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

This bill was last introduced in the 43rd Parliament, 2nd Session, which ended in August 2021.

This bill was previously introduced in the 43rd Parliament, 1st Session.

Sponsor

David Lametti  Liberal

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill.

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.

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.

Votes

March 11, 2021 Passed Motion respecting Senate amendments to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
March 11, 2021 Failed Motion respecting Senate amendments to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) (amendment)
March 11, 2021 Passed Motion for closure
Dec. 10, 2020 Passed 3rd reading and adoption of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
Dec. 3, 2020 Passed Concurrence at report stage of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
Dec. 3, 2020 Failed Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) (report stage amendment)
Oct. 29, 2020 Passed 2nd reading of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)

Criminal CodeGovernment Orders

October 19th, 2020 / 1:25 p.m.


See context

NDP

Alexandre Boulerice NDP Rosemont—La Petite-Patrie, QC

Madam Speaker, I thank my colleague for her speech.

We agree on the fact that people must be given the choice. They must be able to leave this life with dignity and avoid useless suffering. However, there is a provision in the bill that concerns us a little, and that is the fact that the physician must have expertise or specific knowledge of the person's illness.

In the case of people living in rural or remote areas, there may not be a physician with knowledge of a rare illness. Would that not be an obstacle to accessing this right?

Criminal CodeGovernment Orders

October 19th, 2020 / 1:25 p.m.


See context

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, that is one more reason to ensure that health care systems across Quebec and Canada have adequate funding through health transfers, as we have pointed out. This would give people access to specialists who could weigh in. That is why the government must increase health transfers and ensure that people everywhere have better access to care.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:25 p.m.


See context

Green

Elizabeth May Green Saanich—Gulf Islands, BC

Madam Speaker, I agree entirely with my hon. colleague from the Bloc Québécois.

I wonder if there could be a response to an earlier question posed in the debate, which suggested that this legislation would open the door to seeing the possibility of medical assistance in dying for those who were not facing death but who were facing mental illness. As I read the legislation, that is specifically not contemplated here.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:30 p.m.


See context

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, I thank my colleague for her question.

I remind members that the notion of mental health is not addressed in this bill because my colleague, the member for Montcalm, pointed out the need to be careful when dealing with such a sensitive issue as mental health.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:30 p.m.


See context

Bloc

Julie Vignola Bloc Beauport—Limoilou, QC

Madam Speaker, no one likes to talk about death. It reminds us that we are mortal, as are the people we love and the people we are emotionally attached to. We do not like to feel negative emotions. Our brain reacts negatively to these emotions by releasing hormones that make us panic.

Death is such a difficult subject that most people worry when a loved one starts talking about wills, last wishes or funeral plans. They worry about the person’s health, when that person is only trying to plan for the future. This may sound ghoulish, but life always ends in death. Our entire lives are planned, starting with our parents planning our education and then us planning our careers, moves, children, and so on. We can plan for death and funeral arrangements the same way, even if we do not have suicidal tendencies.

For there to be death, there has to have been life. We have a short time on this planet, so we need to act responsibly, not only for ourselves, but also for the generations to come. We are only borrowing this planet. The place where we live is temporary.

I listened to my colleagues’ arguments last week, and I also read a lot about medical assistance in dying. I even discussed it with my father. I love my father. I hope that he will be with us for a very long time. I am a daddy’s girl. Unfortunately, my father’s wishes are currently impossible. He told me that, if he were to be diagnosed with a degenerative disease and told what was going to happen, he would like to be able to tell his doctor, at a certain point in the progression of the disease, that he wanted medical assistance in dying and that he did not want to linger.

For now, that is impossible. It is something to think about.

Even if these discussions about our loved ones’ final moments are difficult, we need to have them. They are important. They ensure that we can respect the person’s wishes to the very end. It does not mean that the person will necessarily opt for medical assistance in dying. It means that we will know what the person really wants at the end. It can also prevent families from being torn apart.

One of the points raised by my colleagues was the fear expressed by several disability advocacy organizations that people with disabilities will be urged to get medical assistance in dying. I must admit that I, too, was concerned before I read the bill.

Once I read the bill, I saw that the request for medical assistance in dying must be made in writing by the person in question, and that it can be withdrawn at any time. When the substance is being administered, if the person gestures or speaks in a way that appears to be expressing a change of heart, everything stops there. That is the case not only for people with disabilities, but also for people whose death is foreseeable.

