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

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

Madam Speaker, when it comes to any safeguards being removed, to me it poses a great threat. We need to provide adequate safeguards for everyone traversing the valley of the shadow of death—

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

Resuming debate, the hon. member for St. Albert—Edmonton.

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

Madam Speaker, I am pleased to rise once again to speak to Bill C-7, the government's medical assistance in dying legislation. I do acknowledge that this is an incredibly complex subject matter for which there are many diverse views.

With that said, the way in which the government and the Attorney General have handled the legislation is a lesson in what not to do, having regard for the gravity of the legislation. I say that having full respect for the Minister of Justice and Attorney General. I believe he is a sincere and intelligent individual who is compassionate and does want to do what he believes to be right.

That said, when the Minister of Justice spoke in the House at second reading, he indicated that there were widespread consultations and that out of those consultations there was a consensus. Neither is true.

The consultations that the minister spoke about were largely over the course of one month in January of this year. They were online consultations that excluded vulnerable segments of the population, including persons with mobility, cognitive or visual impairments, persons without access to the Internet and persons living in remote and northern communities. Their voices were not heard or were not heard as easily as a result of the online consultation process that started and ended within roughly a period of one month.

Not only that, but the consultations were said to have had a predetermined outcome. In other words, the minister had an idea of the legislation that he sought to craft and he used the process as a way of getting the answers that he had hoped to receive.

Do not take my word for that. Take the words of the persons who were involved in the consultation process, including Heidi Janz of the Council of Canadians with Disabilities, or Dr. Catherine Frazee, the former chief commissioner of the Ontario Human Rights Commission and a leading advocate for persons with disabilities. They said that the consultations were predetermined when they appeared before the justice committee.

What about the consensus that supposedly arose out of these so-called extensive consultations that simply were not so? We know that out of those consultations just about every national disability rights organization opposes this bill. As we speak, they are calling on the minister and the government to put this bill on pause. We know that more than 1,100 physicians have penned a letter expressing their opposition. Concerns were expressed by the U.N. Special Rapporteur on the rights of persons with disabilities.

Just about every witness, if not every witness other than the minister himself, who appeared before the Senate legal and constitutional affairs committee that held hearings the last couple of weeks, panned the bill. No one, it seems, is happy with the bill. So much for the minister's assertion at second reading in the House that there was a consensus. There was no consensus, because there was no meaningful consultation, and there was a predetermined result that has resulted in legislation that just about everyone in one way, shape or form has been highly critical of.

I heard over the course of the debate members of the government and other parties talk about this issue in a context as if there were no risks, “Get out of the way, let the patients make their choice and throw out safeguards, because otherwise one is infringing on individual autonomy.” The Supreme Court of Canada recognized in Carter that “there are risks, to be sure”, at paragraph 105 of the Carter decision, and the court talked about how those risks can be “'very substantially minimized through a carefully-designed system' that imposes strict limits that are scrupulously monitored and enforced”. That is what the Supreme Court of Canada said.

When we talk about those risks, one need look no further than the case of Roger Foley, who is severely disabled, requires 24-hour care and is in a hospital facility in London, Ontario. I will read what he said about his experience, because it really is quite shocking. When he came before the justice committee, he talked about what can happen when there are insufficient safeguards, and we are talking about safeguards that are in Bill C-14 which are now being further removed by Bill C-7. He said:

I have been coerced into assisted death by abuse, neglect, lack of care and threats. For example, at a time when I was advocating for assistance to live and for self-directed home care, the hospital ethicist and nurses were trying to coerce me into an assisted death by threatening to charge me $1,800 per day or force-discharge me without the care I needed to live. I felt pressured by these staff raising assisted dying rather than relieving my suffering with dignified and compassionate care.

In the face of that, we put forward an amendment to say that this must patient-initiated. The minister responsible for disability inclusion said that she had grave concerns about what happened to Roger Foley, and she has heard about this regularly. Yet, even in the face of that evidence, the government rejected that very common-sense amendment, rejected other amendments and instead moved recklessly ahead. We are now in this untenable situation where the most vulnerable persons in our society could be put at risk. It really is unfortunate that it has panned out this way. I can only hope that the Senate will bring forward substantive amendments to this deeply flawed legislation.

