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.

Medical Assistance in Dying

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

Madam Speaker, the third petition is in opposition to many of the provisions in Bill C-7. The government has piled many things into that bill that are completely unrelated to the Truchon decision. Those things include, for instance, removing the 10-day waiting period, which would create a mechanism by which there could be same-day death in Canada.

The government is now also trying to allow euthanasia for those with a mental health challenge. Petitioners recognize that mental health associations have said that mental health conditions are neither terminal nor permanent, and euthanasia for people in that situation goes against the advice and opinion of experts.

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

Mr. Speaker, the final petition expresses grave concern about Bill C-7, the government's decision to try to remove safeguards, to open the door to euthanasia for those who are facing mental health challenges and to do so in all these policy areas in ways that are completely unrelated to the Truchon decision.

The petitioners call on the government to amend or stop this bill and, in particular, to remove those aspects of the bill which are completely unrelated to the Truchon decision, which, frankly, is most of them.

I commend these four petitions to the consideration of the House.

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

Mr. Speaker, the last petition I am presenting today regarding Bill C-7 is of prime importance, especially given the bill's amendments concerning mental illness and protecting the disabled in Canada. The petitioners call on the Government of Canada to support measures to protect human life, as all human life should be regarded with a great deal of respect, from inception to natural death.

Criminal Code

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

Mr. Speaker, there have been discussions among the parties, and I believe if you ask, you will find unanimous consent to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

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

Mr. Speaker, the material change here is that we are now 24 hours closer to a deadline induced by the Superior Court. There is a material change, and given that change, consideration should be given by all members to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying)—

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

Mr. Speaker, there have been discussions among the parties, and I would like to ask for unanimous consent to adopt the following motion. I move: That, notwithstanding any Standing Order, special order or usual practice of the House, this evening, after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

I was—

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

Mr. Speaker, there have been discussions among the parties and I would like to ask unanimous consent to adopt the following motion. I move that notwithstanding any Standing Orders, special order or usual practice of the House that (a) after the deferred recorded divisions scheduled later today and the completion of introduction of government bills during Routine Proceedings, the House shall proceed to Government Orders and continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying); (b) when no member rises to speak or at 12 a.m., whichever is earlier, the debate will be deemed adjourned and the House deemed adjourned until the next sitting day; (c) during the debate tonight no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair; (d) Private Members' Business hour shall be suspended later today; and (e) the Private Members' Business item currently number one in the order of precedence shall remain for the next sitting day and not be rescheduled.

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

Madam Speaker, on a point of order, there have been discussions among the parties, and if you seek it, I think you will find unanimous consent to adopt the following motion: That notwithstanding any standing order, special order or usual practice of the House, this evening after Private Members' Business, the House shall continue to sit beyond the ordinary hour of daily adjournment for the purpose of considering a motion respecting Senate amendments to Bill C-7, an act to amend the Criminal Code (medical assistance in dying), and when no member rises to speak or at 12 a.m., whichever is earlier, the debate be deemed adjourned and the House deemed adjourned until the next sitting day; and during the debate tonight, no quorum calls, dilatory motions or requests for unanimous consent shall be received by the Chair.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I want recognize the contributions by the member for Montcalm to the debate and to the justice committee during the study of Bill C-7 as well as Bill C-14.

With respect to the Conservative position, it is one of a free vote both on Bill C-14 and Bill C-7.

I did oppose Bill C-14, because I had some significant concerns at the time that it did not go far enough to protect Canadians who are at risk, and we have seen evidence of that. We heard from witnesses to that effect, including Roger Foley, who was pressured into undertaking medical assistance in dying, because his health care workers determined that he was too much of a burden. I think that case illustrates the fact that Bill C-14 did not provide sufficient safeguards to protect the vulnerable, and the legislation before us does away with them almost entirely.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I have heard my colleague make many interventions on this issue. He took part in the clause-by-clause review of the bill and he is very eloquent.

However, the Conservatives voted against the former Bill C-14. According to my colleague, this bill contained an unbelievable safeguard, but Justice Baudoin declared it unconstitutional. The Conservatives also voted against the current Bill C-7.

Am I wrong to say that the Conservatives' position is that palliative care is the only acceptable option for end-of-life?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I concur with the hon. member for Victoria that the Senate has exceeded its mandate in going far beyond the scope of Bill C-7.

I have to say that I am shocked that the Attorney General did not reject outright the amendment with respect to mental illness being a sole criterion for eligibility for medical assistance in dying. Despite the fact there are a lot of things we do not know, one thing we do know is that of the 4,000 Canadians each year who die of suicide, 90% of them suffer from mental illness. The question becomes: How many persons with mental illness will suffer a premature death as a result of this legislation?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I am rising to speak on Bill C-7.

