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

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

Mr. Speaker, I appreciate the opportunity, and I will be splitting my time.

I want to discuss specific aspects of the legislation today. On Monday, I will have an opportunity to talk about some underlying philosophical questions.

I want to be clear that I do not believe in an all-or-nothing approach. Many of my colleagues and I who have broad philosophical concerns about what is happening here are still willing to vote in favour of legislation that does not recriminalize euthanasia, if it advances positively in the direction of saving some lives, especially minimizing the risk to vulnerable persons. However, this legislation does not contain meaningful safeguards. Without amendment, it will protect no one.

We know that this law has written exceptions. However, it has exceptions to the exceptions; and may I say it has exceptions to the exceptions that are not at all exceptional?

This legislation has a requirement for the provision of written consent. However, if people cannot provide written consent, someone else can do it on their behalf.

This legislation prescribes a waiting period. However, the waiting period does not apply in the event of possible imminent death or loss of capacity.

There is so much ambiguity here.

The government has said that mental illness is excluded. However, in section 241.2(2) the legislation clearly states that physical or psychological suffering qualifies a person to seek premature death.

The legislation says that death must be “reasonably foreseeable”. May I say that death is reasonably foreseeable for all of us? It is those who think that death is not reasonably foreseeable who probably need the medical attention. Why not put in the word “terminal”? When I was learning to drive, my mother thought that death was “reasonably foreseeable” every time we got into the car. That is no criterion.

There is a requirement that two physicians sign off. However, given the huge ambiguities, obviously doctors are likely to have a wide range of interpretations of the rules. The estimates are that there are 77,000 physicians in this country, and the likely practice of doctor-shopping will ensure that people who think they meet the wooly and ambiguous criteria can somewhere find two physicians.

The member for Victoria said earlier today that this is something doctors do every day. No, it is not. Doctors do not take lives every day. This is fundamentally different from the normal practice of medicine. When we have so many different doctors and opinions to choose from, these are not effective safeguards.

Given these five comically ridiculous exceptions to the exceptions, there is no doubt that detailed provincial legislation or regulation will be required in every case. Therefore, it is not at all clear to me what this law is supposed to accomplish.

Further, there are two key areas where the prevailing rules under this law would leave us demonstrably worse off than the Carter ruling alone.

First, there is a terrifying clause in this bill, which states that if someone kills someone else but can demonstrate, at least beyond a reasonable doubt, that he or she had a reasonable but mistaken belief that the criteria applied then that person cannot be penalized. We can find that at 241(6). Therefore, we can kill someone who did not consent and escape prosecution on the basis of reasonable but mistaken belief. Whatever is done, I implore the government to take this very dangerous section out. This is going even beyond the Belgian model.

Second, this legislation provides no protection for conscience rights, despite the court's clear statement that nothing in this decision required particular health care practitioners to be involved, and despite the clear assurance of the Canadian Medical Association that access does not require taking away section 2 conscience rights.

This legislation constitutes a perfect storm. Ambiguous criteria, no advance legal review, no conscience protection, and allowances for doctor-shopping are not meaningful safeguards at all. The bill leaves patients, seniors, the sick, and the disabled vulnerable to error and systemic abuse. We have seen this in Belgium before. I have quoted the studies during questions and comments. We do not want to go down this road in Canada at all.

The government must introduce simple amendments to this legislation, which define the criteria more clearly, which address the problems I have mentioned, and which introduce an effective system of advance legal review.

As I have mentioned, a person seeking hastened death should require the sign-off of competent legal authority. One such model could involve the use of consent and capacity boards or some kind of judicial review. It need not be onerous.

This process need not be complicated. It would ensure that people are not accidentally killed and that their killer is able to hide behind the ambiguous criteria of reasonable but mistaken belief.

We cannot save every life today. However, it is better to light a candle than to curse the darkness. From my perspective, too many have spent too long just cursing the darkness. Let us amend this bill and fix it so that we can get the work we need done.

[The Assistant Deputy Speaker, Liberal, Anthony Rota]

Order, please. The hon. member will have five minutes and a few seconds remaining when this debate is resumed in the House.

It being 1:30 p.m., the House will now proceed to the consideration of private members' business as listed on today's order paper.