[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, the member looks to the government and accuses it of defeating Conservative amendments. I suspect that, if the member were to reflect on what took place in committee, he would likely find that, in a minority situation, it is not just the Liberal Party that would carry the vote in a committee. The member knows this full well.

The Conservatives were unable to convince enough members of the committee to support the Conservative amendments. I suspect that the current legislation, as it is, reflects the overall thinking, dating back to 2015, from the Carter decision to the superior court decision in Quebec, which has in essence put forward the deadline of December 18.

With respect to other members of his caucus, one in particular said that the Government of Canada has two options, going to the Quebec to say that we need an extension or going to the Supreme Court. Does the hon. member share that opinion, and could he expand on it?

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

Madam Speaker, very simply, I do share that opinion. I would further add that it should never have come to this, because the appropriate course of action for the Attorney General to have taken was to appeal the Truchon decision in the first place. Had the minister done so, at the very least, we would not be in this position of trying to rush through legislation on the eve of the stay of the declaration on constitutional invalidity expiring.

[Paul Manly, Green, Nanaimo—Ladysmith, BC]

Madam Speaker, I know the Conservatives have expressed a lot of concern about people who are making money during the pandemic who should not be making money during the pandemic. I know they are not talking about the 20 billionaires who made $38 billion in the first six months of this pandemic.

The Conservatives are talking about people who got the CERB who do not deserve the CERB. In the last week, I have had a number of constituents, people with disabilities, contact my office because they are getting letters from the CRA saying that they need to pay back the $14,000 they received from the CERB. These are people who have disabilities and who are self-employed and use that income to pay their rent and utilities and to help with expenses. They did not understand the difference between the gross and the net amounts in the application process. People on disability benefits here in British Columbia can earn $12,000 a year before their disability starts getting clawed back, dollar for dollar.

Would the hon. member like to see more compassion on this issue of taking care of people with disabilities now, while they are alive, trying to survive? What does the member think should be done?

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

Madam Speaker, what I would hope is that the concerns expressed by the disability community would be heard as we debate this important piece of legislation.

Unfortunately, those voices were not heard by the Attorney General. They were not heard by Liberal MPs. They were heard by my friend from Nanaimo—Ladysmith, who did bring forward some important amendments at the committee, which we supported and which we thought moved in the right direction to provide greater certainty to protect vulnerable persons. However, those amendments were rejected by the Liberals across the way.

I hope, in the face of all of that, the Senate will do better than the process we have had in the House.

[Gary Vidal, Conservative, Desnethé—Missinippi—Churchill River, SK]

Madam Speaker, I knew entering federal politics would mean participating in many very important debates in the House, but speaking on matters of life and death brings that to a whole new level. As someone who comes from a small city in northern Saskatchewan and now has the privilege of representing the entire northern 52% of Saskatchewan, I hope to bring somewhat of a unique perspective to this debate.

As we stand here in Ottawa and debate this legislation, there are several communities in my riding dealing with very high suicide rates. Makwa Sahgaiehcan First Nation, a community of about a thousand people, has over 100 community members currently on suicide watch.

There are long-term care home and palliative care shortages across the country, but this is even more true in northern and remote communities. We need to consider what message we, as legislators, are sending to these vulnerable communities when we go way beyond the Supreme Court of Canada's Carter decision by removing safeguards that would protect Canada's most vulnerable.

The government is now seeking to play an active role rather than a passive role in the end of Canadians' lives. I find this extremely troubling and implore my colleagues on the other side of the aisle to allow the necessary time to consider the truly long-term ramifications of the legislation and to listen to all the voices speaking out on it. This does not need to be done with unnecessary hurry.

There are two main topics I want to address when it comes to Bill C-7. Number one is the impact passing the legislation will have on indigenous communities, and number two is the importance of safeguards to protect Canada's most vulnerable.

I do not stand here pretending for one moment to speak on behalf of indigenous people in Canada. However, over my lifetime I have developed relationships with many first nations and Métis people in northern Saskatchewan and over the year I have discussed this issue of assisted dying with many of them. There is a great worry among the leadership of these nations that legitimizing suicide in our culture will have grave impacts on their younger generations as well as those who are nearing the end of their lives.

