This bill is from the 43rd Parliament, 2nd session, which ended in August 2021.
David Lametti Liberal
This bill has received Royal Assent and is now law.
This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.
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.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.
Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-7s:
Luc Berthold Conservative Mégantic—L'Érable, QC
Madam Speaker, I have a great deal of respect for my colleague who just gave her speech.
The thing that most concerns me is the issue of access to palliative care in Mégantic—L'Érable. I know that many people back home have some concerns about that because this type of care is not always available. I would like to know whether the same is true in her corner of the country and to hear her comments on that.
Karen Vecchio Conservative Elgin—Middlesex—London, ON
Madam Speaker, throughout the entire country we are seeing issues within our long-term care homes, and we have seen throughout this pandemic what is happening. When we are looking at medical assistance in dying, all of the factors that are bundling up on our seniors are making life look hopeless.
I am a person of hope. Sometimes I call myself a Pollyanna. I always believe there has to be a light at the end of the tunnel. I do not think the government is providing enough light to make sure people know we can do better.
Cathay Wagantall Conservative Yorkton—Melville, SK
Madam Speaker, I am thankful for the opportunity to speak again to Bill C-7, an act to amend the Criminal Code (medical assistance in dying) at report stage.
I will touch on two key amendments the Conservatives were seeking, namely to maintain the reflection period of 10 clear days between when the request for MAID is signed and then received, and to extend the assessment period from 90 to 120 days for those whose death is not reasonably foreseeable. Originally, these were amendments we put forward at committee. In fact, these are just two of several amendments we worked really hard to achieve in good faith. They were all rejected by the Liberals.
Therefore, I would first contend that the bill we have received back from the committee demonstrates a lack of concern for the voices of opposition, and not merely those of our Conservative opposition, but rather those of the differently abled and the medical experts whose concerns we compassionately championed. We must thoughtfully consider the alarm of Canadians who are passionately opposed to what Bill C-7 is now proposing.
Bill C-7 would eliminate the requirement of waiting 10 clear days after being approved for the procedure, effectively allowing for a system of death on demand. As we heard at committee, this is troubling for those whose lives have been affected by disability. For those who want to live with dignity, Bill C-7 presents and very clear and present danger. That is what they are saying.
Let us refer to what witnesses told us at committee.
Roger Foley, who lives with a severe neurodegenerative disease, told the committee this:
With the Assisted Dying Regime in Canada, I have experienced a lack of care and assistance for which I need to live.... I have been abused and berated because I have disabilities, and told my care needs are too much work. My life has been devalued. I have been coerced into assisted death by the abuse, neglect, lack of care and threats.
Mr. Foley went on to say, “Assisted Dying is easier to access than safe and appropriate disability supports to live!... You have turned your back on disabled and elderly Canadians!” I found that very difficult to hear.
Dr. Ewan Goligher, a physician-scientist, was clear in his assertion that Bill C-7 singles out those with disabilities when, in many cases, death can be prevented. He said:
Bill C-7 declares that an entire class of people—those with physical disabilities—are potentially appropriate for suicide, that their lives are potentially not worth living. Indeed, were it not for their disability, we would not be willing to end them. I cannot imagine a more degrading and discriminatory message for our society to communicate to our fellow citizens living with disabilities.
As the CBC similarly noted, “While reflecting understandable empathy for often-severe suffering, the bill conforms to an ableist presumption that a life with disability or chronic illness is less worth living.”
Krista Carr, executive vice-president of Inclusion Canada, spoke on behalf of families of those with intellectual disabilities who fear their loved ones will be left without a choice. She said, “families now fear that their family members will be encouraged to end their lives. Rather than addressing their suffering, as we do for every other Canadian who tries to end their suffering through suicide, their lives are now judged as not worth saving.”
