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

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, I agree with the hon. member that this is probably one of the most difficult and sensitive questions in this whole legislative framework.

Whose decision is it when it is the right time to inject a lethal substance? If it is not the person receiving it making that final call, whose call is it to decide when the right time is to do it? It is equally difficult the other way.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Mr. Speaker, I will read a post by a well-known physician in Ridge Meadows Hospital in Pitt Meadows—Maple Ridge. It states, “I personally have had a patient undergo MAID who would have had a very good chance of living for 5 or more years. The quality of care and the decision to administer MAID was very questionable in my view and when I contacted the coroner to request a review was told that these cases are not reviewable by the coroner's service. Where is the oversight?”

Would the member comment on oversight? A lot of these have been taken off.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, that is a very good and important question, but there is no easy answer to it. Of course, there is patient confidentiality, so that information would not be readily available to the public because it was a decision that a patient made in consultation with their doctor.

I would say to keep the 90-day reflection period in and clean up the language to make it much clearer so that doctors and other health care providers understand what the guidelines are. Right now it is too confusing.

[Stéphane Bergeron, Bloc, Montarville, QC]

Mr. Speaker, I have to say that I am very happy to be participating in this debate, not because it is an exciting or joyful topic, but because it is nevertheless a crucially important social debate.

The constitutional distribution of power means that we can talk about one issue in both legislatures. I had the immense privilege of sitting here for 12 years, then sitting in the National Assembly for 13 years, and then coming back here on October 21 of last year. I have had the opportunity to discuss issues relating to same-sex marriage, the subject of a civil union bill in Quebec. When I was an MP, I had an opportunity to talk about gun control. As minister of and official opposition critic for public safety, I debated a gun registry bill in Quebec. When I was an MNA, we talked about end-of-life care and medical assistance in dying. Now I am back in Ottawa, where we are discussing medical assistance in dying once again.

We have heard plenty of relevant arguments on both sides, extremely well-thought-out legal arguments as well as moral arguments.

I do not normally do this in the House, but my speech will be far more personal than usual, because this moral issue is close to my heart.

First, I would like to point out that I am a man of faith. I am Catholic; I was baptized and raised Catholic, but my convictions go much further than that. I do believe that a higher power created the universe, because there is no other way to explain creation other than by that sort of demiurgic form that created the universe. Some have a name for this higher power; others have several names. I think we are all talking about essentially the same thing.

Some people invoke their beliefs, their faith, to say that it is wrong to end a life. I have something to say about that, since it is part of my Catholic upbringing: we should live our lives to the very end, no matter how much we suffer. However, I refuse to believe that the Creator wants his creatures to suffer. I simply cannot bring myself to believe that, first of all.

Secondly, I like to think that if there really is a Creator and he expects certain things of us, then is it not up to each and every one of us to stand before our Creator when we leave this earth and not interfere in other people's lives and the choices they have to make?

It is not for us to determine the choices individuals make. Life is fair in that the same outcome awaits us all, but it is unfair in that the outcome does not await us all in the same way. In some cases, the outcome is gentler, in other cases it is marked by incredible suffering. In some cases, the outcome arrives more quickly and in other cases, much later. The outcome might be the same for everyone, but it is not equitable for everyone and each and every one of us will have to endure suffering to varying degrees.

I can understand some people saying enough is enough, they have had it. Since the outcome is inevitable, if the person no longer wants to suffer, why would we allow them to continue to suffer and even force them to continue to suffer?

I believe that if our faith means something, it must let us be compassionate. To be compassionate is not to watch someone suffer and relish their suffering because we want them to live it to the end, but, on the contrary, to support them in whatever choice they make. If they choose to leave this earth earlier to put an end to their suffering, which will lead them to this inevitable outcome anyway, I think that our duty as believers, human beings and political decision-makers is to support this person's choice and decision.

That is why, as a believer, as someone born and educated as a Catholic, I call on this faith and education not to oppose end-of-life care and medical assistance in dying, but to encourage it, to ensure that it is made possible. In fact, I believe that our role is not to judge what someone else wants to make of their end of life, but to support them in the decision they make for themselves for their end of life.

