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.

Protection of Freedom of Conscience Act

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Thank you, Madam Speaker. Now I feel I can deliver a speech.

I want to make one thing clear to the House of Commons. I think this is the appropriate time to point it out, and I think everyone here will agree with me. No one is condoning bullying, be it of health care workers or here in the House. We all know people who have bullied others. Bullies are mean-spirited people whose actions betray their insecurity and fear. We all agree on that.

That being said, we are well aware that this bill has nothing to do with bullying or protecting health care workers from bullying. What this bill would actually do is interfere with people's ability to obtain medical assistance in dying. As I said this morning, the Conservative Party is once again exploiting a serious problem to put forward a misleading solution. The party claims this bill will protect health care workers from bullying, but it is hiding the real objective, which is to interfere with medical assistance in dying. As I said this morning, this is populism.

This morning, a member corrected me, saying that being populist was not necessarily a bad thing. Fine. I should have used the term “demagoguery”. It is demagoguery.

We know full well that this bill does not seek to eliminate the bullying of health care professionals. Its objective is simply once again to obstruct existing legislation in Quebec. What is more, it seeks to allow a medical practitioner or a health care professional to not refer a case to a colleague. That goes against what we have in Quebec.

Obviously, the Bloc opposes this bill, just as we opposed Bill C‑268 in the last Parliament, and just as we opposed the proposed amendment to Bill C-7 when it was studied in committee. We have always been opposed to this. I do not know why it has come up a third time. Apparently, they have run out of topics, when there are so many to work on. If the Conservatives are looking for topics, we can help them with that.

Again, the Conservative Party is presenting us with a bill that has a certain objective, but which is worded differently in order to hide its real objective.

We oppose this bill for two reasons.

First of all, it contravenes the Quebec charter of values, rights and freedoms. There are already laws in place to protect health care workers in such situations involving intimidation. Let me give some examples of legislation that allows health care workers to refuse to provide medical assistance in dying.

Quebec's Act respecting end-of-life care states the following:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.

Subsection 241.2(9) of the Criminal Code states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

Health care workers are already protected by the Criminal Code.

Finally, section 24 of the Code of ethics of physicians of Quebec recognizes conscientious objection for medical practitioners, which is the right not to resort to a medical act that goes against their values. It is also recognized in Quebec's Act respecting end-of-life care. The physician is nevertheless required to find another physician.

A physician must, where his personal convictions prevent him from prescribing or providing professional services that may be appropriate, acquaint his patient with such convictions; he must also advise him of the possible consequences of not receiving such professional services. The physician must then offer to help the patient find another physician.

Ontario has a similar provision. Therefore, physicians and health care workers in that province do not need this bill.

Second, we are opposed to this bill because it allows physicians not to refer a case. Let us recall certain statistics. It is all too clear: There is a growing demand for medical assistance in dying, in Quebec as well as in Canada, since these laws were passed.

End-of-life care meets a need and helps ease the suffering of patients who are dying. Since the act came into force, the number of cases of MAID in Quebec has increased year over year. In 2016-17 there were 599 cases and in 2020-21 there were 2,426, which represents a 405% increase.

According to the annual report of the commission on end-of-life care, three-quarters of patients who requested MAID had cancer.

We can all agree that individuals who request MAID do not do so lightly. These people have a right to dignity and that is what is most important in all of this.

A certain balance must be struck and a decision made. That is the issue: striking a balance between an individual's dignity and freedom of conscience and religion. This has already been studied. Quebec has been discussing these issues for 10 years. That was the objective of the bill sponsored by Ms. Hivon, who I would like to congratulate today, and which was adopted on June 5, 2014. A lot of work went into this. Years were spent studying and evaluating these issues. Why not trust the work that has already been done by Quebec in this area?

This seems to be a recurring theme in the House. The federal government starts from scratch without building on what has already been done. It does not have to look far; Quebec is just across the Ottawa River.

The Quebec National Assembly is working on the issue; among other things, the Select Committee on Dying with Dignity was created on December 4, 2009. There is a consensus in Quebec that access to medical assistance in dying should not be restricted. The Quebec National Assembly spent 10 years examining both sides of the issue I just spoke about.

I will conclude here. I repeat: Medical assistance in dying is not designed to go against the values, religions or religious practices of certain Conservative Party members. Medical assistance in dying is an essential measure that allows people to die with honour and dignity. That is in line with Quebec's charter of values and its charter of rights and freedoms.

Extension of Sitting Hours and Conduct of Extended Proceedings

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, as I was saying, I rise in the House feeling extremely disappointed. I am disappointed with the government's vision of parliamentary democracy. What a waste of time and energy.

Since securing the support of the NDP, the government has been acting with the arrogance of a majority government. Some will ask whether I am truly surprised. I will answer that I entered politics because, first and foremost, I refuse to be cynical.

Last Thursday, I heard the Parliamentary Secretary to the Leader of the Government brazenly state that this type of motion was nothing out of the ordinary. A brief review showed me that, indeed, this happens too often in the House.

The Liberals said that it was not uncommon and that it was not a big deal, because the Conservatives did it before. Just because the Conservatives did something once, that does not mean that another party is justified in doing the same thing once in power. There is no reason to normalize parliamentary mediocrity and an inability to manage the parliamentary agenda.

The government has been lax, not to say lackadaisical, in administering its legislative agenda, especially when it comes to medical assistance in dying. There was an election, there were three sessions before the election, and a committee was created, but the committee was not recalled until late March, and its first meeting was held on April 8. That is totally unacceptable.

In my view, this motion is unworthy of a democratic Parliament. It is despicable. Either this motion is malicious, deceptive and twisted, or it is astoundingly insensitive toward people who are suffering. Today, with this motion, not only is the government limiting the powers of the opposition parties, but it is doing so for partisan reasons. This is end-of-session quibbling over matters of life and death. The government is exploiting the issue of end-of-life care and capitalizing on the suffering of people who are dying, who are experiencing intolerable suffering, who would like to have access to support in dying with dignity and who would like the proper respect to be shown for their right to make a free, informed choice.

These people trusted us last year when we passed Bill C-7. They assumed we would spend the next year conducting a rigorous, thorough cross-party analysis and produce a credible report on the revision of the act.

In our opinion, the Liberals’ strategy is the epitome of cynicism. They are preparing to trample on the powers of the opposition parties with the NDP’s complicity, while in 2017, 2018 and 2019 the NDP voted against this type of motion. The Liberals are muzzling the opposition parties, something we have always voted against. They are imposing closure, but they are careful to add in the same motion what the Bloc Québécois wants, namely to extend the mandate of the joint committee until October 17. On the one hand, they are giving us less time. On the other hand, they are extending the deadline.

Fortunately, knowing that we could not divide the motion, the Speaker allowed us to divide the vote.

By tabling the motion last Thursday, however, the government placed the Bloc Québécois in a position where it had to vote against its desire to implement a rigorous and credible process to review the act respecting medical assistance in dying in order to allow the joint committee to submit a report worthy of expectations or alternatively compromise its principles of parliamentary democracy. This is the Liberals’ twisted way of governing.

Since the last election, the government has dragged its feet when it came to reconstituting the special joint committee. It did so not in a separate motion, but—nice going—in a motion adopted under a gag order, which muzzled the opposition.

