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

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Mr. Speaker, a wise person, John Wooden, once said, “If you don't have time to do it right, when will you have time to do it over?” The debate today is a perfect example of that.

Back in 2015, we were working against time to pass legislation, and now we have heard the hon. parliamentary secretary say this on a couple of occasions, and particularly this last time, that they found themselves having to bring forward this legislation because of a court judgment, because they did not get it right the first time. Here we are again, racing against time.

What the government could have done was challenge that ruling and heard from the Supreme Court in its wisdom. In parallel with that, we could have had a parliamentary committee study it, as mandated by the previous legislation, and we would have had a shot to get this right. Maybe the hon. member could speak to the importance of due process in getting legislation right.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Mr. Speaker, the member's question is so pertinent to the debate we are having on Bill C-7. It is an opportunity to get improvements to Bill C-14 and we need the opportunity to do that. Due process is what Parliament is all about and we need to have that opportunity in the House.

On the issues of grievous and irremediable medical conditions, as I said in my speech, we could have had an opportunity to put more definition into some of these issues. The foreseeable issues were just another one of those areas where we could have had more definition.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Diversity and Inclusion and Youth and to the Minister of Canadian Heritage (Sport)]

Mr. Speaker, it is an honour to stand in the House of Commons and participate in the second reading debate on Bill C-7, an act to amend the Criminal Code, medical assistance in dying.

In developing these amendments, Canadians were widely consulted in January 2020. During these consultations, approximately 300,000 Canadians completed an online questionnaire. In addition, the Minister of Justice and Attorney General of Canada, the Minister of Health and the Minister of Employment, Workforce Development and Disability Inclusion met with experts and stakeholders in Halifax, Montreal, Toronto, Vancouver, Calgary, Winnipeg, Ottawa and Quebec City to discuss proposed revisions to Canada's medical assistance in dying framework. These experts and stakeholders included doctors, nurses, legal experts, national indigenous organizations and representatives from the disability community.

The high level of participation in both the questionnaire and the in-person sessions is a reflection of the importance of this issue to Canadians. Moreover, the results of consultations were critically important in shaping our government's approach to medically assisted dying as it evolves to reflect the needs of Canadians.

The bill would amend the Criminal Code to allow medical assistance in dying for people who wish to access a medically assisted death whether their natural death is reasonably foreseeable or not. The bill would remove the reasonable foreseeability of natural death from the list of eligibility criteria. It would also expressly exclude people seeking medical assistance in dying solely because of mental illness.

The bill proposes a two-track approach based on whether a person's natural death is reasonably foreseeable. Existing safeguards remain and are used for people whose death is reasonably foreseeable. In addition, new and modified safeguards would be applied to eligible persons whose death is not reasonably foreseeable.

In the spirit of “nothing without us”, I would like to mention that our government remains focused on addressing the concerns of the disability community around vulnerability and choice. The proposed changes to the legislation supports greater autonomy and freedom of choice for eligible persons who wish to pursue a medically assisted death. At the same time, full consideration has been given to the protection of vulnerable persons and to respecting the equality rights and dignity of persons with a disability.

In short, the bill maintains and strengthens safeguards to support fully informed decision-making while also respecting individual autonomy. The bill would allow people who risk losing decision-making capacity to make arrangements with their practitioners to receive medically assisted dying on their chosen date even if they lose the decision-making capacity before that date. The bill would also make advance consent invalid if the person demonstrates refusal or resistance to the administration of medically assisted dying.

In addition, the bill would allow eligible persons who choose to self-administer to provide advance consent or for a physician to administer if self-administration fails and causes them to lose capacity. This type of advance consent would be available for eligible persons regardless of their prognosis.

I would also like to take a moment to speak to the progress our government has made with respect to the rights of persons with disabilities in Canada.

Last year, we enacted the Accessible Canada Act, which aims to create a barrier-free Canada through the proactive identification, removal and prevention of barriers to accessibility wherever Canadians interact within areas under federal jurisdiction. The act is one of the most significant advancements in disability rights since the charter in 1982 and is designed to inspire a cultural transformation toward disability inclusion and accessibility in Canada.

Knowing that I do not have that much time left, I would say that members of my community as well as members of my family and members of the greater Parkinson's and Alzheimer's community have been very vociferous on this issue, and both of those diseases affect people in my family. I am strongly in favour of the bill passing as quickly as possible.

[For continuation of proceedings, see part B]

[Continuation of proceedings from part A]

The House resumed from October 19 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

[The Speaker, Liberal, Anthony Rota]

Before continuing, I wish to inform the House that because of the deferred recorded divisions, Government Orders will be extended by 81 minutes.

Resuming debate, the hon. Parliamentary Secretary to the Minister of Diversity and Inclusion and Youth and to the Minister of Canadian Heritage.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Diversity and Inclusion and Youth and to the Minister of Canadian Heritage (Sport)]

Mr. Speaker, it is an honour to virtually join the debate in the House of Commons and participate in the second reading debate on Bill C-7, an act to amend the Criminal Code, medical assistance in dying.