These concerns were actually raised during debate in the last Parliament by Liberal MP Robert-Falcon Ouellette during his speech on what was then Bill C-14. He said:

In the indigenous world view, everything is interconnected. It is holistic, meaning that when a change is made in one place, the impact will be felt elsewhere, and the two cannot be separated. In the western world view, often we compartmentalize things. We believe that we can play, that we can control certain situations, that we can effect change here and not see change in other places. Above all, we have come to believe ourselves able to predict and control all, to control the future. This does not mean, though, that we should not take action.

The impact of this bill on people in Toronto may be very different than on the people in Nunavik or Attawapiskat. Our role as parliamentarians is to place ourselves in the moccasins of others, to place ourselves outside of our own experiences, to see the world through another cosmology and other world view, and to see the impact that our decisions may have on others.

We are making profound changes in concepts surrounding life, which cannot be undone in the future. In the indigenous tradition and philosophy, we are required to think seven generations into the future. If I am wrong and there is no connection between Attawapiskat and physician-assisted dying or suicide, if the average person does not see a connection and communities do not see a greater stress, then I will gladly say I was wrong; but if there is an impact, which is caused by the valorization of suicide, then what?

Mr. Ouellette then goes on to share a very personal and difficult story of hardship he and his siblings faced as young children, which led him to nearly take his own life. He goes on to say:

If in my life I had seen, or I had known, that my grandmother had somehow used physician-assisted dying or physician-assisted suicide, or others in my family had completed the irreparable act, then it would have made it much more difficult for me to continue.

We might not think the impact will be there, but we do not know. We assume we know these things. We are deciding the future of a few for the end of a few.

Speaking to CBC during the debate on Bill C-14, Senator Murray Sinclair shared similar views. He said:

From the indigenous perspective, ending one’s own life was not encouraged, in fact it was discouraged and there are teachings in my community, Ojibwa teachings, around whether or not you will be able to travel to the spirit world in the proper way or a ceremony could be done for you if you make the decision to end your life without good reason.

In speaking to his colleagues in the Senate, Senator Sinclair, speaking about younger people, said:

It will not take much for a young, vulnerable person to believe that their situation is intolerable to them and, therefore, we need to ensure the message we send to the Canadian public with this legislation is that this is not a right that should be easily exercised or that we are embracing.

First nations people in northern Saskatchewan, Mr. Ouellette from Manitoba and Senator Murray Sinclair are not alone. Tyler White, chief executive officer for the Siksika Health Services, as well as Dr. Thomas Fung, a lead physician of the same nation, are sounding alarms in response to the legislation. During an interview with CTV, Mr. White said, “The expansion of MAID sends a contradictory message to our peoples that some individuals should receive suicide prevention, while others suicide assistance.”

In a letter shared with my office, Mr. White and Dr. Fung told the story of a patient who suffers from a lung disease that causes him to become easily short of breath, even when doing simple household tasks. This patient uses a walker but cannot walk for more than a couple of minutes without gasping for breath. While the man's condition is incurable, he could certainly have an improved quality of life if he had access to funding to support his home oxygen, but he was just out of the range of being approved for funding. Dr. Fung concluded by writing that under Bill C-7, this patient would have qualified for assisted death when it should be clear to all that there are other ways to relieve this man's suffering and improve his quality of life. Patients like Dr. Fung's deserve better.

In a country as developed and resourceful as Canada, we cannot allow ourselves to abandon people like this. Our health care system is the pride of many Canadians, but that is because of universality of access to life-saving treatments, not the universal admissibility to a physician-administered death.

I want to talk for a minute about the safeguards for vulnerable Canadians and how the legislation would fail to provide them. I am not a lawyer, but thankfully the Leader of the Opposition is. We are probably all glad that is the case, that I am not the lawyer. I was glad to be in the House during this speech on Bill C-7 this morning.

Leaning on his legal expertise, allow me to repeat some of what he said regarding previous litigation surrounding assisted death, because it struck me as very important. He said, “All of them talked about the role of the state in protecting the decisionally vulnerable, as they were called, people who could be pushed into end-of-life treatment because they felt they were a burden. This has been talked about since the 1990s, and this Attorney General is removing the safeguards from our regime. Every ounce of case law on the issue of assisted dying, euthanasia or assisted suicide talks about protecting those vulnerable.”

