Bill C-7 (Historical)

An Act to amend the Criminal Code (medical assistance in dying)

This enactment amends the Criminal Code to, among other things,
(a) repeal the provision that requires a person’s natural death be reasonably foreseeable in order for them to be eligible for medical assistance in dying;
(b) specify that persons whose sole underlying medical condition is a mental illness are not eligible for medical assistance in dying;
(c) create two sets of safeguards that must be respected before medical assistance in dying may be provided to a person, the application of which depends on whether the person’s natural death is reasonably foreseeable;
(d) permit medical assistance in dying to be provided to a person who has been found eligible to receive it, whose natural death is reasonably foreseeable and who has lost the capacity to consent before medical assistance in dying is provided, on the basis of a prior agreement they entered into with the medical practitioner or nurse practitioner; and
(e) permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance that was provided to them under the provisions governing medical assistance in dying in order to cause their own death.

Criminal Code

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, I support two very important principles. The first is that choices are patient-initiated, which is very important. The second is meaningful access to care before MAID is carried out.

If we cannot even manage to offer palliative care or psychiatric care, how can we honestly do what we are doing? The palliative care bill that we passed a number of years ago says that MAID cannot be considered voluntary if there is no meaningful access to care. I am begging members to consider that this is a bad bill. We need to focus on offering good medical care.

I will give the member a few statistics that come from the Canadian Association for Long Term Care. The 2017 federal budget included a historic $6 billion over 10 years for home and community care, but long-term care was not included in this investment. The national housing strategy does not include long-term care. The home support work pilot for foreign caregivers does not include employment in long-term care. The 2019 federal budget did not include investments in long-term care. The federal government flowed $343.2 billion in COVID-19-related spending in the first quarter of this year, and not one dollar was committed to supporting long-term care.

How are we going to support our seniors, our vulnerable, if we do not invest in long-term care?

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

Madam Speaker, the member gave an excellent speech.

It is interesting to observe the discussion between some of our colleagues and members of the government. We are pointing out that in testimony, especially at the justice committee, people were reporting significant problems. The member read some additional stories. These are people with disabilities who were being pushed toward euthanasia even when they had not expressed any interest in it. On the other hand, the government is saying that the system must be working, because nobody has been charged, complaints are not being made through official channels, and nobody has called the office of the member for Winnipeg North to report this issue, which I am not sure would be the appropriate reporting mechanism anyway. There is a disconnect, but at the same time, they are both true. It is true that there are problems. We know this. It is also true that people are not being disciplined or held accountable when abuses take place.

The member has spoken about this, but I would love to hear more about how we can actually address this disconnect and ensure that, first of all, abuses are not taking place, and secondly that we have safeguards to support and protect people and that we give them avenues, or have others advocate for them, when there are situations of pressure towards death. The reality is that we will just never know about most of these cases with the problems in reporting and support that are there. We are just never going to hear about the vast majority of times when this happens.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, I have been an advocate on this issue for many years now, and worked with Mark Warawa, an amazing member of Parliament who is no longer with us. I have had many people come to me with their concerns about issues of non-compliance. Perhaps other members have not been paying attention, but had they, and had they been advocating on behalf of the disabled and the elderly, they would know that this was happening. There is absolutely zero way of monitoring it.

Before anything, we absolutely need to ensure that vulnerable Canadians are protected. We are focusing on Bill C-7 rather than on ensuring that there is some sort of protocol in place, as the UN Rapporteur talked about, where we can monitor what is going on rather than just on MAID providers. We are opening it up more and more, and we have no way of knowing how much abuse is happening.

Again, I am speaking on behalf of those who are not able to speak for themselves and I am saying it is happening. We need to watch out. We need to take care not to push these myths forward.

[David Sweet, Conservative, Flamborough—Glanbrook, ON]

Madam Speaker, I appreciate the opportunity to ask my colleague a question. Earlier the Leader of the Opposition referred to a legal term called “decisionally vulnerable”. My colleague was just talking about long-term care, but the promise that the government made a full five years ago, in regard to an investment in hospice and palliative care of $3 billion, has not come to pass.

I am wondering how the member feels in regard to whether that would exacerbate the feeling of being vulnerable for those people who are decisionally vulnerable presently.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, what we are hearing is that those who are vulnerable are not able to access meaningful care. Without access to meaningful care, many of them have no choices. They are in our hands and we are not offering them care. We are offering them euthanasia.

