An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)

This bill is from the 42nd Parliament, 1st session, which ended in September 2019.

Sponsor

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.

This enactment amends the Criminal Code to, among other things,
(a) create exemptions from the offences of culpable homicide, of aiding suicide and of administering a noxious thing, in order to permit medical practitioners and nurse practitioners to provide medical assistance in dying and to permit pharmacists and other persons to assist in the process;
(b) specify the eligibility criteria and the safeguards that must be respected before medical assistance in dying may be provided to a person;
(c) require that medical practitioners and nurse practitioners who receive requests for, and pharmacists who dispense substances in connection with the provision of, medical assist­ance in dying provide information for the purpose of permitting the monitoring of medical assistance in dying, and authorize the Minister of Health to make regulations respecting that information; and
(d) create new offences for failing to comply with the safeguards, for forging or destroying documents related to medical assistance in dying, for failing to provide the required information and for contravening the regulations.
This enactment also makes related amendments to other Acts to ensure that recourse to medical assistance in dying does not result in the loss of a pension under the Pension Act or benefits under the Canadian Forces Members and Veterans Re-establishment and Compensation Act. It amends the Corrections and Conditional Release Act to ensure that no investigation need be conducted under section 19 of that Act in the case of an inmate who receives medical assistance in dying.
This enactment provides for one or more independent reviews relating to requests by mature minors for medical assistance in dying, to advance requests and to requests where mental illness is the sole underlying medical condition.
Lastly, this enactment provides for a parliamentary review of its provisions and of the state of palliative care in Canada to commence at the start of the fifth year following the day on which it receives royal assent.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.

Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-14s:

C-14 (2022) Law Preserving Provincial Representation in the House of Commons Act
C-14 (2020) Law Economic Statement Implementation Act, 2020
C-14 (2020) Law COVID-19 Emergency Response Act, No. 2
C-14 (2013) Law Not Criminally Responsible Reform Act
C-14 (2011) Improving Trade Within Canada Act
C-14 (2010) Law Fairness at the Pumps Act

