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

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

Madam Speaker, I put forward some amendments to the bill during the committee process. One of them was calling to ensure that people were not in a state of decline because of deprivation, social disadvantage, lack of support or perceived discrimination. There are things we can do to help people while they are alive. Some of those we have called for are a guaranteed livable income to ensure people have a good quality of life and universal pharmacare to ensure people have access to their medicines. We know that when people do not have access to medicine, their health declines.

The Conservatives do not support these things. They do not support taxing the billionaire class. That is about economic Darwinism, everybody for themselves, letting people be deprived of their medicine, letting people live on the streets and live in poverty.

Why does the member not want to take care of people? That is what I would like to know. Why does the member not support a guaranteed livable income and universal pharmacare, so we can take care of people while they are living?

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, that is a great question. We want to take care of people. The previous member asked what I thought about palliative care. The lack of palliative in our country is horrible. If people have access to palliative care in the time when they need it, I think it will reduce a lot of the need for people wanting to access MAID. Palliative care is something on which we should be focused. The government indicated that it would have a plan, but it does not have a plan and it has not even begun one.

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

Madam Speaker, I know this is something my hon. colleague cares about deeply. Has he seen the testimony of Mr. Foley at committee?

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, no, I was not at committee when Mr. Foley gave testimony. Therefore, I was not able to see it.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Madam Speaker, I had the opportunity to speak to this particular legislation before it went to committee for proposed amendments, or the hopeful change of amendments. At that time, I raised some very serious concerns that I had about the changes proposed, through the legislation, to the parameters around medical assistance in dying. I shared my concerns that with the removal of existing safeguards, this legislation was eroding protections for vulnerable persons.

Countless medical professionals and advocates for persons with disabilities have come forward to express their great concern with this legislation, but it seems that the government is more concerned with rushing to pass this legislation than with listening to the serious and valid concerns they have. These doctors have lived experience with vulnerable populations, and a deep understanding of not only the demand for medical assistance in dying, but also of broader medical needs. It is reprehensible that their voices are being ignored. We have to ensure that personal autonomy does not supersede the protection of vulnerable persons. When the consequences of getting this wrong are life-ending, we really cannot afford to get this wrong.

We know that Conservatives put forward a number of reasonable amendments to reinstate protections that the Liberal government would remove through this legislation. These amendments were sought in good faith to better protect vulnerable persons, such as reinstating the 10-day reflection period when death was reasonably foreseeable, maintaining the requirement for two independent witnesses or even requiring that patients be the ones to first request information on medical assistance in dying. I am beyond disappointed that these proposed amendments were rejected.

We have heard the testimonies and read the stories that persons with disabilities and elderly Canadians are being offered medical assistance in dying without requesting the service. In those moments, the underlying message being communicated to them is that their lives are “less than”, and that is just not okay. It is not okay for us to create the legislative framework that perpetuates ageism and ableism. Every life has value and every life is worthy of protection.

If members opposite do not believe Conservatives, disability advocates or medical professionals that this is happening, maybe they will listen to the words of their colleague, the Minister of Employment, Workforce Development and Disability Inclusion. In speaking to Senate members about the personal experience of Roger Foley, a person with a disability who was offered, unsolicited, medically assisted death, the minister said:

I absolutely acknowledge and am quite preoccupied by the power imbalance between practitioners and patients, particularly patients who have been in systems that have discriminated against them and ignored their voices their entire lives. I have grave concerns with the particular circumstances of the individual that you spoke of. Quite frankly, I can tell you, he is not alone. I regularly hear from families who are appalled by the fact that they take their child, potentially their older child, in and are offered unprovoked MAID. I think that has to stop. That’s a matter of practice, I would suggest, and we need to get at that through our regulations, through working with our medical associations.

I agree with the minister. This has to stop. Every life is valuable, disability or not.

The rejected Conservative amendment to require patients to be the ones to first request information on medical assistance in dying could help that, but the legislative changes proposed in this bill, to make same-day medically assisted death available and to remove the requirement for the second witness, certainly would not make it stop. A person with a disability who may already feel disempowered would not be empowered by these proposed changes.

In the previous Parliament, I sat on the HUMA committee during the study of the accessibility act, Bill C-81. The guiding principle of that particular piece of legislation was to ensure the full and equal participation in society for persons with disabilities. I have to wonder how we can ensure their full participation in society while eroding these protections in the medical assistance in dying framework.

