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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Ed Fast, Conservative, Abbotsford, BC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Ed Fast, Conservative, Abbotsford, BC]

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

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

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

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

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

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

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

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

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

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

The letter begins like this:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Don Davies, NDP, Vancouver Kingsway, BC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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