risk of confusion and the potential for people to refuse palliative care services because they may confuse them with MAID.

During my consultations on Bill C-7, the doctors I have spoken with have stressed that palliative care is more than providing access to morphine, and that the public needs to be educated on this. As well, concern was expressed that elder abuse and financial motives, such as inheritance, could contribute to an abuse of MAID. Another concern is the temptation to save health care dollars with MAID. It is easy to conclude that MAID is more cost effective than continuing care. This raises ethical questions about its potential overuse, particularly as the previous safeguards are being lifted.

These are all serious concerns. I look forward to hearing what the doctors and health professionals on the front lines recommend as we move forward. I would also like to make a brief comment about the need for conscience protection for physicians. Doctors are concerned that they will be forced to administer MAID. I have been advised that the Ontario College of Physicians has created a policy that doctors have to arrange a referral. Some doctors have confided to me that they are considering leaving their profession over this. Suffice to say that physicians should have their freedom of conscience protected, and that this fundamental freedom needs to be codified in law as has been done in Australia.

In closing, I urge the House to take our responsibility to review this legislation seriously and to do as thorough a job as possible, keeping uppermost in mind those most affected by the decisions that we make. As those 300 physicians said in their letter to the Minister of Justice, “For all patients who seek an assisted death, we must ask first if they have had access to adequate and funded social and living supports, as well as exemplary health care and symptom management, in order to assure that they are not seeking an assisted death.” I think we can and must do better.

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

Mr. Speaker, I will start with the second question first. I agree that more money and resources should go to palliative care. People should be given a real choice. If the choice is between intolerable suffering or seeking medical assistance in dying, that is not a real choice.

As for conflating medical assistance in dying with suicide, the point that I was making was that Bill C-14 amended section 241 of the Criminal Code, which is the provision dealing with suicide.

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

Mr. Speaker, I am pleased to join the debate today on Bill C-7, an act to amend the Criminal Code. Specifically Bill C-7 would amend section 241 of the Criminal Code, the provision that makes it illegal for a person to help someone else commit suicide. This section of the code was amended by the last Parliament in response to a Supreme Court of Canada decision in 2015, the Carter decision.

Bill C-14, a 2016 bill, stated that one of its objectives was, “permitting access to medical assistance in dying for competent adults whose deaths are reasonably foreseeable strikes the most appropriate balance.” I would agree with that. The relevant operative provision in the act then sets out the criteria for determining whether a person qualifies for MAID, including that with respect to that person “their natural death has become reasonably foreseeable, taking into account all of their medical circumstances.” However, all of this is about to change if the government has its way with the current draft legislation, Bill C-7.

I am speaking to that bill because I have been encouraged by many of my constituents. Admittedly I have received some letters in support of the government's initiative to expand the reach of MAID, but the vast majority have encouraged me to speak in favour of leaving the law as it is or further restricting access to MAID.

The correspondence I have received in favour of keeping up the safeguards fall into two categories. First, the reasonably foreseeable death safeguard should stay in place. Second, more should be done to expand palliative care services. It was pointed out to me by many that many seniors and other people with serious diseases did not have good ready access to adequate palliative care.

I will quote Rebecca, one of the letter writers, “Let Canada be a society that is known for its modern and advanced palliative care services and not as a country that has ever-expanding use of MAID.” As a proud Canadian, I agree with that statement.

What is behind the current Bill C-7 is the 2019 Quebec Superior Court decision in Truchon. The plaintiffs in that case challenged the constitutionality of the then three-year-old law, arguing that their charter rights had been violated. The federal government, acting through the Attorney General's office at that time, did the right thing. It defended the law, which is what we would expect an Attorney General to do for Canada's laws.

The AG argued as follows, setting out the three main objectives of Bill C-14, which are still relevant today or at least they should be.

First, it is important to affirm the inherent and equal value of every person's life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled. Second, suicide is a significant health issue. Third, vulnerable people must be protected from being induced in moments of weakness to end their lives. I think we would all agree with that.

However, the Quebec court did not. It refused to accept the first two principles as representing the objectives of the law. It said, “the Court cannot accept the two first objectives advanced by the Attorney General regarding the affirmation of the inherent and equal value of every person’s life and the importance of preventing suicide.”