Since the beginning of the 44th Parliament, the Bloc, represented by myself and my excellent House leader, has told the government that we were short on time and that we should proceed by consensus to extend the deadline for the joint committee’s report. A first compromise was made, and the deadline was extended until June 23. Unfortunately, to succeed, we would have had to sit continuously, and intensively, more than once a week, starting with the first meeting.

The way we conduct this process is important for ensuring the credibility of the findings. This part of Motion No. 11 should at least have been moved separately. Discussions could have continued with the Conservative party; so far, the Conservatives are claiming that the June 23 deadline is reasonable and sufficient.

Obviously, the schedule can be reorganized at the end of the session. Obviously, with this hybrid parliament, resources cannot be optimized to accommodate more work, even until midnight. Obviously, this limits the organization of business. Claiming that we can call witnesses and ensure—

Protection of Freedom of Conscience Act

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I rise in strong support of Bill C-230, the protection of freedom of conscience act, introduced by my friend, the member for Carlton Trail—Eagle Creek.

The bill before us is much-needed legislation to protect the charter rights of medical professionals who conscientiously object to providing or otherwise participating in medical assistance in dying. I want to commend the member for her steadfast leadership in championing conscience rights and for bringing this bill back to the House, as she introduced a similar bill that died on the Order Paper in the last Parliament.

Medical assistance in dying raises profound legal, moral and ethical questions. The trial judge in the Carter decision, which struck down the Criminal Code prohibition against physician-assisted death, stated, “The evidence shows that thoughtful and well-motivated people can and have come to different conclusions about whether physician-assisted death can be ethically justifiable.” This is true of patients, and it is true of medical professionals.

Medical professionals have a duty to do what is in the best interest of their patients and to provide the best possible advice based upon their judgment and experience, all of which are grounded on moral and professional convictions. In the case of medical assistance in dying, there are professional, moral and ethical considerations of the highest weight.

In the Carter decision, the Supreme Court predicated its decision on two things: a willing patient and, as importantly, a willing physician. At paragraph 132 of the Carter decision, the court said that nothing in its pronouncement would compel medical professionals to participate in MAID. The court went further in stating that, “However, we note...in addressing the topic of physician participation...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief.” In other words, again, it requires a willing patient and a willing physician.

Now, there are those who would say that this legislation is redundant, that it is not needed, and that in terms of medical assistance in dying, conscience rights of medical professionals are already protected. They would point to the pronouncement in Carter. They might also cite Bill C-14, which includes a preamble that expressly recognizes conscience rights as well as a “for greater certainty” clause in the Criminal Code, which simply provides that “for greater certainty, nothing in this section compels an individual” to provide MAID.

While the intention of Parliament was to protect the conscience rights of medical professionals when Bill C-14 was debated and passed—and I was there for, and actively participated in, that debate and the study of that bill at committee—in practice, conscience protections and the rights of medical professionals are not being respected across Canada. There is a gap, and that is why, when Bill C-7 was studied at the justice committee, we heard from medical professionals who expressed serious concerns about pressure and coercion in providing MAID.

Indeed, the Ontario Medical Association wrote to our committee and specifically called on the committee to amend Bill C-7 to provide greater conscience protections for medical professionals, given that the “for greater certainty” clause, although better than nothing, simply does not have teeth. It is not enforceable. In that context, while the Criminal Code does not compel a medical professional to provide MAID, there is nothing in the Criminal Code that specifically protects medical professionals when they are pressured or coerced to provide MAID. This bill addresses that gap and would close it by establishing two targeted offences; namely, it would make it an offence to intimidate or coerce a medical professional with regard to providing or participating in MAID, and secondly, it would make it an offence to dismiss or refuse to hire a medical professional solely on the grounds that they object to participating in MAID.

While this legislation would protect the rights of medical professionals, it must also be emphasized that this bill would just as much protect the rights of patients. The bill would protect the rights of patients by protecting the physician-patient relationship. It would do so by safeguarding the ability of medical professionals to provide their best advice and judgment, free of pressure and free of coercion, to a patient who is considering medical assistance in dying. It would protect patients by protecting their right to a second opinion. There can be no second opinion, or at least a guarantee of a second opinion, in the face of coercion or pressure to provide medical assistance in dying. There can be no second opinion when the only choice offered to a patient is medical assistance in dying as a result of pressure and coercion.

The need to safeguard the patient-physician relationship, which this bill works toward achieving, is all the more needed in the face of the radical expansion of medical assistance in dying in Canada with the passage of Bill C-7, which removes critical safeguards, including the criterion that death be reasonably foreseeable and opens the door to medical assistance in dying for persons who are suffering solely from a mental illness, even though it is never possible to predict when someone who is suffering from mental illness can get better. It is never possible to predict irremediability in the case of a solely mental illness. As a result of the removal of those critical safeguards, vulnerable patients are put at greater risk.

When the conscience rights of medical professionals to exercise their best judgment are protected free of intimidation and coercion, the rights of patients are equally protected. This is a timely, targeted and necessary piece of legislation that would protect the rights of medical professionals and their charter rights and the rights of patients. I urge its passage.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, I am pleased though a bit surprised to be speaking on Bill C-230. Less than a year ago, on May 27, 2021, we were in the House debating Bill C-268, the very same bill from the very same member for Carlton Trail—Eagle Creek. While I am a bit in awe of the member's ability to place so highly in the random draw for Private Members' Business in two successive Parliaments, I am also at a bit of a loss to explain why the member would squander her luck on this bill.

There are two reasons I say this. As MPs we get limited opportunities to place bills directly before the House. I had that opportunity in 2013, and I used it to put forward Bill C-279, which sought to add gender identity and gender expression to the list of prohibited grounds for discrimination in the Canadian human rights code and in the hate crime section of the Criminal Code. Though many thought it unlikely, the bill did pass the House with support from MPs from all parties. It took a lot of work to put together that coalition of MPs. While my bill followed a somewhat torturous path, there was always a path forward and it became law.

I wonder why it is that having heard so clearly, in speeches less than a year ago, that there was limited, if any, support for this bill outside her own party, the member for Carlton Trail—Eagle Creek has brought it back again. Since there is nothing to indicate any change of circumstances or any change of heart, this bill will go nowhere this time as well. Failing to bring forth a bill that might have some prospect for passing or reintroducing this bill instead of bringing forward a new bill presenting ideas not already debated here in the House leads me to call reintroducing this bill, at best, a missed opportunity.

The second reason I have for declaring the reintroduction of this bill a lost opportunity has to do with the bill itself. This bill picks up a tiny portion of the extensive and important debates on medical assistance in dying that took place on Bill C-14 in Parliament in 2016 and again on C-7 in the last Parliament. It seeks to take one small and very debatable point and turn it into a wedge issue in the House.

We are waiting for the Special Joint Committee on Medical Assistance in Dying to get down to work on outstanding important and critical issues around medical assistance in dying, but as that committee has yet to get under way, I want to take this opportunity today to restate the principle that has guided New Democrats through these debates.

We believe that medical assistance in dying is an important tool for helping to end unnecessary suffering for patients facing end-of-life issues and for avoiding the unnecessary suffering of their families, who have to accompany them on this journey. This is the reason New Democrats will always defend the right of access to information about MAID and access to the service for all those who qualify for assistance in dying and choose to proceed.

