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.

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 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.

Similar bills

C-7 (43rd Parliament, 1st session) An Act to amend the Criminal Code (medical assistance in dying)

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.

Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-7s:

C-7 (2021) An Act to amend the Parliament of Canada Act and to make consequential and related amendments to other Acts
C-7 (2016) Law An Act to amend the Public Service Labour Relations Act, the Public Service Labour Relations and Employment Board Act and other Acts and to provide for certain other measures
C-7 (2013) Law Canadian Museum of History Act
C-7 (2011) Senate Reform Act
C-7 (2010) Law Appropriation Act No. 1, 2010-2011

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

December 4th, 2020 / 1:20 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, I share the member's concern. I have not actually seen the comments by the leader of the Conservatives, but I have heard it from other Conservatives. They imply that we do not need to take into account the considerations of people facing these issues in Quebec by meeting the deadline from the court.

Why are we at this late date to meet the deadline? That lies squarely at the feet of the Liberal government. However, I believe it is important that we provide approval of Bill C-7 in time to meet the deadline imposed by the court so that we do not leave people in Quebec without necessary protections.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:20 p.m.

NDP

Lindsay Mathyssen NDP London—Fanshawe, ON

Mr. Speaker, I always learn so much from my colleague, the member for Esquimalt—Saanich—Sooke. I appreciate his very thoughtful speech today. The coverage on it was remarkable.

I want to ask about the idea of providing dignity, whether it is dignity in the choices patients are making, the dignity of the health community or the dignity of people living with disabilities. A letter was sent to the Minister of Health asking to provide additional dignities, and I think the federal government can provide more supports.

The $2,200 is absolutely a start for a guaranteed basic income, but what more can be done?

Criminal CodeGovernment Orders

December 4th, 2020 / 1:20 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, I thank the hon. member for her kind words disguised as a question.

The proposal we made to the government for a federal income support program at the national level would free up lots of money in the provinces. It is my hope that provinces would then use the money they had been providing for income support to provide additional methods of assistance to people, whether it is modifying homes so they can stay in their own homes or care assistance. Whatever those people with disabilities need to reach their full potential in life would be more available if the provinces could shift that money to provide supports.

It is really important that Parliament seriously consider taking away the fears that many in the disability community have, as the failure to provide them supports makes them make uncomfortable and awful choices down the line.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:20 p.m.

Conservative

Marc Dalton Conservative Pitt Meadows—Maple Ridge, BC

Mr. Speaker, I read a report this morning from the Canadian Mental Health Association in collaboration with the University of British Columbia. It has said that during this time of COVID, four times as many Canadians are having suicidal thoughts. There are some very serious mental health issues right now that are leading to people considering suicide and mostly likely committing suicide. I know some are requesting MAID.

My assistant told me about her friend's 100-year-old grandmother, a very vibrant, social person who liked to get together with people, and in good health for 100 years old. However, because of the safety precautions, the necessary safety precautions, she was isolated, became more and more depressed and she sought MAID and was approved for it even though she was healthy.

I know the legislation is meant to protect people and not meant for people with mental health challenges or depression, but in this situation, it was approved. The concern is that mental health, mental anguish and depression will lead to MAID.

The member talked about it being for terminal illnesses—

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

The Deputy Speaker Bruce Stanton

The hon. member for Esquimalt—Saanich—Sooke.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, there are so many things I would like to address in that question. First, however, I want to stress again that medical assistance in dying has nothing to do with suicide. These are two completely different issues. I do respect the challenges that COVID has brought with respect to mental health across the country. That is a separate issue for us to address.

In the example he gave, he is doing something that has been done over and over again, and that is to repeat second-hand anecdotal information, which I have no way of verifying, nor does he. However, on the face of what he said, this person does not and could not qualify for medical assistance in dying. Mental illness, as the sole underlying condition, is not allowed as a condition for medical assistance in dying. If a practitioner had provided it solely on that basis, that person would be in violation of the law and his or her professional ethics.