Why are we not listening to the disability advocates who are sounding the alarm? These advocates are telling us that the removal of existing safeguards in medical assistance in death has the potential to devalue the lives of vulnerable persons.

The other significant piece of this conversation is that we cannot truly assert that we are giving Canadians personal autonomy if there is no real choice. If palliative care and medical care needs are not available to a person, but medically assisted death is readily available, there is a problem.

The legislation passed in the previous Parliament required that an in-depth, five-year parliamentary review of the original medical assistance in dying legislation occur, and that the review also consider the state of palliative care in Canada. This government is recklessly pushing through this legislation before that work is done.

The reality is that we already know there is inadequate access to palliative care in Canada. There have been countless studies, and we hear it from medical professionals. We hear it from those who are seeking palliative care and from their advocates. Certainly, this legislation would be better informed if that in-depth parliamentary review had already occurred, and that would be the appropriate order of consideration.

As we navigate COVID-19, we certainly cannot ignore how the quality of care and physical restrictions might impact vulnerable persons. The story of Nancy Russell, who sought medically assisted death rather than face another lockdown in her care home, is heartbreaking. We can certainly imagine that Nancy was not alone in those feelings of loneliness and hopelessness.

First, this story emphasized to me the need for better supports in our care homes. COVID-19 has exposed the acute challenges in long-term care in Canada. These challenges have only been compounded by the pandemic. This government has a responsibility to ensure that there is adequate access to masks and rapid testing, so that our seniors are not forced into endless isolation to the point that ending their lives feels preferable.

Second, this story reinforced my strong belief that we have to be cautious that we are not promoting MAID to those who are experiencing moments of hopelessness. We have to ensure that we are delivering better and adequate supports and services to all Canadians. We need to ensure that there is adequate access to palliative care and home care needs. We have to make efforts to ensure dignity in living, not only dignity in dying. Without ensuring this, we are in fact eroding personal autonomy, and then choice is skewed. In effect, without true personal autonomy in the decision, there is no dignity in dying either.

I implore my colleagues in the House to pay attention to the alarms that have been sounded by so many Canadians, including countless medical health professionals and disability advocates. I ask them to seriously consider the impact of removing vital safeguards for medical assistance in dying, to consider making efforts to address systemic ageism and ableism and not reinforce it, and to not endanger the lives of vulnerable persons by allowing respect for individual autonomy to outweigh the protection of vulnerable persons.

In my view, the proposed legislation does not find that balance. We must do better to protect vulnerable persons, in fact, on all issues, but even more so on issues of life or death.

We owe it to Canadians to properly consult, review and consider legislation. They deserve that from us.

[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]

Mr. Speaker, I have, on many occasions, talked about the importance and significance of all lives being equal. In the many ways that this legislation has come before us, more than just the governing party is supporting it. New Democrats, Bloc members and Green members are supporting the legislation.

In the debate, one of the issues that keeps coming up is personal care at home, and the need to see it enhanced and supported. It is interesting to hear Conservative members say that. They seem to advocate giving cash toward health transfers as opposed to trying to ensure there are standards for home care services. I wonder if the member can help me reconcile why the Conservatives seem to be at odds with that.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Mr. Speaker, I find that question quite funny because I believe all lives are valuable. I have been in situations where a patient has come into the hospital and had nobody. They die and the social worker plans their funeral. They have nobody. They have no friends. They have no family. They have no advocates.

What I am concerned about with this legislation is that we have vulnerable people, whether they are homeless, drug addicts, alcoholics or anything else. If they go into a hospital or a long-term care facility, and it is suggested that they can end their lives right then, if they are told that MAID can be administered with no safeguards and it can be done right then, I have a problem with that. It does not go with what the member across the aisle said about all lives being equal, because that is not true. All lives are valuable.

[Mel Arnold, Conservative, North Okanagan—Shuswap, BC]

Mr. Speaker, it is good to be up to ask a question on this bill again. I spoke during the previous stage of debate on this bill about how, because we are dealing with life-and-death situations, we need to take into consideration all aspects of this bill and all sides of the debate.

I talked about my mother's situation, where her dementia had progressed to the point where she could not use a telephone anymore to phone family members. The day after Christmas, the last Christmas before she passed away, she developed the flu. The next day, when she had recovered from that flu, we were invited to go to see her at the care home and she talked to us like the dementia had reverted to two years prior. She picked up the phone and phoned my five siblings that day, from the numbers that were in her head.