I would like to point out what happened with MP Mark Warawa. He was diagnosed with cancer and it took him nine days to see a palliative care specialist. There were only two of them in the hospital there. The fact that it took him nine days to be able to see a palliative care specialist shines a light on the fact that our system needs more support. We need to ensure that these sorts of care are in place for those who are in need of them. To ignore them like this, and to rush this legislation in the way that we have been doing, is absolutely shocking. To see the vulnerable advocates who came forward at the justice committee, and who were ignored, is quite shocking. I would love to see the government stop and actually listen to those who are begging it to ensure there is care, and not a rush to death.

[Scott Reid, Conservative, Lanark—Frontenac—Kingston, ON]

Madam Speaker, I know my colleague has been following the debate. I saw her on the screen earlier, so she would have heard everything. One of the arguments that has come up in the course of the debate was a suggestion from the government benches that the bill is being introduced in order to comply with court-ordered rules regarding maintaining the constitutionality of our law. Moreover, the Minister of Justice and Attorney General was opposed to the previous MAID legislation because it failed to do this.

With regard to the various amendments that were put forward by the Conservative Party, is it the case that any of these suggested amendments would have had the effect of causing the new legislation to not be compliant with the Constitution, or is it the member's view that the legislation nevertheless would have been fully compliant if amended as suggested by the Conservatives?

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Madam Speaker, it is important to understand that we looked very closely at what our amendments were to ensure that they would be allowed. Unfortunately, the Liberals voted all of our amendments down.

[John Williamson, Conservative, New Brunswick Southwest, NB]

Madam Speaker, I will be splitting my time today with the hon. member for Battle River—Crowfoot.

I rise today to participate in this important debate on Bill C-7, which seeks to expand medical assistance in dying, or MAID. While the Liberal government has summarily dismissed the role of Parliament with respect to the all-party committee study, an evaluation of this law, I believe it is still important to ensure my remarks appear on the record because Bill C-7 is literally a matter of life and death.

Let me begin by quoting my hon. colleague, the member for Lanark—Frontenac—Kingston, who posed this question to the government during the earlier days of our hybrid sittings. In the context of advocating for defibrillators to be placed in community halls, hockey rinks and other places Canadians gather, he asked:

It will cost approximately a billion dollars to renovate Centre Block. I believe that's accurate. It will cost $5 million to put these AEDs, defibrillators, into all police cruisers. This would save 300 lives per annum. Is the cost of saving 300 lives per annum—one half of 1% of a billion dollars—more or less important than renovating Centre Block?

My colleagues on both sides of the House know I am a strong supporter of our institutions and our history, and of protecting them for future generations to appreciate, learn from and, in some cases, even revere. This is true of Parliament, historic sites across Canada and even statues of our founders for their vision and even, at times, for their faults, and sometimes many faults. My hon. colleague for Lanark—Frontenac—Kingston was posing a simple but profound question to Parliament, which was what is the value of life, and how can it be measured? It is a question that all members of Parliament have been consumed with since the start of the coronavirus pandemic: How can we protect and save lives? It is a question that will form the basis of debate in the House of Commons for the remainder of our natural lives and well beyond.

In just over eight months, all levels of government have spent a combined half a trillion dollars in their struggle against the pandemic. Rich or poor, old or young, married or single, with kids or grandparents: it does not matter what families or households look like. Everyone is impacted by COVID-19, and governments have acted. The measures brought forward were, in one way or another, based on one simple, profound truth: that elected officials at every level of government across the country support life, and want our nation to fight for it and protect it.

I stand today as someone who will be voting against this piece of legislation, Bill C-7. Medically assisted death is a practice that, if left unchecked, could in some dark corners of society turn the right to die into an obligation to die.

How is it that a government that advocated overwhelmingly to accept closures and economic lockdowns in response to the coronavirus can be the same government that has unmoored us from protecting Canadians, by vastly expanding the legal parameters of medically assisted death? It is grisly.

I would like to quote the member for Vancouver Granville, the former minister of justice, who stated the following about this legislation, Bill C-7:

[Why] is Bill C-7, medical assistance in dying, abolishing the safeguard of a 10-day reflection period and reconfiguration of consent, thereby introducing advance requests for MAID?

Nothing in the Truchon decision of the Quebec Court of Appeal, which the government chose not to appeal, requires this, and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.

It is very troubling that this is the direction the Liberals have chosen. A single decision in a single province by a single lower court has upended the law as it stands today, passed by a previous Parliament.

A culture of life is abandoned. Even the most basic safeguards are deemed by the current justice minister, the cabinet and caucus to be overly restrictive. We have a fragile consensus established in the last Parliament and with Bill C-7, we will undo that important consensus. I hope we can rediscover that consensus again in a future Parliament when its leaders are more reflective on matters of life and death and perhaps will express some humility when we face these questions.

We must, as parliamentarians, even those who sit across the aisle, reject the unwise extension of medical assistance in dying in our society. However, I am dismayed that this will not happen.

