Bill C-268 (Historical)

Protection of Freedom of Conscience Act

An Act to amend the Criminal Code (intimidation of health care professionals)

This enactment amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or other health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.
It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

Protection of Freedom of Conscience Act

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Thank you, Madam Speaker. Now I feel I can deliver a speech.

I want to make one thing clear to the House of Commons. I think this is the appropriate time to point it out, and I think everyone here will agree with me. No one is condoning bullying, be it of health care workers or here in the House. We all know people who have bullied others. Bullies are mean-spirited people whose actions betray their insecurity and fear. We all agree on that.

That being said, we are well aware that this bill has nothing to do with bullying or protecting health care workers from bullying. What this bill would actually do is interfere with people's ability to obtain medical assistance in dying. As I said this morning, the Conservative Party is once again exploiting a serious problem to put forward a misleading solution. The party claims this bill will protect health care workers from bullying, but it is hiding the real objective, which is to interfere with medical assistance in dying. As I said this morning, this is populism.

This morning, a member corrected me, saying that being populist was not necessarily a bad thing. Fine. I should have used the term “demagoguery”. It is demagoguery.

We know full well that this bill does not seek to eliminate the bullying of health care professionals. Its objective is simply once again to obstruct existing legislation in Quebec. What is more, it seeks to allow a medical practitioner or a health care professional to not refer a case to a colleague. That goes against what we have in Quebec.

Obviously, the Bloc opposes this bill, just as we opposed Bill C‑268 in the last Parliament, and just as we opposed the proposed amendment to Bill C-7 when it was studied in committee. We have always been opposed to this. I do not know why it has come up a third time. Apparently, they have run out of topics, when there are so many to work on. If the Conservatives are looking for topics, we can help them with that.

Again, the Conservative Party is presenting us with a bill that has a certain objective, but which is worded differently in order to hide its real objective.

We oppose this bill for two reasons.

First of all, it contravenes the Quebec charter of values, rights and freedoms. There are already laws in place to protect health care workers in such situations involving intimidation. Let me give some examples of legislation that allows health care workers to refuse to provide medical assistance in dying.

Quebec's Act respecting end-of-life care states the following:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.

Subsection 241.2(9) of the Criminal Code states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

Health care workers are already protected by the Criminal Code.

Finally, section 24 of the Code of ethics of physicians of Quebec recognizes conscientious objection for medical practitioners, which is the right not to resort to a medical act that goes against their values. It is also recognized in Quebec's Act respecting end-of-life care. The physician is nevertheless required to find another physician.

A physician must, where his personal convictions prevent him from prescribing or providing professional services that may be appropriate, acquaint his patient with such convictions; he must also advise him of the possible consequences of not receiving such professional services. The physician must then offer to help the patient find another physician.

Ontario has a similar provision. Therefore, physicians and health care workers in that province do not need this bill.

Second, we are opposed to this bill because it allows physicians not to refer a case. Let us recall certain statistics. It is all too clear: There is a growing demand for medical assistance in dying, in Quebec as well as in Canada, since these laws were passed.

End-of-life care meets a need and helps ease the suffering of patients who are dying. Since the act came into force, the number of cases of MAID in Quebec has increased year over year. In 2016-17 there were 599 cases and in 2020-21 there were 2,426, which represents a 405% increase.

According to the annual report of the commission on end-of-life care, three-quarters of patients who requested MAID had cancer.

We can all agree that individuals who request MAID do not do so lightly. These people have a right to dignity and that is what is most important in all of this.

A certain balance must be struck and a decision made. That is the issue: striking a balance between an individual's dignity and freedom of conscience and religion. This has already been studied. Quebec has been discussing these issues for 10 years. That was the objective of the bill sponsored by Ms. Hivon, who I would like to congratulate today, and which was adopted on June 5, 2014. A lot of work went into this. Years were spent studying and evaluating these issues. Why not trust the work that has already been done by Quebec in this area?

This seems to be a recurring theme in the House. The federal government starts from scratch without building on what has already been done. It does not have to look far; Quebec is just across the Ottawa River.

The Quebec National Assembly is working on the issue; among other things, the Select Committee on Dying with Dignity was created on December 4, 2009. There is a consensus in Quebec that access to medical assistance in dying should not be restricted. The Quebec National Assembly spent 10 years examining both sides of the issue I just spoke about.

I will conclude here. I repeat: Medical assistance in dying is not designed to go against the values, religions or religious practices of certain Conservative Party members. Medical assistance in dying is an essential measure that allows people to die with honour and dignity. That is in line with Quebec's charter of values and its charter of rights and freedoms.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, I am pleased though a bit surprised to be speaking on Bill C-230. Less than a year ago, on May 27, 2021, we were in the House debating Bill C-268, the very same bill from the very same member for Carlton Trail—Eagle Creek. While I am a bit in awe of the member's ability to place so highly in the random draw for Private Members' Business in two successive Parliaments, I am also at a bit of a loss to explain why the member would squander her luck on this bill.