This claim by Ms. Carr was reinforced by the testimony of Taylor Hyatt, who bravely shared a personal story. Having been admitted to the ER with difficulty breathing, she was advised by the doctor that an infection she had could require oxygen. Ms. Hyatt enthusiastically agreed to the use of oxygen, but found it troubling that her answer came as a surprise to the doctor. I know Taylor and she is full of energy and life. It was at this point that Taylor came to a stark realization. She said:
In that moment, I would have been able to refuse treatment and be permitted to die. Or, in a moment of weakness, bought into the stereotype that my life wasn't worth living and requested and received a lethal injection. Breathing supports would be considered standard treatment for a non-disabled person in my situation, especially somebody in their mid-20s as I was.... If this bill goes through, how many more disabled people at their lowest moments could have a drastically different and decidedly unwanted ending to their story?
We on this side of the House recognize that Canadians' tolerance for assisted dying has evolved over the past four and a half years. In fact, a 2020 Angus Reid Institute poll found that four in five Canadians believe that it should be easier to make their own end-of-life-decisions, compared with 73% four years ago. However, the same poll found that 65% believe the option of assisted suicide and euthanasia has the potential to intensify pressure on those with disabilities to choose death as a means to avoid being a burden to others. They want lawmakers and the courts to give significant weight to this concern.
In my view, C-7 abandons the concerns of witnesses and the majority view of Canadians. Appropriate safeguards, such as the 10-day reflection period and a 120-day assessment period for those whose death is not reasonably foreseeable, are absolutely warranted, so why are the Liberals denying this?
My second point as to why the bill should not proceed is that it is the government’s clear intention to go beyond the scope of the Quebec Court of Appeal’s Truchon decision.
One of the key elements of the bill, for me, is the about-face the government has taken. Less than five years ago, Bill C-14 was passed. It was a bill that I, and many in my party, have opposed in principle from its introduction to the present day. However, many Canadians took solace in the fact that Bill C-14 contained a vital element of parliamentary accountability. Clause 10 mandated a five-year review, wherein the provisions of the assisted suicide law, as well as the state of palliative care in Canada, would be fulsomely studied by the House of Commons and Senate before the end of June 2021. This was our responsibility.
This vital element of Bill C-14 has been ignored by the government. As parliamentarians, we have now been tasked to consider a massive expansion of assisted suicide and euthanasia without a clear enough understanding of Bill C-14’s effectiveness, enforceability and areas of acute concern.
It bears repeating something from my speech in October. Rather than appeal Truchon to the Supreme Court of Canada or wait for the all-important five-year review of assisted death in Canada, the Liberals have chosen to run with the Truchon decision and legislate on an expansion of assisted death for the entire country. Not only that, but the bill far exceeds the scope of Truchon.
Indeed, during Oral Questions on November 23, the member for Vancouver Granville, the former minister of justice and attorney general, and author of the original MAID legislation, called into question the government’s effort to eliminate the 10-day reflection period and reconfirmation of consent through Bill C-7. She said:
Nothing in the Truchon decision of the Quebec Court of Appeal, which the government chose not to appeal, requires this, and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard, and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.
The government clearly has its own agenda here. The Liberals appear determined to eliminate safeguards for the most vulnerable when they were not instructed to do so. This is coupled with the fact that the House has not had the benefit of a fulsome study of the original MAID legislation. The House should proceed with the adoption of our very reasonable amendments, as Canadians want them.
Finally, I would like to reiterate a point from my last intervention on the bill. The Liberals continue to lag on a national strategy for palliative care, but at the same time they are moving forward on more accessibility to MAID. The Liberals broke their promise to invest $3 billion in long-term care, including palliative care, and have yet to bring Canadians the national strategy on palliative care they promised and agreed to. Just as 80% of Canadians believe it should be easier to make end-of-life decisions, 70% of Canadians continue to live without any access to palliative care. That is why the Liberals’ approach is nonsensical.
The Angus Reid poll found that 62% of Canadians want those in this place to give due attention to the concern that our health care system might begin to ignore long-term care and chronic disease among the elderly as MAID becomes more widely accessible and routine. We are seeing this happen.
Furthermore, seven in 10 Canadians want us, as lawmakers, to consider whether increased access to assisted suicide and euthanasia will mean less investment in traditional palliative care. I dread that, but in my view that situation is already unfolding.