Bill C-7 is medical assistance in dying in name only. Its sponsors cling to that description to give it a fig leaf of respectability and to make it palatable to the public. Bill C-7 would strip away both safeguards to protect vulnerable Canadians and even the belief that one's death should be near, imminent or even reasonably foreseeable. Whereas medical assistance in dying has built in safeguards, today's bill does not and we are simply left with medical assisted death.

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

Madam Speaker, one of the issues that is really important is the fact that we have to deal with the courts and court decisions, which lays out questions that government has to look at with respect to legislation.

What I find concerning about the last court decision is that the federal government never appealed it. I do not think there has ever been a first nation ruling in any court ever that the federal government has not appealed all the way to the Supreme Court, fighting tooth and nail. However, on a fundamental question on the issue of a foreseeable death, something that is difficult for all of us to deal with but we understand it, we understand why it was brought in and we understand why the Supreme Court made us come forward with legislation, this was ruled on by a provincial court and the federal government did not appeal it before bringing it in for legislation and then went beyond the decision.

Does my hon. colleague think it would have been better if we had actually appealed it, had a very clear ruling from the Supreme Court and then responded to that?

[John Williamson, Conservative, New Brunswick Southwest, NB]

Madam Speaker, I do think that would have been the better approach, to examine the ruling and appeal it the Supreme Court to get a broader interpretation of the law.

The last Parliament was right in the approach it took in crafting the legislation by striking an all-party committee. That committee came up with recommendations. Not everyone agreed with it, but the bill that came out of Parliament had broad consensus in the House despite some of the flaws, which even I see in the current legislation. At least it had that democratic participation. As well, it went through the Senate, received royal assent and became the law.

Today we are left with a single court decision, as my hon. colleague said, from a lower court judge that was not appealed. I think that was done as a rush to judgment by the government to make changes. I will note for the chamber, and I am sure it has been noted before, that the current justice minister voted against the current law.

At the time, he felt it was not sufficiently robust or expansionary. Opportunities have allowed him to re-craft that law in a way that ignores Parliament and ignores the input from the last Parliament, which was sought from all parties. Today we are left with a much diminished bill that breaks that consensus. Because of that, we will be debating this into the years ahead and in Parliaments ahead.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, a lot of discussion has been had around the safeguards issue. I wonder if my friend and colleague could comment on how this bill greatly diminishes the safeguards. He talked about how they were carefully crafted in a way that respected the democratic process in the last Parliament. Could he talk about how some of those safeguards have been reduced or completely eliminated in the bill, which go beyond the court decision that the government uses as justification for the bill it has introduced?

[John Williamson, Conservative, New Brunswick Southwest, NB]

Madam Speaker, that is exactly right. The crafters of this bill like to tell us in Parliament and Canadians that they were forced to do it, that a lower court forced their hand to come up with this legislation. However, in many cases, as my hon. colleagues have pointed out and as the former minister of justice who is now an independent member has noted, this bill goes far beyond the court ruling. It would remove safeguards.

For example, the 10-day reflection period is gone. Other important safeguards have been removed. This will have an impact, I believe. It will have a grisly impact over time as medically assisted death becomes just a push to death in some corners as people are forced to consider things they would not have otherwise considered. I worry about this. I worry about it for those Canadians who are in a vulnerable position or near their end of life or even people who have given up for a brief time. Often, we know, with health care and with better care, that people can rebound, not always, and I know there are tough cases out there, but this legislation will send us in the wrong direction on these important questions.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, it is an honour to enter into debate on such an important subject.

The first thing I would like to address is the comments that the Minister of Justice and other members of the government have been making that somehow the Conservatives are holding this bill up, that we are somehow responsible for this delay. I will expand on this, but there is really one word that completely rejects that argument, “prorogation”.

The government came forward with the legislation before. It certainly will not surprise any of my constituents, but when the government used its excuse for the need for a legislative reset, it just happened to coincide with the day that very revealing documents were to be released relating to an unprecedented scandal the Prime Minister and various members of the government were facing, it prorogued Parliament, resetting the legislative agenda, because of COVID, they claimed. Now many of the bills they introduced in the previous Parliament have been reintroduced in this Parliament. Then they make it about the Conservatives somehow holding up the process.

We are 24 days behind in the legislative process during which we could have dealt with this legislation and many of the other important things, COVID-related and otherwise, yet here we are. The words that come to mind about it are not necessarily parliamentary, but it is a shame that we find ourselves in this position and that members on the government side would suggest we are somehow not doing our jobs by debating legislation that is literally about life and death.