Votes

June 16, 2016 Passed That a Message be sent to the Senate to acquaint their Honours that this House: agrees with the amendments numbered 1, 2(d), 2(e), 4, and 5 made by the Senate to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying); proposes that amendment 2(c)(i) be amended by replacing the text of the amendment with the following text “sistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.”; proposes that amendment 3 be amended in paragraph (b) by adding after the words “make regulations” the words “that he or she considers necessary”; respectfully disagrees with amendment 2(a) because requiring that a person who assists to be free from any material benefit arising from the patient's death would eliminate from participation the family members or friends most likely to be present at the patient's express wish, and this would violate patient autonomy in a fundamental and inacceptable manner; and respectfully disagrees with amendments 2(b), 2(c)(ii), and 2(c)(iii) because they would undermine objectives in Bill C-14 to recognize the significant and continuing public health issue of suicide, to guard against death being seen as a solution to all forms of suffering, and to counter negative perceptions about the quality of life of persons who are elderly, ill or disabled, and because the House is of the view that C-14 strikes the right balance for Canadians between protection of vulnerable individuals and choice for those whose medical circumstances cause enduring and intolerable suffering as they approach death.
June 16, 2016 Failed That the motion be amended by: ( a) deleting the paragraph commencing with the words “respectfully disagrees with amendments numbered 2(b), 2(c)(ii), and 2(c)(iii)”; and ( b) replacing the words “agrees with amendments numbered 1, 2(d), 2(e), 4, and 5” with the words “agrees with amendments numbered 1, 2(b), 2(c)(ii), 2(c)(iii), 2(d), 2(e), 4, and 5”.
May 31, 2016 Passed That the Bill be now read a third time and do pass.
May 31, 2016 Failed That the motion be amended by deleting all the words after the word “That” and substituting the following: “Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), be not now read a third time but be referred back to the Standing Committee on Justice and Human Rights for the purpose of reconsidering Clause 3 with a view to ensuring that the eligibility criteria contained therein are consistent with the constitutional parameters set out by the Supreme Court in its Carter v. Canada decision.”.
May 30, 2016 Passed That Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), {as amended}, be concurred in at report stage [with a further amendment/with further amendments] .
May 30, 2016 Failed “Health, no later than 45 days after the day”
May 30, 2016 Failed “(7.1) It is recognized that the medical practitioner, nurse practitioner, pharmacist or other health care institution care provider, or any such institution, is free to refuse to provide direct or indirect medical assistance in dying. (7.2) No medical practitioner, nurse practitioner, pharmacist or other healthcare institution care provider, or any such institution, shall be deprived of any benefit, or be subject to any obligation or sanction, under any law of the Parliament of Canada solely by reason of their exercise, in respect of medical assistance in dying, of the freedom of conscience and religion guaranteed under the Canadian Charter of Rights and Freedoms or the expression of their beliefs in respect of medical assistance in dying based on that guaranteed freedom.”
May 30, 2016 Failed “(3.1) The medical practitioner or nurse practitioner shall not provide a person with assistance in dying if the criteria in subsection (1) and the safeguards in subsection (3) have not been reviewed and verified in advance (a) by a competent legal authority designated by the province for that purpose; or (b) if no designation is made under paragraph (a), by a legal authority designated by the Minister of Health in conjunction with the Minister of Justice for that purpose. (3.2) The designation referred to in paragraph (3.1)(b) ceases to have effect if the province notifies the Minister of Justice that a designation has been made under paragraph (3.1)(a).”
May 30, 2016 Failed “(3.1) As it relates to medical assistance in dying, no medical practitioner or nurse practitioner may administer a substance to a person if they and the medical practitioner or nurse practitioner referred to in paragraph (3)(e) concur that the person is capable of self-administering the substance.”
May 30, 2016 Failed “(d) their imminent natural death has become foreseeable, taking into account all of their medical circumstances.”
May 30, 2016 Failed
May 30, 2016 Failed “(f) they have, if they suffer from an underlying mental health condition, undergone a psychiatric examination performed by a certified psychiatrist to confirm their capacity to give informed consent to receive medical assistance in dying.”
May 30, 2016 Failed “(f) prior to making the request, they consulted a medical practitioner regarding palliative care options and were informed of the full range of options.”
May 30, 2016 Failed
May 18, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at report stage of the Bill and one sitting day shall be allotted to the consideration at third reading stage of the said Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at report stage and on the day allotted to the consideration at third reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and in turn every question necessary for the disposal of the stage of the Bill then under consideration shall be put forthwith and successively without further debate or amendment.
May 4, 2016 Passed That the Bill be now read a second time and referred to the Standing Committee on Justice and Human Rights.
May 4, 2016 Passed That the question be now put.
May 4, 2016 Passed That, in relation to Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), not more than one further sitting day shall be allotted to the consideration at second reading stage of the Bill; and That, 15 minutes before the expiry of the time provided for Government Orders on the day allotted to the consideration at second reading stage of the said Bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and, in turn, every question necessary for the disposal of the said stage of the Bill shall be put forthwith and successively, without further debate or amendment.

The House proceeded to the consideration of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), as reported (with amendments) from the committee.

Speaker's RulingCriminal CodeGovernment Orders

May 17th, 2016 / 3:25 p.m.

The Speaker Geoff Regan

There are 16 motions in amendment standing on the Notice Paper for the report stage of Bill C-14.

Motion No. 5, submitted by the hon. member for Victoria, and Motion No. 10, submitted by the hon. member for Montcalm, propose additional amendments to provisions of the bill that were previously amended in committee. Both motions seek to amend what is meant by “a grievous and irremediable medical condition”.

It should be noted that very similar definitions were proposed and defeated in committee, although they were proposed in reference to a different clause. In the view of the Chair, the objective of these motions is essentially identical to that of the amendments defeated in committee, and these motions will therefore not be selected for consideration at report stage.

The Chair has received letters sent by the hon. member for Sherwood Park—Fort Saskatchewan, the hon. member for Regina—Qu'Appelle, the hon. member for St. Albert—Edmonton, the hon. member for Saanich—Gulf Islands, and the hon. member for Kitchener—Conestoga arguing that certain motions, though previously defeated in committee, should be selected at report stage as they are of such exceptional significance as to warrant a further consideration, in accordance with the notice to Standing Order 76.1(5).

Motions Nos. 2, 11 and 15, submitted by both the hon. member for Barrie—Springwater—Oro-Medonte and the hon. member for Kitchener—Conestoga, as well as Motion No. 8, submitted only by the hon. member for Kitchener—Conestoga, will not be selected by the Chair as they could have been presented in committee. The Chair has difficulty accepting that they should now be accepted at report stage when no attempt was made by either member to present them in committee.