There are two reasons I say this. As MPs we get limited opportunities to place bills directly before the House. I had that opportunity in 2013, and I used it to put forward Bill C-279, which sought to add gender identity and gender expression to the list of prohibited grounds for discrimination in the Canadian human rights code and in the hate crime section of the Criminal Code. Though many thought it unlikely, the bill did pass the House with support from MPs from all parties. It took a lot of work to put together that coalition of MPs. While my bill followed a somewhat torturous path, there was always a path forward and it became law.

I wonder why it is that having heard so clearly, in speeches less than a year ago, that there was limited, if any, support for this bill outside her own party, the member for Carlton Trail—Eagle Creek has brought it back again. Since there is nothing to indicate any change of circumstances or any change of heart, this bill will go nowhere this time as well. Failing to bring forth a bill that might have some prospect for passing or reintroducing this bill instead of bringing forward a new bill presenting ideas not already debated here in the House leads me to call reintroducing this bill, at best, a missed opportunity.

The second reason I have for declaring the reintroduction of this bill a lost opportunity has to do with the bill itself. This bill picks up a tiny portion of the extensive and important debates on medical assistance in dying that took place on Bill C-14 in Parliament in 2016 and again on C-7 in the last Parliament. It seeks to take one small and very debatable point and turn it into a wedge issue in the House.

We are waiting for the Special Joint Committee on Medical Assistance in Dying to get down to work on outstanding important and critical issues around medical assistance in dying, but as that committee has yet to get under way, I want to take this opportunity today to restate the principle that has guided New Democrats through these debates.

We believe that medical assistance in dying is an important tool for helping to end unnecessary suffering for patients facing end-of-life issues and for avoiding the unnecessary suffering of their families, who have to accompany them on this journey. This is the reason New Democrats will always defend the right of access to information about MAID and access to the service for all those who qualify for assistance in dying and choose to proceed.

In the debate on Bill C-7, many issues arose concerning the challenges Canadians face at the end of life, some of which Bill C-7 addressed directly and some which have not yet been addressed. Two important concerns were front and centre, and these, for me, were the most important. The first was to help alleviate unnecessary suffering by eliminating the waiting period, which was a cause of great concern for patients who feared loss of capacity before they could complete the waiting period and thus make them ineligible for medical assistance in dying and forced to consider suffering.

The second was a change allowing a waiver of final consent. This is a provision I know quite well, personally, as a friend of mine chose to go earlier than she would have liked because of a brain tumour and her fear that she would lose capacity to consent at the last moment and, in doing so, have to continue making her family suffer.

A second challenge was also debated in Bill C-7. How do we preserve as much autonomy as possible for Canadians who are dying? Most of the issues related to this still have to be dealt with at the special joint committee. This includes questions of advance directives, the question of access to MAID for those with mental illness and for mature minors, and whether protections for people with disabilities from being pressured to seek MAID are adequate. I remain frustrated with the delays in dealing with these very important issues. The bill before us is not one of those.

A third challenge that came up in the debate on Bill C-7 was access to services at the end of life. We learned there are a great many gaps in services in our Canadian health care system for those who are facing death. There are gaps in diagnostic and treatment services depending on where one lives, whether it is a major city with excellent facilities or a rural and remote area. We learned of important gaps in palliative care.

However, instead of addressing these challenges, the challenges of autonomy and the challenges of access to services, Bill C-230 is about something else altogether. What this bill would do is override a patient's right to access information about and to have access to legally provided medical services, based on the personal beliefs of a service provider.

Let me put that in plain language. Let us suppose there are a variety of treatments available to a patient. It does not really matter in this case what they are. If a medical professional believes that one of them should not be available, this bill says there is no obligation on that professional to make sure patients find out all the options available to them. Professional organizations, like colleges of physicians and surgeons, and colleges of nurses, have found this to be unethical behaviour, so they require doctors, to varying degrees, to refer patients to someone who is supportive of those services and who is available to provide those services.

This requirement to refer exists in its strictest form in Ontario as the right of patients to an effective referral, meaning a referral to a health care professional who is available, capable and willing to provide that service. This has been upheld by the courts as a reasonable compromise between the rights of patients' access to medical issues and the conscience rights of service providers. That is the main reason I cannot support this bill. If passed, it would result, on a very real and practical basis, in the denial of access to necessary health services for many Canadians.