In the debate on Bill C-7, many issues arose concerning the challenges Canadians face at the end of life, some of which Bill C-7 addressed directly and some which have not yet been addressed. Two important concerns were front and centre, and these, for me, were the most important. The first was to help alleviate unnecessary suffering by eliminating the waiting period, which was a cause of great concern for patients who feared loss of capacity before they could complete the waiting period and thus make them ineligible for medical assistance in dying and forced to consider suffering.

The second was a change allowing a waiver of final consent. This is a provision I know quite well, personally, as a friend of mine chose to go earlier than she would have liked because of a brain tumour and her fear that she would lose capacity to consent at the last moment and, in doing so, have to continue making her family suffer.

A second challenge was also debated in Bill C-7. How do we preserve as much autonomy as possible for Canadians who are dying? Most of the issues related to this still have to be dealt with at the special joint committee. This includes questions of advance directives, the question of access to MAID for those with mental illness and for mature minors, and whether protections for people with disabilities from being pressured to seek MAID are adequate. I remain frustrated with the delays in dealing with these very important issues. The bill before us is not one of those.

A third challenge that came up in the debate on Bill C-7 was access to services at the end of life. We learned there are a great many gaps in services in our Canadian health care system for those who are facing death. There are gaps in diagnostic and treatment services depending on where one lives, whether it is a major city with excellent facilities or a rural and remote area. We learned of important gaps in palliative care.

However, instead of addressing these challenges, the challenges of autonomy and the challenges of access to services, Bill C-230 is about something else altogether. What this bill would do is override a patient's right to access information about and to have access to legally provided medical services, based on the personal beliefs of a service provider.

Let me put that in plain language. Let us suppose there are a variety of treatments available to a patient. It does not really matter in this case what they are. If a medical professional believes that one of them should not be available, this bill says there is no obligation on that professional to make sure patients find out all the options available to them. Professional organizations, like colleges of physicians and surgeons, and colleges of nurses, have found this to be unethical behaviour, so they require doctors, to varying degrees, to refer patients to someone who is supportive of those services and who is available to provide those services.

This requirement to refer exists in its strictest form in Ontario as the right of patients to an effective referral, meaning a referral to a health care professional who is available, capable and willing to provide that service. This has been upheld by the courts as a reasonable compromise between the rights of patients' access to medical issues and the conscience rights of service providers. That is the main reason I cannot support this bill. If passed, it would result, on a very real and practical basis, in the denial of access to necessary health services for many Canadians.

Many communities have a very limited number of doctors and if one of those doctors, or even more than one of those doctors, is unwilling to let their patients find out about medical assistance in dying, then we are condemning those Canadians to suffer at the end of life in ways that other Canadians would not have to suffer. No health care professionals are in fact required by law to participate, and that is why I find titling this bill “intimidation of health care professionals” disingenuous at best. Is requiring a referral actually participation in medical assistance in dying? Clearly it is not, and trying to torque a requirement to provide information into participation helps no one understand the real issues of conscience involved in medical assistance in dying.

An equally important reason for opposing this bill is the dangerous precedent that this bill would set. Its role as a potentially precedent-setting bill has already been noted by anti-choice advocates who have been vocal in their support for this bill. They recognize that it would provide a precedent for denying referrals for access to contraception and abortion services, and I want to point out that denials of service and denials of information are very real in our existing Canadian medical care system.

This bill would also be a very bad precedent for current attempts to deny transgender minors the counselling and medical services they need to affirm who they are. Without access to services that others may think are inappropriate, this will leave families with trans minors struggling to find the information and support that their kids really need. If this kind of precedent is allowed, medical professionals would not have to provide a referral to someone who would be providing a medically necessary service.

As I approach the end of my comments today, I cannot end without mentioning yet another unfortunate precedent set in this bill, and that is its use of inflammatory language. I have no doubt, as I said in my question to the sponsor of this bill, of her personal convictions and their strength. However, as sincere as they may be, the language used in this bill conjures up a spectre of the use of violence to intimidate medical professionals, something of which there is absolutely no evidence of happening in Canada. Invoking the spectre of violent intimidation is certainly not conducive to an informed debate on the real issues that are in question here.

I will close my comments today by restating that, on principle, New Democrats are opposed to any legislation that would limit access to Canadians seeking information about or the service of medical assistance in dying. No matter how strong the beliefs others may hold, this right exists to access medically necessary services. There is no doubt that the end of life is a difficult moment for all families, and medical assistance in dying, I still believe, is an important way of ending unnecessary suffering both for patients and families at the end of life. I would not like to see anyone denied access to information they need to make a choice that protects their own autonomy of how their lives end. At this point, let me salute the health care professionals who assist patients and their families through this very difficult process.

Once again, I lament the tendency of not just this member but, indeed, many Conservative members of the House to use private member's bills for scoring political points and sharpening divisions in the House—

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, the bill we are debating today has to do with protecting the freedom of conscience of health care professionals and practitioners when it comes to medical assistance in dying.

I think we should base our debate on the approach that Quebec took on this matter back in 2010. Quebec studied this issue from 2010 to 2014. The debates were non-partisan. The process allowed for all points of view to be heard and compiled. The focus of the debate was human dignity.

When talking about end-of-life care, we must not forget that the way to protect human dignity lies in freedom of choice. No one can claim to be acting in a patient's best interests if that patient is not allowed to make their own decisions. What is interesting about the Conservatives' bill is that they want the state to be less involved in the economy but more involved in our lives, especially when it comes to death, which is one of the intimate decisions a human being will make.

It is not the state or Conservative members who are going to die in place of the individual, the person who is dying, the patient, so why are they trying to interfere in this decision?

This bill is pointless, and I say this because subsection 241.2(9) already stipulates that no one can be compelled or forced to provide medical assistance in dying against their will.

As I just mentioned, the Quebec legislation should guide us in our debate here today. Section 31 of the Quebec legislation stipulates that medical practitioners cannot be forced to participate directly or indirectly in MAID, and I quote:

A physician practising in a centre operated by an institution who refuses a request for medical aid in dying for a reason not based on section 29 [which sets out all the conditions that a doctor must meet before deciding whether to provide medical assistance in dying] must, as soon as possible, notify the executive director of the institution or any other person designated by the executive director and forward the request form given to the physician, if that is the case, to the executive director or designated person. The executive director of the institution or designated person must then take the necessary steps to find, as soon as possible, another physician willing to deal with the request in accordance with section 29.

This means that a patient who is dying and highly vulnerable should not be burdened with having to take the steps I just mentioned. The bill the Conservatives are introducing today would do just that. It would force these individuals to take those steps at the most vulnerable time of their lives, when they are dying or about to die. However, medical practitioners can refuse to participate directly or indirectly in MAID.

As we heard during the Standing Committee on Justice and Human Rights' study of Bill C-7, some practitioners, citing freedom of conscience, are currently refusing to abide by the Collège des médecins du Québec's code of ethics and forward the request. In other words, they are ignoring the request, which they are not allowed to do.

In Quebec, conscientious objection is defined as follows: “Health professionals must not ignore a request for medical aid in dying. However, a doctor may refuse to administer medical aid in dying because of his or her personal values. The doctor must notify, as soon as possible, the executive director of the institution”.