Having thrown aside those principles, it was easy for the court then to decide that the law needed to be changed. Remarkably, the current Attorney General did not appeal that decision. Instead the Liberals are now hastening to amend the legislation to eliminate the reasonable foreseeability of death safeguard.

With the reasonable foreseeability of death safeguard down, this is what we now have left. First, the applicant for MAID has a serious and incurable disease, illness or disability. Second, they are in an advanced state of decline. Third, their psychological or physical suffering is intolerable to them, which is completely a subjective test.

For example, people with Parkinson's, or MS or quadriplegic patients would check off all those boxes. If they had psychological suffering on top of that, they would be eligible for MAID.

Under this new regime, if it becomes law, people who are not dying but who meet all the other criteria will satisfy the requirements for state-sanctioned assisted dying.

I want to reiterate what Rebecca from my riding said. She said, “Let Canada be a society that is known for its modern and palliative care services and not as a country that has ever expanding use of MAID.”

I know the law will be amended. It must be to satisfy the Truchon decision. However, I will point out four things that I hope the committee will take into consideration in improving Bill C-7.

My first point is that the 10-day reflection period for the track one patients, those whose death is reasonably foreseeable, should come back. It should be there. That was not a requirement of Truchon and I do not believe that Bill C-7 is improved by taking that10-day reflection period out. For track two applicants for MAID, people whose death is not reasonably foreseeable, there is a 90-day reflection period, and I agree with that.

The second point I want to make is about the 90-day reflection period. I agree with it, but the wording is inadequate. I would recommend to the committee that it amend the 90-day reflection period clause to be the same as the 10-day reflection period clause, but with the necessary change in wording.

My third point is that Bill C-7 would reduce the number of witnesses required for a patient's written directive for MAID. There is absolutely no requirement for that at all and it is certainly not an improvement. Many of the legal documents, including last wills and testaments, require two witnesses as a safeguard against coercion and that should be maintained.

The fourth improvement is that the provision in Bill C-7 saying that a patient's request for MAID must be voluntary without coercion should be expanded to prohibit the attending physician or other health care professional from being the first to raise the availability of MAID option. MAID should never be presented as just another option because in some circumstances, that in itself, would be coercive.

When Bill C-7 was first introduced into the House back in January, COVID-19 had not hit us yet. Since then, many seniors have died of this virus and many others are in isolation. I have seen first-hand the devastating effect isolation has on the mental and physical well-being of seniors, my father-in-law included, as it would for any person. We are created to be social creatures after all.

As my constituent Sarah told me in a very thoughtfully drafted, “[Bill C-7] will put many elderly Canadians, isolated and lonely in their long-term care homes, at greater risk of being considered eligible for MAiD. That is not how we should be caring for our seniors!”

Let us use our experience with COVID-19 as a lens to have a very careful review of this draft legislation to reconfirm our commitment to value life and to build as many safeguards as we can around our most vulnerable citizens.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, I thank my colleague for his speech. I wonder if we are wasting our time today.

Yesterday, we were talking about conversion therapy, a file Quebec has been a leader on, but still has to wait for Ottawa. We are always trailing behind Ottawa because we are always waiting for Ottawa to get moving and get on board. Today we are talking about medical assistance in dying because a decision was made in Quebec, which is ahead of the curve there too. We have come back to Ottawa to work on this file again. If Quebec were independent we would not be wasting our time duplicating our work on these types of files.

I want to come back to my colleague's speech. Legislators did not do their job when it comes to former Bill C-14 on medical assistance in dying. That is why we are here today. We have to come back to this file because the Bloc Québécois's proposed amendments in 2016 to avoid bringing the courts into social and political issues were rejected. We are coming back to it today because a decision was made by the Quebec Superior Court.

I would like to hear what my colleague has to say about people who have a serious irreversible illness and are essentially forced to go to court. These people are already sick and have to fight the system to be able to access medical assistance in dying. Sometimes they even have to go on a hunger strike to be heard.

My colleague talked about dignity earlier. Does she see any dignity or humanity in putting people in this position?

[Larry Maguire, Conservative, Brandon—Souris, MB]

Mr. Speaker, I will be splitting my time with my colleague from Fundy Royal.

I want to start by saying that there is nothing more important in life than being true to oneself. People only live once and there are no mulligans or do-overs. During one's short time on this earth if one can find love and, in return, be loved back, there are no words to appropriately describe that partnership. Likewise, little is as important to the core of one's being than the ability to express who one truly is.