The legislation illustrates the dangers that arise when a government puts blind ideology ahead of evidence-based decision-making. The nightmare of this bill and that road that has led to it today began when the Quebec Superior Court judge issued the Truchon decision. In that decision, that lower court judge determined that the most important safeguard in Canada's medical assistance in dying regime, namely that death be reasonably foreseeable, was unconstitutional.

That decision, again, was by one judge in one province. It is not binding in any other province. It does not bind the Quebec Court of Appeal. Indeed, it is a non-binding decision.

In the face of that, one would have thought that the Attorney General, whose responsibility it is to uphold laws passed by Parliament, would appeal that decision. After all, we are talking about a decision that removes the most important safeguard that was part of the legislation was passed a mere three and a half years prior to the issuance of the Truchon decision.

Instead, the Attorney General put ideology ahead of the interests of vulnerable persons, and did something that is virtually unprecedented. The Attorney General did not appeal the decision and, instead, recklessly tabled Bill C-7, which eviscerates key safeguards, including the most important safeguard, namely that death be reasonably foreseeable. In so doing, the Attorney General seeks to radically transform Canada's medical assistance in dying regime from something where such assistance is deemed appropriate to deal with or address suffering in death to now providing death to deal with suffering in life.

In seeking to so radically transform Canada's medical assistance in dying regime, the Attorney General has pre-empted a mandated parliamentary review provided for under Bill C-14. The Attorney General has preceded with completely inadequate consultation, ignoring important voices that represent vulnerable Canadians and, most importantly, that represent Canada's disabilities rights community.

When 72 national disabilities rights organizations wrote to the Attorney General and pleaded with him to appeal the Truchon decision, he ignored them. Their pleas to this Attorney General have fallen on deaf ears.

Why is the disabilities rights community so concerned with Bill C-7 and, in particular, the removal of the criterion that death be reasonably foreseeable? Very simply, when that criterion or safeguard is removed, it means that someone who suffers from a degenerative disability could be eligible for that very reason, despite the fact they may have years, if not decades, to live.

The disabilities rights community, on that basis, has said, in clear and unequivocal terms, that they believe this bill stigmatizes persons with disabilities.

As Krista Carr, the executive vice president of Inclusion Canada, said, this “is our worst nightmare.” As Catherine Frazee, disabilities rights advocate and former Ontario human rights commissioner, said to the justice committee with respect to Bill C-7, “Why us?”

Why, in asking that question, is the government proceeding to discriminate against the rights of persons with disabilities by depriving them of protections against premature death afforded to all other Canadians outside of an end-of-life context? In so depriving those rights, specifically to persons with disabilities, significant questions have been raised about the constitutionality of Bill C-7 and whether it would, in fact, by discriminating against persons with disabilities, violate Section 15 of the charter. However, those questions and concerns were completely ignored by the Attorney General, who puts the ideology of ableism first.

So blinded is the Attorney General that he ignored not only concerns from the disabilities rights community, but also from the UN Special Rapporteur on the rights of persons with disabilities, who has said that this bill violates international human rights norms. So blinded by ideology is this Attorney General that he ignored the UN Commission on Human Rights, which the government is rather fond of, which has stated that this bill runs afoul of the Convention on the Rights of Persons with Disabilities, in particular article 10.

Just when one thought it could not get any worse, we learnt today with respect to the motion the Attorney General tabled in the House that it would, among other things, essentially accept, with some very minor tweaking, radical Senate amendments, including one that would provide that someone would be eligible for medical assistance in dying for having solely a mental illness. This is a radical change, and, despite the fact this issue has not been appropriately studied, the Attorney General has said it is now a fait accompli. This is despite the fact that we do not know how to predict irremediability in the case of mental illness; despite the fact that we do not know if someone's mental illness is the basis for their request or a symptom of their mental illness; and despite the fact that we do not know whether someone's mental health suffering could be alleviated by health and other social supports.

This bill is a reckless, dangerous piece of legislation that would put some of the most vulnerable persons in Canadian society at risk. It must be defeated.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Madam Speaker, I will be sharing my time with the member for St. Albert—Edmonton.

I have spoken to this issue twice in the House, the last time being December 4. I entitled that speech “Stay safe, my son”, because I do tell the personal story of being a father of a 34-year-old developmentally and intellectually disabled son who lives with us and is cared for by us. His name is Jordan.

In a larger way, my speech dealt with the removal of the safeguards for Canadians with disabilities and how the government is choosing to ignore and dismiss the concerns of disability groups across this country who have joined in arms in opposition to Bill C-7 because it fails to protect them and their safety in the long term. A quote that is most often used and referred to by the disability organizations is that this is the worst possible scenario.

After that speech, I discovered the United Nations office on human rights has stated that legislation extending euthanasia and assisted suicide to persons with disabilities “would institutionalize and legally authorize ableism”. For those who may need help with the word “ableism”, as I did, I went to the Oxford Dictionary and this is the official definition in it: “Discrimination in favour of able-bodied people.”