I will take a moment to speak to the progress that our government has made with respect to the rights of persons with disabilities in Canada.

Last year, we enacted the Accessible Canada Act, which aims to create a barrier-free Canada through the proactive identification, removal and prevention of barriers to accessibility wherever Canadians interact with areas under federal jurisdiction.

The act is one of the most significant advancements in disability rights since the charter in 1982 and it is designed to inspire a cultural transformation toward disability inclusion and accessibility in Canada. The act created Accessibility Standards Canada, an organization that will create and revise accessibility standards and support and promote innovative accessibility research. The CEO and board of directors were appointed and the operations began last summer.

That act also established National AccessAbility Week, a week dedicated to accessibility in late May and early June each year. National AccessAbility Week is an opportunity to promote inclusion and accessibility in communities and workplaces and to celebrate the contributions of Canadians with disabilities. It is also a time to recognize the efforts of individuals, communities and workplaces that are actively removing barriers to give Canadians of all abilities a better chance to succeed.

Our government is taking real action to address the rights of persons with a disability. The careful writing of Bill C-7 is a testament to that. Representatives of disability organizations and leading disability scholars participated in consultations across the country and their input informed the reforms proposed in this bill.

We recognize that disability inclusion requires more than legislation and that is why we are continuing to work with the disability community and stakeholders to address stigma and bias. It is important to bring about cultural change to ensure that the important contributions made to Canada by persons with a disability are recognized and valued on the same basis as other Canadians.

Going forward, we will continue to focus on improving the social and economic inclusion of persons with a disability. This means moving forward with our commitment to build on the progress we have made over the past months and years with the development of a disability inclusion plan. This disability inclusion plan would include important initiatives like a new Canadian disability benefit modelled after the GIS for seniors, a robust employment strategy for Canadians with disabilities and a better process to determine eligibility for government programs and benefits. We all benefit when everyone can participate equally in our economy and society.

We will continue to work hard to ensure that every person in Canada is treated with the dignity and respect they deserve, especially when it comes to the deep and personal issue; that is ending one's life. It is imperative that the voices of all Canadians, including persons with a disability, continue to be heard on the issue of medical assistance in dying.

[Matthew Green, NDP, Hamilton Centre, ON]

Madam Speaker, I want to acknowledge the words of the hon. member. I have known him to be a compassionate man.

He talked about people with disabilities living with dignity, yet, as it relates to the COVID situation, with so many people living with disabilities being left out of recovery packages and support, we are hearing that they are considering accessing MAID simply because they do not have the money to survive.

What does the member have to say about programs that have excluded people living with disabilities to the point where they are actually considering accessing this end-of-life scenario?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I profoundly appreciate the work that my colleague across the floor has done for his community in Hamilton prior to his entering federal politics. I am well aware of his many contributions in areas of social justice and I am proud to call him a colleague. He is somebody who stands up for people and ensures their voices are amplified.

In areas of mental health concerns that our government has, we have taken many precautions to ensure that people are being heard and that the correct precautions are being made in order to ensure that mental health and people with disabilities do not fall victim to many of the inadequacies that are baked into the system. This is an effort to change the ways it has been dealt with in the past.

I fully recognize, from consultations with many constituents in my riding who live with disabilities, that the benefit we have promised is too little and too late and that we must continue to do more for Canadians with disabilities, in particular, with regard to mental health.

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

Madam Speaker, with this legislation, it is clear that the Liberals have snuck in a number of different provisions that have nothing to do with the Truchon decision. One of them is bringing in the possibility of same-day death.

The elimination of a 10-day reflection period means that somebody could request and receive euthanasia or medical assistance in dying on the same day, without any further requirements or checking back the following day to see if this was a consistently expressed desire or simply the response to an immediate low.

Does the member believe same-day death is reasonable or does he think there should be a default to a reflection period? Right now, the reflection period can be waived in certain circumstances by the physicians. Does he think the default should be to have some degree of a reflection period so we do not have same-day death?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, while I appreciate the many contributions and reflections upon this and many other issues from my colleague opposite, I, unlike him, rely on experts and expert opinions, research and evidence from people who work in these fields.

As a politician, I do not feel prepared or adequately informed to make these decisions in the House. They are made through evidence finding exercises in consultations with experts, physicians and researchers. Because we are an evidence-based government and one that bases all our decisions on that evidence-based approach, I am very confident we are making the most compassionate, best decision possible.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Madam Speaker, Inclusion BC is seeking additional safeguards for people with disabilities. Would the Liberal government consider providing each province and territory with additional health transfers to cover, under this legislation, supports for mental health and psychiatric care that are embedded into the legislation to give Canadians assurances, especially those with disabilities, that all options are on the table for them when they consider MAID?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I will take the question under advisement and ask the correct officials and the minister in charge if this is something that we might consider.