Motions Nos. 4 and 9, submitted by the hon. member for St. Albert—Edmonton and the hon. member for Regina—Qu'Appelle, seek to ensure that a person who suffers from an underlying mental health condition has undergone a psychiatric evaluation to confirm that they are capable of giving informed consent in relation to a request for medical assistance in dying. Motion No. 14, submitted by the same two members, seeks to ensure that people are free to refuse to provide medical assistance in dying. All three motions are identical to amendments defeated in committee.

The same is true for Motion No. 6, submitted by both the hon. member for Montcalm and the hon. member for Saanich—Gulf Islands. This motion seeks to delete paragraph 241.2(2)(d), which states that an individual's natural death must become reasonably foreseeable in order for the individual to be considered to have a grievous and irremediable medical condition.

In the case of the motions submitted by the hon. member for Sherwood Park—Fort Saskatchewan, Motions Nos. 7, 12 and 13 are also identical to amendments defeated in committee. Motion No. 7 seeks to amend paragraph 241.2(2)(d) to reference instead that the person's natural death must be imminent. Motion No. 12 seeks to add a paragraph providing that no substance is to be administered to a person who is capable of self-administering. Motion No. 13 provides for a review of the safeguards in relation to a request by a competent legal authority. Motion No. 3, which provides that a person must have consulted a medical practitioner regarding palliative care options prior to making a request for medical assistance in dying, is very similar to an amendment defeated in committee. The only distinction between the two is that the latter provided that such consultation had to have taken place within the 15 days prior to making the request.

The Chair appreciates the arguments put forward by hon. members as to why they consider these amendments to be of such significance as to warrant further consideration at report stage. I recognize that this is an important issue on which many members have strong and varied opinions. The Chair notes that the bill before us is unique, in its far-reaching social, moral and constitutional implications. The Chair also notes that, given the variety of opinions expressed by various members in all parties in relation to the provisions of this once-in-a-generation bill, the Chair is open to the argument of exceptional significance as contemplated in our Standing Orders. For these reasons, the Chair is prepared, on this occasion, to give members the benefit of the doubt and to select Motions Nos. 3, 4, 6, 7, 9, 12, 13 and 14, even though they were previously defeated in committee or are similar to motions previously defeated in committee.

All of the other motions, Motions Nos. 1 and 16, were examined, and the Chair is satisfied that they meet the guidelines expressed in the note to Standing Order 76.1(5), which deals with the selection of motions in amendment at report stage.

Therefore, Motions Nos. 1, 3, 4, 6, 7, 9, 12, 13, 14, and 16 will be grouped for debate and voted upon according to the voting pattern available at the table.

I shall now propose these motions to the House.

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:30 p.m.

NDP

Murray Rankin NDP Victoria, BC

moved:

Motion No. 1

That Bill C-14 be amended by deleting Clause 3.

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:30 p.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

moved

Motion No. 3

That Bill C-14, in Clause 3, be amended by adding after line 5 on page 6 the following:

“(f) prior to making the request, they consulted a medical practitioner regarding palliative care options and were informed of the full range of options.”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:30 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

moved

Motion No. 4

That Bill C-14, in Clause 3, be amended by adding after line 5 on page 6 the following:

“(f) they have, if they suffer from an underlying mental health condition, undergone a psychiatric examination performed by a certified psychiatrist to confirm their capacity to give informed consent to receive medical assistance in dying.”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:30 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

moved:

Motion No. 6

That Bill C-14, in Clause 3, be amended by deleting lines 17 to 21 on page 6.

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:35 p.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

moved:

Motion No. 7

That Bill C-14, in Clause 3, be amended by replacing lines 17 to 21 on page 6 with the following:

“(d) their imminent natural death has become foreseeable, taking into account all of their medical circumstances.”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:35 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

moved:

Motion No. 9

That Bill C-14, in Clause 3, be amended by adding after line 26 on page 6 the following:

“(a.1) with regard to paragraph (1)(f), have obtained from the certified psychiatrist a written and signed report following the examination confirming that the person is capable of giving informed consent;”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:35 p.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

moved:

Motion No. 12

That Bill C-14, in Clause 3, be amended by adding after line 30 on page 7 the following:

“(3.1) As it relates to medical assistance in dying, no medical practitioner or nurse practitioner may administer a substance to a person if they and the medical practitioner or nurse practitioner referred to in paragraph (3)(e) concur that the person is capable of self-administering the substance.”