The House resumed from April 22, consideration of the motion that Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be read the second time and referred to a committee.

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

Mr. Speaker, this legislation contains no meaningful safeguards. Even its exceptions are full of holes. The written consent provision excludes those who cannot sign. The waiting period can be routinely waived. Mental illness is not excluded. The requirement that death be reasonably foreseeable would exclude no one, and the requirement that two doctors sign off merely encourages doctor shopping. Even if the already ambiguous criteria are not followed, someone who kills an unwilling patient can be let off the hook if he or she claims a reasonable but mistaken belief that the criteria applied.

Clearly, we have a perfect storm of ambiguous criteria and a reasonable but mistaken belief clause which means that it would be nearly impossible to prosecute anyone who kills a patient, even without consent.

Today I want to make three additional points: the decline of moral language, the need for advance review, and the way in which an absence of conscience protection is further undermining an already inadequate system of palliative care.

This debate has been characterized by a decline of language. Terms like “suicide”, “euthanasia”, and “killing” are rejected and replaced by fundamentally inaccurate phrases like “medical assistance in dying”. Every day physicians assist their patients in the context of dying without killing them.

The decline of language is also evident in the euphemistic use of terms like “dignity” and “compassion”. The phrase “dying with dignity” implies that suffering or disabled people do not have dignity, and this reflects a very dangerous world view. For a long time we have understood that dignity is immutable; it is an intrinsic characteristic of all human beings. Our immutable dignity is the reason we put down suffering dogs, but we do not put down suffering humans.

This human exceptionalism, this idea of universal and immutable human dignity is the basis of our conception of human rights. Human rights, the ostensible basis on which this legislation is advanced, stand on a moral foundation of universal immutable human dignity, and those who wish to redefine dignity so dramatically should at least provide us with their alternative definition.

I have encouraged the government to amend this legislation to include a system of advance review by competent legal authority. This could take many forms. It could involve review by a provincial consent and capacity board. It could involve a requirement for review by a judge. It could involve the simple requirement in this legislation that the provinces set up their own systems of advance legal review or that an independent lawyer certified and retained for this purpose replace the role of one of the witnesses.

There are multiple options here, some better than others. The criteria are not worth the paper they are written on if someone with competent legal authority is not making a determination in advance to ensure the legal criteria are met.

The government, though, wants to force doctors into this role. However, doctors do not constitute competent legal authority. Doctors do not make these types of decisions in other parts of their work, given how aberrant the taking of life is from the normal medical process of protecting life, and the proposed legislation's allowance for doctor shopping does not actually mean that the doctor providing the prior care would provide advance review, since the patient, or worse, someone else, could simply go on the Internet to find a doctor with a more liberal interpretation of the criteria.

A simple system of advance legal review by competent authority would eliminate doctor shopping and achieve the central objective: it would ensure that people who have not consented or do not meet the criteria are not killed, without any effective means to investigate that after the fact. Data from Benelux countries show alarmingly high rates of euthanasia for patients who have not consented; however, prosecution of those who take life without consent in a medical environment is almost non-existent.

Finally, a lack of conscience protection pushes people out of the provision of palliative care when already far too few Canadians have access to it. Dr. Nancy Naylor, a family and palliative care physician with 40 years of experience, is now leaving the profession. She said, "I have no wish to stop. but I will not be told that I must go against my moral conscience." She is speaking out because her patients who will be left without access to palliative care cannot. What good does it do anyone to leave conscience protection out of this legislation, and chase good principled palliative care physicians out of the profession at a time when we need them most?

Many doctors say that this is not medical care at all, and we should let them focus on what they do best.

The Supreme Court decision punched a hole in the previous law, and this legislature cannot change that, but the government appears to be taking advantage of these events to widen the hole still further. No law would be a bad situation, but this law could make a bad situation worse. It would leave vulnerable seniors and sick and disabled persons at risk with no meaningful restrictions.

We should stop the madness and fix the bill.

[Rob Oliphant, Liberal, Don Valley West, ON]

Mr. Speaker, I have a very simple and direct question for the member for Sherwood Park—Fort Saskatchewan.

Does the member support the unanimous decision of the Supreme Court judges in honouring the request of Ms. Taylor and Ms. Carter to have assistance in dying?

