An Act to amend the Criminal Code (medical assistance in dying)

This bill was last introduced in the 43rd Parliament, 2nd Session, which ended in August 2021.

This bill was previously introduced in the 43rd Parliament, 1st Session.

Sponsor

David Lametti  Liberal

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

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.

Elsewhere

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.

Votes

March 11, 2021 Passed Motion respecting Senate amendments to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
March 11, 2021 Failed Motion respecting Senate amendments to Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) (amendment)
March 11, 2021 Passed Motion for closure
Dec. 10, 2020 Passed 3rd reading and adoption of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
Dec. 3, 2020 Passed Concurrence at report stage of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)
Dec. 3, 2020 Failed Bill C-7, An Act to amend the Criminal Code (medical assistance in dying) (report stage amendment)
Oct. 29, 2020 Passed 2nd reading of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying)

Criminal CodeGovernment Orders

October 9th, 2020 / 2:25 p.m.
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Conservative

Ted Falk Conservative Provencher, MB

Madam Speaker, I want to confirm to the House that the parliamentary secretary, in his speech, spoke the truth when he said that the Liberals got it wrong, because the Liberals did get it wrong. I was on the justice committee with the hon. member when Bill C-14 was before it, and the Conservatives presented over 100 amendments that would have strengthened the bill and provided proper safeguards, all of which were rejected by the Liberal government of the day. One thing that did get passed was the requirement for a mandatory review after five years, but the government has circumvented the requirement with a few consultations, which is completely inappropriate and should be unacceptable to the House.

Health care professionals in my riding are continually asking for better health care conscience protection rights for health care professionals. They have looked at the legislation and do not feel it is there. We have heard the Liberals argue that it is there and that it is adequate, but the health care professionals in my riding, including doctors and nurses, say it is not adequate. I would like the member to respond to that.

Criminal CodeGovernment Orders

October 9th, 2020 / 2:25 p.m.
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Liberal

Chris Bittle Liberal St. Catharines, ON

Madam Speaker, perhaps the hon. member forgets that we had witnesses come before the committee and I asked them about this time after time. Can the member name me one time in Canadian history when a doctor has been forced to do a medical procedure against their will? No one, in the history of this country, has been made to do that.

I appreciate the member's revisionist history that suggests the Conservative amendments would have made the bill constitutional. On the contrary, they would have made it worse.

This is a more progressive way to move forward to protect the constitutional rights of Canadians. We still need to do more, and I look forward to the parliamentary review in the near future.

Criminal CodeGovernment Orders

October 9th, 2020 / 2:25 p.m.
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Bloc

Mario Beaulieu Bloc La Pointe-de-l'Île, QC

Madam Speaker, I commend my colleague on his speech. I found it very interesting to hear him talk about consent and the requirement for final consent, which forced some people to apply for medical assistance in dying earlier than anticipated.

Perhaps my colleague agrees with the idea of expanding the concept of waiving final consent so that there is a type of advance consent, including in cases where natural death is not foreseeable. I would like his opinion on that.

Can he provide a concrete example of how we might proceed?

Criminal CodeGovernment Orders

October 9th, 2020 / 2:25 p.m.
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Liberal

Chris Bittle Liberal St. Catharines, ON

Madam Speaker, I believe the parliamentary review that was enshrined in the legislation needs to move forward. We have to focus on this piece of legislation right now, but we need to do better. This legislation is a big step forward, but there is a lot more work that still needs to be done.

Criminal CodeGovernment Orders

October 9th, 2020 / 2:25 p.m.
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Liberal

Bob Bratina Liberal Hamilton East—Stoney Creek, ON

Madam Speaker, I remember in the first go around, back in 2016, the controversy and the various points of view that were brought forward, including by my colleague from St. Catharines. I remember speaking to people in my riding about how proud I was that we were able to come forward with the bill. We heard some positive statistics earlier about people whose suffering was ended through the bill we brought forward.

I would ask my friend from St. Catharines about the point of view that we need to be exactly perfect when we come forward with Canada's legislation on assisted dying. At least we are at a point now that we can consider some very good things that have happened and a way of improving them.

