Bill C-7 (Historical)

An Act to amend the Criminal Code (medical assistance in dying)

This enactment amends the Criminal Code to, among other things,
(a) repeal the provision that requires a person’s natural death be reasonably foreseeable in order for them to be eligible for medical assistance in dying;
(b) specify that persons whose sole underlying medical condition is a mental illness are not eligible for medical assistance in dying;
(c) create two sets of safeguards that must be respected before medical assistance in dying may be provided to a person, the application of which depends on whether the person’s natural death is reasonably foreseeable;
(d) permit medical assistance in dying to be provided to a person who has been found eligible to receive it, whose natural death is reasonably foreseeable and who has lost the capacity to consent before medical assistance in dying is provided, on the basis of a prior agreement they entered into with the medical practitioner or nurse practitioner; and
(e) permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance that was provided to them under the provisions governing medical assistance in dying in order to cause their own death.

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.

[Kenny Chiu, Conservative, Steveston—Richmond East, BC]

Madam Speaker, in my speech I alluded to my father's experience escaping from Communist China. It is a country that does not provide freedom of conscience for its members.

In Canada we do, and that is why we treasure our freedom so much. We must not force people to act under duress and against their conscience.

[The Assistant Deputy Speaker, Carol Hughes]

The member will still have a minute and a half left for questions and answers the next time this matter is before the House.

It being 5:30 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 December 9 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the third time and passed.

[The Deputy Speaker, Bruce Stanton]

When the House last took up this question, the hon. member for Steveston—Richmond East had a minute and a half remaining in his time for questions and comments. We are at the tail end of the five-minute period for questions and comments, which is probably enough time for one good question and response.

The hon. parliamentary secretary to the government House leader.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Mr. Speaker, following your advice, I am up for a good question.

During the debate, we have heard a lot about palliative care. I am wondering if the member could share his thoughts on the important role of palliative care. Could he share what he believes, and how he believes the federal government could be playing a stronger role in that area?

[Kenny Chiu, Conservative, Steveston—Richmond East, BC]

Mr. Speaker, I thank the hon. member for Winnipeg North for asking such meaningful questions.

If I recall correctly, a former member in the House Mark Warawa actually suffered from terminal cancer. He was not able to receive palliative care for a number of days before the end of his life. It is critical that this country provide that support to Canadians who are facing inevitable death. The country could do more to provide options for Canadians facing immediate death.

We know that health care is delivered by provincial governments, but the federal government could actually negotiate more with provincial governments to provide support and funding, and perhaps set standards in palliative care for Canadians in general

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, it is an honour to rise today to talk about such an important piece of legislation.

I will be the first to say that I did not really have a position on this particular legislation when it came before the House four years ago. I supported it back then, because I strongly believe that people deserve a choice and that choices are important, especially when it comes to one's health and medical condition. Since then, I do not even remember if I spoke to it the last time it came before the House, but if I did, I did not do it from the informed position that I find myself in now.

I want to talk about Don Tooley, my father-in-law, who passed away three days ago. Don suffered from cancer, and he died at the young age of 67.

Don grew up in Plevna, Ontario, and for those who do not know, Plevna is north of Highway 7, in my colleague's neighbouring riding. He grew up in a hunting and fishing lodge in Plevna that his grandfather had started in 1944 right after the Second Word War had ended. Don loved life. He was a tough person. He knew how to hunt, fish and do all those “manly” things, at least they would have been considered that way back in the day, but he was also very soft, caring person. He was very artistic and loved things with a great degree of passion.

However, just over a year ago, during the 2019 election, Don was diagnosed with colon cancer and he went through the process of being treated. He wanted nothing more than to live. He was so young, he wanted to live and he wanted to be there for his grandchildren. In the new year, in January, he had a colonoscopy and was declared cured of cancer. Don thought that he had the rest of his life ahead of him. The reality is that it did not go quite as well for Don. By July of last year, he had been experiencing some challenges with his mobility and ended up in the emergency room in the middle of the COVID-19 pandemic during the first wave, where he was told that he had a tumour in his brain. Don went under immediate surgery. He was asked what he wanted to do, and he said that he wanted surgery to have it removed, because he needed to spend more time with his grandkids. Don had the tumour removed on a Friday. The doctor was going to let him out of the hospital once he could walk again. He was so determined to walk that he walked out of that hospital on the Monday morning, 48 hours after having surgery on his brain.