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

Mr. Speaker, I was actually very clear about that point in my speech.

Regardless of the private opinions of members with respect to this issue more generally, we know that the government is not addressing at all the task that the court put in front of it. The task that the court gave the government was to develop a system that would make this happen while also protecting the vulnerable. The government replaced some criteria in the court decision with equally, if not more, ambiguous criteria in its response. We are not seeing any development in this regard from the government at all.

I do have to underline, and again we see it in the question that the member asked, the euphemistic language here. Doctors provide medical assistance in dying every day that does not involve killing their patients. If members defend it, good for them, but they should have the honesty to describe the issue properly, because calling something “medical assistance in dying” is clearly misleading. It distracts from the central question we are supposed to be debating.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Mr. Speaker, I listened with great interest to my hon. colleague.

The reason Parliament has been put in this position by the Supreme Court is the complete lack of action by the Conservatives in dealing with this issue over a period of 10 years. The Conservatives cut the palliative care initiatives that were in place, took no movement on the issue of palliative care, and refused to deal with the fact that they knew the Supreme Court decision was coming.

The Supreme Court has now stepped into that vacuum and has put this Parliament and, I feel, all Canadians in a very difficult position, because if we do not have a law by June, we will have another legal vacuum in which this door could actually be blown open much wider.

The question is, is the role of this Parliament to do something positive, where we can assure that those who are sick and dying are able to access quality palliative care? We had pushed a motion through the House of Commons last session, and there was no money. The Conservatives and the former prime minister took no steps to put that into action.

We now have Motion No. 46 which talks about the need to establish palliative norms, working with the provinces, working to change the EI provisions so that families can get the support they need to take the pressure off them.

Is my colleague willing to accept a legal vacuum in June if this House does not move? Is he willing to work in a proactive manner with our party in establishing palliative care access so that we can actually present Canadians with more of a balance than simply the law on euthanasia?

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

Mr. Speaker, I thank the member for his work on this. I want to address a few of the points the member made.

It is a strange definition of lack of action to say that the repeated express will of the House on the issue of euthanasia somehow constitutes a lack of action. Of course we had proposals that came forward before the court decision, and those were rejected by an overwhelming majority of this House, which included the majority of Liberal and, I believe, New Democrat members at the time, as well.

With respect to the issue of a legal vacuum, I would like to see better legislation come forward which clarifies the situation. I would support this bill if it were amended in a number of key ways. However, the existing legislation does not in any way address the task that the court asked us to do, which is to actually describe and define what the situation would look like in terms of euthanasia and assisted suicide in Canada.

The government has replaced some ambiguity in the court decision with greater ambiguity in the legislation. Legislation is only worth proposing if it improves on the absence of legislation.

In terms of investment in palliative care, I agree with the hon. member that there is more work to do. I would not accept his characterization of the previous government as doing nothing on that issue, but I would certainly agree that more investment is needed.

The problem with this legislation is it moves in the opposite direction. Allowing euthanasia and assisted suicide without conscience protection has the effect of pulling doctors who would otherwise want to be involved in palliative care out of palliative care if they do not want to participate in euthanasia. At the very least, conscience protection should be added. That would preserve the existing system of palliative care that we have, and then we could build on that by working to do more.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I have had the honour of serving the people of Kitchener—Conestoga and being part of many important discussions and debates here in this chamber over the past 10 years. As members of Parliament, we are given the solemn obligation to chart the way forward for our great nation of Canada. The motions we table, the amendments we consider, the legislation we adopt will always impact, positively or negatively, the very people who elected us to represent them in the capital city of our nation, and they will also impact generations of Canadians to follow.

The impact of our deliberations and decisions we make on this critical life and death issue will impact the very fabric of our country. If I may say, it will leave a lasting legacy for good or for ill of our understanding of what it means to part of the human family.

Because of the very serious nature of the topic in front of us today, we, and by that I mean every member of this chamber, must take a step back and consider some very foundational questions. Each of us needs to ask ourselves these difficult questions. How we as members perceive these foundational issues is absolutely key to addressing this sobering topic before us today.

Consider with me for the next few moments these questions. What does it mean to be human? What gives human life meaning and value? Does every human life possess intrinsic value and dignity, regardless of perceived deformity, regardless of perceived disability, regardless of the perception of being a burden, regardless of whether or not a person may have achieved their best before date?