I refer to the Delta Hospice Society, where 10 hospice beds are at risk of being defunded because of its refusal to provide assisted suicide to its patients. The Delta Hospice Society believes that MAID is distinct from, and violates the very purpose of, the palliative care that it is very proud to provide. Indeed, President Angelina Ireland has been clear that the intention is not to overturn MAID. The society is not a threat. It only wants to uphold its approach to the end-of-life care that so many Canadians want and deserve but do not have access to.
A majority of Canadians would side with the position of the Delta Hospice Society. Again referring to the Angus Reid poll, 55% of Canadians reported religious hospitals should be free to refuse to participate in MAID on moral grounds.
Any attempt to cheapen the value of palliative care should be of concern to the House. In the words of Dr. Goligher:
The goal of health care is to help the patient flourish. Palliative care is about helping the patients flourish even as they go through the dying process. I think anything that accelerates or hastens that process and doesn't give the opportunity for reflection and so on is of serious concern.
MAID is antithetical—
Criminal CodeGovernment Orders
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
I am sorry, but we have to go to questions and comments.
The hon. member for Leeds—Grenville—Thousand Islands and Rideau Lakes.
Michael Barrett Conservative Leeds—Grenville—Thousand Islands and Rideau Lakes, ON
Madam Speaker, I appreciated the member's example about the disabled individual who had a very different experience than a Canadian without a disability might experience. I heard a similar story about an individual who, it was apparent, had a physical disability and when suffering a seizure, the very first question asked was if they had a do-not-resuscitate, DNR, order.
Why is it important that Parliament give a thoughtful review, as was committed at the five-year mark, instead of having this hasty process, which goes beyond the Quebec court decision and was not appealed by the government? Why is having a proper review, where stakeholders, including from the disability community, can speak to parliamentarians, testify about their concerns, have their questions answered and have the government answer for why it would make those decisions? Why is that process important and why would that be preferential to what we are seeing happening right now?
Cathay Wagantall Conservative Yorkton—Melville, SK
Madam Speaker, there is such concern in my heart for the fact that the government is choosing on so many occasions to go over and above its own responsibilities within the realm of our Parliament, where 338 members made the decision to bring Bill C-14 forward with the understanding that the proper oversight would take place. This is a huge issue for Canada and we have a responsibility as parliamentarians to do the due research to find out how well it has been functioning and if it has been abused. We are clearly hearing stories over and over again now and yet the government has chosen to move ahead and rush this.
Those who wanted to speak to that review have had to try to make their voices heard and known in the midst of the presentation of Bill C-7. We know that many of them were shut down at committee. Testimony time was not extended and very many reports and dockets were not submitted because there was not time. Thank goodness that time is being taken in the Senate. I feel that the government has abused its responsibilities.
Elizabeth May Green Saanich—Gulf Islands, BC
Madam Speaker, this is a very significant piece of legislation. I support it completely. Amendments were attempted by the member for Nanaimo—Ladysmith for the Greens in the committee, but it is terribly important that we not conflate medical assistance in dying, as a number of Conservatives have done in this debate. My hon. friend did not do this in her speech, but did refer to “assisted suicide”. Some speeches have just called it “suicide” and euthanasia. That is not the effect of this legislation. This legislation is for medical assistance in dying for a very limited group of people who would qualify and specifically does not include mental illness.
I ask my hon. colleague to consider again whether there is a cost to people across this country who believe the rhetoric of the Conservatives and now experience additional anxiety and a thought that Canada is losing its moral compass, because the rhetoric being used in this debate is unworthy of the very good people who are using this language.
Cathay Wagantall Conservative Yorkton—Melville, SK
Madam Speaker, I totally disagree with my colleague's premise. The people we hear from over and over again and come to us for compassionate intervention are the very people feeling threatened by this particular legislation. I know that many who are disabled face very hard challenges, but many of them as well are very capable in many other ways, as I can assure you Taylor Hyatt is.
My concern is that assisted suicide or assisted dying is being encouraged. I am concerned as well for veterans who are told over and over again not to go that direction and yet we are facing a situation where we are not keeping those safeguards that would ensure that the people asking to be protected have the right to be protected in the midst of this legislation.