For full disclosure, I am a parliamentarian who sees Bill C-7 for what I think it is: the next step on the slippery slope in the MAID debate created originally by Bill C-14 in 2016. Today we are being asked by the Senate to make amendments to further remove safeguards for those living with mental illness. The Canadian Mental Health Association's CEO and spokesperson, Margaret Eaton, wrote to all parliamentarians, saying that “The exclusion of mental illness as the sole underlying cause for medical assistance in dying must be maintained to safeguard those living with mental illness.”

Understand that the Canadian Mental Health Association is the most extensive community in mental health across Canada, with a presence in 330 communities across every province and one territory. It provides advocacy, programs and resources that help prevent mental health problems and illnesses, support recovery and resilience and enable all Canadians to flourish and thrive. She goes on to explain the three compelling reasons that the exclusion of mental illness, as the sole underlying cause, was justified and urges all parliamentarians to oppose the Senate amendment that proposes to drop that protection for people with mental illness.

The slippery slope is the continual easing of restrictions and expansion of euthanasia to a day when society will be conditioned to accepting death upon request. Many of—

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, as I reviewed the amendments to Bill C-7 that have been proposed by the Senate, I was struck by how quickly some legislators have embraced radical, unstudied changes to Canada's medical assistance in dying. In many cases, the direction these amendments take Canada's MAID laws was rejected just a few short years ago.

When Parliament legalized medical assistance in dying in 2016, there was a commitment included in that legislation to review the impacts of the law five years after it received royal assent. That was June 17, 2016. We have not yet arrived at that five-year mark. We have not yet done a proper and thorough review of the original MAID legislation, yet now, before this review is even under way, not only are some in this place pushing to expand the accessibility and availability of MAID without the benefit of that study, but we are also considering amendments that disregard all the thoughtful and considered debate of this House, the Senate and the committees of each place that wrestled with this complex subject matter and initially chose not to go down the road that many of these new untested amendments would take us.

The Council of Canadian Academies considered some of the amendments now being proposed, producing several reports in 2018. Former MP and health minister Dr. Jane Philpott and the member for Vancouver Granville wrote in a Maclean's article about the council's conclusions. The article states, “...there is very limited guidance on these issues because there are not enough places in the world that have allowed broader access to assistance in dying.”

That is the context in which we are having this discussion, so it is troubling that the Liberal government has essentially accepted the amendments to throw the doors wide open to MAID for patients with mental disorders, something the justice minister previously had said there was no consensus on. This is a significant reversal that the Liberals ought to explain to the thousands of Canadians who have expressed concerns about the expansion of MAID to those with mental illness.

I am certainly mindful of the fact that COVID-19 and the restrictions imposed by governments as a result have created a tenuous mental health situation in Canada. Loneliness, social isolation and reduced care for vulnerable populations are all very real concerns.

Law professor Trudo Lemmens and Leah Krakowitz-Broker wrote this in a piece for the CBC:

Introducing a social experiment by expanding MAID when people are more vulnerable than ever is not progressive policy making — it is reckless. In its desire to accommodate some who want to control the timing and manner of their death, it puts others at risk of premature death.

I am reflecting on the question of why we are even here at all. Why are we having this discussion before meeting the five-year commitment for the MAID review? It is because the Liberals chose not to appeal the ruling of a Quebec judge.

As Senator Plett said:

Bill C-7 is a result of the federal government choosing to cave in to the opinion of one judge in one province who decided to unilaterally strike down legislation which had been extensively debated and passed by both houses of parliament.

I am speaking, of course, about the Truchon decision in Quebec. The Liberals could have simply appealed the decision in recognition of the upcoming review. It would have allowed for a substantive and careful discussion about the impacts of opening the door to MAID for seriously vulnerable individuals. Even in the Truchon decision, the assumption was that there would be enforcement of strict requirements that ensure the capacity and informed consent of those requesting MAID. Bill C-7 removes some of those very safeguards, including the requirement that the patient remains competent until the very end.

Truchon was also premised on the conclusion that medical assistance in dying, as practised in Canada, is a strict and rigorous process that in itself displays no obvious weaknesses, but that simply has not been shown to be true. According to the chief coroner of Ontario's review of 2,000 MAID cases, case reviews have demonstrated compliance concerns with both the Criminal Code and regulatory body policy expectations, some of which have recurred over time. As well, according to the Quebec end-of-life commission, at least 62 cases in Quebec between 2015 and 2018 did not fully comply with federal and/or provincial law. How can we move forward like this without properly responding to these serious failings?

