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An Act to amend the Criminal Code (medical assistance in dying)
This bill is from the 43rd Parliament, 2nd session, which ended in August 2021.
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:
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The Deputy Speaker Bruce Stanton
I am going to repeat that again, because I am not sure how much was registered by the hon. member who is currently online and who has the floor.
To the member for Desnethé—Missinippi—Churchill River, while I was standing, and as I mentioned, there was some disorder in the House. I was interrupting for that reason. His last sentence or two was probably not registered in debate. I am going to go back to him and let him finish up his final thought on that, and then we will carry on with debate.
The hon. member for Desnethé—Missinippi—Churchill River.
Gary Vidal Conservative Desnethé—Missinippi—Churchill River, SK
Mr. Speaker, not knowing exactly what [Technical difficulty—Editor]
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The Deputy Speaker Bruce Stanton
Let us try that. We are working in manual mode here right now. I think we are encountering some problems with the console. We will try to work in that manner.
I just want to thank the hon. member for Langley—Aldergrove for raising that point as well and helping me to recognize that we were not getting audio even from the Speaker's chair. I thank him for that.
We are now going to go to resuming debate, the hon. member for Langley—Aldergrove.
Suspension of SittingCriminal CodeGovernment Orders
The Deputy Speaker Bruce Stanton
We are going to have to interrupt the hon. member. It would appear that we are not registering audio on those who are participating online, on the Zoom platform, as well.
We are going to have to momentarily suspend the proceedings, just to see if we can get that corrected. I will ask the hon. member for Langley—Aldergrove to stand by. We will suspend momentarily until we are ready to go again. As soon as that happens, we will let the members who are online, and also those here in the House, know that we are ready to go again.
(The sitting of the House was suspended at 9:26 p.m.)
(The House resumed at 9:37 p.m.)
Sitting ResumedCriminal CodeGovernment Orders
The Deputy Speaker Bruce Stanton
We are going to try this again. We think we have a fix in place to at least get us through the evening until we can get something else sorted out. There is some kind of technical issue, but I think we are at a point where we can continue and get back under way.
We are going to go back to the start of the 10 minutes that we began for the hon. member for Langley—Aldergrove, so he will have his full 10 minutes, and we will restart that right at that location.
The hon. member for Sherwood Park—Fort Saskatchewan is rising on a point of order.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, I am not sure if he is still on, but I believe the final response from the member hon. for Desnethé—Missinippi—Churchill River was also missed. I was told the sound problem was also occurring at that point, just so you are aware. I do not know if we want to go back to him or not, but that is just for information.
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The Deputy Speaker Bruce Stanton
I thank the hon. member for Sherwood Park—Fort Saskatchewan for thinking of that. He is probably right, although we will have to check on that with debates to see if that did, in fact, get picked up.
The hon. member is no longer online. I do not like to point out the absence or presence of hon. members, but nonetheless it appears that we are not able to go back to him in this case, so we will go back then. I thank the hon. member.
We will go to resuming debate with the hon. member for Langley—Aldergrove.
Tako Van Popta Conservative Langley—Aldergrove, BC
Mr. Speaker, the government's proposed legislation to expand the availability of MAID to people whose natural death is not reasonably foreseeable is, in my opinion, deeply flawed and the term MAID, in those circumstances, is a misnomer. If Bill C-7 passes, we are no longer talking about doctors and nurses helping those who are dying and alleviating suffering, but helping people to die who are not even near death.
The reasonable foreseeability of natural death standard, which was so central to the Carter decision, makes sense from a medical perspective, as doctors might be willing to expedite the natural dying process given their traditional roles of assisting medically to relieve suffering. It is quite another question whether medical ethics contemplate doctors now bringing death into the equation, where natural death is not even reasonably foreseeable. It is no longer medical assistance in dying, but medical aid to end a difficult life. This is a big shift for Canadians, but the average Canadian was not even consulted on this big shift.
After the Truchon decision of the Quebec Superior Court, the Attorney General and the Liberal government are treating as settled constitutional doctrine this very key question, whether those who are not dying but suffering grievously and irremediably must be given the right to choose MAID. The government side of the House, throughout the debate on this topic, has stated that it has consulted widely with Canadians, but the extent of the consultations was an online survey that was open for a couple of weeks, containing confusing and ambiguous questions with multiple choice answers that left some respondents, people I have spoken to, having to choose the least of a selection of evils. The public was never asked whether the reasonable foreseeability of natural death standard should be dropped. A judge in one province thought so, but what do Canadians think? We will never know, because the question was not asked. A so-called public consultation that fails to ask the key question is not a real consultation. It is a pretext for the government to advance an ideological agenda.
Truchon was poorly reasoned and unbalanced. It has been left unappealed. By failing to appeal this decision, the Attorney General and the government have conceded that one judge in one province can curtail Parliament's power to promote broader societal interests in protecting people who are elderly, ill, disabled or vulnerable. One judge in a lower court was allowed to overturn Parliament's well-reasoned response to the Supreme Court of Canada's decision, and Parliament's well-considered opinion expressed in Bill C-14, four years ago. In my opinion, the Attorney General failed to do his job.
What happens if nothing happens? What if this bill does not pass, either in the House or in the Senate, before the Quebec Superior Court's now-extended deadline of December 18? It will become law in Quebec, which means that provision in our Criminal Code will restrict MAID to only those whose death is reasonably foreseeable in Quebec. That is, out of circumstance, better than the new regime introduced by this flawed Bill C-7, so let it fall. Let the deadline come and go. There will be more protection for vulnerable people if nothing happens than if Bill C-7 becomes law.
