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

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Mr. Speaker, I thank my colleague for her very moving speech. I really got a sense of her friend's sadness, but also her courage, and that of her friend's family, as she shared their story.

Five years ago, I served on the Special Joint Committee on Physician-Assisted Dying. We were inspired by how this issue evolved in Quebec, and I even remember attending a meeting with Véronique Hivon and Pierre Moreau. It was quite controversial, but it was very important to have that discussion. Quebec has really been a leader on this issue.

Is there anything else my colleague would like to see addressed in this process regarding medical assistance in dying, this very important choice?

[Caroline Desbiens, Bloc, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, in response, I will say what I hope not to see. I do not want to see any wandering discourse meant to sweep this under the rug.

I also want everyone here to acknowledge that we are but humble humans, not experts. We will hear from the experts in committee, experts who will guide us on what useful, appropriate tools should be included in the bill.

We must not use urgency as an excuse to rush this. Once again, I am thinking of those who must have nothing better to do at the moment and are listening to us on ParlVU. They are probably thinking that we should stop talking and get on with it already.

[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]

Mr. Speaker, I want to add to the member's comments, which are very much appreciated. She puts faces and reality to the legislation we are debating today.

It was not that long ago, back in 2015, that we had to bring in legislation. We have been seeing it evolve, and in many ways it cannot evolve fast enough. We could take a look at the province of Quebec, for example. In certain areas, they are further advanced than other parts of Canada. That is one of the benefits of the federation. I agree with the member: I would ultimately like to see the bill go to committee, because I think a lot of stakeholders are interested in contributing to the discussion.

This is more of a comment than a question.

[Caroline Desbiens, Bloc, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, since I am probably coming to the end of my time, I would like to commend my esteemed colleague, Véronique Hivon, who worked very hard to ensure that Quebec led the way in medical assistance in dying. It now sets the standard. I take this opportunity to acknowledge her.

I will also take this opportunity to say that Quebec is often a source of inspiration. In this case, that is probably even more true. I hope that everyone will look to Quebec's example in passing this legislation.

[Martin Champoux, Bloc, Drummond, QC]

Mr. Speaker, like my colleague opposite, the member for Winnipeg North, I want to add to my colleague's speech.

I, too, have some touching stories that are often hard to talk about because it is such an emotional subject. I want to congratulate my colleague for her very poignant speech. These stories humanize the debate and show us the situations that we are making decisions about.

In my riding, a woman who had fought to obtain MAID passed away last year. She did not have time to complete the process. As my colleague said, we must stand together to ensure that people who are dying have the right to die with dignity.

[Caroline Desbiens, Bloc, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, once the bill is passed, we will put our faith in eminent experts who are much more knowledgeable than we are, thanks to a university system that is supported by our tax dollars. They will testify in committee, and we will listen to them. We will improve the bill, to make sure that the act is fair and easy to implement.

[Kerry-Lynne Findlay, Conservative, South Surrey—White Rock, BC]

Mr. Speaker, I appreciate the opportunity to rise and speak this evening on Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), or MAID.

The meaning and consequence of this bill should weigh heavily on all Canadian parliamentarians. Today we are debating the competing interests of individual autonomy and the sanctity of human life. We are addressing the suffering of our loved ones, the dignity of the elderly and disabled and the moral, legal and ethical concerns that are inextricably tied to medically assisted death. We are setting out the rules, standards and boundaries by which Canadian doctors and nurses can, at a patient's request, terminate life. This cannot be taken lightly and it is not legislation that should be rushed, but that is the predicament that this Parliament finds itself in.

In 2016, the Liberal government passed Bill C-14, legalizing MAID. Last year, in the case of Truchon v. Attorney General of Canada, the Quebec Superior Court ruled that it was unconstitutional to restrict the availability of MAID to individuals whose natural death was reasonably foreseeable. Contrary to the requests of my Conservative colleagues and many advocacy groups, the Attorney General, who bears the responsibility of upholding laws passed in Parliament, chose not to appeal the ruling in Truchon. It is difficult for me to understand how something as essential to life as one's departure from it is not important enough for the Liberal government to appeal. This is something that should have had both comment and decision from the Supreme Court of Canada.

Because of the Liberal government's inaction, we are now working up against a December 18 Quebec-court-imposed deadline to enact a legislative response for the whole country. Its declaration of constitutional invalidity expires on that date. I want to assure my constituents in South Surrey—White Rock and all Canadians that, as a member of Parliament and a member of the Standing Committee on Justice and Human Rights, I will stand up for their shared values and beliefs and work tirelessly to ensure the amendments proposed in Bill C-7, and their consequences, are carefully studied and considered despite the impending December deadline.