For me, the answer to all of these question is a resounding “yes”. Every human life is worthy of our utmost respect and protection. Every human life matters. Therefore, needless to say, I do not support physician-assisted suicide, or voluntary euthanasia or any legislation that would further devalue human life.

My world view is influenced by my life experiences, and most profoundly it has been shaped by my faith. I believe every human life has intrinsic value and dignity that needs to be held in high honour and esteemed, in other words, to be considered worthy.

There is a saying in the Talmud, “Whoever destroys a soul, it is considered as if he destroyed an entire world. And whoever saves a life, it is considered as if he saved an entire world.”

On the Peace Tower of our Parliament buildings carved in stone above the west window, members will find these words taken from ancient Hebrew writings in the book of Proverbs, “Where there is no vision, the people perish.”

What is our vision for Canada? I ask each of my colleagues today what their vision is for Canada.

My vision for Canada is one where every human life is valued and cherished from the moment of conception to the moment of natural death. It is my firm belief that life is a gift from God and that this gift is far too precious to be discarded or destroyed. Every human life is filled with infinite value and, yes, every person, regardless of disability, deformity, depression, or devaluation based on criteria of so-called “usefulness” has something to teach us about what it means to be human.

For those who are suffering, we have the privilege to come alongside and care deeply. We provide proper pain relief, palliative care, human touch and love, in other words, we provide compassion.

The very meaning of the word compassion is “to suffer with”. It is to come alongside and enter into the suffering, to come alongside with feeling and care. Compassion is supporting them. It is to ignore the fact that compassion has everything to do with relationships if we are to allow physician-assisted suicide. We simply cannot have compassion if the relationship has been intentionally terminated.

That being said, the Supreme Court of Canada has established grounds for an exemption from prosecution for physicians who would assist in administering the suicide dose or carry out the act of euthanasia. The Supreme Court of Canada has done this, completely rejecting the fact that the elected members of the House of Commons have rejected initiatives to legalize physician-assisted suicide on at least 15 occasions since 1991. Most recently, a bill to allow physician-assisted suicide was rejected in 2010 by a vote of 59 to 226. My contention is that it is not the job of the Supreme Court to create laws but rather to interpret them.

I was one of the members of Parliament who served on the joint committee appointed to study physician-assisted dying. Our committee heard from many witnesses representing many different viewpoints. We heard from medical professionals, palliative care experts, mental health professionals, the disability community, the aboriginal community, various faith communities, legal and constitutional experts, and ethicists. As members might expect, from such a large variety of people, there was a very diverse response.

The unfortunate reality is that the timeline given to our committee for the completion of our report and recommendations did not allow for the large number of groups who wanted to appear before this committee. Groups like the Euthanasia Prevention Coalition, L'Arche Canada, Living with Dignity, as well as Dr. Balfour Mount, who is considered to be the father of palliative care in Canada and in fact in North America, were not allowed to appear at all.

The joint committee report had no teeth when it came to insisting that before physician-assisted suicide could be offered or even considered in Canada, there should at the very least be a credible offer of accessible and affordable palliative care to those who faced such a final solution of hastened death. Like the committee report, Bill C-14 fails miserably in stepping up with real change on this crucial issue.

Dr. Harvey Chochinov, chair of the external panel, professor of psychiatry at the University of Manitoba, and Canada research chair for palliative care, suggests that all patients requesting medical aid in dying would need to have a palliative care consultation to ensure that patients would be fully informed of all palliative care options that could be initiated in order to mitigate the suffering of patients. To ignore the very real lack of choice without a concurrent real offer of palliative care is to offer no choice, only hastened death.

I am thankful that Bill C-14 has incorporated many of the viewpoints of the dissenting report. However, it still includes very vague and subjective language and does not address many key issues raised by witnesses who appeared before the joint committee.

A major concern in this entire discussion has been the overt attempts to soften the language. Rather than call it physician-assisted suicide or voluntary euthanasia, it was then referred to as physician-assisted dying. Even physicians objected vigorously to the term “physician-assisted dying”, especially palliative care physicians. For many decades these doctors have been assisting patients through the natural dying process.