If all Bill C-7 did was reflect the Truchon requirement, then this bill would be more acceptable. Rather, the government has taken this opportunity to go much farther than was required by the Truchon decision.
Bill C-7 includes some additions that were not required by Truchon, including advance directives and dropping the requirement for contemporary consent. It also drops the reflection period for those whose death is reasonably foreseeable and, for no apparent good reason, it drops the requirement for two witnesses.
Should we leave the safeguards in place? It has been argued by the government side of House that safeguards are just barriers to implementing the decisions that people have already made. However, that is exactly what safeguards are for. They are intended to be barriers to protect the vulnerable. That is the objective, not to create inconvenience, although safeguards may be inconvenient in some cases.
Now I want to talk about advance directives. We have heard arguments in favour of them, and some have cited the Audrey Parker case. Ms. Parker chose to end her life earlier than she had planned because she feared losing cognitive ability to make the decision later on, when she would have really preferred to make her final decision to die. The best argument, in my opinion, against the Audrey principle is that some people have indeed changed their mind when the time came for the lethal injection.
The first annual report on MAID in Canada, published in July 2020, stated that 3.6% of patients who had made a written request for MAID later changed their mind and withdrew their request. While 3.6% seems like a low number, it was based on 7,300 MAID deaths. That means 263 people changed their minds.
I want to go back to the consultation of 300,000 Canadians. If the government had asked as a question about whether Canadians were accepting of a safeguard that would be designed such that only 263 people would have died, with their lives terminated against their wishes, I think the answer would have been quite different. That is the thing about consultations and surveys: They depend very much on the way questions are written. I do not think Canadians were properly consulted.
The same argument can apply to the 10-day reflection period. The whole idea is to let people reflect on the gravity of the document they have just signed and have the opportunity to change their minds. Last year, 263 people did indeed change their minds. We need to protect people like them.
I now want to talk about seniors care. According to that same report, 771 MAID recipients gave isolation and unbearable loneliness as a reason for requesting death. Easier access to MAID is not the right solution to loneliness and isolation. It is palliative care.
I want to briefly give an example in my family. My father-in-law just recently passed away. He had excellent palliative care at Langley Memorial Hospital, and I want to thank the caregivers there. If every Canadian had palliative care like he had, this would not be the debate that it is. This is what we should be talking about. We should be talking about expanding palliative care, rather than expanding MAID to people whose death is not even reasonably foreseeable.
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December 2nd, 2020 / 9:45 p.m.
St. Catharines Ontario
Liberal
Chris Bittle LiberalParliamentary Secretary to the Minister of Transport
Mr. Speaker, I am enjoying this debate. It is interesting to find there is a new-found love of the Supreme Court in the Conservative Party. There was nothing in existence before, as the former Conservative government did nothing after the Carter decision. However, there is a new-found love, and these unconstitutional requirements need to wait years longer. This is from a party that did not support the previous legislation.
Why is the hon. member suggesting that individuals cannot change their minds? That is a dangerous thing to say. It is not that this legislation requires a person to make up their mind and they cannot possibly change it. Why does he and the Conservative Party mislead and suggest that people cannot change their minds, that people will be forced to die against their will? Is their argument so thin that they have to resort to those kinds of arguments?
Tako Van Popta Conservative Langley—Aldergrove, BC
Mr. Speaker, first I will talk about the Supreme Court of Canada. As a lawyer practising law for many years, I have the deepest respect for the Supreme Court of Canada. Very many well-written decisions come out of there, which are shaping Canadian society. I have the deepest respect for them. If the Truchon decision had been appealed to the Supreme Court of Canada, we would have had a different outcome. We certainly would have had good constitutional considerations put into the decision.
As for people changing their mind, I recognize that Bill C-7 would allow people to change their mind if they have cognitive ability, but that is the whole point. Advance requests do not protect people who have cognitive disability at the time that the lethal injection is going to be applied. This also puts the doctor in a very difficult position of having to make that final decision to apply the lethal injection. I do not think that we are any further ahead.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, my colleague spoke about this issue of people changing their mind. I would refer him and members of the House to the powerful testimony, before the committee, of Dr. Ramona Coelho. She is a physician who has, within her practice, a very large number of vulnerable people. She is practising in Ontario.
She expressed concern with the way this legislation is set up, removing safeguards and dramatically shortening timelines, in one case completely eliminating the timeline so they could have same-day death. She made the point that there is a real risk that people who are experiencing temporary suicidal ideation will not receive the care and treatment that they need that allows them to move in a different direction, and that the result will be people being pushed into choosing this option without seeing the alternatives and without seeing what may very well be the light at the end of the tunnel.
We know that the data suggest that when people have the onset of a disability in their life, that can be a very difficult adaptation period, that people can certainly experience genuine angst and suicidal ideation, but temporary suicidal ideation. That speaks to the importance of an appropriate time frame, at least a 10-day reflection period, and for at least the opportunity, in the case of a disability, to get information and to receive treatment first. That is the testimony we heard at the justice committee. I would appreciate the member's feedback.
Tako Van Popta Conservative Langley—Aldergrove, BC
Mr. Speaker, that is exactly the point of a 10-day reflection period or any reflection period. It is for the person who just signed the document to give deep reflection to the document that he or she has just signed as to whether this is the right thing. It might have been the right thing at the time. It could very well be that within the reflection period they could change their mind. It was a good safeguard that was put in place in Bill C-14, a well-considered opinion of this Parliament, and it should be maintained. There is absolutely no reason to eliminate it, if the purpose is to comply with the Truchon decision.