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

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

Madam Speaker, as I said in my speech and in response to other questions, we are debating a bill that would, by removing the safeguards, dramatically expand the existing euthanasia regime in Canada. We need to protect vulnerable Canadians. We heard that over and over again from many stakeholders, as well as those representing disability groups. We really need to pay attention to what physicians and these advocates are saying to us.

[The Assistant Deputy Speaker, Carol Hughes]

Order. 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 Sherwood Park—Fort Saskatchewan, Persons with Disabilities; the hon. member for Victoria, The Environment; the hon. member for Nanaimo—Ladysmith, International Trade.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, I am pleased to have the opportunity to debate Bill C-7 at report stage. This is my first opportunity to speak to this really important piece of legislation.

The government has a deadline and of course is trying to rush this process through, but we have to remember that the Liberals prorogued Parliament for six weeks. I have to say, again, that the government's lack of planning is not my emergency. We had a number of days where important debate could have happened prior to the Liberals dealing with their deadline issues. I look at those six wasted weeks, and I believe we should have been sitting and dealing not only with the emergency issues but with some of the legislation that was critical.

I want to reflect with some general comments before I specifically talk about the report stage. In 2016, Parliament was debating the initial legislation for medical assistance in dying. It was very thoughtful debate. It is perhaps some of the most thoughtful, heart-wrenching debate that I have witnessed and been part of.

We have 338 parliamentarians, and we had legislation that was introduced in a partnership. One of the ministers who introduced it, as members are aware, was Dr. Philpott, who is no longer in this Parliament. She was a doctor, so she brought the lens of the health care provider to the conversation. The other minister was the former attorney general, who is now the member for Vancouver Granville. What we had was careful, very thoughtful debate by 338 parliamentarians, representing 37 million Canadians. We came up with what we thought was a reasonable framework for the first five years. Those five years is where we have to be very careful. This is new and it is something very profound. This is life-altering. We need to be watchful and worried about this.

I was very supportive of the original legislation in 2016 and all the way through, because I felt the ministers were listening, taking in amendments and adapting the legislation so that there was a level of comfort with it. In my riding, there was a lot of work in terms of polling, and I believe that most of my constituents were also favourable. It was in the 70% range. We had round table after round table.

When I voted for the original legislation, I believed I was representing my constituents and I was also representing how I felt about moving forward. I was also comforted by some very careful protections and safeguards.

What we have now is a judge from the Superior Court of Québec who made a decision, and a government that chose not to refer it to the Supreme Court. We know that the current Attorney General, right from the word go, wanted to expand that. He voted against the legislation, saying he did not feel it went far enough when it was originally presented. He was in the minority of parliamentarians. Clearly the court decision in Quebec aligned with his personal beliefs, as did the decision by the current government that it would not refer it to the Supreme Court.

From my perspective, this court ruling undermined Parliament's power to issue broad legislation aimed at protecting the rights and interests of the elderly, ill and disabled, and preventing suicide.

I find it kind of interesting which section of the charter the judge quoted. It was deemed to be violating and infringing on “life, liberty and security”. The word “life” is in the charter in section 7, but here we are, talking about dying as opposed to life.

I was comfortable, as I said, with the original legislation. In the debate at the time, I talked about the potential slippery slope and that we would have to safeguard against it. I knew that there were some unresolved issues, and the five-year review that was built into the original legislation should have been the opportunity for Parliament to, first of all, see what happened in the first five years of this very profound legislation and then look at those unresolved issues, as opposed to one court decision about one particular section of this.

Many people talk about a slippery slope. I am almost wondering if we are heading down an avalanche path, on which there are going to be no safeguards that remain, which will be a real problem.

I understand that, out of the 81 witnesses at the Senate, there was no one who actually supported the legislation. Many thought there were gaps, but there was also a number who, like in the other debate, felt that it needed to go further. However, there were 81 witnesses and no one said that this was a well-crafted piece of legislation.

Certainly, we are very aware that there have been people who have been vocal. The disability community has been very vocal in terms of its concerns about what this legislation would mean to its members. Regarding indigenous communities, I noticed a tweet from a very prominent indigenous person who said that had that 10-day waiting period not been there, they would have lost a relative before they should have lost that relative. We also have had many physicians who have expressed their concerns. I always recall an email that I got very early on that talked about how life can be very difficult and messy. He said that it spills all over the floor.

However, in terms of this pathway the government has chosen to deal with those very difficult concerns, there is no question that people have profound struggles in their lives, in terms of health issues and where their life path is taking them. I do not think anyone diminishes that, but we have only had this original legislation for five years, and it needs to have that five-year review process. It needs to be very carefully looked at.