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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
Resuming debate, the hon. member for Provencher. He will have only two minutes before we go into Private Members' Business. He will be able to proceed afterward.
Ted Falk Conservative Provencher, MB
Madam Speaker, John Diefenbaker once said that freedom is the right to be wrong, but not the right to do wrong.
As we review Bill C-7, the proposed expansion of the medical assistance in dying regime, we must strive to uphold that value: the value of dignity and worth of all people. Canadians value our right to think freely, to consider our thoughts and opinions and to change our minds if we so choose. As a free society, we want to make room for all people to feel valued as contributing members of society.
Dr. Leonie Herx, past president of the Canadian Society of Palliative Care Physicians and chair of a division of palliative medicine at Queen's University, sees life stories every day that show people can change their mind with respect to MAID. She refers to one beloved patient who arrived at her clinic asking for MAID, but quickly abandoned his quest after being assured of his worth and that he would not be a burden.
Recently, the member for Vancouver Granville asked the justice minister in the House why the 10-day reflection period and reconfirmation of consent were waived in this proposed legislation. She talked about the fact that the removal of these safeguards was not required by the Truchon decision, the ruling that the Liberals chose not to appeal, by the way. Instead, the Liberals introduced Bill C-7 to expand MAID to abandon the critical safeguards that Parliament passed into law just a few years ago.
I noted the member's comments with great interest, given that she was the justice minister who had brought forward the original bill to legalize MAID in Canada. In response to her questions and critiques, the current justice minister replied that the 10-day waiting period only increased suffering, and that he—
Criminal CodeGovernment Orders
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
I am sorry, to the hon. member for Provencher, but I do have to interrupt. The hon. member will have eight minutes left in his time after we resume debate.
It being 6:10, the House will now proceed to the consideration of Private Members' Business, as listed on today's Order Paper.
The House resumed consideration of Bill C-7, an act to amend the Criminal Code (medical assistance in dying), as reported (with amendment) from the committee, and of the motions in Group No. 1.
Ted Falk Conservative Provencher, MB
Madam Speaker, to bring folks up to speed as to where I left off, I was talking about the 10-day reflection period that would be removed from the medical assistant in dying legislation and how the current justice minister said that the 10-day waiting period added to the pain and suffering of people.
We know that is false. Modern medicine gives us the tools to alleviate pain and suffering, if only governments had the courage to make them widely available. It simply is not right or fair that people who are suffering may not have access to good palliative care, home care or to the medications they need to reduce their pain, suffering and anxiety. Ensuring all Canadians have access to care needs should be our top priority to address the needs of suffering Canadians. Death cannot and should not ever be the only choice to end excessive suffering.
Suffering Canadians must also be free to exercise a change of heart if they choose. The elimination of the reflection period and the removal of the requirement to reconfirm consent take away this option. It takes away the option to reconfirm consent. It takes away the option to give comfort in making that decision.
How are we preserving the right for people to change their minds when we waive the waiting period? It would seem the bill would make MAID not only final, but unwavering and resolute, because it would remove the waiting period and the need to reconfirm a person's consent.
The First Annual Report on Medical Assistance in Dying in Canada, 2019, published in July of this last year, relates that in 2019, 3.6% of the patients who made written requests for MAID subsequently withdrew those requests. That may seem like an insignificant number, but the number of deaths put in context works out to 263 deaths that were avoided because people changed their mind. Of the 7,336 who applied for medical assistance in dying, 263 people changed their mind, 3.6%.
We shut down economies for death rates of 0.2%. We now have what would be a wrongful death rate of 3.6% that could be averted and we turn a blind eye to it. Every single one of them deserved the freedom to make that choice. What if, on an annual basis, 263 people would reverse that decision based on having that 10-day waiting period? Now that 10-day waiting period is being removed.
Another primary concern I have is with respect to a glaring omission in the bill, which is the issue of conscience rights protections for medical professionals and health care workers as well as the rights of workers in hospices and other institutions not wanting to cause the death of people in their care.