Don continued to live life, he continued to spend time with his grandkids, but everybody kind of knew where it was going and what the inevitable was. I think Don even did, although he really never talked about it. In the fall, about a month and a half ago, he had radiation, which helped his situation a bit. Then two weeks ago, Don ended up in the hospital again, because after a routine CAT scan it was determined that he needed to go back to emergency right away.

My father-in-law headed back to the hospital where he was informed that he had very few choices: he could be operated on again with great risk and not knowing how that would turn out, or he could let nature take its course effectively. Don chose to be operated on again, because he wanted nothing more than to live. His objective was to live for another day for his grandchildren and to be there with them, because he loved spending time with them.

Don was operated on about three or four days later. It did not go as well as it had the first time that he was operated on, in the summer. Don ended up being told that he was not going to walk again. He was given the grim reality that the cancer had grown to a point where the doctors could not operate on it in its entirety, they could not remove it all and that he probably did not have a lot of time left to live.

Don still did not give up. He wanted more input into this. He wanted to talk to other people. He refused to give in to the idea that it could end.

About three or four days after that, the doctors had a very frank conversation with him and they said, “Don, this is the reality of where you are in your life, and what is going to happen.” Once he fully grasped that and fully understood, I believe that is when Don came to terms with the reality of his course and where his life was going. That night, just over a week ago, he suffered a massive heart attack. I truly believe it was because his heart just realized that he was not going to live much longer.

The next morning, my wife and my mother-in-law and my brother-in-law went to the hospital because Don wanted their advice as to what he should do. At that point, Don realized that the fight was over, that it was time to give up; and he chose to not be treated. The doctors said that they could treat him for the heart attack, but the likelihood of its being effective was very small because of the blood thinners and the effects of everything else going on in his body. Don chose to let nature take its course.

For seven days, Don was in palliative care in the same hospital. I had the opportunity to see him once. Because of COVID restrictions, it is very hard to get in and out of the hospital. Don suffered during that time. That is the reality of the situation. He wanted to live so badly, but when he knew that his time was coming to an end, he recognized that was the case. I do not even know if Don would have chosen medical assistance in dying if that had been an option for him. He certainly did not have 10 days to have the reflection period, and I do not even know if he would have chosen that. However, what I know is that he did not have a choice.

The reality is that I strongly believe coming from a more informed position now, yet not as informed as so many other people, that people need that choice. Our medical system has advanced so much in this world, doctors fight to keep people alive at every opportunity they can. I do not blame the doctors for being against parts of this legislation and some who are against all of it. That is what they are there for. Doctors are there to fight and keep fighting to keep people alive, but sometimes it gets to the point where that is not going to happen.

If he, and so many other people like him, had made that choice, Don could have prevented seven or eight days of his own suffering. For a year, he fought to live and the last seven days he realized that it was not going to happen. If anybody is put in that position, I strongly believe that they should have the choice to make that decision.

[David Sweet, Conservative, Flamborough—Glanbrook, ON]

Mr. Speaker, I want thank my colleague Kingstonian, a son of Kingston whom many Kingstonians would be proud of today. I only have a comment, and my colleague had some kind comments for me a few days ago.

I want to thank him for giving space in this legislature for people who are having a tough time with this decision in regard to the legislation. He has demonstrated that, in the heart of hearts of every human being, there is this strong drive to live. In most cases, we deal with legislation where we are trying to upbraid bad behaviour, whether with the Criminal Code or regulations on white-collar crime. In this case, we are looking at legislation that actually would cause the state to intervene in someone's life.