The Canadian Charter of Rights and Freedoms states that people with disabilities have the same rights as people without disabilities. This implies that they have the right to life, and that they are entitled to receive the treatments appropriate to their condition. Why would they not also have the right to medical assistance in dying if they meet the criteria clearly indicated in the bill? Do people with disabilities not have the right to decide for themselves simply because they have a disability? I find that unacceptable. I reject the idea. People with disabilities are capable of making their own decisions. They are rational beings. This has nothing to do with making decisions for other people.

It has to do with allowing people the right to make their own decisions concerning their own death.

I would add that other safeguards have been put in place, namely the three-month wait time with support services. My colleagues talked about that. It is not always easy to get in touch with a doctor or social worker, for example. I used to live in the regions. My doctor was a general practitioner. However, I do not think anyone ever had a better doctor because, when the time came to pick up the phone and call a specialist, he was the first to do so. Nothing could stop him. I wish everyone had that kind of doctor.

All of this makes me think that people with disabilities are not at risk. They will decide for themselves, they will have the same rights and responsibilities as people who do not have disabilities and for whom death is foreseeable.

I read that people are concerned that doctors will suggest medical assistance in dying based simply on a person’s disability. The very idea is repulsive, since doctors would not encourage patients to die. They would first try to relieve their pain and make suggestions for how to live with their condition. Beyond that, according to the bill, it is not up to the doctor to decide, but the patient. Doctors assess the situation and the request. Their role is not to suggest but to inform. It is the patient’s role to request and suggest.

I also read that some people believe that opening up medical assistance in dying to people with disabilities might suggest that their lives are not worth living. I have read and re-read the bill, and nowhere does it say that the life of a person with a disability is not worth living. Did anyone here tell Stephen Hawking that his life was not worth living? Did anyone tell any of our Paralympic athletes that their life was not worth living?

I am getting worked up because I have a little cousin who suffers from severe cerebral palsy. She barely speaks, but when she wants something, she knows how to make herself clear. She will never be able to request medical assistance in dying. Given her personality, I am convinced that, even if she could speak, she would not request it, because she is a ray of sunshine, because she is the person in our family who always believes that everything is good, everything is right and, at the end of the day, we can get through whatever life throws at us. I love her. She makes us see the beauty of laughter and closeness.

Although her life is complicated, it is certainly worth living. Therefore, saying that the bill is suggesting that the lives of people with disabilities are not worth living is yet another despicable point that was made.

The bill’s preamble states that life and the dignity of seniors and people with disabilities must be respected and that suicide must be prevented. I agree. To deny people with disabilities who are capable of making the choice the right to decide whether to receive medical assistance in dying is to deny them their dignity. Are we prepared to do that?

That amounts to treating these people as if they were less important, as if they were incapable of making decisions because of their disability. The very idea is repulsive to me.

Not everyone with a disability will request medical assistance in dying, just as not everyone without a disability will request it. Medical assistance in dying is an exceptional measure. It is not the rule. It is a choice that is fundamentally personal and that should not in any way be imposed by another person.

Some called in particular for the withdrawal of the 10-day wait period for people whose death is foreseeable.

Once again, I have very personal reasons for supporting that withdrawal.

I had an aunt who was quite the character. She spent five years fighting cancer and receiving treatments, some of them experimental. At some point, she could no longer stand it, and asked for medical assistance in dying. Because of the 10-day wait period, she died the day before she was to receive the drug to help her die—

Criminal CodeGovernment Orders

October 19th, 2020 / 1:40 p.m.


See context

Liberal

The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

I am sorry, but the time has expired.

The Parliamentary Secretary to the Minister of Justice.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:40 p.m.


See context

Parkdale—High Park Ontario

Liberal

Arif Virani LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Madam Speaker, I thank the member for Beauport—Limoilou for her speech, and I would like to congratulate her for highlighting the autonomy of people with disabilities.

I would just like to add that the two people at the centre of the Truchon and Gladu ruling that we are discussing today had disabilities themselves, and the judge recognized their autonomy in making choices.

We have heard several times that our government made a mistake by not appealing the Truchon and Gladu ruling to the Supreme Court. When a provincial superior court decision is well developed, carefully analyzed, rigorous and clearly articulated, should we appeal the ruling to the Supreme Court, or should we take action, as our government is doing, to protect the dignity and autonomy of vulnerable people?

Criminal CodeGovernment Orders

October 19th, 2020 / 1:40 p.m.