Many communities have a very limited number of doctors and if one of those doctors, or even more than one of those doctors, is unwilling to let their patients find out about medical assistance in dying, then we are condemning those Canadians to suffer at the end of life in ways that other Canadians would not have to suffer. No health care professionals are in fact required by law to participate, and that is why I find titling this bill “intimidation of health care professionals” disingenuous at best. Is requiring a referral actually participation in medical assistance in dying? Clearly it is not, and trying to torque a requirement to provide information into participation helps no one understand the real issues of conscience involved in medical assistance in dying.

An equally important reason for opposing this bill is the dangerous precedent that this bill would set. Its role as a potentially precedent-setting bill has already been noted by anti-choice advocates who have been vocal in their support for this bill. They recognize that it would provide a precedent for denying referrals for access to contraception and abortion services, and I want to point out that denials of service and denials of information are very real in our existing Canadian medical care system.

This bill would also be a very bad precedent for current attempts to deny transgender minors the counselling and medical services they need to affirm who they are. Without access to services that others may think are inappropriate, this will leave families with trans minors struggling to find the information and support that their kids really need. If this kind of precedent is allowed, medical professionals would not have to provide a referral to someone who would be providing a medically necessary service.

As I approach the end of my comments today, I cannot end without mentioning yet another unfortunate precedent set in this bill, and that is its use of inflammatory language. I have no doubt, as I said in my question to the sponsor of this bill, of her personal convictions and their strength. However, as sincere as they may be, the language used in this bill conjures up a spectre of the use of violence to intimidate medical professionals, something of which there is absolutely no evidence of happening in Canada. Invoking the spectre of violent intimidation is certainly not conducive to an informed debate on the real issues that are in question here.

I will close my comments today by restating that, on principle, New Democrats are opposed to any legislation that would limit access to Canadians seeking information about or the service of medical assistance in dying. No matter how strong the beliefs others may hold, this right exists to access medically necessary services. There is no doubt that the end of life is a difficult moment for all families, and medical assistance in dying, I still believe, is an important way of ending unnecessary suffering both for patients and families at the end of life. I would not like to see anyone denied access to information they need to make a choice that protects their own autonomy of how their lives end. At this point, let me salute the health care professionals who assist patients and their families through this very difficult process.

Once again, I lament the tendency of not just this member but, indeed, many Conservative members of the House to use private member's bills for scoring political points and sharpening divisions in the House—

Freedom of Conscience

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, the third petition I have to present today is from Canadians from across the country.

The petitioners are concerned about coercion, intimidation and other forms of pressure intended to force physicians and health institutions to become parties in assisted suicide or euthanasia in the violation of their freedom of conscience.

The petitioners call upon the Government of Canada to enshrine in the Criminal Code the protection of conscience supported by the passing of Bill C-268, the protection of freedom of conscience act, and to protect the charter rights of medical professionals who have chosen to not take part directly or indirectly in euthanasia or medical assistance in dying, ensuring that all medical practitioners and health care institutions are free from coercion and intimidation related to providing these services.

Sex-Selective Abortion Act

[Christine Normandin, Bloc, Saint-Jean, QC]

Madam Speaker, I would really like to say that I am pleased to rise in the House today to speak to Bill C-233, which was introduced by the member for Yorkton—Melville, but that would be a lie.

Unlike what some would have us believe, Bill C-233 does not seek to restore the balance between the situation of young girls and young boys. It is not a bill to combat sexism. It is anti-abortion legislation, period. It is a pretext, a roundabout way for the member to achieve her purpose, an attempt to reopen a debate that we hoped had been closed for several decades now. The member is shamefully using and hijacking the discourse on human rights to hide other intentions. I am not trying to freely impute motives, unlike what some of my colleagues might try to accuse me of following my speech.

This is a fairly well documented situation, which was the subject of at least two CBC reports just before the last election in which the journalists talked about new pro-life lobbying methods. As an aside, I want to mention that, in my opinion, the term “pro-life” is a term that has been overused so that people do not have to say anti-abortion, even though that is what it means.

The groups featured in these reports have abandoned certain strategies in recent years and have adopted new ones. Their stated purpose is to get dozens of anti-abortion members elected. Alissa Golob, one of the cofounders of the group RightNow, explained on camera that if, instead of spending two hours holding a sign on the sidewalk, they were to spend that time knocking on doors for a candidate, it would probably be a much more effective use of their time.

In the report that was recorded in June 2019, RightNow explained that it was employing several tactics. First, the group encourages pro-life activists to run for office. Then, during the nomination races in various ridings, it suggests to its supporters that they become members of a party that is running a pro-life candidate and that they vote for that candidate, obviously. Finally, RightNow's volunteers go door to door to find voters who would be willing to support anti-abortion politicians. The day of the election, the group encourages voters to go vote. Without specifically naming them, the lobby admitted to targeting some fifty-odd ridings during the 2019 election.