Turning now to the substance of Bill C-7, I am concerned that the bill, as written, is too broad and lacks the safeguards necessary to protect Canada's most vulnerable populations. Let me be clear. The removal of the “reasonably foreseeable” standard will significantly increase the number of Canadians eligible for MAID. The breadth of qualifying conditions widens considerably under Bill C-7. For anyone who initially opposed MAID on slippery slope concerns, it appears we are now sliding down that proverbial hill. Will we eventually follow the Netherlands' lead, which recently ended up in its announced plans to offer MAID to children under 12?

As a group of physicians recently put in a letter to the Minister of Justice and Attorney General of Canada, urging an appeal of the Truchon decision, “Canada will have moved well beyond allowing an autonomous life-ending decision at the end of life into the realm of death on demand for almost any reason at any time.”

We know, from Health Canada's annual report published in July, that 2% of deaths in Canada in 2019 were medically assisted.

How much higher would that number be under Bill C-7, and how many Canadians would be eligible for MAID without the “reasonably foreseeable” requirement? Both questions must be answered.

If this is in fact the direction in which Parliament decides to take this legislation, we need more safeguards to protect the more vulnerable, not fewer. As written, Bill C-7 redefines who qualifies for the end-of-life procedure and strips away some of the protections put in place a mere four years ago.

One such amendment is the elimination of the mandatory 10-day reflection period. Under the original legislation, unless an exception applied, individuals wishing to receive MAID had to wait a period of 10 days after submitting their signed requests. In most instances, the waiting period makes sense. It ensures time for reflection before taking the irreversible action of ending one's life.

We know from Quebec's annual end-of-life care reports that since 2015, over 300 patients in Quebec alone changed their mind after requesting medical assistance in dying. In any event, exceptions already exist under the original law for those whose death is fast approaching and for people who will soon lose the capacity required to provide the necessary informed consent. Why then remove this 10-day reflection period?

Bill C-7 also takes aim at another safeguard included in the previous laws, reducing the number of independent witnesses needed to sign and date the candidate's application for MAID, from two to one.

This amendment would now apply to the newly eligible class of persons who are not faced with reasonably foreseeable or imminent death. Contrary to statements made in the House by the member for Winnipeg North, this is a real concern for many.

As a civil litigation lawyer, I have had my fair share of exposure to all sorts of legal documents requiring the signatures of independent witnesses to ensure both authenticity and true intent: wills, divorces, financial disclosures, affidavits and mortgages, to name a few. To express one's intentions in a will in B.C., a person must have two independent witnesses not named in the will to witness the authenticity of their signature and their intention at the time of signing. If these requirements are there to safeguard intentions regarding possessions, should they not also be there to safeguard a person's intentions regarding the method and timing of their death?

It should be noted that Bill C-7 does include a 90-day assessment period and directive that applicants be informed of available alternative treatments, but will these safeguards sufficiently protect our most vulnerable populations? When does the 90-day period begin? Is it recorded?

Another piece of the bill that I have difficulty with is that it allows patients who may lose capacity before the end-of-life procedure is performed to give their final consent in advance. This troubles me for the same reasons discussed before with respect to the 10-day waiting period. As we have seen, people do change their minds.

In recent weeks, we have heard from many representative groups that have expressed concern about the decision in Truchon. The Council of Canadians with Disabilities, the Canadian Mental Health Association, the ARCH Disability Law Centre and others have articulated the concern that making individuals with disabilities who are not facing imminent death eligible for MAID would be harmful to the disabled community at large, affirming the untrue stereotype that a life with disabilities is not worth living.

We must pause to reflect on that. Those who are passionate advocates for Canadians with disabilities are very concerned about the direction these court and policy decisions are taking us, yet the Liberal government moves forward.

There still exists the legal concept of undue influence. Who are most susceptible to undue influence and coercion? It is the vulnerable. We have also heard from hundreds of physicians who share a concern that some patients have chosen the path of MAID due to the suffering caused by a lack of proper supports. A tragic example is from B.C., where a father suffering from Lou Gehrig's disease chose to undergo the end-of-life procedure because he did not receive the support and resources he so desperately needed.