Speaking of protecting the vulnerable, the leader also said, “All major disability groups in Canada agree with the compassionate and reasonable position being presented by my Conservative colleagues. I am very proud of the advocacy we have shown. We have also been joined by legal scholars, indigenous leaders and people working with people with mental health issues.” I wholeheartedly echo the comments made by my hon. friend this morning and repeat the need for the government to step back from its repealing of the provisions that would ensure a 10-day waiting period, as well as two witnesses.

As a matter of fact, regarding the 10-day waiting period, a senior employee of the AFN shared on Twitter recently, “This ten day period literally saved a member of family’s life. MAID must be accessible but also account for clear and thoughtful consent. The Liberals should rethink this.”

In closing, I want to completely acknowledge that both sides of this debate are coming from a point of view of compassion. I understand that the government has approached the drafting of the legislation in good faith, but the reality is that it has fallen short of its duty to Canadians. That is why I will be voting against this dangerous bill and I hope that my colleagues on the other side of the aisle will reconsider their support for it as well.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Madam Speaker, the member talked about this being a life and death issue. Oftentimes, when we sit in this place, we look to these issues with the degree of magnitude that they deserve.

As the bill went through committee, there were some challenges. I know some reasonable amendments were put forward by the Conservative caucus. I am wondering if the member could speak to those reasonable amendments and just how important they are to determining this piece of legislation.

[Gary Vidal, Conservative, Desnethé—Missinippi—Churchill River, SK]

Madam Speaker, I agree that some reasonable amendments were proposed, and we would like to see the 10-day reflection period I talked about put back. I would like to share a really personal story about this, which I think will emphasize that point to the House.

Back in 2014, in my small city in Meadow Lake, Saskatchewan, a young lady graduated from high school, a tremendous athlete. She had just finished her nursing degree, and I think one Tuesday night she was in a terrible car accident and ended up a paraplegic. This was a family friend of mine, and I had the privilege, or maybe the horror, of being in the hospital with her family that night and in the following days. I can guarantee the House that this young lady would have chosen death over life at that point if she had had that opportunity.

Now this young lady, several years later, is a Paralympic athlete. She has gotten back to doing incredible things with her life. She has been all over the world for athletics. I could talk for a long time about this, but I am going to say something that came from her dad. He said, “One of the really cool things we are slowly catching is the members of this special group of people don’t see themselves constrained in any way.” People with disabilities do not see this when they get past the hurdle of the original burden, which, in this case, was this young lady's accident.

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

Madam Speaker, we know that physicians are very concerned about conscience protections for medical practitioners. Right from the beginning, with Bill C-14, many stressed that this should be part of Bill C-7, yet the Liberal government has totally ignored it and punted it down to the provinces. I believe it is impacting palliative care and impacting people's perspectives of serving in the medical profession. I would just like some comments from the member in that regard.

[Gary Vidal, Conservative, Desnethé—Missinippi—Churchill River, SK]

Madam Speaker, I fully agree. Probably the second most common concern I have heard about from people is conscience rights. I have talked to people who believe that is a huge issue. They do not believe that their personal belief system, faith or life journeys should be impacted by some imposition of government.

I want to share one other quick comment here. In the debate on this in the last Parliament, the former attorney general and justice minister commented about preventing the normalization of suicide to protect vulnerable person who are disproportionately at risk of inducement to suicide. She spoke of that repeatedly. This is from a CTV article:

In defending it before the Senate, [the former justice minister] warned that expanding the eligibility criteria to include anyone who is suffering intolerably would “send the wrong message that society feels it is appropriate to address suffering in life by choosing death. This message may encourage some who are in crisis and already considering suicide to act.”

I really do not think we should be putting our medical professionals in that place.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Madam Speaker, I feel honoured tonight to be speaking to Bill C-7 given the many great speeches by my Conservative colleagues, who are concerned about our citizens and especially those in the disability and senior communities.

I speak today deeply concerned about Bill C-7 and the changes being proposed in the legislation. I know this is an emotional issue for everyone, and it is an important discussion we are having this evening. Any legislation that is introduced in Parliament requires a thorough review, but this is especially true for bills that are literally matters of life and death.