It has been said that all social engineering is preceded by verbal engineering. We will find no better example of that verbal engineering than in the matter before us today. This topic is far too important to allow this vague and euphemistic language to go unchallenged. As Dr. Chochinov notes, Bill C-14 makes no distinction between physician-assisted suicide and euthanasia, yet both are included in what the bill calls “medical assistance in dying”. It is extremely important to outline the difference, because international experience reveals that they are vastly different in terms of their uptake and lethality. In jurisdictions that offer only physician-assisted suicide, such as Oregon, these deaths account for about 0.3% of all deaths. In jurisdictions that offer euthanasia, hastened death accounts for approximately 3.0%, a tenfold increase.

If we were to extrapolate these figures to Canada where there are approximately 260,000 deaths per year, under a physician-assisted suicide regime, there would be approximately 780 deaths per year. However, if we were to extrapolate that to allow for euthanasia, the number of deaths would increase to 7,800 per year, which as I pointed out is a tenfold increase. The reason for the lower numbers under a physician-assisted suicide regime is ambivalence. It is crucial that at the very least the government needs to point out that if we are to proceed with this, we have to ask that those who request physician-assisted death must follow through on physician-assisted death rather than voluntary euthanasia because the numbers are so different.

Another key missing component is the matter of conscience protection for doctors and health care workers. If it is possible to ensure a “consistent approach to medical assistance in dying”, as the preamble asserts, there is no reason why at the same time a consistent approach to guarantee conscience rights cannot be included in Bill C-14.

Finally, Bill C-14 should include a system of judicial oversight in order to protect vulnerable persons. While two independent witnesses and two independent doctors sounds good on paper, the risks of overt or subtle coercion are too great and the possibility of abuse too real. These assertions need to be verified under a framework of legal oversight.

In summary, we should be offering hope to all Canadians. As legislators, we should be doing everything in our power to ensure that not one single person dies needlessly. It is with this in mind that I repeat the need for at least three major amendments to Bill C-14: first, vulnerable Canadians need better protection with a system of judicial oversight; second, doctors, health care personnel and institutions need clear conscience protection; and, finally, Canadians who are suffering need a real option of palliative care not hastened death.

[Anthony Housefather, Liberal, Mount Royal, QC]

Mr. Speaker, it is clear that the hon. member is very passionate about life, and that certainly comes through in what he has said.

I want to ask the member about his comments with respect to the Supreme Court. He seems to believe that the Supreme Court needs to defer to the will of Parliament. However, that is not the Charter of Rights oriented system we now have in Canada. We adopted the Charter of Rights because we believed it would guarantee the protection of individual liberties, regardless of what the majority necessarily believed. In this case, whether the member, other members or I like it or not, the Supreme Court came to a decision in Carter that said medically-assisted dying was open to a certain segment of the Canadian population.

Based on what the hon. member has said, it sounds as if he is suggesting the only real path is using the notwithstanding clause to override the court's decision. Is the hon. member asking us to do that?

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I know my colleague is also passionate about life.

It is clear that there was a very short timeline for the committee to hear witnesses, take all of that input and come up with a report to give to the government, and then the government to craft legislation. Now we are under a very strict timeline, even in terms of debate in the House. The justice committee itself will be under an extremely short timeline. It is clear to me that we do not have adequate time to give this serious topic the serious consideration it really needs.

Whether the government wants to invoke the notwithstanding clause or not, I will not suggest that. It certainly would be one option. What I do know is that by rushing ahead the way we are at this point, we will not have the kind of law Canadians deserve.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Mr. Speaker, I have great respect for the work my colleague has done on issues of palliative care over the years with the parliamentary committee.

We agree on many things and disagree on some things, as wont in the House. I share his frustration with the Supreme Court's decision on the timelines. I respect the Supreme Court's right and power to establish rules and laws where it believes Parliament has left a vacuum. However, the new government should have been given the opportunity, as a form of good will, to engage the population of our country in this very important discussion as it affects every person and cuts across party lines. It would have been fair to give the new government the ability to hear from Canadians. I agree with the member. We are now under a very strict timeline of which Canadians are watching but are not a part.