The government is not listening to the heartbreaking stories of these ALS sufferers and their cries for the fast-tracking of life-lengthening and life-sustaining hopeful therapies that we cannot get in Canada. Is the government giving those sufferers and Canadians true options? We need compassion, yes, but compassion takes many forms.

Hospices are not readily available to all Canadians as an alternative. A good friend of mine died a couple of years ago of inoperable brain cancer. He was a doctor. In his case, he very carefully weighed MAID as opposed to living in hospice. He chose hospice because it extended his life for five months, which he could spend with his family. They were okay with his deterioration because they loved him, and they wanted to support him and be with him. However, he had that true option.

If we are going to expand the legislation, the government should equally ensure robust support for the vulnerable, hospice care and hopeful therapies are available. Everyone matters.

Finally, I would like to reflect on the health care professionals who are asked to implement this proposed law. We are now celebrating our doctors and nurses for their tireless efforts to keep our country healthy and safe. We should also ensure that they have the ability to decide whether this is compatible with their will or beliefs, and not be mistreated for any refusal to administer it.

To conclude, I have heard from constituents in my riding who are on both sides of this argument. I ask my colleagues to really take the necessary time to study the bill and reflect on these proposed amendments, especially as they affect the most vulnerable. We must be compassionate but we must also respect human life.

The House resumed from October 26 consideration of the motion that Bill C-6, An Act to amend the Criminal Code (conversion therapy), be read the second time and referred to a committee.

[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]

Mr. Speaker, it is with pleasure that I continue with my comments from yesterday.

After listening to the debate yesterday, I wanted to highlight a couple of important points that were made. I believe the most important one is that people should feel free to be who they are. The consequences of societal pressures on people to conform to something they are not causes a great deal of stress and anxiety that leads to some very severe consequences. We heard about some of those consequences yesterday. The most extreme of these, of course, which is a sad reality, is that some people will ultimately commit suicide. This is not to mention the many other things that will take place as a result of society and attitudes that really need to change.

This is not to say we have not made progress. I am 58 years old, and in my generation there has been a great deal of change over the years. I am encouraged by that. Yesterday one of my colleagues said that we want to make Canada the safest place to fall in love, and that speaks of Canada's rich diversity. Diversity goes far beyond our wonderful ethnic diversity. It should incorporate all aspects of the human being and our society in general, and we should be very proud of it.

As I have indicated, I truly believe in Canada's Charter of Rights and Freedoms and how important our standing in the world is regarding the degree to which we recognize the importance of freedom. I am therefore encouraged to see this legislation. What I found really encouraging yesterday, in listening to discussions on the issues of conversion therapy, is that it seems everyone inside the House opposes it and sees the type of harm it causes in society. A number of members have raised issues and wanted some clarification, but on principle, the House appears to be unanimous in its thinking regarding the dangers of conversion therapy. I hope we will see unanimous support for this legislation, because I believe it is worth being supported by all members of this chamber.

I will be specific with what the legislation would criminalize. We should all note this. It would criminalize causing a person under the age of 18, a minor, to undergo conversion therapy; removing a minor from Canada to undergo conversion therapy abroad; causing a person to undergo conversion therapy against their will; receiving financial or other material benefits from the provision of conversion therapy; and advertising an offer to provide conversion therapy. The essence of what this bill would do is protect minors from conversion therapy regardless of whether it is provided within or outside of Canada, protect adults who are vulnerable to being forced to undergo conversion therapy and protect Canadians from the commercialization of conversion therapy.

I see this as a positive step forward, and I want to reflect on some of the comments I made yesterday, and already this morning, on the degree to which things have changed.

I can recall my school days quite vividly, and I had no sense of what “gay” was. It was not even talked about in school. I had no sense, in terms of any type of behaviour, of what was being perceived or pushed on from the norms of society. It was not until the latter years of high school I started to get a sense there was a part of life that I was not privy to, or that was frowned upon.

When I went into the Canadian Forces, I really started to see discrimination against people who were gay, and the negative impacts of being gay. I suspect I do not need to cite specific examples for people to understand some of the things I am implying with that statement.

Once I entered the political realm in the mid-eighties, things were taking place that were actually fairly encouraging. For example, the Pride parade in Winnipeg was established in 1987. It was not meant to be a Pride parade, per se, but it was a gathering of people with respect to an action from the Manitoba legislature. The action would have included sexual orientation as part of the Manitoba Human Rights Code. Hundreds of people were gathering, either to protest the fact that it did not pass or to celebrate the fact it did pass. It turned into a parade. That was really significant back in the eighties.