At this very moment, there are LGBTQ2 Canadians who are listening to us debate this legislation while they are struggling to be who they are. Some are afraid of what others will think or say. Some are concerned people will disown them or think less of them. Some think there is something wrong with them. Here is the thing: There is nothing wrong with them.

Just two weeks ago, it was National Coming Out Day. Every year, people across the country come out and say they are proud of who they are. When many people shared this with their closest family and friends, they did something brave, which was to tell the world who they were. It has not always been that way. During the 19th century, same-sex activity between consenting adults was considered a crime punishable by imprisonment. The mental health professionals of that era deemed homosexuality as a mental illness. If we fast-forward to modern times, it was not too long ago when people had to live in the shadows. Many were targeted. They were discriminated against because of who they dated or fell in love with. Some lost their jobs or were looked over for a promotion.

While we have made tremendous strides toward equality, there is more work to be done. As a Conservative, I have advocated for fundamental freedoms my entire life: freedom of speech, freedom of religion, freedom of conscience, freedom of assembly and association, and that every individual has the right to equal protection and equal benefit of the law without discrimination. Those are not just words. They are in our Charter of Rights.

I support the end goal of the legislation before us today because I am a Conservative. Back in 2016, I voted in favour of Bill C-16, which amended the Canadian Human Rights Act to add gender identity and gender expression to the list of prohibited grounds for discrimination. We know that transgender Canadians face elevated levels of sexual violence. They have been bullied and have had to face discrimination in applying for jobs and securing housing. Many within the transgender community have taken their own lives due to depression and feeling that there was no future.

I believe in the right of individuals to live their lives as they see fit. Liberty as defined by the Oxford Dictionary is:

The state of being free within society from oppressive restrictions imposed by authority on one's way of life, behavior, or political views.

The spirit of liberty must be renewed in all of us, for if we waver or deny our fellow citizens the same freedoms that we so cherish, we will have failed to protect them in their time of need. If we are free to decide where we work, go to school, practise our religion and whom we vote for, then it is within that spirit that people must be free to be who they are. We must protect them from those who wish they were someone else.

In almost every other example of trampling on one's fundamental freedoms, such as forcing someone against their will to change religions or their political allegiances, there would be an uproar and rightfully so.

At its very core, the end goal of this legislation is to defend freedom. As a Conservative, I believe that we as parliamentarians have a role to do just that.

During this debate, and inevitably at the justice committee, we will get into the finer details such as the definition of conversion therapy, as explained in the bill. For those who worry that this legislation would criminalize private conversations, spiritual guidance or infringe on religious liberties, the best approach to resolve those concerns is to specifically carve out what the legislation does not do. When there are concerns about the clarity or implications of a bill, the obvious remedy is to provide them those reassurances.

For example, back in 2016, when we were debating Bill C-14, the government's medical assistance in dying legislation, the phrase “does not” was used six times to provide clarity for what the legislation covered and what it did not cover. If we take that same approach to this legislation, we immediately resolve many questions while improving the bill. In fact, we do not have to look too far as the government's own press release contains some of the language that we could insert into the bill to alleviate concerns.

When the original legislation was tabled on March 9, the Liberals' press release stated that the legislation “would not criminalise private conversations in which personal views on sexual orientation, sexual feelings or gender identity are expressed such as where teachers, school counsellors, pastoral counsellors, faith leaders, doctors, mental health professionals, friends or family members”.

Inserting this clarification in the bill would go a long way to better clarify what would be fenced off from the five new proposed Criminal Code offences. It is my sincere hope that the Minister of Justice reaches out to his fellow MPs and incorporates their views and insights, particularly when he needs the support of opposition parties.

If the Liberal government is determined to ignore the following advice, it was due to its own political calculations, as I believe there is a path to garner even further support from all MPs regardless of their political persuasion. As the leader of the official opposition said, we will put forward amendments. We want the legislation to be crystal clear in its intentions and ensure that it meets its intended goal, which is to ban the practice of forcing individuals and minors to undergo conversion therapy.

Since my good friend from Durham became the leader of the official opposition, I have been impressed with his message and how he is building bridges to those who have not traditionally seen themselves as Conservatives, which includes those in the LGBTQ2 community. I know he is sincere in getting this legislation right. He wants to ensure that no Canadian is ever forced to undergo this dangerous and discredited practice that has already hurt so many.

