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

[Kenny Chiu, Conservative, Steveston—Richmond East, BC]

Mr. Speaker, Bill C-7 seeks to amend medical assistance in dying by eliminating various safeguards on how and when the service is delivered and introducing others. Some of the changes to end-of-life decision-making include the removal of a 10-day waiting period between MAID requests and its administration, proceeding without immediate consent and the creation of a second track that allows individuals who do not meet the reasonably foreseeable death criteria to receive MAID.

I proudly voted against the second reading of Bill C-7 because it does not adequately protect Canadians from harm. The bill creates a pathway to end of life that would disproportionately impact the disabled without sufficiently encouraging the alternatives. It also does not include sufficient consideration for the right of doctors to refuse to provide death as a service. Any legislation that is introduced in Parliament requires a thorough review and that is especially true for bills that are literally matters of life or death. Bill C-7, which seeks to expand medical assistance in dying, is one of these bills.

I have been told that members of the justice committee have heard first-hand from disability advocates vehemently opposed to Bill C-7 and its rapid expansion of MAID, who argue it amounts to a “deadly form of discrimination”, making it easier for persons with disabilities to die than to live. 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 and medical professionals.

Conservatives are focused on ensuring that this type of legislation includes safeguards for the most vulnerable in our society as well as for the conscience rights of physicians and health professionals. The opposition has introduced a number of reasonable amendments to reinstate balances the government has removed including: first, reinstating the 10-day reflection period when death is reasonably foreseeable; second, maintaining the requirement for two independent witnesses when death is foreseeable; third, ensuring physicians have expertise in the patient's condition; fourth, extending the reflection period when death is not reasonably foreseeable; fifth, protecting vulnerable patients by requiring the patient to be the one who first requests information on medical assistance in dying; and sixth, protecting conscience rights for health care professionals.

It is essential that the government begin a separate and comprehensive parliamentary review of the original MAID legislation passed in 2016 and the state of palliative care in Canada. It is critical that this review analyzes how the government's MAID legislation negatively impacts persons with disabilities. I might add, such a review could have taken place over the summer, but instead the Liberal government shut down Parliament and prorogued it to hide their ethical scandals.

Medical assistance in dying is a very complex issue and evokes strong emotions. Recognizing we need more time to review the bill, my Conservative colleagues and I repeatedly proposed increasing the number of meetings dedicated to reviewing the bill and hearing from witnesses. Each time, the Liberals refused. Canada's Conservatives will continue to highlight the flaws in the government's MAID legislation that threatens the lives, rights and dignity of people with disabilities and work to protect vulnerable Canadians, especially persons with disabilities. Canadians deserve this much.

In the midst of a global pandemic, and at a time when people with disabilities are experiencing significant hardship, the government should be ensuring access to needed support, but it is offering people with disabilities an assisted death. To add insult to injury, Bill C-7 is being rushed through the parliamentary process. Given the implications of the bill, this is unconscionable.

The Government of Canada prides itself on championing inclusion and accessibility. With its current position of the reintroduction of the MAID legislation, the government reminds us that it has a glaring blind spot when it comes to its vision of a more inclusive Canada. This is not simply an unfortunate omission. This is a betrayal of the fundamental principles of inclusion, and one that puts the lives of people with disabilities at risk.

If the government is truly committed to building a more inclusive and accessible Canada, it must continue to restrict MAID to end-of-life circumstances and prevent MAID from being provided on the basis of having a disability. The government has a responsibility to protect the human rights and dignities of all Canadians, especially persons with disabilities.

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

Mr. Speaker, a 10-day reflection period, which can already be waived in certain circumstances, is really all that we are asking for with the first amendment. The second amendment calls for a 120-day period for those for whom death is not reasonably foreseeable so that people could actually get treatment before they are pushed forward into this or before they proceed with it.

I just think that these amendments are eminently reasonable. Anybody, regardless of what side of the issue they are on, should be able to accept that a 10-day reflection period before a person dies is quite minimal. It is either that or the government's position right now of same-day death, and being able to request and receive it on the same day. I do not think that a person's worst day should be their last day.

I just cannot understand why the government will not listen to the witnesses, listen to the experts and accept these reasonable amendments. I would like to hear the member's comments on that.

[Kenny Chiu, Conservative, Steveston—Richmond East, BC]

Mr. Speaker, it is quite unconscionable, as I said, to shorten this reflection period in the guise of providing a more immediate response to shortening a person's pain, understanding that, a lot of times, people under such circumstances could have other alternatives provided or presented to them and, therefore, change the situation altogether. However, once MAID is administered, it would be too late for anybody to reverse the decision, and that is why a reflection period, especially for those who do not have a reasonably foreseeable condition, needs to be reinstated in order to have the chance to reconsider.