As an editorial in Maclean's explains:
Many doctors are willing to expedite the natural process of dying, given their traditional role to relieve suffering. There is, however, a qualitative and ethical distinction between hastening a death which is already drawing near, and ending a life which is expected to persist.
This is a very valid point.
When one senator asked an expert witness whether it was true that medical professionals were leaving because of the lack of conscience rights, Dr. Herx replied, yes, that she knew of doctors who had taken early retirement for reasons of professional integrity or for their own moral compass.
Let us make no mistake. These are real lives, real people, real consciences being impacted by the decisions the House is making this week. Do we want to harden the hearts of those who, by their world view, cannot comply, those who by responding to MAID feel it is a betrayal of their professional commitment to save lives, a betrayal of their faith or their conscience?
Likewise, other professionals have concerns, for example, pastoral care and workers who attend to people who are suffering on a regular basis. They know they are not dealing with many of the root causes of pain, loneliness, fear, distress and despair.
With the revelation of the horrific conditions for our elderly, as described by the Canadian Armed Forces just recently when providing assistance to some personal care homes during this COVID crisis, the Canadian Council of Catholic Bishops asked how “in good conscience” could the criteria for MAID be expanded when we were not even responding to their basic human care?
The bill, if passed, has some very real life and death concerns. According to the Council of Canadian Academies, without its reasonably foreseeable natural death provision, which is being removed, Canada will become more permissive with respect to MAID than any other jurisdiction in the world.
Two other voices, Lemmens and Krakowitz Broker, explain that unlike any other country in the world, the new bill fails to explicitly require that all reasonable options be available and tried first before allowing physicians to end a patient's life.
Ensuring consent is so vital in avoiding any sense of coercive implication, subtle or otherwise, for the dignity of all lives. People just may change their minds. The Council of Canadian Academies advised that a major reason why people change their minds about MAID is the disability paradox, which is understood as healthy people imagining a future health condition and ending up discovering it has much more quality than anticipated. In other words, people may tend to overestimate the intolerability of a future health scenario.
An alarming suggestion made by the report is that people may have written their request under duress or coercion, fearing that a lack of social and health support created a bias to their future quality of life.
Expert opinions, speaking to the Senate committee on Bill C-7, discussed how, in the proposed bill, MAID would include treatable diseases where death was not imminent, which is where the bill adds a 90-day assessment period. However, it is no wonder that people with disabilities or chronic illnesses are feeling threatened by the legislation. This addition is especially concerning when people are faced with a sudden, dramatic, life-changing illness or disability, as it often takes much longer than three months to gain a renewed perspective of life after a diagnosis like that.
It is no wonder that former member of Parliament Jane Philpott and the current member for Vancouver Granville wrote an editorial for Maclean's, urging parliamentarians to proceed with caution, questioning whether there was enough medical and social evidence to even understand the implications of the potential changes being presented in the bill.
Rosemarie Falk Conservative Battlefords—Lloydminster, SK
Madam Speaker, I want to thank my colleague for his words of wisdom. It was wonderful.
In my life, previous to becoming elected, I had the privilege and opportunity to work in an interdisciplinary team in a hospital setting as a social worker. A lot of times I got to go into end-of-life situations, palliative and more. It was a real honour to work with a family in a palliative situation. A lot of family therapy happens in that moment, which is for the good, and a lot of reconciliation.
The statistic right now is that only 30% of Canadians have access to quality palliative care. For sure, it is not people who live in rural and remote northern communities.
Would my hon. colleague agree that it is absolutely appalling that only 30% of Canadians have access to palliative care?
Ted Falk Conservative Provencher, MB
Madam Speaker, my colleague, the member for Battlefords—Lloydminster, happens to share my last name.
It is absolutely horrible that in our country only 30% of people who require palliative care have access to it. In my riding of Provencher, we have many good personal care homes and there is always a need to increase beds. We are seeing some expansion in one of my larger communities right now.
Statistics tell us that when people have access to good, quality care, their demeanour, their perspective on life changes and it could prevent them from making a hasty decision. Now, if they make a hasty decision on MAID, it would be terminal for them, because no reflection period would be required anymore.
Access to medical palliative care is very critical.