In one of our last debates in the House, when I suggested that if Bill C-7 were to pass as it was, even before the amendments by the Senate were added, it would be believed to be the most permissive bill with respect to MAID in any country in the world, one of my colleagues expressed surprise that I did not think it was a good thing, as if being the most permissive jurisdiction was somehow inherently a good thing. A law's success should be judged by its outcome, not its permissiveness.

Any time life is devalued or death is made easy, clearly, is not good. Life is to be valued and treasured as the gift it is, which is why we need to put our energy into supporting positive alternatives, such as strengthening a patient-focused palliative care service for all Canadians. There was unanimous agreement from the special joint committee studying physician-assisted death on the need for a pan-Canadian strategy on palliative care with dedicated funding.

Those suffering deserve the best possible care. After all, there is no real choice for Canadians facing end-of-life decisions without adequate palliative care options available to them.

As parliamentarians, we have a high calling to actively listen. Our obligation is to protect our most vulnerable citizens. Unfortunately, none of the proposed amendments addresses the serious concerns raised by disability advocates. As many in the House have mentioned during these debates, over 70 of Canada's leading disability rights organizations and advocates have expressed deep concerns regarding this bill. Therefore, so should we.

We should be especially concerned for disabled Canadians who lack socio-economic means and face a greater risk of coercion. If there is even a tacit suggestion that their lives are not worth living, we should care about the implications of that. Their lives matter. Canadians should never feel pressured or as though the law perceives their lives as a burden.

The Christian Legal Fellowship writes that by singling out life with a disability as the only existence deserving state-sanctioned termination, Bill C-7 perpetuates ableism in a most dangerous way.

We have already discussed in the House what UN experts have highlighted as a contradiction in Canada's international human rights obligations. We do not want to create a two-tiered system in which some would get suicide prevention and others get suicide assistance based on their disability status and specific vulnerabilities.

The justice committee was faced with very difficult stories where some of our most vulnerable felt pressured to accept MAID. Numerous groups were represented. Fifty religious organizations and faith leaders, including Jews, Muslims and Christians, expressed their opposition. Nine hundred physicians and 145 members of the legal community stated their positions.

It is not just the disabled who are vulnerable. Practising physicians fear that they will face legal charges if they refuse to participate in the deaths of their patients. There are blatant inequities and legitimate anxieties with this legislation.

Let us be clear: any inequities of support, systemic discrimination, family network or specific community should be addressed before people choose death. We need to make every accommodation for people to choose life, which is why I am perplexed by the Liberal government's decision to support the Senate amendments based on race-based data collection.

There is nothing wrong with collecting data to better inform policy, but we are sure going about this in an odd way. Rather than considering how expanded access to MAID would impact marginalized communities today, this amendment suggests we should investigate the impact when it is already too late for those many who have already accessed MAID.

This amendment seems to acknowledge that, but data may have a troubling story to tell us while opting to study that impact on the fly, before we understand what it will mean for the life-and-death decisions of the members of marginalized communities.

That being the case, we should refer back to the Council of Canadian Academies' expert panel, which identified a number of concerns associated with expanding MAID in this way. Its claim suggests that the data is predictable, as having a mental disorder is strongly correlated with certain social, economic and environmental inequalities such as poverty, unemployment, homelessness, social isolation, stigma and discrimination, and that people with mental disorders face impediments to accessing appropriate mental health care in Canada. Let us not wait for people to feel forced to make the choice of death to collect this data.

It has not taken long for us to forget the safeguards that we put in place for the protection of our most vulnerable just a few short years ago. I have expressed my deep concern for this bill a few times in the House. My conviction is that life is a gift to be valued. These amendments only heighten my deep concern.

Life is a gift. I am reminded of when my kids and grandkids brought home gifts that they had made at school. Sometimes they were not very attractive and, quite frankly, perhaps I was not the proudest to put them on my mantle or display them on my fridge, but they were gifts.

Life is a gift. I did not then take those gifts and give them back, saying that I did not really want their gifts because they did not look very nice. No matter what the gift looked like, no matter in what condition it was, it was a gift and I recognized the gift. I showed appreciation to my grandchildren for the expression of their love toward me. For each and every Canadian, life is a gift and we need to appreciate it for what it is. They do not all look the same and some life circumstances put some of our constituents and fellow citizens in situations that are not desirable, yet we have to recognize that life is precious and life is a gift.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Madam Speaker, I would like to mention Dr. Sonu Gaind, who is the co-director of the division of adult psychiatry and health systems and an associate professor in the department of psychiatry at the University of Toronto, where he has been a member of the faculty since 1999. During a consultation with medical professionals that I attended this past weekend, he indicated that the number of elderly people requesting MAID since COVID restrictions have been causing isolation and growing depression has grown from 1,200 to 21,000.

Does this not illustrate the exact concern of the member in regard to Bill C-7 being brought forward to this House during such a challenging time for all Canadians, and especially for our most vulnerable?