I said somewhat the same thing as what I just said before the Quebec National Assembly when I was a member there. When I expressed this opinion at the time, it generated a lot of interest from the bishop of the diocese in Saint-Jean-Longueuil, where I live. Bishop Gendron invited me to dinner at his home, where we ate spaghetti and talked a little bit about all of this. He wanted to understand where I was coming from as a Catholic to say that I was in favour of medical assistance in dying. I told him that I was in favour of abortion for the same reasons. My Catholic beliefs are what led me to be in favour of abortion because, if it is true that the Creator is opposed to abortion, then it will be up to the individual to stand before our Creator and give account when she leaves this world. It is not up to us to judge that woman or to impute motives that will make the already difficult decision of having an abortion even harder for her.

Similarly, I was proud to vote in favour of same-sex marriage in the House. I told my bishop that I could not believe a religion that emphasizes love so much would refuse to accept that people love each other.

Because of my Catholic convictions and my faith in our shared humanity, I believe that we must not judge others' choices, whether we are talking about love lives, terminating an unwanted pregnancy or unbearable suffering. It is not up to us to judge these choices. Our role, as human beings, as decision-makers, is to support these people's choices.

I touched on this at the beginning of my speech and I want to close in the same vein: The people of Verchères, and now Montarville, have entrusted me to represent them, and I have had the immense privilege, during my wonderful career, to be able to speak to certain social issues that are at the very core of what I just mentioned, specifically that we all have an obligation to support others and refrain from judging them.

[Ron Liepert, Conservative, Calgary Signal Hill, AB]

Mr. Speaker, I enjoyed listening to the presentation by my colleague from the Bloc Québécois. It is not very often that I find myself agreeing with just about everything he said.

I ask the member for his thoughts on what I am hearing from the majority of my constituents. They support medical assistance in dying but are asking that we look at going somewhat further, with things like advance consent for when people are no longer of sound mind and cannot make a medical decision. I would like the member's impression on whether or not that is something we should be allowing sooner rather than later. Also, how can we get the government to undertake this study immediately?

[Stéphane Bergeron, Bloc, Montarville, QC]

Mr. Speaker, I thank the hon. member for his question, because it allows me to address another issue, one that is just as important as what I talked about in my speech.

If one detects early signs of a degenerative disease, such as Alzheimer's or Parkinson's disease, for example, should that person not be given the opportunity to indicate in advance, like a kind of living will, what their intentions are regarding how to move forward when they might no longer be able to make an informed choice?

I must say, I am pleased that the government decided to introduce this legislation, because, let's admit it, the previous one was too restrictive and some people think that even this one is too restrictive. Perhaps we should start thinking about expanding it even further, as the Government of Quebec is doing with its legislation.

[Lenore Zann, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, I want to thank our hon. colleague for his passionate speech. I found it informative and extremely emotional. As somebody who was brought up as a Catholic as a young girl, I too feel people should have their own choice as to how they end their life if they are in great pain and suffering.

What would my hon. colleague say to our colleagues on the floor who are having trouble with this bill because their constituents have said it could be used the wrong way to perhaps put people to death who are having some kind of problem? What would he say to those people so they see his perspective?

[Stéphane Bergeron, Bloc, Montarville, QC]

Mr. Speaker, again, I think that is an extremely legitimate concern.

We cannot allow people to be euthanized based on a consent that might not reflect their true intentions. That is why it is so important to bring in parameters and safeguards that allow us to be sure of the person's consent.

Once informed consent is clearly expressed, whether in advance, as I mentioned a few moments ago, or in the present-time situation, I believe we must respect it. I believe this is a legitimate concern and we need these parameters to help us be certain of the informed consent of the person choosing to end their life.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Mr. Speaker, I would like to thank my hon. colleague for his articulate and passionate speech. I only wish that my French was better so I could hear its full impact. His words about the duty not to judge but to support and honour people's choices had a particular impact.

I had the honour recently to sit with some constituents, and I heard their deeply held concerns about medical assistance in dying. While my party and I support the bill, I wonder sometimes when speaking with these individuals whether at the heart of this is an unreconcilable conflict between beliefs and perspectives when it comes to the end of life.

[Stéphane Bergeron, Bloc, Montarville, QC]

Mr. Speaker, I sincerely believe that, in most cases, apart from the legal arguments, people's reservations about this issue and their resistance to the idea stem from moral arguments. That is why it was so important to me to express my point of view, however humbly among my fellow MPs, which is that I support MAID for moral and even religious reasons, just as I support abortion and same-sex marriage.

I understand why people who oppose MAID for moral reasons have those reservations. They truly believe it is a sin, but that sin, if it really is a sin, is on the part of the individual, who must bear responsibility for it when brought before their Creator. It is not society's or the community's sin; we are not responsible for the choices of others. Each person must take responsibility for their own choices.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Mr. Speaker, today I am pleased to present my maiden speech to advocate on behalf of those who cannot advocate for themselves. It is truly a privilege to be a voice for them. Some of them will even be voices from beyond the grave.