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

It is my duty pursuant to Standing Order 38 to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Mégantic—L'Érable, COVID-19 Emergency Response; the hon. member for Calgary Nose Hill, Health; the hon. member for Courtenay—Alberni, COVID-19 Emergency Response.

[Richard Bragdon, Conservative, Tobique—Mactaquac, NB]

Madam Speaker, it has been said the character of a nation is revealed in how it treats its most vulnerable citizens. It is my priority to ensure that this type of legislation has the proper safeguards to protect the most vulnerable in our society, like our seniors and those with disabilities. Throughout COVID-19 we are learning of more and more persons with disabilities who are considering MAID as an option due to the increased economic challenges they are facing, as well as the increased social isolation that has arisen, as a result of COVID.

There also must be proper safeguards for the conscience rights of physicians and allied health professionals. The key principle of any democracy is freedom of belief and conscience, the freedom to be able to hold those beliefs, practise those beliefs and carry out in one's life what one feels is a true reflection of those beliefs, without impediment.

We have a responsibility as parliamentarians to make sure we get this legislation right. From the beginning, the federal government should have appealed to the Supreme Court, so that there could be certainty on the framework within which Parliament can legislate. Sadly, it did not and as a result there are still many questions surrounding this legislation.

There are many things we can talk about when it comes to an issue as sensitive as this, a bill that affects the lives of many Canadians and people throughout our country, many of whom are in situations where they find themselves struggling to cope or to handle a circumstance that has put them in a very vulnerable state. I feel that we as parliamentarians need to measure all options on this and be extremely cautious because of the ramifications this type of legislation can have, and not just now but for many years to come.

This issue is near and dear to my heart because of my background. I worked for many years in the private sector and spent some time working with vulnerable populations, people who have faced the tremendous challenges that can arise when they are battling mental health related issues, such as depression and anxiety. I have seen people who have had battles with addictions and considered taking drastic measures to somehow end the suffering they were going through at that time. I recall one particular instance, which I would like to share with the House today, that had a huge impact on my life and really informs some of what I would like to talk about here this afternoon.

I will never forget the day. I was called by a local police force in our region to get to the bridge in our local community as quickly as I could. At that time, my wife was visiting a friend of hers who had just had a baby in the hospital, and I happened to be out in the vehicle with our youngest child who was sleeping in the car seat. I told the officer that my wife was at the hospital and that I did not know what room she was in. I said that I did not know how to get to her and that I had an infant child with me, and I asked if he could help me. He said he would be right there and stay with my child, and the other officer would take me to the bridge.

Of course, immediately my heart started to pump and I felt the emotion of it. With my background, I said a quick prayer, hoping things would turn out okay. We rushed down to the bridge in our community. The traffic was backed up on both sides. I got out of the police car and ran up onto the bridge. Search and rescue was there in the water, and a lot of police officers were on the scene. There was the young lady, standing on the outside of the railing and clinging to a lamppost.

She was waiting there, because she wanted to tell me the things she wanted me to say to her parents and to her infant child. Of course, I was scrambling, trying to come with anything to say to dissuade her. As she told her story, I was holding her hand and trying to dissuade her from making the decision to jump. She told me what she wanted me to tell her mom and dad and her little girl, and I told her that she did not have to do this and that she could talk with them. I told her that her little girl needed her and that her parents loved her. I was doing all the things I could think of.

I will never forget. She looked me straight in the eye. She let go of my hand and said, “Thanks for doing this, Richard. Goodbye.” Then she jumped.

Immediately, everything flashed in front of me. I wondered if I could have said something different. I was very emotional at the time.

Thankfully, when she hit the water, the search and rescue teams had enough time to be in place so that when she emerged from her plunge, they were able to pull her out of the water and get her to the hospital. I am glad to say that she is on the road to recovery. She came through it. Even though her journey from that point has not always been easy, I am glad to report that, several years later, she is still with us. Now she is impacting many people's lives for the better. She is helping other young women who have found themselves in desperate situations and struggling with addictions and health related issues. She is helping to provide an example of hope.

I share that story, because I believe it is so important that we do everything we can to make sure we build in all the safeguards possible and all the bridges possible to allow people to make the choice of life and to choose to keep going, even in the midst of adversity, even when things look hopeless and even when things look like they cannot turn around. Some of the best stories that have ever been written, some of the most inspiring songs that have ever been sung, some of the best writings that have inspired generations were written from very dark places, places where shadows run deep. They have come from people who have literally walked through the valley of the shadow of death and came out on the other side.

I would encourage the House to do everything possible to put those safeguards in place and to make sure we do everything we can to foster an atmosphere where people who are in vulnerable places can be inspired towards hope and realize that they are not alone. All the adequate supports should be there with a full range of options for those in desperate times.

I am thankful for the opportunity to share that story today. I hope it encourages all of us to reflect and take the time to seriously consider the bill before us and to ensure that we put every safeguard possible in the bill.