The government suggests that it did a lot of engagement and says that it had an online process, which most people in my riding had no awareness of. The government says that it has struck the right balance. I will go back to my original comment. I support medical assistance in dying. I have witnessed the very difficult challenges that people have in their lives, but this particular piece of legislation is, in my opinion, poorly crafted. It is taking out many of the protections that we thought were important to have in place. The approach of the government now, contrasted to 2016, when it truly was listening to parliamentarians and truly caring about what different people had to say, is almost “my way or the highway”.

In conclusion, I supported the bill at second reading. I wanted to hear what the witnesses would say. There are parts of it that I can actually agree with, but on balance, I think we have not created the right balance. Unless there are some very dramatic changes, I will not be able to support it in terms of the next step.

Again, it is really important, and I urge all members to think very carefully about whether this has struck the right balance, when we have so many people from vulnerable communities who say it has not.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Madam Speaker, courts and rights are important because sometimes politicians listen to what the majority wants, and we infringe upon those rights. When measures are unpopular, it matters more than ever that we have courts and rights to depend upon.

When we look at the Supreme Court in Carter, it specifically interpreted the same section that the Quebec superior court judge interpreted, section 7, which is the right to life, liberty and security of the person. The word “life” was still in there. When we go back to that Carter criteria, unanimously upheld by the Supreme Court and unanimously upheld subsequently by the Alberta Court of Appeal, specifically we see the eligibility criteria of sound mind, having capacity, irremediable illness and unbearable suffering. I wonder why the member thinks that this notion of terminal illness ought to be an additional criterion.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, obviously the courts and their decisions are very important, but I also believe every single one of the 338 parliamentarians thoughtfully engaged their constituents and spent a lot of time reflecting on what is a really significant piece of legislation. A mechanism needs to be built in that lets us take a very cautious step, review it and then make sure things are okay. Then we need to look at the other pieces.

I do not think we need to look to other countries. We are one of the few countries around the world that has this kind of legislation, so taking those very cautious steps, reflecting and then perhaps readjusting the legislation is important. This should have been, in our opinion, referred to the Supreme Court. There are still many unresolved issues. It would have been better to have a more focused five-year review process.

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

Madam Speaker, I am sure my colleague is aware that the Conservative Senate leader, when questioning the Minister of Employment, Workforce Development and Disability Inclusion, spoke to her about the case of Roger Foley.

The minister's response really spoke to my heart. As reported in the Toronto Star, she said:

...she has “grave concerns” about what happened to Foley.

“And I can tell you he's not alone.”

She said she “regularly” hears from people who are “appalled” to discover a family member with a disability has been offered what she called “unprovoked MAID.”

She then said:

“I think that has to stop ... It really speaks to the underlying systemic discrimination that we can’t not talk about anymore in this country.”

I wonder what the member's thoughts are on this statement from the individual who serves as the disability inclusion minister for our government.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, that was a very profound statement by the minister. I did talk a bit about the process in the Senate, but we needed to get it right in the House. We had proposed many amendments. We know the disability community is very concerned, and they have raised some very powerful specifics.

The current government did not support the amendments that were proposed. To be frank, I think we are going to have some more challenges when it hits the Senate. We should have made sure it was a good piece of legislation before sending it to the Senate.

[Eric Duncan, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, I actually share all my colleague's views. I was not a member of the chamber back when the original legislation went through, however I have concerns here now about some of the changes and safeguards.

With her background, particularly as a nurse and in health care, could she talk a bit about the lack of options for palliative care, perhaps in her region of British Columbia, as a key concern many of us have not seen developed since the original legislation?

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, palliative care throughout the country is a real gap, and it is an important part of our health care system. That was always to be part of how we move forward. Medical assistance in dying was to be part of a larger piece and was to be part of a comprehensive look at what was available in palliative care. We had a colleague who put forward a motion, and nothing was ever done with it.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, it is an honour for me to rise in the House today as one of 338 federal lawmakers in Canada whose duty it is to make good laws that will have a positive impact on the lives of Canadians now and for generations to come.

The weight of my duties as an MP have become more evident as I have been serving my constituents through the pandemic. Canadians have been struggling intensely for nine months as a microscopic organism called the coronavirus has caused us to shut down our lives and institutions on so many levels.

Today, as I speak on Bill C-7, an act to amend the Criminal Code on medical assistance in dying, the weight of my parliamentary role is compounded because what I say today may be the most important thing I have spoken about in the 12 months I have been an MP. Today, I am compelled to speak from the depths of my heart, conscience and love for my fellow humans, and nothing less, because the very flow of life and death in our nation is in my hands and the hands of each member of this House through Bill C-7.