Motion No. 13

That Bill C-14, in Clause 3, be amended by adding after line 30 on page 7 the following:

“(3.1) The medical practitioner or nurse practitioner shall not provide a person with assistance in dying if the criteria in subsection (1) and the safeguards in subsection (3) have not been reviewed and verified in advance

(a) by a competent legal authority designated by the province for that purpose;

or (b) if no designation is made under paragraph (a), by a legal authority designated by the Minister of Health in conjunction with the Minister of Justice for that purpose.

(3.2) The designation referred to in paragraph (3.1)(b) ceases to have effect if the province notifies the Minister of Justice that a designation has been made under paragraph (3.1)(a).”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:35 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

moved:

Motion No. 14

That Bill C-14, in Clause 3, be amended by adding after line 26 on page 8 the following:

“(7.1) It is recognized that the medical practitioner, nurse practitioner, pharmacist or other health care institution care provider, or any such institution, is free to refuse to provide direct or indirect medical assistance in dying.

(7.2) No medical practitioner, nurse practitioner, pharmacist or other healthcare institution care provider, or any such institution, shall be deprived of any benefit, or be subject to any obligation or sanction, under any law of the Parliament of Canada solely by reason of their exercise, in respect of medical assistance in dying, of the freedom of conscience and religion guaranteed under the Canadian Charter of Rights and Freedoms or the expression of their beliefs in respect of medical assistance in dying based on that guaranteed freedom.”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:35 p.m.

Green

Elizabeth May Green Saanich—Gulf Islands, BC

, seconded by the member for Montcalm, moved:

Motion No. 16

That Bill C-14, in Clause 9.1, be amended by replacing line 22 on page 13 with the following:

“Health, no later than 45 days after the day”

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:40 p.m.

NDP

Murray Rankin NDP Victoria, BC

Mr. Speaker, I appreciate your thoughtful ruling and your recognition that this is indeed a historic event and, as you said, a generational issue. In Motion No. 1, I have suggested that we delete clause 3 of the bill, which is one of the central features of it.

The Supreme Court's ruling in the Carter case was a watershed moment for many Canadians, especially those who had fought so long to have their suffering recognized and their autonomy respected. I was proud to support the principle of Bill C-14 during second reading. I did so thinking of Sue Rodriguez of Victoria, Gloria Taylor, and Kay Carter, and of all of the others who paved the way for the rights of other suffering Canadians to be recognized by the Supreme Court and by Parliament.

While I was proud to support the bill in principle, at the time I raised serious concerns about particular provisions in it. Still, I was optimistic that these concerns would be resolved and the bill improved by hearing from experts and making the necessary amendments in committee. Sadly, that was not to be done.

The first day of consideration in the justice committee ended without a single opposition amendment accepted by the Liberal majority. By the end of the week, after more than 100 amendments were proposed, just 16 were accepted. Of course, I am pleased that my amendment was accepted to strengthen the government's commitment to providing more Canadians with palliative care, mental health supports, better services for patients with Alzheimer's and dementia, and culturally appropriate services for indigenous patients. I thank my colleagues from all parties for supporting my amendments to that end. However, many of the handful of changes at committee were simply minor technical changes.

Along with members from several parties, I offered a solution to the glaring flaw in the bill, the elephant in the room, namely the fact that it simply did not square with the Supreme Court's ruling. I proposed using the exact words of the Supreme Court to determine eligibility. That was of course one of the main recommendations of the special House Senate joint committee that addressed this bill. Sadly, all of these proposals were rejected. It became clear that the government had no interest in changing the central feature of this bill. Therefore, does the Liberals' bill square with the Supreme Court decision in Carter? The answer is clearly no.

The Supreme Court declared the two laws that prevented medical assistance in dying:

...void insofar as they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life; and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

That language defined the circumference set out by our highest court as to who had the right to physician-assisted dying. Outside of that circle, there remains a total ban on assistance in dying. Mature minors, those who have lost or never had the capacity to give legal informed consent, those with solely psychiatric conditions, and those with merely minor medical conditions were never eligible in the Supreme Court decision. However, within the circle are all consenting competent adults with a grievous and irremediable illness, disease, or disability that causes enduring and intolerable suffering.

This bill would erase the circle set by the Supreme Court and draws a much smaller circle within it, covering only those nearing the end of life and facing what is called reasonably foreseeable natural death, a phrase which just recently the Collège des médecins du Québec called incomprehensible from a medical perspective.

A lawyer representing the British Columbia Civil Liberties Association at the court hearings said this to the justice committee, “Bill C-14 cuts the heart out of our victory in the Carter case”. By adding an end-of-life requirement onto the court's ruling, Bill C-14 would revoke the right to choose from an entire class of competent adult Canadians. That group is everyone suffering intolerably from an irremediable but non-fatal condition.