Scott Hayward, another co-founder of RightNow, explained in the same report that the group's objective was to get into the corridors of power to pass legislation that will reduce the number of abortions in Canada as much as possible. He conceded that the strategy to have a total ban on abortion was doomed to failure. This group's new strategy is to take incremental steps.

Another news report from September 2019 revealed the communications strategy of lobby groups. Their strategy is to attack the consensus that the issue of women's right to control their own bodies is a debate that should be considered to have been closed for decades.

Although the leader of the Conservative Party at the time, the current member for Regina—Qu'Appelle, who has openly stated that he is pro-life, said in the last election campaign that the debate would not be reopened, the same story reported otherwise. The report reminded readers that backbenchers would nevertheless have the right to introduce private members' bills seeking to restrict the right to abortion.

The group We Need a Law is another anti-abortion group. The same news report explained that its approach is to lobby the public and politicians to convince them that Canada needs an abortion law.

It is important to remember that the general situation in Canada is that we trust women to make their own decision, and we trust doctors, who receive guidelines from their associations that cover the stage of pregnancy starting at which specific criteria must be taken into consideration before they can sign off on termination. According to We Need a Law, in order to change the law, we must first change the way people think. For both We Need a Law and Right Now, that means the discourse must be refreshed, but also softened.

These days, anti-abortion groups are deliberately softening their approach. They are moving away from the all-or-nothing route and focusing more on a middle-of-the-road approach, and guess what? One of their strategies involves creating a precedent with abortion-related legislation, particularly by trying to get laws passed that seek to criminalize sex-selective abortion or to ban abortions after a certain point in the pregnancy.

Bill C-233, the bill before us today, fits that pattern exactly. It seeks to chip away at abortion rights with the stated long-term goal of making it harder and harder to access abortion. That is the frame of mind we need to put ourselves in as we examine this bill.

After all that, I have not even talked about the many other problems with Bill C-233, such as the potential interference in areas under Quebec's jurisdiction.

The member for Yorkton—Melville is clearly trying to use the Criminal Code to regulate medical practice, which is not something that falls under federal jurisdiction. However, we have become accustomed to this tactic. It is something that we debated in the House just yesterday during the study of Bill C-268, which seeks to criminalize certain aspects of medical assistance in dying as a way to indirectly sabotage something for which there is a consensus, particularly in Quebec.

I am not even talking about the difficulties associated with implementing Bill C-233, which would involve a major violation of doctor-patient confidentiality for charges to be laid under the Criminal Code provisions Bill C-233 proposes.

Nor am I talking about the possible consequences of this bill for racialized people. If Bill C-233 passes, doctors could engage in profiling by only asking pregnant women of Asian or Indian origin, communities in which sex-selective abortion seems statistically more prevalent.

No, I am going to talk about what is behind Bill C-233.

I am talking about the red herring and the tactic that some members use when they say they do not want to reopen the abortion debate but then turn around and introduce bills like Bill C-233 to do just that. I urge the bill's sponsor and her leader to at least have the decency and transparency to acknowledge the real purpose of the legislation they put forward.

I was born in 1984, only four years before the Supreme Court ruled in the Morgentaler case. From that moment on, logically, my adult life should not have been punctuated by attempts to ensure that others could decide in my stead what is good for me or dictate what I should be doing with my own body. What is being proposed is a step backwards and a disservice to the progress that women's rights have supposedly made since then. That is why I believe it is still relevant to quote Simone de Beauvoir, who said, “Never forget that it only takes one political, economic or religious crisis for women's rights to be put in jeopardy. Those rights can never be taken for granted. You will have to remain vigilant your whole life”.

Let us not be fooled. Let us stay vigilant, as she said. This bill is nothing more than the umpteenth iteration of a form of antiquated bigotry temporarily clad in the guise of feminism, which is suddenly so timely. No matter how sugar-coated the pill is or how polished Bill C-233 looks, we must not lose sight of the fact that, deep down, it is motivated by values that have no place in a democratic institution.

Because I am a woman, because I am a feminist and because I am progressive, I simply cannot support Bill C-233.

Medical Assistance in Dying

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Mr. Speaker, conscience rights are a fundamental freedom protected by the Charter of Rights and Freedoms. Sadly, this right is being severely undermined for medical processionals in relation to medical aid in dying. When euthanasia and MAID were first legalized in 2015, the government promised that people would not be coerced to take part in euthanasia against their will. Without the force of law behind it, this promise has proven to be completely empty.

Physicians as well as other medical professionals are now constrained by law to offer MAID as a primary treatment option even in cases where they do not believe it is in the best interest of their patient. Without conscience rights, patients will no longer have access to a second opinion for their end-of-life care. As a result, patient rights and well-being are being undermined. My private member's bill, the protection of freedom of conscience act, seeks to address this deterioration of rights.