Bill C-7 came about after the Superior Court of Quebec struck down the reasonably foreseeable natural death clause of this legislation as unconstitutional. This ruling resulted from a case of two individuals with degenerative diseases, Truchon and Gladu, who had sought to repeal this provision in the law and access MAID. The judge asserted what the plaintiffs were really looking for was for the law to recognize equally the suffering, dignity and, ultimately, autonomy of people who, like them, are affected by serious and irremediable health problems without any hierarchy, whether death is near or not.

Bill C-7 would eliminate the clause that requires a 10-day waiting period between when MAID is requested and when it can be administered when death is reasonably foreseeable. Bill C-14, the original MAID bill that was given royal assent on June 17, 2016, already allowed for this period to be waived under specific circumstances, which are if two medical practitioners are both of the opinion that the person's death or the loss of their capacity to provide informed consent is imminent, or any shorter period is considered more appropriate by the first medical practitioner or nurse practitioner in the circumstances.

Many lawyers, doctors, families and advocates for individuals with disabilities feel Bill C-7 has gone beyond what the ruling in the Truchon-Gladu case called for. They feel Bill C-7 is discriminatory to the disabled and risks the abuse of MAID.

Amy Hasbrouck, a representative from the group Not Dead Yet, said this about the court ruling in a press interview: “Basically this decision is saying that as far as society's concerned, it's better to be dead than disabled”. Hasbrouck feels governments should improve services for people with severe disabilities to help improve their quality of life and allow them to continue living in their own homes.

This bill has also raised the concern of deepened challenges on the conscience rights of doctors. There are limited protections for the conscience rights of medical professionals already, and loosening restrictions will cause greater strife to those already uncomfortable with MAID. Throughout the debate, Bill C-7 has raised a lot of concern that as it expands MAID accessibility, it risks palliative care suffering. As a result, patients will view MAID as a better option. Unless there is more focus on improving and expanding palliative care so that palliative care is more accessible, MAID may appear to be the more practical solution for Canadians.

I now speak on Bill C-7 as a potential trigger to another pandemic within a pandemic. Canadians are currently experiencing multiple pandemics within the pandemic. They are struggling with depression and anxiety about their future because of economic uncertainties and collapse. They are facing social isolation. Although uncertain about the full ramifications of the coronavirus, in order to prioritize and protect the health and safety of Canadians, multiple tiers of government across our nation opted to take drastic measures throughout the pandemic with lockdowns and travel restrictions, which have infringed on some civil rights.

Social isolation is putting seniors in a mental health crisis. Recently, Nancy Russell, a 90-year-old woman living in a seniors home, chose MAID because she did not want to go through another lockdown or isolation this winter. According to some MAID practitioners, there is a trend of more reports of seniors interested in MAID and accelerating their timelines because of COVID.

I would like to ask each member in the House this: Is the passing Bill C-7, with its safeguards removed, during a pandemic, when Canadians are vulnerable to depression and suicide, a responsible and timely action? The government had the option to appeal this, but it chose not to.

I fully appreciate that the debate on Bill C-7 brings issues of compassion, dignified death, suffering and personal rights into a complex but profound discourse. Medically assisted death is complex, and debates on human rights are important, but in this time of severe and drastic measures to protect lives and keep Canadians safe from a virus that has the potential to take many lives, the government has entered into emergency mode. It has put health and safety above many important things.

We have allowed the economy to fall apart to flatten the curve and save lives. Canadians put a precedent on saving lives over some basic rights.

Rights do not exist in a vacuum. They exist to support the overarching vision and mandate, which I hope unifies all of us in the House, which is to protect the lives, sustenance and flourishing of humans; to ensure all people, regardless of who they are, their behaviour, ideology or capacity, to be functional in life; to protect their existence and sustenance needs; and to provide individuals with fair opportunities to dream and make the most of their lives. I understand the principles of debate and rights, but in the context of this pandemic we are facing, my humanity and my heart burn like a mother bear for the lives of Canadians.

In a recent report from the Canadian Mental Health Association, 3,800 Canadians died in 2018-19 after being admitted into hospitals for self-harm. With the stress, hopelessness and trauma created by the pandemic, that number is on the rise, especially for the most vulnerable.

In a survey held by CMHA in May during lockdowns, 38% of the people surveyed said that their mental health had declined due to COVID-19, 6% had suicidal thoughts and 2% had tried to harm themselves in response to COVID-19. Based on this survey, if there are 30 million adult Canadians, then it would mean that 1.8 million adult Canadians have had suicidal thoughts and 600,000 have tried to harm themselves as a result of the challenges caused by the pandemic.

The count for the number of Canadians who have died from COVID-19 is 12,211 from yesterday's numbers. If only 6% of the 3,000 Canadians who participated in the survey had suicidal thoughts, that would still be 180 people. What does that translate to in Canada's entire population?