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

Mr. Speaker, I would like to thank my colleague for Steveston for his great speech on this. As I have gotten to know him over the last year or so, he is a valued member here, and I am very happy to call him a colleague.

One of the issues we have seen with the removal of the 10-day waiting period is that there is no real ability to withdraw the request. As we have seen in Canada, it has been reported that over 270 people a year withdraw their request for assisted suicide. I wonder if the member has any thoughts on whether the bill should address that better.

[Kenny Chiu, Conservative, Steveston—Richmond East, BC]

Mr. Speaker, it is an honour to represent the good people of Steveston. My riding also includes an area of Richmond East that is populated with a lot of good citizens, so it is important to actually mention the full name of Steveston—Richmond East.

In matters of life and death, as I mentioned in my speech, I think it is prudent for any government to provide as much protection as it can, especially for vulnerable citizens of the population. With a decision like MAID where there is no reversal, it is even more important that people make that decision under careful consideration, consultation and discussion with families and medical professionals, so that they understand its implications.

Therefore, I think that it would not be unreasonable to reintroduce the 10-day period of reflection or even a longer reflection period for those who do not have a reasonably foreseeable condition.

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

Mr. Speaker, it is a pleasure tonight to speak to Bill C-7 at report stage, an act to amend the Criminal Code on medical assistance in dying.

My journey on this over the last while, as a new member of Parliament and listening to my constituents, has been one where I realized this is a very personal issue and brings out a very strong and emotional response from people on all sides of this issue. The stories are personal and impactful and people have very strong opinions on all matters to do with the bill.

The thing that has landed for me as I have considered this is that there are a few things we need to ensure are dealt with in the legislation. One, as we have heard many of my colleagues talk about, is the protection of the most vulnerable in our society. The second is the protection of the conscience rights of physicians and health professionals. To that effect, a number of amendments were introduced by my party at the committee stage, for great reason.

The first one talked about reinstating the 10-day reflection period when death was reasonably foreseeable. I was in the House last week and had the privilege of listening to some debate on this matter. It was a very moving experience for me as I listened to my colleague, the member for Flamborough—Glanbrook, share a very personal story in a question to a member. It was a very moving and impactful story.

He talked about the finality of the decision his daughter made when she chose to take her own life some years ago. He talked about how it was at a very low point in her life that she chose to take her own life. We talk about the removal of the 10-day reflection period, but when I heard that story, it personally moved me and caused me to say that it is so important that we protect people in their most vulnerable moments.

My colleague talked a few minutes ago about the idea of maintaining the requirement for two independent witnesses when death was foreseeable. As an accountant for many years, dealing with many legal and financial matters, there were so many things I did over my career that required the signatures of multiple witnesses. The matters I thought were important over all of those years were nowhere near the importance of determining life and death matters like we are talking about today. The requirement for two independent witnesses being reduced to one is appalling when I consider the matters I dealt with as a professional over the years, which required the signatures of at least two or multiple people.

The other point we have talked about over the last few weeks is ensuring physicians have expertise in a patient's condition. It is imperative that we maintain the ability for people to prove it and have multiple opinions. The extension of the reflection period when death is not reasonably foreseeable is another amendment the Conservatives believe is vital and important to this process.

Protecting vulnerable patients by requiring them to be the ones to first request information on medical assistance in dying is really important. It overwhelms me to think that a vulnerable member of our society could walk into a doctor's office or a health provider's office, while being at a low point and suffering from whatever ailment, and a health care professional or somebody in a position of trust initiating a conversation about medical assistance in dying. It is unconscionable.

The removal of that provision is not acceptable. For that reason, there is no way I would ever support this with those kinds of things still included in the bill.

As I mentioned earlier, there is the protecting of conscience rights for health care professionals. We need to respect the opinions, beliefs and rights of those people to maintain their values and beliefs and maintain the things they believe are important in their approach to their professional journey. It is imperative we protect those folks. The thing I have heard the most from people, along with the protecting vulnerable people, is protecting the conscience rights of health care professionals.

As we think about the process, any legislation that is introduced in Parliament requires a thorough review. Just like I talked about in the context of having the two independent witnesses, when we are talking about matters that are literally life and death, it is important that we ensure we have due process. There was the review that was supposed to be done.

We have a strong belief that this decision should have been appealed to the Supreme Court so we could get certainty in the framework. So many of these things did not get accomplished, as has been mentioned by a number of my colleagues and members today. This is somewhat as a result of the prorogation of Parliament and the fact that we missed a number of weeks of opportunity to debate legislation and deal with these important matters.

I want to reflect upon the witnesses and the testimony that was presented to the justice committee. We heard from numerous people and groups that advocated on behalf of people with disabilities. People are opposed to the bill and the rapid extension of the legislation that has been put before us compared to the former legislation, Bill C-14. It is shameful that we are rushing this. It is a matter of life and death. We are now rushing this to try to get it done before Christmas. We could have done so much more in the weeks past.