In those cases, we have seen a report on medical assistance in dying and the number of complaints that have been filed on professional ethics or criminally for people providing medical assistance in dying to those who are not eligible is zero.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

St. Catharines Ontario

Liberal

Chris Bittle LiberalParliamentary Secretary to the Minister of Transport

Mr. Speaker, the member has done an excellent job at taking down many of the points that have been raised in opposition to this bill.

It was disappointing to hear Trump-like language in an attempt to undermine the Canadian Medical Association. In the entire opposition, there seems to be a lack of trust for medical professionals, that they cannot regulate themselves and they cannot provide the necessary oversight even though they do so for medical procedures all the time. I hope the member could comment on that.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, the member's question gives me a chance to thank four practitioners, and I will not name them for reasons of privacy, who provide medical assistance in dying. They shared a lot of their personal time with me to talk about what it meant to them as physicians to provide this service. They feel that medical assistance in dying is a way of fulfilling the highest ideals in their medical oath, that they are assisting people in avoiding unnecessary suffering and they are assisting families in that task.

Frankly, they have been appalled by some of the wild charges that have been alleged about what they are doing in their professional task in helping people with the end-of-life issues they face.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

Green

Elizabeth May Green Saanich—Gulf Islands, BC

Mr. Speaker, my hon. colleague and I share some geography, my riding being Saanich—Gulf Islands and his being Esquimalt—Saanich—Sooke. Anyone observing will know that our ridings are near each other.

I could not be prouder to have someone from Vancouver Island so strongly explain and so clearly set out the difference between what is in the legislation and some of the quite unfortunate, even deliberate, fearmongering statements that we have heard in the House. I regret very much that Canadians could imagine for one moment there was such a thing as same-day death approval in this act.

On behalf of the Green Party, I think I can take the leap to say that we totally support and are very pleased with the initiative of the hon. member and the member for Elmwood—Transcona to ensure disability payments, essentially a first step toward guaranteed livable income.

Could the member quickly explain again the safeguards that would prevent some of the more extreme examples that have been put forward in the House?

Criminal CodeGovernment Orders

December 4th, 2020 / 1:25 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, I want to stress this again. Bill C-7 would not change the basic requirements for receiving medical assistance in dying. People must have an incurable medical condition and be in an advanced state of irreversible decline and intolerable suffering. Two independent medical assessors are required to certify that the patients meet those requirements. If and only if those requirements are met, then they proceed to a medical assistance in dying. A practitioner, doctor or nurse practitioner can then render that assistance to people in what are sometimes very difficult moments at end of life.

Criminal CodeGovernment Orders

December 4th, 2020 / 1:30 p.m.

The Deputy Speaker Bruce Stanton

It being 1:30 p.m., the House will now proceed to the consideration of Private Members' Business as listed on today's Order Paper.

The House resumed from December 4 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the third time and passed.

Criminal CodeGovernment Orders

December 8th, 2020 / 10:05 a.m.

Durham Ontario

Conservative

Erin O'Toole ConservativeLeader of the Opposition

Mr. Speaker, it my pleasure to rise on behalf of the Conservative Party on probably the most important bill before this Parliament. I say that, without knowing how long this Parliament will run, because this is a decision with respect to the state interacting with one of its citizens at end of life.

This is probably one of the most important debates this Parliament will have, and if there is commentary coming from the government or from some pundits on why we are late and why we are approaching a time limit, that was entirely in the hands of the government for three reasons.

First, the government decided, with no reason and no grounds, to prorogue Parliament. We lost several months that could have been spent having substantive and compassionate debate on Bill C-7 and a range of other things.

Second, the bill results from a Superior Court judgment in Quebec, and normally something so fundamental would have been appealed to two higher courts: the Court of Appeal in Quebec and the Supreme Court of Canada. That was not done, and it should have been. Most legal observers believe this should have been the case.

Finally, as we may hear from the government and the Attorney General today, they could have asked for more time, given the prorogation, their own delays and the pandemic. I think they will end up doing that today, and that is appropriate.

We are getting close to the deadline for this bill because of the government's inaction. The government was slow to appeal a Quebec court decision. The government also prorogued Parliament. That is why we are so close to a deadline set by a Quebec court decision.