More survey results show that not everyone is affected equally. While 6% of the general population have had suicidal thoughts since the outbreak of COVID-19, suicidal contemplation has been happening with 18% of people already struggling with their mental health, 15% of people with a disability, 14% of people with low incomes and 16% of people who are indigenous. This is not fair.

This is the question I would like to ask all members: Do we, as members, take mental health seriously? Do we recognize that extraordinary suicide prevention must be part of our COVID response? Do we see the danger of passing a bill such as Bill C-7 in the context of a pandemic where we see rising numbers of mental health challenges and suicidal contemplation?

The mental health side of the pandemic does not end with a vaccine, because healing from trauma and financial restoration takes time. What is the message we want to send to the Canadian public right now as parliamentarians? In the name of saving lives, we have allowed families to be separated, and we have allowed businesses and institutions to be pulverized, but what support are we providing to counter the depression and hopelessness that comes from these drastic measures? We should be more focused on creating more access to counselling and mental health support.

For those who say that mental health is a provincial issue, I would say to them that mental health is a serious issue and one that all tiers of government must come to the table to discuss and implement solutions for. We have a responsibility as lawmakers to look at the big picture and understand the time we are in right now.

We do not see suicides reported, but all of us know someone, whether directly or by one or two degrees of separation, who has attempted or committed suicide. Let us be sober. The bill before us could open doors to a suicide pandemic during this pandemic. Our duty is to pass legislation that protects the life, sustenance and flourishing of our fellow humans and not make them more vulnerable and susceptible to death.

Canadians need hope. Will my colleagues, with a clear conscience, be able to say that they did everything they could to prevent suicide? Will they be able to say with conviction that they had helped someone find hope and not have to resort to death?

I want to be wrong. I hope there is no suicide pandemic, which the unpredictable waves and lockdowns of COVID-19 would exacerbate, but the government has chosen to put the priority of saving lives at a high cost. Were the drastic measures reasonable or too severe? I think most Canadians would say that saving lives was worth it. Will it be worth saving lives by stopping the spread of a culture of suicide through a bill like Bill C-7 during this pandemic?

The very life breath of Canadians are in our hands right now. I cannot support the bill in the name of mental health and saving lives in this pandemic. I do not want blood on my hands for the death of any Canadians who were inspired by the passing of Bill C-7 to cope with mental health challenges and hopelessness during the pandemic, especially when we do not have enough to give them more hope.

Being a parliamentarian comes with responsibility. Ideology comes with responsibility. Legislation comes with responsibility. Legislation is not separate from the current plight Canadians face. I encourage every member to examine this bill, recognizing there is not enough hope to safeguard against the dangers of Bill C-7.

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

Madam Speaker, I appreciate the passion of the member in expressing and sharing her thoughts with regard to the legislation. Unfortunately, with the very small amount of time I have in the form of a question, there are many statements I would like to make that I am not able to. Suffice it to say that mental health is very important, as is palliative care. These are all important issues and some of the reasons why I am not saying we as a government stand alone. We have been pushing that agenda for years now. By pushing that agenda, we have also invested hundreds of millions, going into the billions, of dollars over the last number of years.

The question I have for the member is this. We recognize that all lives are of equal value. There is no doubt about that. Going forward with this legislation is not just supported by one political party: amendments were brought forward and opposition parties are supporting the legislation. It seems the consensus of the 337 members of the House is to continue to move forward, given the importance of this issue to the individual.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, my speech today has to do with the timing of the bill because of the unique circumstances we are in. If we were not in a pandemic, I would not have given this speech.

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Madam Speaker, I do not agree with the principles put forward by my colleague.

Medical assistance in dying seeks to help those people. They are vulnerable, but they still have all their faculties and can make decisions.

The member spoke about discrimination against people with disabilities. I disagree with her because people with disabilities also have the right to choose whether to live or die with dignity, regardless of their illness. There are professionals taking care of these people. They have access to mental health care and palliative care.

It is unreasonable to use extreme examples like you did. I think that this legislation will support these people and they need that support. This bill should therefore be passed. Did you read the bill carefully before mentioning these things and expressing your point of view?

[The Assistant Deputy Speaker, Carol Hughes]

I would like to remind the hon. member that she must address her comments to the Chair and not to another member directly.

The hon. member for Port Moody—Coquitlam.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

Madam Speaker, I am not disqualifying the thoughtfulness and value of these discussions. Again, I am raising this in the House today because of the unique circumstances of the pandemic we are in, which is putting many people at risk. The very sound bites, the dialogue and the contemplation of suicide should not be exacerbated by having something like this to inspire people in the wrong direction. I am not talking about those who are legitimately seeking the assistance of MAID to find dignified death. I am speaking in the context of the larger Canadian population in this pandemic.