I have to question why the 10-day reflection period has been removed from this, because at that time I had a representation agreement to make medical decisions for my mother. Medical assistance in dying was not an option at that time, so we did not even think about it.

However, I put this situation to others who might be placed in that situation now. Her dementia turned around, basically overnight. Are there cures out there that we may find next week or next year that would reverse some of these situations? I would like to ask the member for Battlefords—Lloydminster how she sees that the protection needs to be in this legislation.

[Rosemarie Falk, Conservative, Battlefords—Lloydminster, SK]

Mr. Speaker, I would like to thank my colleague for being vulnerable. It is sometimes very hard to share those stories that can trigger our emotions, so I thank him for that.

If palliative care is only available to 30% of Canadians, a number that I would argue is even lower in rural, remote and northern communities, that is a problem. When palliative care is happening, sometimes it can take months. My mother was in palliative care for not just a day, but for a few months. However, during that time, even though it is such a very hard time, there is reconciliation. There is the opportunity for broken families and people who have had disagreements and hurt and anger and broken hearts to heal.

I believe that if we do not offer palliative care to people, we are actually robbing families of reconciliation and being whole. Therefore, I really want to encourage the government. There is an importance in palliative care, and we will have better families if we are able to offer this particular service.

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

Mr. Speaker, in the evenings there are fewer people around here, so it is always a challenge to keep an audience, but I appreciate that you are in the chair for sure. I know that you always listen to my speeches with rapt attention.

I know that the member for Winnipeg North, without a doubt, is here listening with rapt attention as well. We are sometimes concerned that he never leaves that chair or that he sleeps there. He is usually in that chair before I appear here, and he is usually here after I leave. There are rumours that he may actually live here. I do not mean any disrespect, as I appreciate his interventions. I can recognize his voice from a mile away.

Today we are at report stage for Bill C-7. The report stage is reporting to the House on what was discussed at committee. The committee heard some very compelling testimony from witnesses. Most impactful to me was the testimony from a Mr. Foley.

Mr. Foley gave testimony via Zoom to the committee and he was in a hospital bed. He has a degenerative disease that has made him immobile, and he needs full-time care. It was suggested to him several times that perhaps he should pursue MAID. The bed he is in is a very expensive spot to be taking up, and they are not able to move him out of the hospital into a long-term care bed, so it has been suggested to him that MAID is a viable treatment option for him.

It was shocking to listen to him from his hospital bed tell us that. If colleagues have not had a chance to see his testimony, I recommend they have a look at it. The fact that this is being brought up by medical professionals as if it is another treatment is very concerning to me. Assisted suicide is not a treatment. Assisted suicide is eliminating the patient, not the symptoms and not the pain. It is eliminating the patient.

That was very much the concern that everybody had when assisted suicide was introduced back in 2016-17. I remember that was one of the first pieces of legislation I had to deal with my career here. It was a traumatic bill at that time because I really felt that this was a complete shift away from one of the traditions of western civilization, the Hippocratic oath, which is nearly 2,000 years old. I also feel that it is the government's job to defend life.

At that time I said that this is a slippery slope. Who gets to decide who gets to live and who gets to die? I was assured that that was, indeed, not the case, and that this was where they were going to hold the line. I remember specifically the former justice minister and the former health minister assuring us that they had gotten the balance right. I take them at their word. I do believe they firmly believe they had gotten the balance right.

I do not impugn any of their motives, but both of those individuals are no longer in those positions, and here we are, four short years later, with a gentleman in his hospital bed saying that he is being offered assisted suicide, euthanasia, as if it were just another treatment option. We have treatment option A, treatment option B, and assisted suicide or euthanasia, as if someone should pick one. One is relatively inexpensive and it will free up the bed. The other options will take us a little longer.

Mr. Foley said that he does not want to die. He does not. He still enjoys life even though he is incapacitated to a large extent, so the testimony of Mr. Foley was very telling for me.

The Senate has begun its study and has heard from disability advocates, over 85 witnesses to this point, and none of them has been supportive of the bill. The disability community is very concerned, as the testimony of Mr. Foley really points out. They are very concerned about the pressure that is placed on folks with a disability to pursue MAID, euthanasia or assisted suicide.

One of the most interesting witnesses at committee was the minister for folks with disabilities. At committee, when concerns were raised, she agreed that those were concerns she shared, and that they were also the concerns she had heard from stakeholder groups, which she is closely tied to because this is her portfolio. The voice of the minister responsible for folks with disabilities in Canada had not been heard at the cabinet table or when the bill was drafted.