It is my firm belief that the federal government should have appealed to the Supreme Court to get certainty on the framework within which Parliament can legislate. Unfortunately, that did not happen, so here we are with a rushed bill that puts the lives of our most vulnerable at risk.

Make no mistake: As a Christian I am firmly against the use of medically assisted dying. That said, I understand that the courts have made a ruling and the legislation is required. However, we must ensure that this type of legislation includes safeguards for the most vulnerable in our society and for the conscience rights of physicians and health professionals.

That is why we Conservatives introduced a number of reasonable amendments to reinstate protections that the Liberal government has simply removed, which is troubling. These include reinstating a 10-day reflection period when death is reasonably foreseeable, extending the reflection period when death is not reasonably foreseeable, protecting vulnerable patients by requiring that the patient be the one who first requests information on medical assistance in dying and protecting the conscience rights of health care professionals.

It is unfortunate that these amendments have been rejected by the government. I am deeply concerned that this legislation will allow assisted death for Canadians who are not dying by removing the requirement that a person's death must be reasonably foreseeable for them to be eligible for assisted suicide and euthanasia.

My dad is 86 and my mom is 76, and as the son of two elderly Canadians, I am very concerned about what this would mean for our nation's seniors and the positions they may be put in when trying to access health care. Will they be placed in a position where they will have to decide between care and ending their lives because of outside pressure? As the bill expands medically assisted dying further, there is a risk that palliative care will suffer and, as a result, patients will view medically assisted dying as a better option.

I know Canadians share my concerns. It must be said that every national disability organization in Canada opposes this legislation. Krista Carr, executive vice-president of Inclusion Canada, said at committee, “Bill C-7 is our worst nightmare.” These organizations caution that removing the end of life requirement discriminates against those who are disabled and puts their lives at even greater risk. Ms. Carr notes:

The end-of-life requirement was the only safeguard whereby disability was not the sole criterion. By having a disability itself under Bill C-7 as the justification for the termination of life, the very essence of the Charter of Rights and Freedoms would be shattered. Discrimination on the basis of disability would once again be entrenched in Canadian law.

It is shameful that in the Liberal government's rush to pass the bill before Christmas, it continues to neglect to address legitimate concerns being raised by persons with disabilities.

I am also deeply concerned about the limited protections for the conscience rights of our medical professionals. While some doctors and health care workers may have been comfortable with medically assisted dying under Bill C-14, the continued expansion may cause them to rethink their participation.

Others who have always been against medically assisted dying are already feeling the pressure to go against what they believe. As the Physicians Alliance Against Euthanasia said in a news release just last March, “The pressure has been intense for many physicians, especially amongst palliative specialists, some leaving their profession even before this latest development. Descriptions were made of toxic practice environments and fear of discipline by medical regulators.”

Members of the justice committee have heard first-hand from disability advocates vehemently opposed to Bill C-7 and its rapid expansion of medical assistance in dying. They argue it amounts to a deadly form of discrimination, making it easier for persons with disabilities to die than live. It is shameful.

Health care professionals have also spoken out, concerned not only about their conscience rights but also about the speed at which the government is trying to pass Bill C-7. To quote Adam Taylor about the lack of consultation on this legislation, “As an emergency and family doctor, I know the importance of consultation, along with the day to day experiences and sufferings of Canadians which cannot be ignored. I'm terrifically concerned about this.” Even so, here we are, and the Liberals are continuing to push through the bill, ignoring concerns of those who would be directly affected by these changes. Again, it is shameful.

As the Evangelical Fellowship of Canada said in its submission to the House of Commons Standing Committee on Justice and Human Rights, we must carefully consider the impact of Bill C-7 and the concerns being raised by many Canadians, particularly Canadians with disabilities. The legislation, not to mention the human lives the bill would negatively affect, is too important to be rushed.

The House resumed from December 8 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the third time and passed.

[The Deputy Speaker, Bruce Stanton]

The hon. member for Prince George—Peace River—Northern Rockies had four minutes remaining in his time when the House last took up debate on the question. We will now go to him by video conference.

The hon. member for Prince George—Peace River—Northern Rockies.