Criminal CodeGovernment Orders

October 9th, 2020 / 2:30 p.m.
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Liberal

Chris Bittle Liberal St. Catharines, ON

Madam Speaker, I appreciate the hon. member's comments. However, I look at this in a different way, because many of these concerns were brought to the attention of the decision-makers previously. Those voices were ignored and people suffered unnecessarily. I take this as a personal loss and wish my voice could have been stronger to prevent that suffering. We took a step forward with the previous legislation, but we need to keep taking steps forward.

Criminal CodeGovernment Orders

October 9th, 2020 / 2:30 p.m.
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Liberal

The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

The motion that the House do now adjourn is deemed to have been adopted. Accordingly the House stands adjourned until Monday, October 19, at 11 a.m. pursuant to Standing Orders 28(2) and 24(1).

Happy Thanksgiving, everyone.

(The House adjourned at 2:31 p.m.)

The House resumed from October 9 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.

Criminal CodeGovernment Orders

October 19th, 2020 / 11:05 a.m.
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Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary 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, allow me the opportunity to reflect on what has brought us to this point.

Shortly after the 2015 election, a number of pieces of legislation were brought before the House. One of those pieces was Bill C-14, a direct response to courts and the many concerns Canadians had with regard to the issue of dying with medical assistance. The issue was thoroughly discussed and debated. A lot of dialogue took place inside and outside the chamber, and, in fact, across the country. The number of Canadians who were engaged in the legislation was extraordinarily high. That was reinforced earlier this year, but I will get to that particular point later.

Back in January or February 2016, there was a great deal of dialogue taking place. Bill C-14 ultimately passed just prior to the summer break, in June 2016. At the time, parliamentarians recognized that there would be a need to make some modifications. In fact, within the legislation we passed, we created the opportunity for us to review it.

It should come as no surprise to anyone that the issue continues today. Even without legislation, dialogue has been taking place among members of Parliament and constituents. I have had ongoing feedback on the issue, in particular through emails, since 2016. People have expressed concerns and issues with the legislation.

The Superior Court of Quebec made a determination on the legislation, which ultimately dictated that we had to bring in Bill C-7. We had initially introduced the bill earlier this year, I think in February. Prior to its being introduced, Canadians were once again formally called upon to provide their thoughts on the issue. It was amazing that in a relatively short time span, we heard from in excess of 300,000 Canadians. People from all across the nation responded to provide their thoughts and ideas on what they would like to see the government and members of Parliament deal with on this very important issue.

We were very hopeful that a committee would have the opportunity to meet and review the legislation, with the idea of looking at ways it might be changed. Then came the pandemic. As we all know, the focus and attention of Canadians changed, just as the House's priorities had to change, in order to respond to the COVID-19 pandemic. As a direct result, we lost the opportunity for that parliamentary group or committee to get together to review the past legislation, and in fact even the legislation that was being proposed in January or February.

Fast-forward to where we are today. Bill C-7 responds to a decision of the Superior Court of Quebec. It is a reasonable and acceptable piece of legislation that, in this form, makes some changes. It deals with some very difficult issues. For example, it drops the number of days of waiting from 10, after a person is approved and in a near-death situation. I believe this will generally receive good support from all sides of the House. There is the reduction of witnesses from two to one. From what little debate there has been thus far, I believe this has the potential to receive good support. The criteria that a person's death must be reasonably foreseeable is an issue that no doubt will be talked about at great length, both in the chamber and at committee. There are other aspects of this legislation that I find very compelling, and I am very interested to hear what people have to say about them.

A big concern I have is the idea that someone is able to provide consent today but, as an illness or a disease continues, might be prevented from being able to give consent knowingly later, thereby disallowing them from having medical assistance in passing. I know many Canadians share that concern. I am expecting to see a good, healthy discussion on that, whether inside the chamber, in committees or in our constituencies, where we receive feedback.

There is the issue of mental illness and the severity of it. This area is worth ongoing exploration, in different ways. As a former member of the Manitoba legislative assembly, I remember that often when we talked about spending money in health care, mental illness was nowhere near being part of the discussion. In fact, it was a very dear friend of mine, Dr. Gulzar Cheema, who raised this issue at a time when very few people raised it. In general, it is something we need to debate more.