As I said when I spoke to the previous bill, now Bill C-7, four and a half to five years ago, when we debate the role of the state at the end of life of one of its citizens, there is compassion on both sides. There are people who do not want to see the suffering of someone near the end of life.

I will speak to the Sue Rodriguez case, when the Supreme Court was first charged with this. Someone with ALS, or Lou Gehrig's disease, loses their physical abilities and is confined in a horrible way. Approaching end of life, are they able to consent in the same way that someone would otherwise and make their own decisions about end of life?

There is compassion from people who want the well-being of their loved ones to be provided for. There is also compassion from people who are concerned about the state making determinations about quality of life. In fact, the justice in Quebec quoted many speeches from the last Parliament on the previous bill, following the Carter decision, including my speech. I talked about the concerns of a slippery slope and that we would be back in a few years. I said more vulnerable people might be swept into a law, and I am sad to say that is exactly where we are.

As a parliamentarian, a lawyer, a father and the son of a brave woman who fought cancer, with profound memories of her from the palliative stage of that disease when I was nine, I am here to make sure the bill is debated properly and that safeguards are provided. Anyone who suggests we should be rushing this debate does not understand how profound it is.

Today's debate should be approached with respect and compassion. It is not a normal debate on normal policies. We are talking about the power of the government to take away a person's life at that person's request. It is a very serious action, and the debate that seeks to establish an appropriate legal framework is a necessary one. We are talking here about the value of human life, about human dignity.

I know that people on both sides of this debate have good intentions, but I am concerned that the bill is a first dent in the value we place on life. It is a slippery slope that we should not be taking with such a vague law and no safeguards.

In the Rodriguez decision, Justice Sopinka, who represented the Supreme Court at the time in the 1990s, talked about the distinction of a passive role of the state and an active role of the state at the end of life. “Passive” refers to palliative care, assistance with pain and, potentially, non-intervention, do not resuscitate, but the active role, when the state takes that role, attaches to section 7 of the charter, which is based on human dignity. The Attorney General clerked under Peter Cory of the same court, and in fact, the McLachlin and Cory dissents both focused on human dignity with respect to section 7 of the charter.

All of them talked about the role of the state in protecting the decisionally vulnerable, as they were called, people who could be pushed into end-of-life treatment because they felt they were a burden. This has been talked about since the 1990s, and this Attorney General is removing the safeguards from our regime. Every ounce of case law on the issue of assisted dying, euthanasia or assisted suicide talks about protecting those vulnerable.

That went on in the Carter decision, which reinterpreted and changed the stare decisis, the precedent of the Rodriguez decision, because of societal norms, but the one thing that did not change was the need for safeguards. In fact, the Carter court said that a “carefully designed...system of safeguards” was required and that they would be scrupulously monitored.

That is the only way the Carter decision changed the Rodriguez decision and allowed there to be assisted dying in Canada. However, Bill C-7 does not provide for assisted dying. It provides for assisted suicide, where the end of life, the reasonably foreseeable death, is removed entirely, and it removes the safeguards that every decision of the court on this subject has said are fundamental to the state having a role at end of life.

The Attorney General seems to be out of touch with the entire body of case law with respect to assisted death. I think it is shameful that he is not allowing reasonable amendments to reinsert a scrupulous approach to the vulnerable. He is removing the 10-day waiting period. There is no coming back from this decision, and when the state plays an active role in the death of its citizens, the two-witness requirement is also removed.

The Attorney General, who is entirely out of touch with the case law in Canada, out of touch with the decision of Mr. Cory whom he clerked for, is rushing something, suggesting we are being unreasonable, when all Conservatives want to do is safeguard the decisionally vulnerable, something both Supreme Court decisions in Rodriguez and Carter said was critical to human dignity, section 7 of the charter. All disability groups are opposed to this bill the way the government is presenting it because of the removal of safeguards and because of the redefinition.

Inclusion Canada's Krista Carr said:

Equating assisted suicide with an equality right is a moral affront. Having a disability should not become an acceptable reason for state-provided suicide. MAiD should remain restricted to the end of life.