According to a study released by the Community-Based Research Centre, as many as one in five sexual-minority men has experienced sexual orientation change efforts. The long-lasting harm done to survivors is real and far too many Canadians have taken their lives. Both the Canadian Psychiatric Association and the Canadian Psychological Association oppose any therapy that tries to change a person's sexual orientation. Expert after expert has proven that conversion therapy can lead to depression, anxiety, drug use, homelessness and suicide. No longer will people be forced against their will to change who they are.

When this legislation is referred to the justice committee, I know the members will hear the horror stories from Canadians who have been unjustifiably subjected to this harmful practice. They will hear how close people went to the very edge of committing self-harm.

Let me be clear: For the millions of Canadians who are part of Canada's LGBTQ2 community, being who they are is not a defect, it is not an illness and it is certainly not something that needs to be changed. The expression of their identity and uniqueness is welcomed and celebrated in Brandon—Souris, throughout Manitoba and across Canada. This bill is not merely symbolic. It is an important step forward in protecting and upholding Canadians' charter rights. This is about ensuring that all Canadians can live their lives as they see fit.

It is with that in mind that we must turn our efforts to making sure we get this right. I urge every MP to review the legislation and to put our collective heads together to ensure the definition of conversion therapy as defined in this legislation is succinct and will meet its intended goal for the benefit of all Canadians.

[Kerry-Lynne Findlay, Conservative, South Surrey—White Rock, BC]

Mr. Speaker, I appreciate the opportunity to rise and speak this evening on Bill C-7, an act to amend the Criminal Code with respect to medical assistance in dying, or MAID.

The meaning and consequence of this bill should weigh heavily on all Canadian parliamentarians. Today we are debating the competing interests of individual autonomy and the sanctity of human life. We are addressing the suffering of our loved ones, the dignity of the elderly and disabled and the moral, legal and ethical concerns that are inextricably tied to medically assisted death. We are setting out the rules, standards and boundaries by which Canadian doctors and nurses can, at a patient's request, terminate life. This cannot be taken lightly and it is not legislation that should be rushed, but that is the predicament that this Parliament finds itself in.

In 2016, the Liberal government passed Bill C-14, legalizing MAID. Last year, in the case of Truchon v. Attorney General of Canada, the Quebec Superior Court ruled that it was unconstitutional to restrict the availability of MAID to individuals whose natural death was reasonably foreseeable. Contrary to the requests of my Conservative colleagues and many advocacy groups, the Attorney General, who bears the responsibility of upholding laws passed in Parliament, chose not to appeal the ruling in Truchon. It is difficult for me to understand how something as essential to life as one's departure from it is not important enough for the Liberal government to appeal. This is something that should have had both comment and decision from the Supreme Court of Canada.

Because of the Liberal government's inaction, we are now working up against a December 18 Quebec-court-imposed deadline to enact a legislative response for the whole country. Its declaration of constitutional invalidity expires on that date. I want to assure my constituents in South Surrey—White Rock and all Canadians that, as a member of Parliament and a member of the Standing Committee on Justice and Human Rights, I will stand up for their shared values and beliefs and work tirelessly to ensure the amendments proposed in Bill C-7, and their consequences, are carefully studied and considered despite the impending December deadline.

Turning now to the substance of Bill C-7, I am concerned that the bill, as written, is too broad and lacks the safeguards necessary to protect Canada's most vulnerable populations. Let me be clear. The removal of the “reasonably foreseeable” standard will significantly increase the number of Canadians eligible for MAID. The breadth of qualifying conditions widens considerably under Bill C-7. For anyone who initially opposed MAID on slippery slope concerns, it appears we are now sliding down that proverbial hill. Will we eventually follow the Netherlands' lead, which recently ended up in its announced plans to offer MAID to children under 12?

As a group of physicians recently put in a letter to the Minister of Justice and Attorney General of Canada, urging an appeal of the Truchon decision, “Canada will have moved well beyond allowing an autonomous life-ending decision at the end of life into the realm of death on demand for almost any reason at any time.”

We know, from Health Canada's annual report published in July, that 2% of deaths in Canada in 2019 were medically assisted.

How much higher would that number be under Bill C-7, and how many Canadians would be eligible for MAID without the “reasonably foreseeable” requirement? Both questions must be answered.