I suspect that as we continue the debate, whether in the chamber or at committee, we will see that it is very emotional for a number of people. I know first-hand how important palliative care is, through the experience of the passing of family, in particular my grandmother and my father. I am very grateful for the Riverview Health Centre in Winnipeg for the service in palliative care they provided. To be there at the passing of my father meant a great deal for me personally, as I knew that when he was there he had the love and care of professionals who deal with people who are passing on. A person has to have a very special heart to deal with that. I had a similar experience with my grandmother, at St. Boniface Hospital. They are two totally different institutions, but the thing they have in common is the supports that are there.

I believe we need to do more in the area of palliative care, and I would love to see more discussion, more debate and more action on the issue. I believe the federal government has a role to play in that area too.

To conclude, I will emphasize for members that here is an opportunity for us not only to look at the core of the issue and have discussions, but to look at some of the issues surrounding end of life and the circumstances that, either directly or indirectly, we are all somewhat familiar with.

Criminal CodeGovernment Orders

October 19th, 2020 / 11:15 a.m.
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Conservative

Eric Melillo Conservative Kenora, ON

Madam Speaker, one of the things the member mentioned was improvements to palliative care. I think it is important to note that northern regions of the country and rural and remote regions, particularly indigenous communities in my riding, are chronically underserved in health care delivery.

What does the government plan to do to ensure that residents of indigenous communities, and northern and remote communities, have access to all health care options, including palliative care?

Criminal CodeGovernment Orders

October 19th, 2020 / 11:20 a.m.
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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, that is an excellent question, and that is why it is so important that Ottawa work with provincial jurisdictions. Health care, which incorporates palliative care, is administered by the provinces. The palliative care units that we often talk about are administered through our provinces. Ottawa has a role to play through standards and financial support.

We can learn a lot from the provinces. Some provinces deal with health care in different ways, such as urban versus rural. There are opportunities for us not to reinvent the wheel, but rather to look at who is doing it best: look for best practices and ensure that there is some sense of a national standard so that, when our loved ones need palliative care, their ending days are appropriately taken care of.

Criminal CodeGovernment Orders

October 19th, 2020 / 11:20 a.m.
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Bloc

Julie Vignola Bloc Beauport—Limoilou, QC

Madam Speaker, this bill is one more step toward more equitable situation-dependent access to medical assistance in dying. This weekend, I had a conversation with my father. I believe there is an issue here with respect to foreseeability.

Take, for example, a person diagnosed with a very serious terminal illness who may nevertheless live for months or years. Can that person ask their doctor now to administer medical assistance in dying once the disease has progressed to a particular stage, even though that person may be incapable of requesting MAID once that time comes?

Will that be possible?

Criminal CodeGovernment Orders

October 19th, 2020 / 11:20 a.m.
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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, I do not necessarily know all of the details. Within the legislation, from what I understand, the issue of second consent is important, as is the impact that it has on people who have a deteriorating illness. Today, they might be in a position to give consent, but in their dying days they might not be in that same position.

I believe there is an attempt to deal directly with that issue within the legislation. It is a good question, and I suspect it will be asked once it hits the committee stage.

Criminal CodeGovernment Orders

October 19th, 2020 / 11:20 a.m.
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NDP

Heather McPherson NDP Edmonton Strathcona, AB

Madam Speaker, this is a very important conversation to be having, and I appreciate all of the interventions that have been made by members of the House.

One of my questions is around that second track of accessing MAID, which requires that one of the two medical practitioners assessing the person has expertise in that condition. Considering that in Alberta, in particular, there are many communities where doctors have been leaving because of current fights with our provincial government, how will the government deal with the fact that some people will not be able to access doctors? Those doctors are not working in remote or rural communities right now, for that second track of the MAID.

Criminal CodeGovernment Orders

October 19th, 2020 / 11:20 a.m.
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Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, we need to go to my first answer, where I recognized that Ottawa needs to work with the provinces, particularly the different departments and ministries of health, to ensure that there is a sense of fairness and equity, no matter what region of the nation people are in.