I have constituents in my riding who fall into that outer ring beyond the circle of rights recognized by the government, people who are suffering, who saw their suffering recognized by the Supreme Court and who cannot, for the life of them, understand why the government now insists on removing their right to choose this option.

What justification has the government offered for this disturbing decision? At the House and Senate committee, and again at the justice committee, some argued we could not afford to expand the circle of compassion, that the Supreme Court ruling could not be obeyed in full, that not all those who were granted rights in Carter could see those rights upheld because to do so would pose an unacceptable risk to vulnerable persons.

These are important arguments, but they are not new. In fact, they were advanced ably and in great detail before the Supreme Court of Canada. Here is what the court wrote.

At trial [the Crown] went into some detail about the risks associated with the legalization of physician-assisted dying. In its view, there are many possible sources of error... Essentially...there is no reliable way to identify those who are vulnerable and those who are not. As a result, it says, a blanket prohibition is necessary.

I emphasize this:

The evidence accepted by the trial judge does not support Canada’s argument...The trial judge found that it was feasible for properly qualified and experienced physicians to reliably assess patient competence and voluntariness, and that coercion, undue influence, and ambivalence could all be reliably assessed as part of that process....As to the risk to vulnerable populations (such as the elderly and disabled), the trial judge found that there was no evidence from permissive jurisdictions that people with disabilities are at heightened risk of accessing physician-assisted dying....no evidence of inordinate impact on socially vulnerable populations in the permissive jurisdictions...no compelling evidence that a permissive regime in Canada would result in a “practical slippery slope”. accepted by the trial judge does not support [this] argument.

That was the conclusion of the Supreme Court after considering the evidence and arguments raised in Carter, the very same evidence and arguments that were advanced at the joint House and Senate committee, which I was honoured to serve on, and at the justice committee just last week. After considering that evidence and those arguments, the court issued its ruling in Carter, establishing the right to choose medical assistance in dying for everyone inside a carefully measured circle of eligibility.

Quite simply, there was a large circle of eligibility. The government has chosen within that circle to define a smaller class. It simply cannot do that if we believe in the rule of law, if we believe in the fact that the Supreme Court should be listened to in this case.

In conclusion, I simply cannot support moving any further with a bill that would revoke from an entire class of competent adult Canadians rights granted to it by the Supreme Court of Canada.

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:45 p.m.

Liberal

Anthony Housefather Liberal Mount Royal, QC

Madam Speaker, I thank my hon. colleague from Victoria for his passionate remarks. It has been a great pleasure serving with him on the justice committee. I always appreciate his intellect.

The amendment the hon. member is putting forward would strike clause 3 from the bill. However, if I look at clause 2, all of the exceptions in that clause relate to exceptions that are set out in section 241.2, which is set out in clause 3 of the bill. Effectively by removing clause 3 of the bill, all of the exceptions disappear from clause 2 of the bill because they are all found in clause 3 of the bill.

While I understand the hon. member's desire to create a greater class of people, could he explain how the rest of the bill can continue to exist since all of the references in all the remaining sections of the bill relate back to clause 3?

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:50 p.m.

NDP

Murray Rankin NDP Victoria, BC

Madam Speaker, I thank my hon. friend, the chair of the justice committee, who did an excellent job in herding cats during the exercise that we were part of and a very difficult exercise at that.

As the hon. member will know, the constraints imposed upon members at report stage are very stringent. As a consequence, the only way that we could bring this problem to the attention of Parliament was to ask that clause 3 be deleted.

We would of course wish that the bill could be redrafted to deal with the very practical problems that my friend raised, and I hope we can go ahead and do that in this chamber.

The fundamental point remains that clause 3 contains the essence of Parliament's proposed response to the Carter case and that response is simply inadequate, and with great respect, unconstitutional.

Motions in amendmentCriminal CodeGovernment Orders

May 17th, 2016 / 3:50 p.m.

NDP

Linda Duncan NDP Edmonton Strathcona, AB

Madam Speaker, I thank my colleague for his hard work on the bill all along, including coming to my constituency and sharing his knowledge from his experience on the special committee and on the justice committee.

One of the big concerns in my constituency has been the inability to give a direction in advance. Could the member speak to the fact that the bill would not allow for giving directions in advance so when one became incapable of doing that, one's wishes would be fulfilled?