This bill is from the 43rd Parliament, 2nd session, which ended in August 2021.
David Lametti Liberal
This bill has received Royal Assent and is now law.
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.
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:
Tamara Jansen Conservative Cloverdale—Langley City, BC
Madam Speaker, as I mentioned, our health care system has been chronically underfunded, especially in regard to palliative care. We are also noticing that our older community is aging, and we do not have quality palliative care in place.
I absolutely agree. We need to start acting now before it is too late.
Gord Johns NDP Courtenay—Alberni, BC
Madam Speaker, Audrey Parker campaigned to make Canadians aware of the challenges created by the current medical assistance in dying legislation and the requirement for final consent at the time that the assistance is rendered. It forces those already assessed and approved for medical assistance in dying to make that cruel choice when they are faced with the possible loss of competence that would make them then unable to give consent. They are then forced to either go earlier or risk not being able to receive the assistance they need to avoid continuing to live with intolerable suffering.
I asked this question earlier, and I appreciate my colleague's passion on this. Do she and the Conservative Party support Audrey's amendment in helping those facing end of life avoid this cruel choice?
Tamara Jansen Conservative Cloverdale—Langley City, BC
Madam Speaker, I am here today talking on behalf of the disability community, which has called this its “worst nightmare”. We need to keep that in mind, so let us make amendments that will protect the vulnerable among us, because that is our job here in the House.
Elizabeth May Green Saanich—Gulf Islands, BC
Madam Speaker, we debated this process of medical assistance in dying in previous Parliaments. I think one of the things that really was notable about those debates was a lack of rancour and a deep willingness to respect each other and to understand that the best motives of all parliamentarians can be seen in moments like this, when we are dealing with issues that are complex and morally difficult, but where ultimately we have a responsibility to ensure that the words of the courts are observed and that we do the best for Canadians.
I would urge the hon. member to perhaps show respect to every member of this House.
Tamara Jansen Conservative Cloverdale—Langley City, BC
Madam Speaker, I would like to take my last 10 seconds to speak on behalf of the indigenous community, which is a very spiritual community that wants nothing to do with this.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Madam Speaker, we are here today debating specific amendments that have been proposed to Bill C-7. I would encourage all members, whatever their first instincts are on the broader philosophical question of euthanasia or medical assistance in dying, to put those aside and look at the particular amendments that are in front of us. These are amendments that have been put forward by my colleague, the member for St. Albert—Edmonton, who I know has worked very hard on this issue ever since it first came to Parliament and he first came to Parliament in 2015.
These amendments are reasonable amendments that all members, regardless of party and regardless of underlying philosophy, should be able to support on their merits because they preserve the principle of autonomy as well as preserving protection of the vulnerable.
The first amendment seeks to preserve a 10-day reflection period. Right now, a person who has gone through the assessment process and been approved for euthanasia or medical assistance in dying has a 10-day reflection period before this is actually carried out.
This reflection period is important because we know that people may have varying experiences of pain and a varying response to their circumstances over time. It is consistent with the principle of autonomy to want to ensure that, when people are making decisions about life and death, they are doing so not in the situation where they are rushed, pushed or feel like they need to make a snap judgment, but rather they are doing it in a way that involves some period of reflection and consultation and that they are not just responding to very immediate but transient circumstances. That is why Parliament, in its wisdom a mere four years ago, thought that this reflection period was important. Also, there was some recognition that there may be some cases where that reflection period is not appropriate. That is why, right in the existing legislation, there is a mechanism by which the 10-day reflection period can be waived. The process for waiving that reflection period is not onerous. It is not required that a person make an appeal to the courts, in order to get that reflection period waived.
The requirement for the waiving of the reflection period is merely that the physicians who sign off on the request also sign off on the waiving of the reflection period. It sets in place a default. It puts in place the concept that generally speaking, in the majority of cases, there should be a reflection period. There should be a mechanism to ensure that we do not have somebody requesting, having an assessment and receiving this thing on the same day.
We have pointed out that the government's proposal now in Bill C-7 to remove the 10-day reflection period could bring in a situation of same-day death, of somebody requesting this, going through the assessment and receiving this all on the same day. I do not think it is reasonable that a person's very worst day should be their last day, that a person could visit their mother or father on Wednesday and everything seems fine, and then go in on Friday to find that they went through the process on Thursday because that is what they wanted that day.
Members have said this would not happen in practice as physicians are reasonable, health care systems are reasonable, and that it is very unlikely that this would all go through in one day. Nonetheless, we heard repeatedly, at committee, testimony from people who did feel that they were being pressured. The parliamentary secretary asked if there are any examples of this happening. If someone reads the committee evidence they will see that testimony and hear the gut-wrenching stories of a mother whose daughter was told that she should go for medical assistance in dying. The daughter said she did not want it. Then the family was told that they were being selfish, so that family left that hospital because they did not feel safe in that environment. They were having medical assistance in dying pushed on them to such an extent that they did not feel safe.
Do I think that most doctors or most health care practitioners behave that way? Of course not, but that is why it is called a safeguard. A safeguard because most people using common sense, acting in a responsible way, would not need that safeguard in place. The safeguard exists to protect people in cases where that good judgment that we want to see in action does not take place. The principle of safeguards is not that most people might act in an abusive way, but it is the fact that some minority may act in a way that is not appropriate. That is why we have rules in place in the legislation to protect people. The safeguards are worth it because we are talking about life and death.
I encourage members, however they feel on the issue more broadly, to recognize the inherent reasonableness of a 10-day reflection period, which can already be waived in certain situations.
Most of these votes will take place on a partisan basis, but I say to every member, Liberal, New Democrat or Bloc Québécois, it is their conscience on the line and this is a matter of life and death. Every one of us, regardless of party, have a vote in this place that we have a right to exercise.