That is the issue. The Conservatives have introduced a bill to add a provision to the Criminal Code that would make what they call intimidation in health care facilities an offence.

This would be a situation where a health care professional dealing with a family supporting a dying patient—a father, a mother, a brother, a sister—offers end-of-life options without ever mentioning medical assistance in dying. That is the kind of scenario we are talking about.

Quebec was a leader in this area and contributed to advancing the legislation, but there is still a lot of resistance on the ground when a patient requests medical assistance in dying. That can manifest in various ways. The surprising thing is that this resistance stands in stark contrast to what I consider the essence of Quebec's legislation, which was to integrate end-of-life care into the palliative care continuum.

In the current debate, there is one side advocating for palliative care and another advocating for medical assistance in dying. Quebec's legislation did not fall into the trap of such unnecessary division. Palliative care should be accessible, and the continuum of palliative care can give rise to a request for medical assistance in dying. A request for MAID emerges when a patient is given the opportunity to make a free and informed choice.

A person's dignity must not be defined by how they die, and it cannot be compromised because death is considered to be distasteful. To respect a human being is to respect their dignity, and that means respecting their independence and capacity for self-determination until their last breath.

The law enshrines the principle of self-determination throughout our lives, especially when it comes to medical decisions. No one can interfere with my person without my free and informed consent. Why then, at the most intimate moment in my life, would the state interfere in my life and take away my right to self-determination? I can only make a free choice if the practitioner is able to offer me all the choices, including access to palliative care, palliative sedation, and medical assistance in dying. This is a decision that only a dying person can make.

These types of bills and debates take us away from far nobler objectives. There is nothing new here to crow about; it was already set out in the legislation.

I would like members to understand why the Bloc Québécois will oppose this bill. We oppose this bill because at present, in Quebec, some people requesting MAID in a hospital are not being admitted to a palliative care unit. It is shameful that people at the end of their lives must live their last moments in a place that is far from peaceful and far from what is recommended as appropriate for dying with dignity. Why oppose that?

We must focus our efforts on having a continuum of care, working to ensure that palliative care is as available and accessible as possible in all forms, whether at home, in hospices, or elsewhere. A request for assisted death must be viewed not as a failure, but as a success in accompanying an individual towards death.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

moved that Bill C-230, An Act to amend the Criminal Code (intimidation of health care professionals), be read the second time and referred to a committee.

Mr. Speaker, it is a privilege to rise today to begin the debate on my private member's bill, Bill C-230, the protection of freedom of conscience act. This bill revives my private member's bill, which died on the Order Paper, from the last Parliament, with some slight modifications.

I would be remiss if I did not once again acknowledge that this bill is built on the hard work and determination of former members of Parliament. The first bill proposed to address this issue was introduced by the late Mark Warawa in 2016. His bill did not proceed because of the government's introduction of Bill C-14. After Bill C-14 was passed into law, my former colleague David Anderson introduced his private member's bill, Bill C-418, during the 42nd Parliament. However, that bill also died on the Order Paper when the general election was called in 2019.

I would like to thank all those who have been championing this issue for many years and their willingness to work with me. Experts throughout Canada have provided information and advice, while thousands of grassroots Canadians voiced their support for protecting our fundamental freedoms. I would also like to thank the Library of Parliament for its timely, diligent and expert research, which helped inform this proposed legislation.

For the purposes of this debate, I think it is important to understand conscience. There are numerous definitions of conscience, but they are consistent in defining it as an individual’s inner sense of knowing the difference between what is right and wrong and allowing that knowledge to guide their behaviour. The Canadian Charter of Rights and Freedoms, under the heading of “Fundamental Freedoms”, in subsection 2(a) states that everyone has the fundamental freedom of conscience. In this way, Bill C-230 is straightforward. It seeks to add two new offences to the Criminal Code of Canada. I will read the summary so members will know what they are:

This enactment amends the Criminal Code to make it an offence to intimidate a medical practitioner, nurse practitioner, pharmacist or other health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of medical assistance in dying.

It also makes it an offence to dismiss from employment or to refuse to employ a medical practitioner, nurse practitioner, pharmacist or other health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

This bill is a response to calls from disability rights groups, first nations, the Ontario Medical Association, legal experts and many medical and mental health professionals to protect conscience rights. It ensures that medical professionals who choose not to take part in or refer a patient for assisted suicide or medical assistance in dying will never be forced or coerced to violate their freedoms as stated in the charter.

Previous Parliaments have passed laws that created the unintended consequence of doctors and medical professionals being forced to participate in providing a patient's death, regardless of whether they believe it is in their best interest. Bill C-14 and Bill C-7 created a federal standard for medical assistance in dying and assisted suicide but not for conscience protections.

By way of background, sections 241.1 to 241.4 of the Criminal Code of Canada deal with the provision of medical assistance in dying. These sections are in part VIII of the code. It deals with offences against the person and reputation, which include offences such as homicide, kidnapping, assault and many more. Subsection 241(1) of the Criminal Code still makes it a criminal offence to counsel or aid in a suicide. It reads:

Everyone is guilty of an indictable offence and liable to imprisonment for a term of not more than 14 years who, whether suicide ensues or not,

(a) counsels a person to die by suicide or abets a person in dying by suicide; or

(b) aids a person to die by suicide.

When creating the exemption allowing for MAID, the government had to create an exemption to this prohibition on counselling or aiding in suicide. This then leads to the untenable claim that the Criminal Code already protects the conscience rights of medical professionals.

Some claim that the clarification clause, section 241.2 (9) of the Criminal Code, somehow protects conscience rights. It states:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

While I understand why some would want to think it protects conscience rights, I believe they are sadly mistaken. While I appreciate and support this inclusion in the Criminal Code, it only addresses one side of the coin. This clause only confirms that the Criminal Code is not the source of compulsion to participate in medical assistance in dying.

For the Criminal Code to have any teeth on this issue, it should articulate that it is an offence to compel someone to provide, or assist in providing, medical assistance in dying against their will. Compelling someone to participate in MAID can and does happen, which is why I have brought forward this legislation and why it needs to pass.

Regarding jurisdictional questions about this bill, as I mentioned earlier, this bill proposes that two new offences be added to the Criminal Code of Canada to address intimidation, dismissal from employment or refusal to employ a medical professional. This is similar to section 425 of the Criminal Code, which addresses the same actions taken by an employer to compel employees with respect to belonging to or organizing a union. I would suggest that if it is appropriate to have section 425 in the Criminal Code, it is reasonable to include the amendments I am proposing.

I would also submit that it is inaccurate to argue that conscience rights legislation somehow interferes with the role of the provinces while, at the same time, believing that the legalization of medical assistance in dying does not. Ensuring that conscience rights are protected is the responsibility of Parliament and of the Government of Canada, which is why I introduced this bill and why it should be passed.

Additionally, provinces can introduce their own conscience rights legislation for medical professionals. For example, Manitoba has passed simple and clear legislation in this regard, and I would encourage all provincial legislatures and parliaments to follow Manitoba’s example.

While the text of this bill focuses on the conscience rights of medical professionals, this legislation also serves to protect the right of patients to receive a second opinion. What do I mean by this? If all doctors are forced to propose MAID as a treatment option to their patients, this one-size-fits-all approach would give Canadian patients less choice, not more.