What is most frustrating about this is that we have seen opportunities for the Liberal government to listen to Canadians on this in several instances. The bill was introduced at the beginning of the Parliament. Then there was the WE scandal, so to get out of that, the government brought in prorogation and the bill was reintroduced after prorogation. The government had heard many of the concerns about the bill prior to prorogation, so it had the opportunity to fix some of the issues it had heard prior to prorogation. It could have reintroduced the bill with some of those fixes, but it never did. It chose not to do that.

Then at committee, I think there were 16 amendments, but the government ignored the amendments that the disability community was seeking. Liberals ignored the amendment to prevent same-day death. Many in the disabilities community said our worst day should not be our last day.

When people are at their worst and say they do not want to do this anymore, that should not be their last day. They should be able to reconsider. This is literally life or death. There is no coming back from this. Many of them brought in amendments to say a 10-day waiting period is acceptable and even a seven-day waiting period would be acceptable.

I heard from a fellow living with a disability who said it takes him longer to get a wheelchair than it would to get assisted suicide. That is one of the major concerns we have. If other treatments are not readily available, then we will see folks being pushed into making a choice that is not really a choice, which is to choose between assisted suicide or going on without treatment for days and days. There were a number of amendments to eliminate the same-day death.

There was also an amendment that was probably the best one in terms of dealing with Mr. Foley's concerns that this is not treatment. It is not a treatment option, and it should be something that is always brought up by the individual. I moved several amendments at committee to Bill C-14 in the previous Parliament around this not being health care. I thought it should definitely be taken out of health care system because I did not want to see euthanasia and assisted suicide being treated as a treatment option.

There was a great amendment to Bill C-7 brought to committee that would have ensured that health care professionals would never be allowed to be the one to instigate the conversation on MAID or assisted suicide. The Liberals also ignored that amendment. The disabilities community is very concerned about the bill. The Liberals have refused to listen to them, and I hope to see the bill get amendments from the Senate.

[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]

Mr. Speaker, for many years, since 2015, we have had a great deal of debate, literally hundreds of hours of debates, committee meetings and all forms of presentations and so forth. This is true even most recently, with regard to the amendments the member opposite made reference to.

The Bloc, the NDP and the Green Party are all saying that this would appear to be the best going forward, so it would appear that a solid majority support the legislation. I am wondering if my friend could provide his thoughts on what appears to be a consensus for the legislation to move forward.

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

Mr. Speaker, I do not know who said it, but I remember a quote from somewhere that says, “I'd rather be right than be president.” To some degree, that is kind of the case here as well. I am not that concerned about how many political parties the member can line up and say agree with the Liberals.

The truth and what is right do not necessarily depend on what the majority is. We should come to this place, debate these issues and hear out the testimony of these individuals. We do have a vote in this place, but it does not necessarily make it the best decision. We have heard 85 witnesses at committee, and all of them in the Senate have been opposed to this bill.

Just because one side of the political spectrum happens to not agree with those witnesses does not mean their testimony is invalid. The Liberals should bring this bill back to—

[The Deputy Speaker, Bruce Stanton]

We will go to the next question.

Continuing with questions and comments, the hon. member for Nanaimo—Ladysmith.

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

Mr. Speaker, I have been working with the Diversability community here in Nanaimo—Ladysmith for a number of years. I did consultations with its members about this legislation as well, and what I hear often is that they live with a form of legislated poverty. They are deprived of a lot of things other Canadians enjoy.

To have a fair country, what we need to be doing is taxing some of these billionaires who have reaped huge benefits during the pandemic, the 20 billionaires and their $28 billion in additional profits, to even out the playing field and take care of those who are most vulnerable in our communities.

I am wondering whether the hon. member would stand with me and ask that we tax the billionaires and spread out some of that wealth so people can live with dignity in this country.

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

Mr. Speaker, at committee, the member for Nanaimo—Ladysmith moved an amendment I was very excited we could support. I believe he worked with Inclusion Canada, and he might correct me, and they had brought forward that amendment. I do hope we can continue to work together to get an amendment like that passed in this bill.

When the Liberals say everybody is supportive of this bill, it is not necessarily true in this place. Other political parties, such as the Greens, put forward amendments that were very easy for us to support. They should have been very easy for the Liberals to support as they have wide support across the Canadian population.