Given these are the limits that have been placed on us by the Supreme Court, my concern is the legal vacuum that happens if we as the House do not respond to this, and the dangers that legal vacuum will create with other individuals and organizations stepping forward knowing they can go to the Supreme Court if Parliament has not acted.

Therefore, has my colleague considered the danger of that legal vacuum if we do not have a law in place by the end of June?

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I want to thank my colleague for the work he has done on palliative care. I was honoured to support the motion he presented to the House last year. It was an honour to work across Parliament, across partisan lines, to facilitate the report “Not to be Forgotten”, which includes many recommendations. I am proud to say that a number of those recommendations have been completely or partially implemented, but we have a long way to go.

I am concerned as well about the potential legal vacuum that could exist if we do nothing. However, I have pointed out in my comments that there are at least three key amendments that the legislation needs if it is in any way going to resemble what I think are adequate safeguards for vulnerable people. Those include that vulnerable Canadians need better protection with a system of judicial oversight. It is fine to say that there are two medical doctors, two independent witnesses, and yet no way of actually asserting that those are in fact independent.

Another one is health care protection for conscience of health care workers. It would be totally inappropriate for an institution that was set up to improve end-of-life care and to walk with patients through that end-of-life natural process to demand that they go diametrically opposite to the principles under which they were founded and now have to participate in physician hastened death.

[Rob Oliphant, Liberal, Don Valley West, ON]

Mr. Speaker, I will be sharing my time with the member for Oakville North—Burlington.

I want to begin by taking a moment to pay tribute to two Canadian women whom I did not know but have come to know in their deaths, and who I think are two of the most courageous women. They are Gloria Taylor and Kay Carter. These two women were on a journey of life that was not of their choosing, and they came to the point in their lives where they wanted some assistance in the final days of their lives in the final part of their journey.

As a United Church minister, I walked that journey with many people, hundreds of people in fact, and have done even more funerals where I did not know the people and only came to know them through the stories of their families and the legacy they left behind. Kay Carter and Gloria Taylor are two such women whose courage, tenacity, hopefulness, and love of life have instructed us to this very day, where we are now considering a bill on medical assistance in dying.

In paying tribute to them, I also want to give them thanks for engaging us in what is one of the best civics lessons that we could ever have as a chamber. Each of the branches of our government has a chance to speak to this. There is a legislative branch and a judicial branch, as well as the executive branch.

We actually began this conversation in 1982 where we invoked the charter that is now so much part of our Canadian culture of rights and freedoms. That charter has instructed all Canadians, Canada's courts, and Canada's legislators since the day it was passed. The reality is that when Kay Carter and Gloria Taylor made their appeal to the Supreme Court of British Columbia, and it went to the Court of Appeal in B.C. and then to the Supreme Court of Canada, we had the opportunity to have our judicial branch take a look at their rights and the possibility of their having assistance in their deaths. The courts ruled on that and gave one year for the parliamentary branch and the executive branch to come up with a law.

The parliamentary branch then spoke by having a joint committee with the House and the Senate. I need to say to this chamber that it was probably the richest experience I have had as a member of Parliament. Men and women—senators and members of this House—engaging in a discussion, listening to the stories of life and of death and of healing and of hope, changed me profoundly. It gave me the opportunity to recognize that the parliamentary system that we have gives Canadians a great opportunity to hear their voices being heard at committee and now in this House.

The executive branch then picked up from the report and has presented Bill C-14. I want to thank the minister for her work on this, and the work of her office and of justice, for taking the report that we did seriously, engaging in it further, and coming up with a piece of legislation that at this time I am very clear I will be supporting at second reading.

That does not mean that I think we are finished with this piece of legislation, because it is now back to the parliamentary system where we are to engage in the dialogue with the executive branch about making a law that could be good enough better. When we are dealing with issues of life and death, I do not think “good enough” is good enough. We can honour the quest that Gloria Taylor and Kay Carter engaged in and that the Supreme Court of Canada ruled on and that the executive branch has presented a law on, and as parliamentarians take seriously the Charter of Rights and Freedoms, take it to our hearts and look at what it is that we as members of Parliament are sworn to. It is more than allegiance to Her Majesty. It is about upholding the Constitution of this country and engaging in it with love, with commitment, with passion, and with hope, and looking at how the decision that the Supreme Court made can actually live out in the life of Canada.