Additionally, individuals who object to MAID would be deterred from entering the medical profession altogether. Patients would no longer be able to seek a second opinion for their end-of-life care. In this way, conscience rights for medical professionals not only protect medical professionals and their patients, but they also protect our health care system.

Without conscience rights, doctors are constrained to provide, or refer their patients to receive, medical assistance in dying, regardless of whether it is their professional opinion that it is in the best interest of the patient. This concern for the patient’s best interest does not mean that a medical professional objects to medical assistance in dying in all cases, just that in his or her opinion it is not an option that should have to be offered in every case. This became especially pertinent to the medical community with the passage of Bill C-7.

To highlight the impact of the removal of the safeguard that death be reasonably foreseeable, I would like to quote from a recent column published online in Policy Options magazine which states the following:

Many injuries and physical illnesses are indeed accompanied by temporary depression and suicidal thinking. For example, research demonstrates increased risk of suicide for two years after a spinal cord injury. This suicidality overwhelmingly ends with adaptation and recovery support. Offering death to anyone during a period of transient increased suicidality is, in our view, unethical and violates the standard of medical care by which physicians must abide.

The fact that the newly expanded law may facilitate death in those circumstances of increased suicidal thinking is, in and of itself, problematic.

Some have tried to frame conscience rights as the rights of the patient versus the rights of the doctor. Nothing could be further from the truth.

Health care is fundamentally about the doctor-patient relationship. For example, take the psychiatrist who supports MAID in certain circumstances, but in a certain case has spent 15 years counselling a patient who suffers from bouts of depression and suicidality. For 15 years, they have built understanding and trust. What would happen if that patient, suffering from a bout of suicidality, should demand assisted suicide? Under current law, that psychiatrist would be forced to refer that patient to someone else so he or she could die. They must do this, despite knowing that the suicidal thoughts are temporary and that otherwise the patient is joyful and loves his or her life. Ending that patient's life would be wrong, but the psychiatrist’s hands are tied. This should not be what passes for medical care in Canada.

Some might claim that there are safeguards in place to prevent such tragedies, but I would ask them if they are absolutely sure. With the passage of Bill C-7, many safeguards for medical professionals were removed. We are talking about ending a human life. There is no room for uncertainty when a life hangs in the balance.

Additionally, should the first line of safeguards not be the expertise of the medical professionals who know their patients best? If those medical professionals do not believe death is the answer, should we not at least consider if they are right? However, this then leads to the concern some raise that protecting the conscience rights of medical professionals will block access to those who truly want it. I would suggest this is both misleading and nothing but baseless fearmongering. Medical assistance in dying and assisted suicide are readily available throughout all of Canada. There are information phone lines, hospitals staffed with willing medical professionals, even email addresses to help set up appointments. In a word, MAID has become the status quo. It is available.

The Canadian Medical Association also stated clearly that conscience protections would not affect access because there were more than enough physicians willing to offer MAID. Therefore, common sense should tell us that the charter rights of medical professionals are breached when they are forced to either offer or refer assisted suicide or medical assistance in dying. Surely, we have the capacity to both ensure access to MAID while still protecting the fundamental charter right to freedom of conscience.

Finally, some have suggested that medical professionals should leave their morality at the door. I do not believe we want this to happen. For example, we would all want and expect doctors to be bound by their morals if they were offered a bribe to move someone up on a waiting list. If we hold our medical professionals to a higher standard, we cannot then tell them to ignore their personal moral standards. Further, while discussing the issue of conscience rights with a doctor, she told me that, in the absence of conscience protection, the group with the most to lose are the patients, and they are the ones we are trying to help. This bill protects the doctor-patient relationship by ensuring that doctors and other medical professionals are always able to recommend and provide the care they believe is best for their patients. Patients need this bill to pass. Canada’s medical professionals need this bill to pass.

Over the past two years, we have seen just how important our health care system is and how critical the medical professionals who work in that system are to Canadians and our way of life. We need to create a work environment for medical professionals that protects them, supports them, and encourages them to continue in the critical work they do.

In closing, I encourage all members to support passage of the protection of freedom of conscience act.

Alleged Premature Disclosure of Bill C-10

[Gérard Deltell, Conservative, Louis-Saint-Laurent, QC]

Mr. Speaker, I am very pleased to participate in today's debate.

However, I want to raise a very serious concern about what we call a question of privilege.

I am rising on a question of privilege regarding the premature disclosure of the content of Bill C-10, an act respecting certain measures related to COVID-19, by the Prime Minister himself while it was on notice and before it was introduced and tabled in the House of Commons. On Saturday, a special Order Paper was published that contained the notice for Bill C-10.

As members know, according to our Standing Orders, notices of bills must be very succinct. In this case, the notice was. It gave the title of the bill and the number, Bill C-10.

Yesterday at noon, the Prime Minister held a press conference in front of his house. Incidentally, we were able to see that, despite the fact that he and his two children have COVID-19, he is doing well. That is good.

However, he said a lot more about Bill C-10 than what was written in the notice.

In fact, CTV, in a publication following the press conference, noted that the Prime Minister provided a bit more detail about the bill's contents beyond its title. Those details provided by the Prime Minister were as follows: “We'll be introducing legislation to ensure we continue providing as many rapid tests as possible to the provinces and territories.”

Yesterday, after question period and the Prime Minister's press conference, Bill C‑10 was introduced during Routine Proceedings. At that very moment, it became clear to us and to all Canadians that what the Prime Minister had said was exactly what was in the bill.

The bill authorizes the Minister of Health to make payments of up to $2.5 billion out of the consolidated revenue fund in relation to the coronavirus disease 2019, well known as COVID-19, tests. It also authorizes the Minister of Health to transfer COVID-19 tests and instruments used in relation to those tests to the provinces and territories and to the bodies and persons in Canada.

The Prime Minister talked about Bill C‑10 in detail at the press conference before the bill was introduced. In our view, that is a breach of trust under the rules that govern us.

The Prime Minister's disrespect for Parliament goes beyond just the premature disclosure of a bill. The Prime Minister, having wasted so much time with a prorogation, followed by an expensive and unnecessary election, is trying to play catch-up by leaning on the opposition to co-operate and fast-track his bill.

In an attempt to show some goodwill, his House leader provided embargoed copies to the House leaders of the opposition. For our part, and for the part of all opposition parties, we did respect the fact that we cannot make any comment publicly about the bill. That is the way to do it. Unfortunately, yesterday the Prime Minister did not respect that situation.

On March 10, 2020, you commented on the premature disclosure of Bill C‑7 on medical assistance in dying. You said the following:

...based on a reading of the Canadian Press article on Bill C‑7 on medical assistance in dying, and in the absence of any explanation to the contrary, I must conclude that the anonymous sources mentioned were well aware of our customs and practices and chose to ignore them. It seems clear to me that the content of the bill was disclosed prematurely while it was on notice and before it was introduced in the House.

...

The rule on the confidentiality of bills on notice exists to ensure that members, in their role as legislators, are the first to know their content when they are introduced. Although it is completely legitimate to carry out consultations when developing a bill or to announce one's intention to introduce a bill by referring to its public title available on the Notice Paper and Order Paper, it is forbidden to reveal specific measures contained in a bill at the time it is put on notice.