If members think that a 10-day reflection period, and most of the time it could still be waived in certain circumstances, is reasonable to ensure that vulnerable people are not pressured, then vote in favour of these amendments. Vote in favour of these amendments, first for a 10-day reflection period and second to clarify an assessment period in the case where death is not reasonably foreseeable, a 120-day assessment period, to ensure that people who have a disability, who experience a new kind of challenge, will actually go through a process of receiving treatment or at least be more likely to receive treatment before they complete the waiting period that has been put in place.
Would we not all agree that it would be a problem if someone could get medical assistance in dying faster than they could get actual care and management of their situation, if it is easier to access death than to access the basic implements that would allow a person with a disability to adapt to their new circumstances?
I would suggest that it is eminently reasonable that people be offered and receive treatment and support for adaptation to their circumstances before they receive death. Instead of just being abstractly—
Criminal CodeGovernment Orders
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
I must interrupt the member, because it is 1:30 p.m. The hon. member will have three minutes to finish his remarks once we return to the study of the bill.
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 November 27, consideration of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), as reported (with amendments) from the committee, and of the motions in Group No. 1.
Criminal CodeGovernment Orders
The Deputy Speaker Bruce Stanton
When the House last took up the motion before the House, the hon. member for Sherwood Park—Fort Saskatchewan had three minutes remaining in his time for debate. He will also have five minutes for questions and comments.
The hon. member for Sherwood Park—Fort Saskatchewan.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, to conclude my remarks on Bill C-7, I will speak to the way the bill would enshrine discrimination against people living with disabilities. I will explain how that is.
Historically, when people experience extreme existential angst or suicidal ideation and present at a professional environment, perhaps an emergency department, they receive suicide prevention care. The intervention the system provides to them is trying to prevent them from acting on their suicidal ideation.
This is done out of a sense that suicide prevention is good for the person involved. It has been, and still is by many people, seen as consistent with small-l liberalism or a belief in autonomy more generally. When people experience these kinds of feelings, they are counselled and advised in a way that affirms the idea that life for them is very much worth living. This is the standard practice of suicide prevention as it has been practised for most of our history, and as it is practised for most people.
Based on what we have already heard regarding the experiences of people with disabilities, what they are sometimes presently experiencing when interacting with the health care system is that, when they come forward with the same kinds of feelings, they do not receive suicide prevention. Instead they receive suicide facilitation.
In other words, if I, as an able-bodied person, were to come to an emergency department with the same feelings as a friend of mine, who happens to be a person with disabilities, this friend would be much more likely to be offered suicide facilitation, whereas I would be offered suicide prevention. That is discrimination by definition.
The question for this House to consider is this: Who should get suicide prevention, and who should get suicide facilitation? This is an important question that people with disabilities are raising and have been raising at committee, that they would experience something different from the health care system than people who are able-bodied.
The direction in which members want to resolve that discrimination, according to their values, is an open question, but the fact is that people will now be treated differently if they have a disability compared with if they do not. That is very clear from this legislation and the fact that, overwhelmingly, all of the organizations representing people with disabilities that testified before the committee expressed grave concerns about the implications this would have.
I think we want to be the kind of country that treats people fairly and equally, and affirms the life and dignity of all people, regardless of whether or not they are living with a disability. This is one of many concerns that was top of mind and presented at the committee discussion on Bill C-7. I hope members will listen to it, take it seriously and think about it as they proceed to vote on these amendments at report stage.
Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons
Mr. Speaker, one thing the member left out of the equation is the incredible efforts provided by our medical profession, individuals who, I believe, would provide proper and consistent advice. I do not think anyone would encourage the type of behaviour the member is implying in his comments.
I wonder if, upon reflecting of some of his comments, he might take this opportunity to recognize the sense of professionalism provided by the health care workers in our health care system today.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, the member is referring to some of the comments I have raised about the committee testimony, which already shows concern for people with disabilities being treated differently in the system, even being pushed toward euthanasia or assisted suicide, and the need for safeguards against that.
I agree that the vast majority of our health care workers are well intentioned and do great work. Three out of four of my siblings, as well as my wife and my father, all work in health care, so I probably have more direct familial contact with people in health care than many other members.
There are hundreds of thousands of people in this country working in health care. The reason we have safeguards is not because most of those people might make problematic decisions; it is because there is always a risk, and we have already heard from people in the disability community that people are having these negative experiences, of being encouraged toward medical assistance in dying.
One person testified about being called selfish for not wanting this option. That is why we have safeguards in place. It is not for the general cases; it is for the exceptional cases, because life and death are still involved in exceptional cases.
Dane Lloyd Conservative Sturgeon River—Parkland, AB
Mr. Speaker, I have a concern about the removal of the reflection period for people who might be suffering from mental challenges if they might qualify under what is understood as a reasonably foreseeable death. We know not all doctors are equipped to assess those challenges.
Therefore, could the member talk about the possible risks of removing the reflection period for people with mental challenges and how we could see some very dangerous consequences from that?
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, I know my colleague's work on this issue. The reflection period is one of the amendments in front of us to vote on. It is important for members to understand the reflection period can already be waived in certain circumstances. For any argument that the reflection period might not be appropriate in certain circumstances, it can already be waived. However, the reflection period creates a default, a sense that we should not have same-day death.
A person may be experiencing an extensive set of challenges on a particular day that may be very real but very transient. The reflection period is designed to ensure that the choice people make reflects considered exercise of autonomy over time, not a momentary place of darkness.
Philip Lawrence Conservative Northumberland—Peterborough South, ON
Mr. Speaker, the member spoke eloquently about some of the shortcomings of the legislation. I want to give him a chance to talk about any particular amendments with respect to helping persons with disabilities and strengthening the legislation.