Constituents will hold government members to account on this subject. I have heard often from those concerned on all sides of this issue. I will get to some of the comments that the Minister of Justice has made more recently. There is the need for dialogue, discussion and careful consideration so we can strike the right balance. That is why Parliament exists, the hallowed chamber that we all have the honour and privilege of sitting in,so we can have discussions.

I would love to see the composition of the House changed a little with respect to the numbers of seats that particular parties have. I am certainly doing my best to ensure that happens, and there is some encouraging news on that front. However, it is interesting that the people who Canadians send to this place, regardless of the composition, is due to the importance of the dialogue associated with every aspect of our jobs here, whether it be COVID-related, or related to medical assistance in dying, as we are debating today, or the many other issues that come before this chamber and its committees.

We cannot diminish the requirement for us to do our due diligence in every aspect of the word. I am certainly doing my part in this debate and resoundingly rejecting the government saying that somehow the Conservatives are delaying this. The blame for that lies directly on the desks of the members of the Liberal government. They are manufacturing urgency when the reason there is even urgency to begin with is due to carefully crafted political games by members of the government opposite.

As listened to the Minister of Justice talk about Bill C-7 over the course of specifically the last number of weeks, there has been an evolution in his responses. The last time I participated in debate was from my constituency office and the Minister of Justice, the day before, had talked about how the Liberals had found broad consensus on this issue, that they had come together and done what the people had asked them to do.

He bragged about the 300,000 submissions to the consultations, when I know for a fact, and I mentioned this in my last speech, that the position the government came to was certainly different from many of the consults my constituents sent in, which did not seem to be acknowledged.

I find it very interesting that when the minister answered yesterday, there was a change in his tone. The Minister of Justice referred to this as a sensitive subject. He was much more nuanced in his approach, acknowledging that there is wide disagreement on it, but that Conservatives should hurry it up. I am paraphrasing, but the change in the minister's tone is a clear example that the Liberals' hands have been slapped. The Liberals claim to have consensus on an issue when it is clear they do not.

We have disability rights advocates and medical professionals who certainly seem to have a wide consensus, although I will not go so far as to say it is universal, as that is an inappropriate use of a term with such a broad application. However, there seems to be a tremendous amount of consensus, not universal, that this bill is flawed and deserves due consideration.

That is exactly what this institution's role is, whether it is us or the other place debating Bill C-7. I imagine the bill will pass. At second reading and report stage we certainly saw the bill pass, so I anticipate that we will see a similar result and that the other place will also have the opportunity to go through the dialogue.

I do want to talk about how we are facing a tragic irony. The Government of Canada, like governments around the world, like provincial governments and like municipal governments, has poured trillions of dollars into COVID response programs. It is without question that those who are most at risk and most vulnerable among us for this virus, which has gripped our world over the last number of months, or close to a year, are seniors. I find it tragically ironic that, in the legislative reset supposedly prioritizing COVID, we would be debating this bill, which puts some of our most vulnerable at risk.

While governments have poured trillions of dollars, in many cases rightfully so, into COVID relief and response programs, we are here debating a bill that would allow people to end their lives and reduce safeguards on a decision that can be no more final. That tragic irony brings us to today. The government members will talk about the need, and often they criticize Conservatives' debate on many aspects of the COVID response, yet here they are pushing for something that is the antithesis of what all parliamentarians would certainly say is trying to do what is best for constituents, which is doing what is best for Canadians.

Often the constitutionality of this place is forgotten, and the reality that the highest elected office in this land is not that of the prime minister, but that of the member of Parliament. We could have a lengthy discussion about why there is that misunderstanding, whether it is because of the prominence of American media in Canada, education or whatever the case may be, but in regard to the primacy of Parliament in Canadian law and society, the member Parliament is the pinnacle of what this institution is.

There are 338 of us. When constituents talk about things like western alienation, they ask how we can make a difference. My response is that I know I can make a difference because I occupy the same number of seats as the Prime Minister does, as the member for Winnipeg North does, and as does any one of my Conservative, Bloc, NDP and Green colleagues. That is the strength of our institution and why free votes are a part of the reality of this place. I would certainly encourage my colleagues—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

The hon. parliamentary secretary to the leader of the government.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, it is a false argument for the Conservative opposition to give the impression this is about process. It is not about process; it is more about a lack of confidence. The Conservatives, as the official opposition, are saying they do not trust the Superior Court of Quebec, which I would suggest impugns the character and competency of the Superior Court of Quebec judge. They are saying no to the legislation because it should have been appealed.

My question to the member is this: Will he come clean, be transparent with Canadians and say that the Conservatives do not like the legislation, and that if they were in government, they would not respect the superior court and go to the Supreme Court of Canada?