On April 19, 2016, the Speaker found there was a prima facie question of privilege regarding a similar bill, namely Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts, respecting medical assistance in dying. He said the following:

As honourable members know, one of my most important responsibilities as Speaker is to safeguard the rights and privileges of members, individually and collectively. Central to the matter before us today is the fact that, due to its pre-eminent role in the legislative process, the House cannot allow precise legislative information to be distributed to others before it has been made accessible to all members. Previous Speakers have regularly upheld not only this fundamental right, but also expectation, of the House.

Another question of privilege was raised on March 19, 2001, regarding the media being briefed on a bill before members of Parliament. In that ruling, Speaker Milliken said, at page 1840 of the House of Commons Debates:

In preparing legislation, the government may wish to hold extensive consultations and such consultations may be held entirely at the government's discretion. However, with respect to material to be placed before parliament, the House must take precedence. Once a bill has been placed on notice, whether it has been presented in a different form to a different session of parliament has no bearing and the bill is considered a new matter. The convention of the confidentiality of bills on notice is necessary, not only so that members themselves may be well informed, but also because of the pre-eminent rule which the House plays and must play in the legislative affairs of the nation.

The Speaker at that time found another case of contempt on October 15, 2001, again involving the media being briefed on the contents of a bill prior to the legislation being introduced in the House. The precedents are very clear in these matters. The Prime Minister is in contempt of the House for disclosing the content of Bill C-10 while it was on notice and prior to being introduced in the House.

In conclusion, I would like to point out that this issue of COVID tests was part of the opening round of questions during the first question period my leader attended in September 2020 after becoming the leader of the official opposition. This issue is a really serious one and we care about this situation. It may have taken the Prime Minister a while to get it and I understand he now needs help to hurry things along, but he does himself no favours by thumbing his nose at the privileges of this House and the goodwill of the opposition parties by playing by his own rules.

This practice has gotten him into trouble before. On more than one occasion, he ran into difficulty with the Ethics Commissioner. The commissioner found in 2019 that he breached ethics rules. The Prime Minister had tried in 2018 to undermine a decision by federal prosecutors allowing a construction company, the SNC-Lavalin Group, to face a corrupt trial. The Ethics Commissioner also sanctioned him in December 2017, ruling that he broke conflict of interest rules when he accepted a vacation on the Aga Khan's private island in 2016.

I could go on and on, but to quickly get to the point and pursue a resolution to this matter, I ask, Madam Speaker, that you find a prima facie case of privilege. I am prepared to move the appropriate motion.

Medical Assistance in Dying

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I thank you for your wise exercise of discretion on that point.

The petition I was tabling when I was interrupted by my good colleague was on Bill C-7, a bill that came forward in the last Parliament. At the time, the government chose to support an amendment that came from the Senate, an amendment that allowed individuals who are suffering from mental health challenges to receive facilitated suicide within the medical system.

Petitioners highlight the fact that mental health challenges are not irremediable. The Canadian Mental Health Association states, “As a recovery-oriented organization, CMHA does not believe that mental illnesses are irremediable".

Petitioners are very concerned this policy change completely changes the message to those who are struggling with mental health challenges, effectively offering them suicide instead of recovery as a path forward. They call on the government to reject this policy of facilitated suicide for those suffering from mental health challenges and to protect Canadians struggling with these challenges by facilitating treatment and recovery.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, the next petition highlights concerns about Bill C-7 from the last Parliament.

The petitioners note this bill raised significant concerns from the disability community about how this would really push people toward death instead of giving them options for life. They called on the House to reject this approach of allowing mental illness to be an adoption for assisted death and to protect Canadians struggling with mental health challenges by facilitating treatment and recovery, not death.

Resumption of Debate on Address in Reply

[Alain Therrien, Bloc, La Prairie, QC]

Mr. Speaker, we can look at all the bills and go over their history. I have no problem with that.

We could talk about Bill C-7 on medical assistance in dying. The Conservative Party blocked that bill, as my colleague said. The Bloc Québécois, meanwhile, decided to support the bill and move it forward.

No, the Conservatives' approach to Bill C-6 was not exemplary. However, an election should not be called simply because one or two bills get stuck, when many bills are going through without a hitch. I know; I was there.

Yes, the Conservatives could take a good hard look at themselves when it comes to this bill. They have not been effective, one could say, but the fact remains that this is a democracy. The Conservatives were against the bill and they showed it.

What I am trying to say is that when there is a strong, robust, intelligent and effective legislative agenda, things go well. That was the problem in the last Parliament. The government did not get the job done.

Bill C-10—Time Allocation Motion

[Greg McLean, Conservative, Calgary Centre, AB]

Madam Speaker, we were talking about the very notion of the freedom of speech Canadians enjoy, one of the rights Canadians have enjoyed since being introduced by Prime Minister John Diefenbaker in 1960 and embedded in Canada's Constitution in 1982. Freedom of expression in Canada is protected as a fundamental freedom by section 2 of the Canadian Charter of Rights and Freedoms. The charter also permits the government to enforce reasonable limits.

I would say from experience that a large amount of Canadian communication between parties, individuals, businesses and organizations of all types, even governments and their agencies, happens via the Internet. Where does the problem arise in this legislation? Bill C-10 creates a new category of web media called “online undertakings” and gives the CRTC the same power to regulate them that it has for TV and radio stations. What is an online undertaking? Whatever one uploads onto the web is an online undertaking, such as videos, podcasts, music and websites. It is a huge regulatory stretch. However, Canadians should not fret as the CRTC will not act in the way the legislation is written, or so it has said.

Let us look back at that notion of freedom of expression and how we as legislators are supposed to ensure the legislation we consider abides by this fundamental piece of protection embodied in our constitutional bill of rights and freedoms. The Department of Justice Act requires the justice minister to provide a charter statement for every government bill that explains whether it respects the charter. The charter statement for Bill C-10 directly cites the social media exemption in its assessment that the bill respects this part of the Canadian Charter of Rights and Freedoms. Then, poof, at committee the Liberals removed the cited exemption from the legislation. When my Conservative colleagues rightly asked for a new assessment based on the new wording of the legislation, the Liberals decided to shut down debate at the committee.

At this point, I think Canadians would ask where the Minister of Justice is on this issue and why he will not seek and provide the legislative charter statement from his department. I have watched the Minister of Justice and let me illustrate how he operates in my opinion.

Regarding Bill C-7, an act to amend the Criminal Code (medical assistance in dying), admittedly no bill is perfect, yet this bill passed through committee here in the House of Commons and members from all parties voted in a free vote to pass the legislation. The legislation passed with the input of witnesses who wanted to respect the rights of disadvantaged Canadians and it worked through this House. The minister, despite that democratic process, manipulated the legislation with an amendment at the Senate and forced an amended bill back to this House, a bill that disrespects the input he received through witnesses and parliamentarians in the process. It was pure manipulation.

Regarding Bill C-15, an act respecting the United Nations Declaration on the Rights of Indigenous Peoples, after one hour of debate on a bill that my indigenous constituents are asking for clarity with respect to the defined terms in Canadian law and how it affects them, the Minister of Justice shut down debate, saying it had been debated enough.

Perhaps it is unparliamentary to state openly here that the minister's remarks are completely disingenuous. I have watched him during question period while he brazenly denies that his judicial appointments have nothing to do with Liberal Party lists. That is disingenuous. I know why Canadians are losing faith in governments.