I want to thank the member for breathing some air of reasonableness into this debate, and for giving people space to have conflicting positions on this.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, I totally agree. I started my speech by saying that I am at a very different position on this particular legislation than I was four years ago when it was debated in this House. I do not harbour any ill feelings toward people who take a different position from me on this.

The reality is that, from what I have seen, I only ever envisioned people who did not want to fight for life, but I have seen with my own eyes somebody who fought as hard as he possibly could until the moment that he knew that it was not possible anymore. I thank the member for his comment, and I respect the position of every member of this House. I am certainly not here to try to convince people differently from their own position on this. It is hotly contested. There is a lot of energy behind this debate, and there are a lot of different emotions behind it, but I just wanted to let people know where I am on it and where my position has evolved from.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I also want to thank the hon. member for Kingston and the Islands and extend deep condolences to him and his wife and family on the loss of his father-in-law. Certainly, the stories that we have shared and how emotional and difficult this subject is for each and every one of us is really clear. For myself, I came to the position of strongly supporting the bill when we dealt with it in the last Parliament, and the issue was made clear to me by many constituents who raised the issue with me.

Sue Rodriguez, who took the matter all the way to the Supreme Court of Canada so many years ago, was a resident of North Saanich, within my constituency, and there is a huge support base for her personally and the cause she raised. Therefore, in the time remaining I want to ask the member: if we do not deal with this issue, vote and get it to the Senate before we rise for Christmas, what is the legal effect for the people of Quebec, where the Truchon decision will take legal effect and there will be a void of the law for end of life in Quebec?

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, I would rather speak not so much about the legal effect, but the effect on the individuals who will be in these positions like my father-in-law was just a few days ago. There will be more people who suffer, quite honestly. I want to make it very clear that the doctors and the nurses in Kingston General Hospital did everything they could for my father-in-law to make sure that he was as comfortable as possible, but there was still a great degree of pain there. By not passing this legislation today, we are potentially putting ourselves in a position where other people will suffer the same way, and that is just not something that I want to see.

[Chris Bittle, Liberal, Parliamentary Secretary to the Minister of Transport]

Mr. Speaker, I would like to thank my friend for doing this. It is something I know I could not do just a few days after such a tragic event.

I was hoping he could talk about those 10 days, because at the justice committee, when I was on it, we heard about suffering. I know it is difficult to ask this of my friend, but could he talk about the 10 days and the difficulty, knowing that there is that period of time that one cannot escape from the legislation?

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, even if Don had been able to say on day one that he wanted this procedure, he would not have been able to confirm that, if he had lasted 10 days. During that 10-day period, there was an incredible amount of hardship and pain that he went through. There were, obviously, his loved ones around him who also felt a great degree of pain and suffering, but for the individual in that position, I witnessed it first-hand, and it is nothing that I would ever want to see somebody go through, if they chose not to go through it.

[Pierre Poilievre, Conservative, Carleton, ON]

Mr. Speaker, today we rise to discuss a matter of the gravest importance, literally a matter of life and death.

It has been my practice as a member of Parliament to favour the expansion of free choice and individual human agency in all our decisions. I believe that government's principle role is to protect the life and liberty of its people, and that doing so means allowing people to make decisions for themselves with minimal application of force, in essence to minimize force and maximize freedom.

I am the finance critic and I have applied that principle to all economic matters, such as how can we allow individuals to make their own decisions with their own money. Here we talk about a matter that is more important than money, the matter of life and death.

I look upon this bill to determine whether it extends or withdraws individual freedom and free will from the people to whom it will apply. As I look through the practical application of the bill, it is my view that the bill will do more to withdraw individual choice and freedom than it will to extend it.

Let me begin by quoting the member for Thunder Bay—Rainy River, a physician and Liberal member of Parliament, who said:

My biggest concern, as someone who has spent my whole life trying to avoid accidentally killing people, is that we don't end up using MAID for people who don't really want to die.

Medical assistance in dying was supposed to be exclusively for people who did want to die, who, having been presented with all the worldly alternatives, chose death. We have a member of Parliament and former physician on the government side saying that the bill will have the effect of forcing people to a decision they would not otherwise make.