If this is in fact the direction in which Parliament decides to take this legislation, we need more safeguards to protect the more vulnerable, not fewer. As written, Bill C-7 redefines who qualifies for the end-of-life procedure and strips away some of the protections put in place a mere four years ago.

One such amendment is the elimination of the mandatory 10-day reflection period. Under the original legislation, unless an exception applied, individuals wishing to receive MAID had to wait a period of 10 days after submitting their signed requests. In most instances, the waiting period makes sense. It ensures time for reflection before taking the irreversible action of ending one's life.

We know from Quebec's annual end-of-life care reports that since 2015, over 300 patients in Quebec alone changed their mind after requesting medical assistance in dying. In any event, exceptions already exist under the original law for those whose death is fast approaching and for people who will soon lose the capacity required to provide the necessary informed consent. Why then remove this 10-day reflection period?

Bill C-7 also takes aim at another safeguard included in the previous laws, reducing the number of independent witnesses needed to sign and date the candidate's application for MAID, from two to one.

This amendment would now apply to the newly eligible class of persons who are not faced with reasonably foreseeable or imminent death. Contrary to statements made in the House by the member for Winnipeg North, this is a real concern for many.

As a civil litigation lawyer, I have had my fair share of exposure to all sorts of legal documents requiring the signatures of independent witnesses to ensure both authenticity and true intent: wills, divorces, financial disclosures, affidavits and mortgages, to name a few. To express one's intentions in a will in B.C., a person must have two independent witnesses not named in the will to witness the authenticity of their signature and their intention at the time of signing. If these requirements are there to safeguard intentions regarding possessions, should they not also be there to safeguard a person's intentions regarding the method and timing of their death?

It should be noted that Bill C-7 does include a 90-day assessment period and directive that applicants be informed of available alternative treatments, but will these safeguards sufficiently protect our most vulnerable populations? When does the 90-day period begin? Is it recorded?

Another piece of the bill that I have difficulty with is that it allows patients who may lose capacity before the end-of-life procedure is performed to give their final consent in advance. This troubles me for the same reasons discussed before with respect to the 10-day waiting period. As we have seen, people do change their minds.

In recent weeks, we have heard from many representative groups that have expressed concern about the decision in Truchon. The Council of Canadians with Disabilities, the Canadian Mental Health Association, the ARCH Disability Law Centre and others have articulated the concern that making individuals with disabilities who are not facing imminent death eligible for MAID would be harmful to the disabled community at large, affirming the untrue stereotype that a life with disabilities is not worth living.

We must pause to reflect on that. Those who are passionate advocates for Canadians with disabilities are very concerned about the direction these court and policy decisions are taking us, yet the Liberal government moves forward.

There still exists the legal concept of undue influence. Who are most susceptible to undue influence and coercion? It is the vulnerable. We have also heard from hundreds of physicians who share a concern that some patients have chosen the path of MAID due to the suffering caused by a lack of proper supports. A tragic example is from B.C., where a father suffering from Lou Gehrig's disease chose to undergo the end-of-life procedure because he did not receive the support and resources he so desperately needed.

The government is not listening to the heartbreaking stories of these ALS sufferers and their cries for the fast-tracking of life-lengthening and life-sustaining hopeful therapies that we cannot get in Canada. Is the government giving those sufferers and Canadians true options? We need compassion, yes, but compassion takes many forms.

Hospices are not readily available to all Canadians as an alternative. A good friend of mine died a couple of years ago of inoperable brain cancer. He was a doctor. In his case, he very carefully weighed MAID as opposed to living in hospice. He chose hospice because it extended his life for five months, which he could spend with his family. They were okay with his deterioration because they loved him, and they wanted to support him and be with him. However, he had that true option.

If we are going to expand the legislation, the government should equally ensure robust support for the vulnerable, hospice care and hopeful therapies are available. Everyone matters.

Finally, I would like to reflect on the health care professionals who are asked to implement this proposed law. We are now celebrating our doctors and nurses for their tireless efforts to keep our country healthy and safe. We should also ensure that they have the ability to decide whether this is compatible with their will or beliefs, and not be mistreated for any refusal to administer it.

To conclude, I have heard from constituents in my riding who are on both sides of this argument. I ask my colleagues to really take the necessary time to study the bill and reflect on these proposed amendments, especially as they affect the most vulnerable. We must be compassionate but we must also respect human life.