Now we have this, the refusal to provide an updated charter statement. Shame on the minister.

Coming back to the bill, if passed, Canadian content uploaders will be subject to CRTC oversight. Yes, the Canadian Radio-television and Telecommunications Commission will be looking at uploads all day long. That is in fact who is writing the bill and in fact the government organization trying to gain some relevance with it, but Canadians do not have to worry because it will not enforce the law as it is written.

Let me quote Timothy Denton, a former national commissioner of the CRTC, who now serves as the chairman of the Internet Society of Canada, who stated:

...their fundamental [principle here] is...that freedom of speech through video or audio should be in the hands of the CRTC — including Canadians’ freedom to use the internet to reach audiences and markets as they see fit.... The freedom to communicate across the internet is to be determined by political appointees, on the basis of no other criterion than what is conducive to broadcasting policy — and, presumably, the good of our domestic industry. As always, the interests of the beneficiaries of regulation are heard first, best, and last. Consumers and individual freedoms count for little when the regulated sector beats its drums.

Finally, let me congratulate the government on this one step. We have been through 15 months of an unprecedented time in our modern history, with lockdowns, economic dislocation and devastation, and literally a pandemic. The press does not cover what happens in the House and the myriad mistakes the government has made because governments make mistakes in unforeseen, unprecedented times. Canadians have given the government some benefit of the doubt about these mistakes and so do all people of goodwill, but it is our job in opposition to do our utmost for the country in oversight and to provide solutions to make our outcomes better.

I thank all my colleagues for the work in helping Canadians during these unprecedented times. I should thank the Liberal government for providing a coalescing issue that has Canadians from all backgrounds and political beliefs in my riding united in reaching out to make sure the bill does not pass. The bill and the government's responses to reasonable amendments to protect Canadians' rights show its ambivalence to Canadians and their rights.

Medical Assistance in Dying

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Mr. Speaker, I want to present a few petitions.

The first petition I am bringing to the attention of the House is signed by Canadians from across Canada. They are concerned with the Senate amendment to Bill C-7 that would allow Canadians with mental illness as their sole medical condition to access euthanasia.

The petitioners recognize that suicide is the leading cause of death for Canadians between the ages of 10 and 19. Therefore, they are calling on the government to reject the Senate amendments to prevent those struggling with mental illness from obtaining assisted death and to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the third petition I am presenting is with respect to Bill C-7 that recently passed and the issues raised in it around euthanasia or medical assistance in dying for those with mental health challenges. The petitioners are very concerned about the decision of the government to add in euthanasia for those with mental health challenges at the last minute, when it had previously said it did not support these measures. They want to see the government do more to protect Canadians struggling with mental illness by facilitating treatment and recovery, not death.

The petitioners are also supportive of the idea of having a national, three-digit suicide prevention line.

Criminal Code

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Madam Speaker, conversion therapy has been found by all experts to be fraudulent and harmful. It is not sanctioned by any professional organization and many Canadians are surprised this practice still goes on in Canada. However, we heard powerful testimony at the justice committee, documenting the fact that conversion therapy still took place in both what I would call its traditional form, focusing on sexual orientation, and in a new form that argues that those who are transgender, non-binary or gender diverse ought to be talked out of their personal identity.

The New Democrats and almost all members of the SOGI community have long been calling for a complete ban on conversion therapy in all its forms. What we have before us, after amendments at the committee, is a bill that comes close to a complete ban, as close as possible without actually being one.

The Minister of Justice has repeatedly said that the reason for not going ahead with a complete ban is his fear that it would not survive a charter challenge on the basis that it would restrict the rights of consenting adults to freely choose to subject themselves to conversion therapy.

There is an alternative argument that says a complete ban would indeed likely survive a charter challenge because there are strong legal precedents that argue that no one can actually consent to being defrauded or injured. The clearest parallel in the Criminal Code is the case of fight clubs, which remain illegal, as one cannot consent, no matter how freely, to being physically injured. Therefore, if the evidence is undeniable that conversion therapy is inherently fraudulent and harmful, the same legal principles should apply.

What is banned in Bill C-7? The strongest provision in the bill is a complete ban for minors, including the offence of transporting a minor outside the country to undergo conversion therapy, which is a much more common practice than most Canadians would assume.

Growing up in a society that remains heteronormative and intolerant of any challenges to the binary cisgender norms is challenging enough for queer youth without ending up being pressured into therapy whose goal is to get them to deny who they actually are.

Though Bill C-6 does not institute a complete ban on conversion therapy, it will establish an effective ban on the practice as it prohibits generally what might be called the business practices around conversion therapy. This means there will be a ban on charging for, or profiting from, conversion therapy and a ban on paid or unpaid advertising of conversion therapy.

Working together at committee, we did strengthen Bill C-6, although the Conservatives are acting like no amendments actually took place at committee. One of the most important improvements was to alter the original language in Bill C-6, which proposed banning conversion therapy “against a person's will”. This was vague language with no parallel elsewhere in the Criminal Code of which I know. My amendment was adopted to change this language to a ban on conversion therapy “without consent”.

Using the language of without consent clearly situates the ban on conversion therapy within the well-understood and well-developed Canadian jurisprudence on what does and does not constitute consent. I was disappointed that a second amendment, which sought to spell out the specific limitations on consent that would apply in the case of conversion therapy, was defeated. The testimony we heard from survivors about the kinds of duress they were almost universally under to subject themselves to conversion therapy would clearly obviate any claim of consent.

The second important improvement made at the justice committee was to expand the scope of the definition of conversion therapy to include gender identity and gender expression. This makes the language in Bill C-6 consistent with our existing human rights legislation and the hate crimes section of the Criminal Code as amended by Bill C-16. This is important as the new forms of conversion therapy I mentioned are directed at transgender and gender diverse individuals and at the attempt to get them to deny their gender identity under the guise of helping individuals “adjust”.

A third change to Bill C-6 made at committee was to add to the definition of what was in effect a for greater certainty clause stating what was not covered in the ban, something the Conservatives say they wanted and something they are certainly ignoring as it is now in the bill.

Bill C-6 now makes clear that it does not ban good faith counselling. Let me cite the specific definition again, as I did in my question earlier, as it could not be more clear. This definition “does not include a practice, treatment or service that relates to the exploration and development of an integrated personal identity without favouring any particular sexual orientation, gender identity or gender expression.” That is specifically in the bill.

Opponents of Bill C-6 continue to insist that the bill will somehow prevent conversations between parents and children or pastors and their faithful on the topics of sexual orientation or gender identity. There is no truth to this claim. The only way these conversations could be captured is if, in fact, they were part of a sustained effort to change someone's sexual orientation or gender identity that constitutes a practice or service under the bill. It would be a giant stretch to characterize efforts of parents or pastors to “try to talk their kids out of it” as a practice, service or therapy.

The vehemence of the debate on Bill C-6 around gender identity certainly reflects the fact that trans and gender-diverse Canadians face the highest levels of discrimination of any group in Canada. That discrimination results in high levels of unemployment, difficulties in accessing housing and high levels of violence, including the murder of two transgender Canadians in the last year alone, just for being trans.