I call on my colleagues today to truly stop a moment and hear the cri de coeur from those who are still among us and from those calling to use from the next life. They should take a moment to listen to what we here in the House have done to destroy the value of their lives, to exclude them from society and to encourage them to exit the stage rather than wait for the curtain to fall once the final act is finished.

I will begin by introducing members to Roger Foley. As a young man, Roger was a musician and creator. He loved life, and it showed. However, in his early thirties, Roger was diagnosed with cerebellar ataxia, a debilitating disease that has stolen away his physical abilities one function at a time. Roger is now completely reliant on care providers for every necessity of life.

In the summer of 2018, after almost dying from a life-threatening case of food poisoning he contracted in long-term care, Roger was trying desperately to access funding for patient-directed care to hire and train his own consistent caregiver in his own home, as opposed to living in a hospital or in long-term care with rotating staff who do not understand his specific care needs. Members may remember Roger as the man who recorded his caregivers offering him euthanasia as an easy way out of his suffering. As we heard in the recording, the nurse says, “You don’t have to do it in some dramatic manner. You can apply for assisted—you know.” The nurse could not even bring himself to utter the word “euthanasia”, yet there he was, against Canadian law and all moral and ethical standards, offering a desperate man an easy way out. It was problem solved. However, Roger is a fighter, and even though he was overwhelmingly desperate, Roger decided he wanted to fight this injustice on behalf of himself and all our vulnerable brothers and sisters.

Roger's path intersected with mine early this year at the beginning of my time on the health committee. In preparation for a study on palliative care in Canada and a review of the euthanasia regime, issues that I thought would soon be on the table for discussion, I reached out to him and his lawyer for his perspective as someone within the system. I finally had a chance to speak via telephone with Roger while he was in Victoria Hospital in a private ward getting good care. While not in his preferred setting of his own home, I found him to be very open and engaging. His knowledge of the issue of euthanasia and the danger it posed for the vulnerable was enlightening. Just before we hung up that night, I said to Roger, “I wish you were on the committee because you are so much more equipped to speak to this issue than I am”, and we agreed to speak again soon.

Then COVID-19 hit, and Roger Foley's world changed completely. Roger was repeatedly transferred between units where there was little room for lift equipment and insufficient staffing for his specialized care. Living at the mercy of care attendants who are pressed for time was agonizingly difficult. Roger has very little in his life that is in his own control, but one thing he can do is swallow when offered food, with a certain technique. His head needs to be tipped at just the right angle, and the spoon needs to be offered in just the right way. For Roger, the ability to swallow affords him a feeling of independence. It may seem like a little thing to us, but to Roger it means a whole lot.

When the hospital wanted to feed him with a feeding tube to minimize the care hours required, his mental health took a turn for the worse. On May 15, Roger's brother filed a complaint with the ombudsman on Roger's behalf, yet things just got worse. Roger was suddenly informed that he would be transferred to the long-term care facility that had led to his original food poisoning and hospitalization. Understandably, Roger refused the transfer, begging instead, if not allowed self-directed care, to go back to his original unit, where staff knew him and his needs well. The hospital ignored his request, insisting that it was not safe for him because of COVID and that he needed to transfer.

The night before the transfer was to take place, Roger became completely desperate. He had not been sleeping, due to his fear and anxiety of being transferred. He became so distressed that he told his caregivers that he would throw himself off the gurney if they tried to transfer him the following morning. With no hope of help in sight, Roger reached out to his brother. His brother reached out to his lawyer. His lawyer reached out to me.

That evening we spent three hours on a conference call with Roger, encouraging him to be positive, to keep up the faith and to stay the course on behalf of those in the disabled community who would not have his strength and courage. All the while, I was attempting to contact the hospital administrators on another phone to beg them to back down and to warn them that Roger was possibly suicidal and needed them to reconsider for his mental health's sake.

Suddenly, I could hear on the phone in the room with Roger a new voice. The voice introduced herself as the hospital's mental health personnel, there to administer the 10-question suicide checklist on Roger. She began with her first question, attempting to gauge his distress level. Roger told her that he had no intention of answering her questions, since it was her and her bosses' fault he was in so much distress. She tried over and over, and he refused until she finally left the room in a huff.