One of the leading scholars, which I would invite the Attorney General to review, Professor Grant from the University of British Columbia, said:

Disability organizations hear almost daily from individuals who are considering MAiD because the appalling lack of state supports makes life intolerable. It may be because they are institutionalized, because they cannot afford treatment, or because they are socially isolated. We have seen the social inequality of illness with COVID-19.

The government is a little upset the Conservative caucus is demanding what two decisions of the Supreme Court have demanded and is asking for, reasonably, what section 7 of the charter is built upon, which is dignity of life, to make sure we do not change the regime in a manner I spoke about five years ago: a slippery slope for the decisionally vulnerable such as the elderly isolated in a home.

We heard testimony of some people feeling like they were pushed or pressured because of the cost or lack of institutional care. Some of the professors and some of the indigenous witnesses who have raised concerns also raise concerns about generational trauma, residential schools and people who are facing that trauma and pain in their lives. Is the state then going to provide assisted suicide as a tool or should we help these people?

This is about compassion. This is about an appropriate role for the state. This is not about fundamentally changing a regime that has only been in place for a few years.

I said at the outset there is compassion on both sides, but there is an entirely out-of-step approach from the Attorney General. In fact, the former attorney general, the member for Vancouver Granville, has also criticized the reckless approach of this Attorney General with respect to the post-Carter decision regime, because he would be removing the safeguards both courts have said need to be scrupulously monitored: 10 days, a few witnesses.

All major disability groups in Canada agree with the compassionate and reasonable position being presented by my Conservative colleagues. I am very proud of the advocacy we have shown. We have also been joined by legal scholars, indigenous leaders and people working with people with mental health issues. I have worked on mental health and suicide prevention for many years since my time in the military.

We are also not providing enough palliative care support. Going back to the original Rodriguez framework, where Justice Sopinka talked about the passive role of the state, allowing someone's life to end without pain and to be present, allowing family gathering at palliative, we are not doing that well enough.

The government has actually violated the spirit of the Carter decision by removing the safeguards. Remember, the safeguards, the carefully designed safeguards, were fundamental to the Supreme Court Carter decision change from Rodriguez. Why after a few years would the government remove those, particularly when some of the vulnerable Canadians, seniors and disability rights advocates, have said they feel under attack? In fact, another comment Ms. Carr made is that Bill C-7 is their “worst nightmare”.

What is the job of Parliament? We are not just delegates here to be polled. We are here to bring our perspective in the Burkean tradition of being passionate representatives for our communities, our families, our values and our points of view. I cannot think of a more important debate for us to bring those values.

As the Supreme Court said back in Rodriguez and throughout, this is about human dignity with respect to access to section 7. The early debate, both in Carter and Rodriguez, was always that we cannot have an unfairness for someone who cannot physically make a decision about end-of-life suicide, so we have to have an approach. That was McLachlin's approach in the dissent in Rodriguez. She thought that choice was cruel with respect to Sue Rodriguez.

It was never about just having a widespread approach to assisted suicide with no irremediable or reasonably foreseeable death being a part of it. Now this is opening up a state-run regime with respect to suicide, with vague terms about grievous conditions or just disability writ large. The same concerns I raised reasonably a few years ago around people with mental health issues, who could get help if we are there for them, or people who are decisionally vulnerable, as the court said for now a generation, are why the safeguards are there.

The government should not lecture us about timelines when it prorogued Parliament and when it did not appeal a superior court decision on a fundamental issue just a few years after the Supreme Court ruled in Carter. It is now ignoring disability advocates. It is ignoring indigenous leaders. It is ignoring physicians, legal scholars and the opposition. What are we demanding? We are not saying eliminate the system that was established in the last Parliament. We are saying to maintain the safeguards. There would be no Supreme Court right under section 7 of the charter were it not for the safeguards.

I am proud that the Conservative opposition is not going to step away and allow our vulnerable to be forgotten. We are going to scrupulously maintain the safeguards that the state should have when we are making profound decisions about the end of life of our citizens. We are here for the people without a voice. We are here for the people who might feel coerced, in isolation during a pandemic, into an end-of-life regime without full capacity and consent.