During hearings in committee there was a wave of hatred expressed toward me as an individual on social media, which showed me the level of hostility generally toward trans and gender-diverse people in our country. The insults thrown at me ranged from interfering with parental rights to supporting mutilation of children and, most absurdly, being in the pay of big pharma, apparently because transitioning involves hormones. That is a particularly ill-informed charge against someone who has fought all my time in public life for reducing the power of pharmaceutical companies through shorter patents, expanded use of generics, bulk-buying to bring down costs and, ultimately, the establishment of universal pharmacare.

Those insults also included direct threats of violence directed at me, but, again, I remind myself that the hatred I saw, and will inevitably see again after this speech today, provided only a small glimpse into what transgender and gender-diverse Canadians face every day of their lives.

Many of those objecting to the bill have used what I call a “false detransitioning narrative”. To be clear, I am not rejecting the validity of the stories of individuals who may have chosen to detransition, but opponents of Bill C-6 have adopted those stories to construct a false narrative about the number who choose to detransition and their reasons for doing so. Professional, peer-reviewed studies from the U.K. and Scandinavia tell us that very few transgender people actually later detransition. Both major studies cite a number of fewer than five in 1,000 who detransition, and, even more interesting, both studies report that most of them say they detransitioned not because it was not right for them, but because they did not get support from family, friends and the community they live and work in.

The implication by critics seems to be that there is something in this bill that would prevent counselling concerning detransition, when this is absolutely not the case. Using the detransition narrative to detract Bill C-6 is false, in that I am pretty sure this argument often actually has nothing to do with the ban on conversion therapy being proposed; it is an argument about the very validity of transgender Canadians.

Let me say that I find these arguments against the bill, and being at my most charitable, are at a minimum parallel, if not identical, to those that continue to cause harm to trans and gender-diverse Canadians, and they indicate why we need this ban. At some point, some might ask why have a bill at all, when CT is universally condemned as fraudulent and harmful. Again, as many members have pointed out, studies show that literally tens of thousands of Canadians have been subjected to this practice.

It is important to listen to the voices of survivors of conversion therapy; only then can we understand the need for this bill. Once again, I want to extend personal thanks to two survivors, Erika Muse and Matt Ashcroft, who spent a lot of time with me trying to give me a better understanding of the horrors they faced and their own challenging roads to recovery.

On a personal note, let me say again that I have seen progress in my lifetime for some in the sexual orientation and gender identity community, but we have a much longer road to follow when it comes to those who are transgender and gender-diverse. What a ban of conversion therapy really says is this: we know it is impossible to change someone's sexual orientation, gender identity and expression, and trying to change or repress one's identity is harmful. Let's stop literally torturing young Canadians for being who they are. Let's put an end—

Protection of Freedom of Conscience Act

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, it is an honour to rise in strong support for Bill C-268.

This is a straightforward piece of legislation, the objective of which is extremely important, namely to ensure that the charter rights of health professionals who conscientiously object to participating in medical assistance in dying, or MAID, are protected, charter rights that include freedom of religion and freedom of conscience, those rights being not any rights but fundamental freedoms guaranteed under the charter.

For that, I want to commend my colleague, the hon. member for Carlton Trail—Eagle Creek, for her steadfast leadership in bringing forward this timely and targeted bill to address an issue of charter infringements on health care professionals. I would also acknowledge my former colleagues Mark Warawa and David Anderson for their leadership in bringing forward similar pieces of legislation in previous Parliaments.

Contrary to the assertion of the Parliamentary Secretary to the Minister of Justice, the infringement of charter rights of health professionals is not a hypothetical. It is real. It is happening in Canada and has been happening since the Supreme Court of Canada struck down the blanket Criminal Code prohibition against physician-assisted death in the Carter decision.

Many health professionals have been pressured or coerced into participating in MAID, notwithstanding their conscientious objection to doing so. At the justice committee, on Bill C-7, we heard many witnesses who came forward and spoke about serious concerns about coercion and pressure, the need for clarity in the law and a set national standard. That is precisely what this legislation seeks to do by amending the Criminal Code to see that no one will lawfully be able to coerce or pressure health care professionals for the purpose of compelling them to participate in MAID, or refuse to hire or terminate one's employment on the basis of a health care professional objecting to MAID.

The Parliamentary Secretary to the Minister of Justice made reference to Bill C-14 in his speech. It is a piece of legislation that I am very familiar with, because I sat on the special joint committee leading up to Bill C-14, and I sat on the justice committee when Bill C-14 was studied. At that time, there was much discussion around protecting conscience rights.

The parliamentary secretary is correct that the preamble of the bill was amended to include an expressed recognition of conscience rights. He is further correct to note that at subsection 241.2(9) of the Criminal Code, there is a “for greater certainty” clause that simply provides that no one shall be compelled to participate in MAID.

In that broad sense, there was an expressed intention of Parliament to protect health care professionals. However, what is missing is teeth. There is no enforceability mechanism provided for in the legislation. That was something that I saw as a problem at the time, and it has borne out to be so. That is precisely what this bill seeks to do, to fill that very real void.

The Parliamentary Secretary to the Minister of Justice as well as my colleague, the member for Esquimalt—Saanich—Sooke, spoke at varying lengths about the Ontario Court of Appeal decision in Christian Medical and Dental Society of Canada v. the College of Physicians and Surgeons of Ontario and the issue of access, that somehow this bill would interfere or undermine access to medical assistance in dying.

I say two things to those who would raise the issue of access. Manitoba passed Bill 34, which provides for conscience protections, not dissimilar to what this bill proposes. There has not been one instance that has been brought forward where access has prevented a willing patient from accessing MAID in that province, a law that has been on the books for more than four years. With respect to the Ontario Court of Appeal's decision, although the court, in its analysis, looked at hypothetical issues around access, the court actually incorporated the divisional court's finding into its ruling. The divisional court said on the question of physicians who object on the basis of conscience, “...there was no direct evidence that access to health care is a problem caused by physicians' religious objections to providing care”. There we have it right from the Ontario Court of Appeal that on the issue of access, when it came to providing direct evidence, it simply was not there. At the justice committee, when we studied Bill C-7, it was not there either.

When we talk about the Carter decision, it is important to emphasize that it is predicated upon two things: number one, that there be a willing patient; and, number two, and equally important, that there be a willing physician. Too often over the last five years, we have focused singularly on the issue of a willing patient, which is very important, to the exclusion of a willing physician notwithstanding charter rights of those physicians that are very much at play.

In the Carter decision, the Supreme Court did expressly acknowledge the rights of health care professionals in terms of freedom of religion and freedom of conscience, but the court actually went further. The court warned against compelling health care professionals to provide or otherwise participate in MAID. More specifically, at paragraph 132 of the Carter decision, the court said:

However, we note...in addressing the topic of physician participation...that a physician’s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief.

Now, the foundational principles that underlie freedom of religion and freedom of conscience, guaranteed under paragraph 2(a) of the charter, were set out in the Big M Drug Mart Ltd. decision; and, in enunciating those principles, this is what the Supreme Court had to say:

Freedom can primarily be characterized by the absence of coercion or constraint. If a person is compelled by the state or the will of another to a course of action or inaction which he would not otherwise have chosen, he is not acting of his own volition and he cannot be said to be truly free.... Coercion includes indirect forms of control which determine or limit alternative courses of conduct available to others.

Those are precisely the principles that this bill seeks to uphold and on that basis I urge its passage.