This is not just a theoretical issue. Allow me to read the story of Mr. Roger Foley. This is from a CTV story, which states:

Foley suffers from cerebellar ataxia, a brain disorder that limits his ability to move his arms and legs, and prevents him from independently performing daily tasks.

Roger Foley, 42, who earlier this year launched a landmark lawsuit against a London hospital, several health agencies, the Ontario government and the federal government, alleges that health officials will not provide him with an assisted home care team of his choosing, instead offering, among other things, medically assisted death.

In other words, we have a state health care system to which everybody is forced to pay and of which everyone is forced to be a part, from which it is impossible to avoid receiving care because paying out of pocket is illegal, private insurance is not allowed for essential care. When this gentleman then went to the care, the only care the government would allow him to have, it said that it could not provide him with that care, but what it could do was end his life, that he could pack it in, that he could just give up.

That is not free choice. That is the state effectively compelling a man to end his life or face endless years of unnecessarily turmoil that could have been avoided were appropriate care allowed. For that reason, I cannot support the bill.

I add my voice to thousands of people from the community representing persons with disabilities. The government is often fond of quoting the UN. The UN Special Rapporteur on the rights of persons with disabilities was “extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities” deemed eligible for assisted dying “have been provided with viable alternatives.” Mr. Foley's case is a prime example of that.

Therefore, those most vulnerable are not given a choice, but rather they are funnelled toward one inescapable outcome and compelled by the state to end their lives at threat of merciless and unnecessary suffering. Rather than providing these people with the care that would mitigate their suffering and fulfill the wishes of a happy life, they are told they have no choice but to end life altogether.

I will quote from disability groups, 72 of which wrote a letter to the government expressing their opposition to the bill.

I will start with Krista Carr, the executive vice-president of Inclusion Canada, an organization that works with Canadians with intellectual disabilities. She stated, “Bill C-7 is our worst nightmare.... The community of Canadians with disabilities and their families have long feared that having a disability would become an acceptable reason for 'state-provided suicide'.”

There are the words of Dr. Goligher, an assistant professor at the University of Toronto, who said, “Bill C-7 declares an entire class of people, those with physical disabilities, as potentially appropriate for suicide — that their lives are potentially not worth living. Indeed were it not for their disability, we would not be willing to end them. I cannot imagine a more degrading and discriminatory message for our society to communicate to our fellow citizens living with disabilities.”

We are meant to give a voice to all Canadians, but most of all to the voiceless, and the voiceless are speaking through their advocates. Seventy-two groups have spoken out against the bill, the dehumanizing way with which it treats persons with disabilities and the manner by which it robs them of their free will and human agency. I fear that it adds to the quiet and sometimes unspoken narrative of certain politicians and opinion leaders who suggest that persons with disabilities do not have the same worth as others, a concept I find repulsive.

The lives of persons with disabilities are every bit as valuable and precious as the lives of the rest of us. No legislation should ever pass through the House or the next House that devalues the precious gift of life that persons with disabilities should have the right to enjoy. No bill should rob people of their free choice and human agency to live on in peace and dignity should they so choose.

This bill does not contain any protections against scenarios where people who are conflicted might try to suggest upon a person with disabilities that they should simply accept death. We put forward an amendment to ensure that a case like Roger Foley's would never happen again by banning medical professionals and other caregivers from raising the issue of assisted dying with a patient rather than letting the patient raise the issue himself or herself. The government opposed that.

The government is removing the requirement that there be two witnesses to sign off before someone dies. It is removing the 10-day waiting period, which allows people, who might be in a burst of urgent distress, to consider and reconsider their decision, a decision that we all know is absolutely irreversible, the most irreversible of all decisions, and that is to end one's life.

Why the government would oppose such protections that would ensure the patient truly does consent to end of life I do not know, but I do know one thing and will conclude on this. We must protect the freedom and choice of all our people and we must recognize the dignity and worth of every human life.