Madam Speaker, I am very grateful for the opportunity to put a few words on the record concerning Bill C-7, an act to amend the Criminal Code, medical assistance in dying, which I will refer to as MAID throughout my remarks.
The bill from the Liberal government would amend the original MAID legislation that achieved royal assent only four and a half years ago. The new bill was initiated in response to the Truchon case, where a federal court in Quebec struck down the clause in the original legislation that said MAID could only be applied if natural death was reasonably foreseeable. The Quebec Superior Court judge ruled on September 11, 2019, just over a year ago, that this clause violated section 7 of the Charter of Rights and Freedoms, which guarantees the right to life, liberty and security of the person, making this clause of the original legislation unconstitutional.
The court's ruling will come into effect on December 18 of this year. The Conservatives have held firm to the position that this ruling by the Quebec Superior Court should have been appealed by the federal government to the Supreme Court of Canada. Given that it is a ruling that affects life and death, I sincerely agree with our position.
Had the Liberal government appealed, it would have given Canadians significantly more time to discuss this very critical issue, and had the Liberal government not prorogued Parliament for six weeks in August and September, Parliament would have had more time to study and debate the bill. However, this position was resoundingly ignored by the Liberal government. Now we are voting on a radical expansion of MAID, and I have many concerns and will not be supporting the bill.
I do understand the desire for legalizing MAID in Canada. I witnessed my grandmother suffer terribly at the end of her life. MAID was not made available to her and, frankly, I do not know if she would have chosen it. She was a very strong and resilient woman, with a gift of the gab and an incredible ability to write, which I have inherited those gifts. That is why I am able to be here today as a member of Parliament, which she would have been so proud to see. She had these abilities despite not even having a grade eight education. She would have achieved amazing things had she not been born into a very poor family in rural Manitoba.
She tragically suffered a stroke and after that she could not speak or write, her favourite things. Then her diabetes wreaked havoc on her body and her leg had to be amputated as a result. A short while later, the doctors told us that they would have to amputate her other leg. It was really horrible and the worst thing in my life to see her go through this. I wonder if MAID would have been a kinder option for her. For that reason I understand and deeply appreciate why MAID was legalized in Canada.
However, the Conservatives have flagged a number of critical issues with this new expansion of MAID and we worked hard to bring forward amendments to ensure safeguards remained in place for Canada's most vulnerable people. Unfortunately, the Liberals voted against every one of our proposed amendments, and I really do not understand why. We presented many strong, sound arguments from stakeholders across the country, most of whom had no partisan connection whatsoever to the Conservative Party. In fact, this is not a partisan issue and yet it is being treated like one by the Liberal government, which I find deeply upsetting.
When I was researching the bill to determine my position, I was startled to discover that over 1,000 physicians had written to the Attorney General in opposition to the bill. I would like to read into the record some of what their letter said because I found it extremely compelling. They said:
This bill, expanding “medical assistance in dying” (MAiD) to virtually everyone who is sick and suffering in Canada, will, if passed in its current form, make our country the world leader in administering death.
As medical doctors, we feel compelled to voice our dismay...The shock of a sudden illness, or an accident resulting in disability, can lead patients into feelings of anger, depression, and guilt for requiring care - emotions that, with proper support and attention, can resolve over time.
They went on to say:
The care and encouragement shown by physicians may be the most powerful force in overcoming despair and providing hope. Unfortunately, patients can no longer unconditionally trust their medical professional to advocate for their life when they are at their weakest and most vulnerable. Suddenly, a lethal injection becomes part of a repertoire of interventions offered to end their pain and suffering.
Finally, they went on to say:
Bill C-7 would allow those who are not dying to end their lives by a lethal injection at the hands of a doctor or nurse practitioner. Shockingly, most of the safeguards that Parliament deemed necessary in 2016 to protect the lives of vulnerable individuals from a wrongful death are being removed. Under the new bill, an individual whose natural death is considered to be “reasonably foreseeable” could be diagnosed, assessed and euthanized all in one day. We are very concerned that removing the 10-day reflection period and other safeguards will lead to an increase in coerced or tragically unconsidered deaths.
The reckless removal of safeguards previously deemed essential will place desperately vulnerable patients directly in harm’s way and may cost them their very lives.
The comments tie in very well with what we have heard from the disability community at the justice committee and the like when we were studying this legislation. In fact, 72 national disability advocacy groups have opposed this legislation. I personally fielded many calls from my constituents, who were the first to tell me that they usually vote NDP, yet they felt very compelled to reach out to me to express their fear of what this bill meant to them.
There is a genuine terror in the disability community of this bill, which I have heard first-hand, yet those fears are being completely discounted by the Liberal government. I really do not understand why.