As Conservatives, we will continue to fight on behalf of the vulnerable in our society. We will continue to fight on behalf of all Canadians with disabilities. We will continue to ensure that their interests are protected and that they are protected as we move forward in this process.

I want to comment on the impact of this on indigenous people. As the shadow minister for indigenous services, I am always engaged in the lives of those folks. As I speak to my indigenous and first nations friends, they really struggle with this legislation. There is a spiritual element and spiritual being to a lot of indigenous folks. They struggle with the advancement of the legislation and how rapidly it is moving.

I could go on for a while about some of the inequities experienced by indigenous people. I could talk about some of the witnesses at the committee. They talked about the voices of indigenous people not being heard, even though the percentage of the indigenous population in the Northwest Territories, from Nunavut to some of the other communities is so high. Those voices were not heard and have not been heard.

I have a quote that states, “The Indigenous peoples of Canada, including those living with disabilities, do have a voice, however, the opportunity to speak to Bill C-7 has not been adequately conveyed or provided” to those groups.

I want to end with a letter from one of my constituents and I want to frame this carefully. This is from a gentleman and his wife who served for years as chaplains of the Salvation Army in my community. They have dealt with disadvantaged people for many years. They reached out to me early on in this process.

Their letter states:

“As two of your constituents, we are concerned about Bill C-7 and the changes to Canada's law on medical assistance in dying. Canadians living with disabilities and chronic ailments as well as other vulnerable people already have difficulty getting the support they need to live. Removing the end of life requirement from the MAID law puts these Canadians at even greater risk. We oppose changes to remove the safeguards for MAID law for those whose death is foreseeable, like the 10-day reflection period, the ability to consent at the time of death or the requirement for two independent witnesses. We urge you to fight for these safeguards. It is essential that the government protect vulnerable Canadians from abuse and harm. We urge you to call for a reintroduction of an end of life requirement in the MAID law.”

[Chris Bittle, Liberal, Parliamentary Secretary to the Minister of Transport]

Mr. Speaker, I believe it comes from a genuine place of wanting to protect Canadians, but the ultimate result is limiting individuals' charter rights. I have heard a number of Conservatives, and the member is not the only one, talk about the conscience rights of doctors, about which we should all be concerned. It is why there was an amendment in the original bill in 2016 about those rights.

This is a question I asked a number of witnesses at the Standing Committee on Justice in 2016, and I will ask the member. This is such a red herring in this debate.

Could he name for me any time in Canadian history or give me an example of one of his constituents, a physician or anyone, who was required to perform a medical procedure against their will and if not, why is the Conservative Party continuing to perpetrate this red herring during this debate to limit people's charter rights?

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

Mr. Speaker, I will not go into specific examples, but I have talked to many physicians and health care providers and this is an issue for them. They do not want to be put in a place where they are going to be challenged and going to be before a court because of their beliefs. We have a fundamental right in our country for freedom of religion and a freedom of belief, and it should apply in this case as well.

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

Mr. Speaker, the ignorance of the member for St. Catharines of the policy of the College of Physicians and Surgeons in his own province is quite striking.

The Ontario College of Physicians and Surgeons has a policy that requires physicians to provide effective referral and in emergency situations, to provide services that are the standard of the care, even if they go against their conscience. That is a fact. It is an existing college policy.

The member claims to be unaware of the predicament his constituents are in. The fact of this is that when we debated medical assistance in dying last time, we spoke about the case of Dr. Nancy Naylor, who was a palliative care physician in Ontario. She said that because of the pre-existing policy, she was being forced to close her practice earlier.

The striking ignorance of the member for St. Catharines on these facts from his own province about the attack on conscience in the country is incredible. I would love to hear my colleague's comments on that.

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

Mr. Speaker, as I said, the examples he has outlined are a perfect example of the situation where that has happened in Ontario. It is imperative that we protect the beliefs and the choices physicians and health care providers want to make in their own journeys and their own professional practices.

[Chris Bittle, Liberal, St. Catharines, ON]

Mr. Speaker, the hon. member is repeating the same red herring. The hon. member from across the way did not say that it happened. He said that a witness said it may happen and they were concerned about it.

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

Yes I did. It is the policy. It has happened.

[Chris Bittle, Liberal, St. Catharines, ON]

If the hon. member would let me speak, I believe I have the floor.

Again, I will repeat the question because the hon. member refused to answer it. Could he name one single incident where a doctor in the province of Ontario or anywhere in the country has been required to do any medical procedure against his or her will? I have a spoiler alert. He cannot. Why is he repeating this red herring?

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

Mr. Speaker, if the member wants to get into a debate, maybe he should actually recognize where my riding is, which is in northern Saskatchewan, not in Ontario. Let us actually talk about practical—

[The Deputy Speaker, Bruce Stanton]

[Technical difficulty—Editor]