The House heard me right; the mental health professional was so annoyed that Roger refused to answer her suicide checklist, she left the room and never returned. I was absolutely dumbfounded on the other side of the line, sitting helpless in my office in Langley. All these able-bodied health care professionals were able to leave the room freely. Everyone could leave as they pleased, except Roger. Roger was trapped.

When we finally got some assurances that a trusted doctor would come and talk to Roger, and it encouraged him to try to rest, I hung up the phone, I had no idea what was going to happen in the morning. I was helpless, but not nearly as helpless as Roger. I can tell members that it was with great relief in the morning that Roger had indeed received an intervention through a trusted doctor and was getting proper care and nutrition. However, this event was a life changer for me. It dawned on me that without the help of his lawyer, who stayed on the phone with us the entire time, Roger's story may have ended quite differently. I wondered how many others in the country are at risk under this new MAID regime. How many vulnerable disabled are offered euthanasia when they are at their weakest? I made it my mission to find out.

What did I find out? I found out that Roger's case is by no means an isolated case. We can see this sort of abuse happening across the country. Take, for example, Jonathan Marchand: 43 years old, suffering from muscular dystrophy and living confined to bed in a nursing home in Quebec. He produced a video from his hospital room which he released on YouTube in response to living in long-term care during the pandemic. Jonathan states, “Increasingly, euthanasia is offered as a solution to institutionalization. The idea is if you don't want to go into a long-term facility and die a slow death, then we are going to help you kill yourself. And those ideas are based on false assumptions about people with disabilities - like our lives are not worth living, that it's better to be dead than to have a disability - but it's not true!” He says that he decided that he would not go ahead with euthanasia, but would fight to get out of that place. Jonathan said, “In a world where there will be no empathy for people who need more help, it would be terrible. It would be something out of the nightmare of the Third Reich.”

Bill C-7 is an absolute nightmare that is facing disabled Canadians. Many are already afraid to go to hospital for fear they will be treated differently from the able-bodied. With the implementation of MAID in 2015, the community braced itself for the slippery slope ahead. Everyone said they were just overreacting. They said that safeguards were in place and euthanasia was meant to be safe and rare. We jump to 2020, and here we are racing down the hill at breakneck speed. In consultation with the disabled community, they have expressed firm opposition to this bill.

They explain that with the wording of Bill C-7, the Liberal government is proposing to set up two lines. Line one is for the able-bodied, who, in times of extreme distress, will be offered suicide prevention. Line two is for the disabled, who, in moments of weakness that they all endure as life ebbs and flows, will be offered assisted suicide, because their lives are not worth living, they are told. Add to all that the fact that current safeguards have already been proven completely ineffective. There is a complete lack of accountability structures to ensure abuses do not occur, and yet we are being asked to loosen restrictions even more. Where is the palliative care that was promised? Where is the review that was supposed to have happened? What are the Liberals afraid of finding out? Is it that in actual fact MAID has led to coercive deaths across our country, which go on undetected daily?

I stand here on behalf of all those who cry out for compassion and dignity as they travel a very tough road filled with complex care needs and physical ailments that require far more from us as a society. I stand here as the voice of Roger in Toronto, Jonathan in Quebec, Raymond Bourbonnais, Candice Lewis, Sean Tagert, Archie Rolland and so many more who we may never know.

“Lean on me.” That is what I want all of us to say here in this House—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

We are unfortunately out of time.

Questions and comments, the hon. parliamentary secretary.

[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]

Madam Speaker, I appreciate the member sharing her thoughts and in particular highlighting some individuals. Part of this debate, from its origins five or six years ago, was the citations from real people about what is happening in their lives. We have looked at those as well as the court decisions that have taken place, and listened to the literally thousands of Canadians throughout the country who have had the opportunity to participate and provide information. We are talking about hundreds of thousands of Canadians who have provided input.

I believe the legislation before us is fairly good, in that it puts us in a place where the bill can be sent to committee and the member can hopefully get some of her concerns addressed. I am wondering if the member supports the bill being sent to committee, at the very least, to hear some others' thoughts and maybe get some of her questions answered.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, a recent statement was penned and signed by over 800 physicians in Canada in response to Bill C-7. Only 25 people are required to sign a petition for it to be recognized, so when a document is presented with 800 signatures from experts in a relevant field, the House should pay close attention to what that document says. Let me read—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

My apologies to the hon. member, but the time is up.

It being 5:30 p.m., the House will now proceed to the consideration of Private Members' Business as listed on today's Order Paper.