More than that, the Liberals are even ignoring the United Nations with this legislation. A UN special rapporteur on the rights of persons with disabilities responded to the expansion of MAID with clear dismay. She said:
I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying. I have further received worrisome claims about persons with disabilities in institutions being pressured to seek medical assistance in dying, and practitioners not formally reporting cases involving persons with disabilities. I urge the federal government to investigate these complaints and put into place adequate safeguards to ensure that persons with disabilities do not request assistive dying simply because of the absence of community-based alternatives and palliative care.
That is a pretty powerful quote, in my opinion.
We know that there are considerable issues with palliative care. We know that 70% of Canadians, seven out of 10, do not have access to palliative end-of-life care in Canada. I find that to be a shocking number, and I had no idea until I did research for this bill.
I do believe that without access to good quality palliative care, we have failed to offer Canadians a real choice. If they cannot peacefully live out their final moments with safe, reliable care that is supportive and catered to their needs, then I can understand why MAID would be so appealing.
More than that, the COVID-19 pandemic has really lifted the veil on the terrible state of elderly care in Canada. In Winnipeg, our residents in elderly care homes have suffered tremendously. While we have many care homes that are doing phenomenal, outstanding work, others, not so much. A few weeks ago, Manitobans were horrified at revelations of an elderly care home just outside of my riding that was understaffed, and overwhelmed by COVID-19 cases.
When paramedics arrived, they found that some residents had been dead for hours and no one knew. Others were severely dehydrated and starving to death. If we are to provide dignity in dying, we must also ensure dignity in living. This is paramount to the discussion and has been completely ignored by the Liberal government. In fact, in the Liberals' 2015 election platform, they promised billions of dollars for palliative care. This was never delivered.
Further to that, I found it alarming that the 10-day reflection period in the original MAID legislation would be eliminated with the passage of this bill. It is important to note that the existing MAID legislation allows the 10-day reflection period to be waived under special circumstances, so flexibility on this 10-day reflection period is already in the existing MAID framework.
I am really not married to the 10 days specifically. It could be a bit shorter, or it could be a bit longer. I would need to hear from professionals in psychology to truly understand how many days are best to ensure end-of-life decisions are not made emotionally, or made in the heat of the moment, so to speak. However, I do firmly believe, at the very least, someone who requests MAID should have to sleep on it, given that there is no going back from it.
Given there are tough days, whether someone had a poor interaction with a health care worker or does not like their new room or facility, or their family has not visited in a while, or it has just been a physically or emotionally tough and painful day, there are so many reasons why someone within their most vulnerable state should have safeguards in place when making life-ending, “game over” decisions. With this legislation, if it is passed, MAID could be administered only hours later.
What really solidified my thoughts on the removal of this safeguard was the former Liberal minister of justice, the member for Vancouver Granville, who was responsible for the original MAID legislation only four and a half years ago. She questioned the current justice minister on removing the reflection period, given removing this safeguard was not called for in the Truchon decision. The person who brought forward this legislation four and a half years ago is asking why the Liberals are removing this reflection period, yet we received no firm answer from the Liberal government as to why that is. I find that to be pretty compelling. The Liberals, for reasons unknown, went far beyond what was required in the Truchon case when they created Bill C-7, and I believe these concerns are valid.
In fact, we learned in the “First Annual Report on Medical Assistance in Dying in Canada, 2019”, that 3.6% of patients who made written requests for MAID subsequently withdrew those requests. Now, 3.6% may not sound like a lot, but of the 7,336 people who applied for MAID, 263 of them changed their minds.
We should keep in mind that MAID is new in Canada and not easily accessible everywhere. Members can imagine how many people will be applying for this after Bill C-7 passes. As MAID becomes increasingly normalized, we know that 263 lives were allowed to continue to live on because of that reflection period, which is, in my opinion, so important to maintain. However, it will not exist moving forward because of the Liberal government's refusal to listen.
Conservatives also proposed an amendment that would extend the new 90-day reflection period for those seeking MAID whose deaths are not reasonably foreseeable. We proposed to extend it to 120 days, and the arguments for this are solid. The over 1,000 doctors who I quoted earlier have said, “We live in a country where the wait time to see a psychiatrist in certain areas is 4-8 times longer than the 90-day waiting period proposed in the bill for those whose natural death is not considered 'reasonably foreseeable'”.
Further, we know that after a catastrophic accident causing, for example, a life-altering injury, suicidal ideation is very common, but with the proper support it goes away and a happy and purposeful life can resume. Moreover, it takes much longer in many cases to get a wheelchair or quality specialized rehabilitation care than the 90 days, so I ask this: What good is 90 days if someone is not able to access alternatives in that time period? I do not know.