See context

Bloc

Julie Vignola Bloc Beauport—Limoilou, QC

Madam Speaker, I thank my colleague for his question.

I am not a lawyer. However, in this case, a superior court handed down a ruling to address an unfair and unjust situation, where a right was taken away from people who were supposed to be treated equally. In my humble opinion, continuing the legal proceedings would only have added to the impression that these people are separate and different. They are full citizens, and they are entitled to be given our consideration and included in our reflections.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:40 p.m.


See context

Conservative

Arnold Viersen Conservative Peace River—Westlock, AB

Madam Speaker, the member mentioned that, in her opinion, there does not seem to be two classes of Canadians coming out of this. In the previous bill, there were two requirements: grievous and irremediable suffering, and reasonably foreseeable death. This bill would remove the reasonably foreseeable death requirement, therefore creating two classes of citizens. An individual who is suicidal and has no grievous and irremediable suffering would be given the host of services Canada provides to prevent suicide. A person who has a grievous and irremediable issue would be eligible for MAID.

Does the member not see that this bill would create two classes of citizens?

Criminal CodeGovernment Orders

October 19th, 2020 / 1:40 p.m.


See context

Bloc

Julie Vignola Bloc Beauport—Limoilou, QC

Madam Speaker, I thank my colleague for his question.

Nowhere in the bill does it say that someone who is suicidal can access MAID. On the contrary, the bill states that someone with a degenerative disability would have 90 days to reflect on their decision and would have the necessary support to ensure that they are not in a state of distress. The necessary safeguards are there to ensure that someone in a state of distress would get the help they need. Furthermore, the request may be denied if the assessment indicates that the problem lies elsewhere.

These are the same reasons for which mental health is not covered. We must start by providing support for mental health problems without giving people with mental illness access to MAID. A good assessment and good support are the safeguards in this bill.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:45 p.m.


See context

Conservative

Dane Lloyd Conservative Sturgeon River—Parkland, AB

Madam Speaker, my hon. colleague said that there is no way that a handicapped or disabled person could be given medical assistance in dying without their consent because, of course, they would write it on a piece of paper. Would the member not agree that there could be a number of factors put in there, from being put under pressure to feeling like they are a burden on society? Would the member not agree that there need to be protections to ensure that people are not being affected by other factors to ask for medical assistance in dying?

Criminal CodeGovernment Orders

October 19th, 2020 / 1:45 p.m.


See context

Bloc

Julie Vignola Bloc Beauport—Limoilou, QC

Madam Speaker, I have said it once and I will say it again: Yes, it is important to ensure that individuals make a free, informed decision and that they not be coerced. That is why the bill calls for a 90-day waiting period and support from a social worker.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:45 p.m.


See context

Liberal

Lloyd Longfield Liberal Guelph, ON

Madam Speaker, before I get started, I will let you know I am splitting my time with the member for Markham—Stouffville.

Today, I have the opportunity to participate in this debate on Bill C-7 from my riding in Guelph. Before I get going on the debate, I would like to recognize that Guelph is situated on the ancestral homelands of the Anishinabe people, specifically the traditional territories of the Mississaugas of the Credit First Nation.

I am proud our government has brought forward a bill that proposes changes that respond to the Superior Court of Quebec's September 2019 Truchon ruling. The proposed changes were informed by concerns and issues raised during consultations earlier this year in discussions with provincial, territorial and indigenous partners. As a result, we have had careful consideration of past experience with MAID in Canada.

I recognize medical assistance in dying is a deeply personal and complex issue. I have heard extensive feedback from my constituents on this topic as recently as this morning. During today's debate, we are hearing very personal stories from MPs that are very similar to what we heard when we first brought forward the legislation in Bill C-14. There are arguments for and against, which we need to recognize and look at.

Some of my constituents who have shared their support for these amendments and the swift passage of this bill have noted to me the importance of dying with dignity, as well as consistent and equal accessibility for all Canadians, as part of what our legislation needs to provide.

Earlier this year, I had a constituent reach out to me and share her personal story regarding medical assistance in dying. She told me that she felt very strongly about this issue because her husband of 56 years, John, had passed last December after four years of battling an illness and how appreciative she was that we had taken some first steps toward addressing these issues. She told me about the vibrant man John was, with a big heart, a successful career and an impressive education. She told me they had conversations about getting old together and how they would deal with aging, but these discussions did not include suffering or what might happen if the pain became too great. As John's illness progressed, he was moved into a long-term care facility where he spent the rest of his life. It was there that she saw so many others who were unable to be independent. She was saddened to see there was no dignity for these people, or for her husband John, as they were no longer able to look after their own personal needs. I saw this myself with my mother as she went through care in her last 10 years of life. The story of my constituent was one that conveys the importance of providing a diverse end-of-life option for Canadians that will help them provide the right decisions to be able to end their days with dignity, comfort and peace of mind.