We have a piece of legislation that is before us today, and it was decided that section 7 of the charter could not be used to deny the rights of two women looking for assistance in their deaths. The government of the day tried to fight that section 7 declaration of rights by invoking section 1 of the charter, saying that there were reasonable grounds to withhold those rights. However, the Supreme Court of Canada did not allow that. It said it would be unreasonable to deny those rights to be given to those women. The court made a very specific decision on a very specific case at a specific time.

The Supreme Court also said in paragraph 127 of the decision that it did not pronounce on things that were not before it in that case. That was a requirement for Parliament and also the bill, which, yes, does engage all Canadians in a discussion about what it is that we can have as a continuum of care that continues to the place where we help people on that final journey.

We come at it differently. I have full respect for the hon. member for Kitchener—Conestoga. He has engaged this subject well and I have taken into account the fact that he has passion. We have come at it differently, but I have no doubt that everyone on both sides of the House is concerned about the well-being of Canadians. However, I think the bill needs to go even further to be faithful to our Constitution.

I have concerns in that I think there could be further challenges to the bill in the courts, which I do not think Canadians should have to endure. I have a couple of very specific concerns that I would like to raise in the House and one is the use of the word “incurable”.

The court was very clear that it did not want to use the word “incurable”. Instead, it used the word “irremediable”. By invoking the word “incurable”, one begins to look at the disease instead of the person. What I mean by that is that sometimes a disease may be incurable or curable, but the person has the right, the Supreme Court said, not to undertake treatments that are not acceptable to that person. The treatments may be cruel or punishing and the reality is that the court said they do not need to undertake them. The disease may be curable, but that person has chosen a different path and that, under section 7, is their right. I have that concern about invoking that word.

The other concern I have is the introduction of the concept of foreseeable death or death in the foreseeable future. All of us live a precarious life. Life is fragile, life is precious, and life is dear, but for some life has become intolerable. Some diseases are not necessarily mortal in the sense that people are automatically going to their final days with that disease, but people still have pain that is intolerable. The Supreme Court decision in Carter says they have the right to medical assistance in dying.

The introduction of that concept of death in the foreseeable future has muddied the waters. Physicians are asking what it means. Does it mean “terminal”? Some hospitals have a different definition of “terminal” than other hospitals and other physicians have. We have to be very careful on that.

The third point I would make is about one of the safeguards. This is robust legislation. There are safeguards in place that I do not believe are of great concern. One safeguard worries me, and that is the final one in the third section on safeguards, proposed paragraph 241.2(3)(h), which says that immediately before the administration of those substances that will cause death, the person needs to, once again, declare competently that they want death to happen.

I have been in too many hospital rooms. I have sat with too many dying people. Most of the people who will access this kind of continuum of care are dying and will probably be receiving morphine. To take them off the morphine to ensure they have the capacity to give consent is cruel. The reality is that in a 15-day period, that person should be allowed to make a gracious exit and be given the compassion not to be once again required to become competent, because the morphine is helping them with their intolerable suffering. That they are suffering intolerably has already been declared.

With those exceptions, I am supportive of the bill. The justice committee has its work to do. I am looking forward to thorough deliberations. I have utter confidence in every member of that committee. I am looking forward to the bill returning to the House and going to the other place. I know that Canadians will have a law that helps them and makes Canada a richer and stronger country.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I want to thank my colleague for his work as co-chair of the committee and for the good working relationship that our committee had.

There is one concern I have, and this happened frequently during our committee hearings as well, I believe unintentionally, or perhaps intentionally. There is a conflation of two issues. One is physician-assisted dying or physician-assisted suicide, and the other is simply discontinuing medical treatment.

Patients have always had the right to refuse what my colleague refers to as punishing medical treatment that may prolong their lives. I wonder if my colleague would clarify that this was not his intent, and that, in fact, patients have always had the right to refuse medical treatment that would extend their lives unnecessarily or, as people say, “It's okay to pull the plug”.

These are issues that we have dealt with for many years. That is not the issue that we are talking about today. I am concerned that this kind of language is creating some confusion on the part of people who may think we simply want to extend life at all costs with whatever medications are necessary, or with medical procedures that may go beyond what the patient requests.