Additionally, Conservatives believe we can better protect vulnerable patients by requiring the patients to be the ones who first request information on medical assistance in dying, and not have it openly or flippantly offered to a patient as a standard everyday option like pain medication or various therapies. Conservatives believe MAID is an extremely serious matter and should not be something pushed on patients in their most vulnerable state.
Whenever members on this side of the House state the potential for pressure to be put on patients concerning MAID, I do find, during these debates, that Liberal members essentially roll their eyes. They scoff and say that never happens, while the justice committee heard something different. It heard first-hand from witness accounts that pressure does, in fact, happen and has been happening over the past four and a half years.
Roger Foley is an infamous example of this pressure. He was offered MAID on four separate occasions to date and never once indicated that he was interested. In fact, he indicated quite the opposite. When he was having a bad day it was offered to him. It was almost as if they were tempting him by saying there is an easier way and suggesting he should just end it all. I just find that terrifying.
I find Roger's case very alarming. Safeguards must be put in place to ensure that when people are at their weakest and most vulnerable moments, they are not offered something that would end their lives forever, but rather are provided various options for better care and support, if they want it.
Another issue I have with this bill is that it moves to expand MAID so quickly. Really, this MAID legislation's original framework was just legalized four and a half years ago, which is really a blink of an eye in relative terms. The original legislation was thoroughly researched and vetted, and numerous safeguards were put in place to ensure our most vulnerable were protected. Those safeguards were considered critical at the time.
Now, less than five years later, the Liberal government is massively expanding MAID and doing away with many of those safeguards it itself deemed critical in the first legislation not even five years ago. At this pace, I very much believe and fear that we may be debating expanding MAID for children or those with mental health issues within my lifetime, and I find that absolutely terrifying.
More than that, this legislation comes before the mandatory five-year review. I feel that without that we are flying blind without the proper data that could have been revealed in a comprehensive review. There are simple questions I would have hoped would have been assessed in that review, such as these: “Who is taking MAID?”; “Is it mostly the elderly or the poor?”; “Is it racialized communities or wealthier white people?”; “Is MAID affecting certain demographics?”; “Why those demographics?”; “Are there reoccurring themes for choosing MAID that could be addressed by providing better care during suffering at end of life, rather than death?”.
We should be doing everything we can as legislators to provide alternatives to MAID that are reliable and easily accessible to everyone, yet the current government is not doing that at all.
What I find interesting on this is that the current Liberal justice minister is responsible for this aggressive expansion of MAID. He, in fact, voted against his own government's Liberal legislation on MAID, the original one four and a half years ago, because he believed it did not go far enough. We have known for a long time what his position is, and that leads me to question whether the Liberal consultations on this bill were really impartial. It may explain why this legislation goes far beyond what the Quebec superior court judge called for in the Truchon ruling.
There are so many questions with this new freedom Canadians have with MAID. I firmly believe we have the responsibility as legislators to proceed on ending the lives of Canadians with extreme caution. There is a profound shift happening in our society concerning MAID, and we must proceed thoughtfully and with thorough, exhaustive research, which has not happened with this expansion of MAID. For me, this expansion, to put it plainly, is too much, too fast, too soon.
Bill C-7 would remove other critical safeguards as well, such as the requirement to have two independent witnesses sign off on MAID for a patient. This safeguard helps to prevent abuse and coercion of MAID and provided much-needed oversight on those discussions with patients. To think a person needs two independent witnesses to sign off on a will, but not to end their actual life, makes me feel as though we are living in the twilight zone.
Further, Conservatives have advocated for amendments that would ensure physicians who sign off on MAID applications have expertise in a patient's condition. One would think that for a life-ending decision such as MAID, the safeguard would be a given, but no, the Liberals disagree, and again for reasons largely unknown.
Additionally, a number of constituents have reached out to me with significant concerns that health care professionals who do not agree with the morality of MAID would be forced to help administer it. The Liberals have insisted that this will not be the case and that the conscience rights of health care professionals will be protected. However, communication on that has been dismal, to say the least, otherwise I would not be receiving so many calls about it. I urge the Liberal government to invest more time and energy into communicating on this specific issue.
I will end with a quote from the over 1,000 doctors who I have mentioned throughout my remarks. They said:
Our profession has been coerced into facilitating suicide rather than preventing it, for ever-increasing numbers of citizens. We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws. We, the undersigned, declare that the passage of Bill C-7, if left unchecked, will contribute to the destruction of much more than our medical profession, but fundamentally, of a Canadian society that genuinely values and cares for its most vulnerable members. Canadians deserve better.