If we step outside the bubble, I do not care what political party one belongs to or associates with, all Canadians want to make sure the vulnerable are provided for. That is all we are asking. If we have to stay here for 24 hours a day, seven days a week to stand up for those Canadians, we will do that.

Who is being unreasonable? Is it the Attorney General, who does not understand the entire body of jurisprudence with respect to assisted death? I am actually very disappointed. He was a law professor at McGill and seems to have not read the Rodriguez and Carter decisions. He is removing safeguards that are fundamental to protecting the decisionally vulnerable as per Sopinka, McLachlin and Cory in Rodriguez, and the McLachlin court in Carter.

Every single indication from the Supreme Court of Canada says that we cannot have end-of-life assisted dying, assisted suicide, euthanasia or whatever words someone uses, that section 7 charter right cannot be accessed without a very carefully crafted and scrupulously governed system of safeguards. This includes a 10-day review period to make sure somebody was not at their lowest point and then the state moves in, and two witnesses to make sure that there is not someone vulnerable being forced or coerced into it. These are very reasonable amendments that not just Conservative MPs are asking for, but Canadians are asking for.

We are adopting a reasonable approach by proposing amendments to the bill on medical assistance in dying. It is a critical issue for our society and that is why we, the official opposition, are here to defend the most vulnerable members of our society. That is why we already proposed reasonable amendments for seniors, people with disabilities and Canadians with mental health problems.

This is a very important debate for the well-being of Canadians across the country. That is why I am proud of my caucus, whose approach to Bill C-7 is very compassionate and defends the most vulnerable members of our society.

It is up to the government. Today, it might be asking for a delay from the court, which is something it should have done months ago. It should have appealed the decision or not prorogued Parliament. Even with the fact that we feel there is a deadline, we should not lose sight of who we are safeguarding.

When we come to the bar and bow to you, Madam Speaker, that is because Parliament is a court. It is the highest court and we have a dialogue with the Supreme Court on decisions related to the charter. Parliament is supreme. When the government suggests we are being unreasonable because we want to keep with the spirit of the Carter decision, this court should be respected that as well. I have not seen this from the government yet.

If the government just reviewed the Carter and Rodriguez decisions and provided those safeguards, held up the dignity required under section 7 of the charter, we could ensure that the right guaranteed in Carter would be respected with a rigorous and scrupulous approach to protecting the decisionally vulnerable and most vulnerable in our society. The Conservatives are here to provide those reasonable amendments for the well-being of our country.

I appreciate the opportunity today to allow Canadians to realize that it is not the Conservative Party holding up legislation or not respecting a court. This is the Conservative Party asking for the will of the Supreme Court, through these two decisions, for our most vulnerable in society to be protected.

Criminal CodeGovernment Orders

December 8th, 2020 / 10:30 a.m.

Argenteuil—La Petite-Nation Québec

Liberal

Stéphane Lauzon LiberalParliamentary Secretary to the Minister of Seniors

Madam Speaker, I want to thank my colleague, the leader of the official opposition, for his speech.

We are accountable to Quebeckers and Canadians, as well as to the Quebec Superior Court.

I would like to know how the leader of the official opposition can believe it is appropriate to disregard a decision from the Quebec Superior Court.

Criminal CodeGovernment Orders

December 8th, 2020 / 10:30 a.m.

Conservative

Erin O'Toole Conservative Durham, ON

Madam Speaker, what is appropriate is to protect the most vulnerable in our society. That was actually the essence of the Supreme Court of Canada's decision in both Rodriguez and Carter.

Unfortunately, that was not the Liberal government's approach. Now here we are, with the deadline fast approaching, because of prorogation. We are here because of the government's inaction. That is why we are proposing reasonable amendments. That is why we will continue to protect the most vulnerable, including seniors at the Herron long-term care centre, for example, who are very isolated.

We are here for Canadians, people with disabilities and seniors. That is why the amendments, the safeguards, are so important.