Fast-forwarding 25 years, it is really encouraging to look at the Manitoba legislature. Located in downtown Winnipeg in a beautiful building, the chamber, with its horseshoe shape, is one of the finest debating chambers in Canada and possibly even North America. Huge Roman heritage pillars are at the very front of the building. It has a beautiful lawn. About 25 years after that first Pride parade, we saw a celebration and the different colours of the rainbow shining up the pillars. We recognized just how far we have come. It was part of a week of Pride celebrations.

We need to think of the impact that has on our community. It is very difficult for us to comprehend the pressures people are under when hiding their feelings. Because of my upbringing, it is very hard for someone like me to imagine that. I can only attempt to understand the difficulty of young people, in particular, dealing with a very difficult situation in their school, home or work lives. The least I can do is to encourage that freedom where I can. Bill C-6 is a good example. It sends a positive message, but the work is not done. We can still do so much more.

The other thing I am very proud of is the fact that Glen Murray was the first openly gay mayor of a major urban centre in Canada: my home city of Winnipeg.

I thank Glen Murray and Randy Boissonnault from the Liberal caucus, both people I have known over the years who have been such strong advocates, and my daughter to a certain degree, for making sure I am sensitive and have a better, more comprehensive understanding of an issue that is important to all of us.

[Alex Ruff, Conservative, Bruce—Grey—Owen Sound, ON]

Madam Speaker, through you to my colleague across the way, I have a couple of quick points.

First, he mentioned at the start of his speech that he was confused as to whether he was 57 or 58 years old. I would appreciate that clarification.

I would like to note that I learned something new about him, which is that he served in the Canadian Armed Forces in the past. We will have that discussion.

Some of the previous members spoke about potential amendments to the bill and what they would like to see. I would like to state that conversion therapy is wrong and should be banned, but the Justice website states:

These new offences would not criminalise private conversations in which personal views on sexual orientation, sexual feelings or gender identity are expressed such as where teachers, school counsellors, pastoral counsellors, faith leaders, doctors, mental health professionals, friends or family members provide affirming support to persons struggling with their sexual orientation, sexual feelings, or gender identity.

Does the member have a concern that anything in that statement would prevent it from being included in this legislation?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, on the age front, January 22, 1962, at St. Boniface Hospital, was a very special moment for my parents. I will let the member do the math.

The member brings forward a very reasonable question. From statements made by the minister, I believe that once the bill goes to committee we, as a government, are open to the possibility of making some changes working with opposition members. All I ask members of all political parties to recognize is the immense amount of consultation and work that was done to bring the legislation we have today in its current form.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, the member and I are both of the same age group. I remember, when I was a teenager, my queer friends were expelled from their families. It was common that if they came out to their parents, many of those young people were told they were not welcome in their own homes. I think of that because my mother goes to mass every single day, but in our home my parents always made sure that the dinner table was set for those who had been kicked out of their own families and had no place else. When we were teenagers, my father told us who we love is who we love, and that is what we must always remember. I think of how, with the young generation today and my daughter's friends, being gay or queer is not an issue. It is considered okay. We have come a long way, but we have not come far enough. I think banning conversion therapy is a huge step we have to take as a nation, to say that we will not go back and undermine the rights of people to be who they are. I want to commend my colleague for his speech.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, it is important for us to recognize how things have changed and why it is so important that we continue to move forward. The very first time I had an appreciation of how society needed to change was in the early eighties, when I first heard the phrase “gay bashing.” From what I can recall, it had taken place behind the Manitoba legislature. Although I would have been in my teens or early twenties, that is when I first became aware of it. Other families were possibly far more progressive than mine, which I appreciate in one sense. That is why it is so important for me to share my thoughts with my family, and my daughter Cindy in particular is probably now even further advanced on the issue than I am.

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, we are talking about removing something from our society that can create harm.

I would also like to hear the parliamentary secretary's thoughts around some of the ways we need to improve investing in services and supports: wrap-around care. I am thinking about Clinic 554 in Fredericton, New Brunswick.

Across the country there are things we need to do to ensure that trans health care is something we protect and invest in, as an example. I am just wondering what the member thinks about that as a conversation.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I absolutely think it is important that, as a government, we work with other jurisdictions and do not underestimate the value of non-profit organizations that are advocacy groups and provide direct services. I know at least two or three websites have all sorts of wonderful resources.

There is so much more there now than a decade ago. However, there is still a need for governments to work together to ensure there is that ultimate freedom for people to be who they are.