Of course, there are two sides to this debate. I have heard from other people and received a lot of feedback that they understand we are coming at this as a deeply personal and sensitive topic for everyone, but are concerned these new amendments may impact the disability community, something we have discussed in the debate today, and the conscience rights of medical practitioners or our work toward improving palliative care. They all really do stitch together. While I am sympathetic to these concerns, I am also pleased to see our new legislation strikes the right balance of autonomy and protection of vulnerable people. This is thanks to many disability advocates who have participated actively throughout the consultation process, including specific round tables that focused on issues faced by the disability community. As was mentioned earlier in the debate, 300,000 people had input throughout the month of January 2020 to help us get to where we are today.

Additionally, our law specifically acknowledges the conscience rights of health care providers and the role they play in providing medical assistance in dying. These new amendments do not make changes to these rights and I know we will continue to work with provinces and territories to support access to medical assistance in dying while also respecting the personal convictions of health care providers.

However, the most common concern I have heard from my constituents is the need to prioritize palliative care over medical assistance in dying.

It is really the end-of-life care that we are talking about in both cases. In palliative care, Canadians are approaching the end of their life, and they deserve to receive care in the setting of their choice and to live out their days in comfort and dignity. They also deserve the freedom to make this fundamental decision about life and death without fear of their personal choice being obstructed by politics or government.

In Guelph, we are very blessed to have a wonderful palliative care facility that has been growing over the years as people recognize this as an option towards the end-of-life care that they are looking for.

However, 70% of Canadians are left without access to adequate palliative care. We have the responsibility to act in the interests of patients and their families, which is why our government supports access to both palliative care and medical assistance in dying. End-of-life issues are as diverse as Canadians themselves, and these issues also change throughout the course of medical needs and procedures that are available.

It is our responsibility as a government to provide as many options as possible for Canadians, so that they can take these deeply personal choices and make them on their own. That is why our government has worked collaboratively with partners, such as the provinces and territories, to develop a framework on palliative care. To support this framework, our government is implementing a targeted action plan that will help to improve access to palliative care for underserved populations; support families, health care providers and communities; and look at the funding that is needed to be able to execute our plans.

I would like to take this opportunity to thank Hospice Wellington and its executive director, Pat Stuart for the amazing work they do to support our most vulnerable citizens, including through palliative care.

I would also like to thank the constituents of Guelph who have personally reached out to me over the last several months to share their feedback, suggestions and personal stories around medical assistance in dying. I look forward to continuing to engage with my colleagues on this important subject and with my constituents, so that we can work to create a system that is responsive to the needs of patients, and creates an environment that can create comfort and reassurance for patients and their families.

Criminal CodeGovernment Orders

October 19th, 2020 / 1:50 p.m.


See context

Conservative

Dave Epp Conservative Chatham-Kent—Leamington, ON

Madam Speaker, I wish to thank my hon. colleague for his perspective on this issue. Indeed, I want to thank all of the members from both sides of the aisle who have shared on this deeply important topic.

My concern, and the member raised it, as did several of the previous speakers, is about the concerns expressed by the most vulnerable in our society, the disabled. They wrote, one month after the Truchon decision, to the Attorney General, 72 groups of them, pleading that this case be appealed to the Supreme Court for several reasons, that would buy time for a proper consultation process as part of the review, and that their voices would be further heard.

Could my hon. colleague please comment on why this process has been chosen superior over the voices and wishes of 72 representatives of the disabled community?

Criminal CodeGovernment Orders

October 19th, 2020 / 1:55 p.m.


See context

Liberal

Lloyd Longfield Liberal Guelph, ON

Madam Speaker, I thank the hon. member for Chatham-Kent—Leamington, where we also have family members. As we have these discussions, we do see the cross-ties across Canada as we look at these issues.

The disability community is involved with the consultation process and will continue to be involved. We are reacting to the Superior Court ruling from Quebec, where we do need to look at some amendments. When we can get those in place, we will do the further review of Bill C-14, which will include the broader issues the member has mentioned.