Evidence of meeting #4 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was amendment.
A recording is available from Parliament.
NDP
Don Davies NDP Vancouver Kingsway, BC
I, like Ms. Jansen, am a little surprised. It appears that there were some changed positions at the last moment.
I want to be very clear about what it is we're studying. First of all, I want to make sure I understand this. Is the motion that Mr. Thériault moved the same...? Is it the third paragraph of his motion?
Could you read it out?
Conservative
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm asking what the motion is, and then I still have some comments.
Liberal
The Chair Liberal Ron McKinnon
I don't have the French version. I have the English version as I received it from the analysts.
Basically, we're taking your motion and inserting, I believe, just after it says “care in Canada”— Monsieur Thériault can correct me if I'm mistaken—“and other countries where palliative care and assisted dying are offered, with a particular focus on availability and accessibility”.
Conservative
NDP
Don Davies NDP Vancouver Kingsway, BC
Sorry, I have the floor.
Can you just read the motion so that we all know what we...?
Liberal
The Chair Liberal Ron McKinnon
As I understand it, motion as amended is that:
The committee undertake a comparative study on palliative care in Canada and other countries where palliative care and assisted dying are offered, with a particular focus on availability and accessibility, and that, pursuant to Standing Order 109, the committee request that the government table a comprehensive response to the report.
NDP
Don Davies NDP Vancouver Kingsway, BC
Maybe everybody understands the scope of this; we've just massively blown up this study.
By combining the two, we're going to undertake a study of palliative care in Canada, the state of palliative care in Canada, and then a comparative study of Canada and countries where palliative care and assisted dying are offered.
Mr. Chair is shaking his head, but that's what was just read.
We're not studying other countries' palliative care systems now; we're studying only other countries where palliative care and assisted dying are offered together. Then with the “particular focus on availability and accessibility”, it's not specified whether you are referring to palliative care or assisted dying, so I presume it's the availability and accessibility of both palliative care and assisted dying. Now we've brought assisted dying into the issue of palliative care.
We're not going to be able to study other countries that just have palliative care. That strikes me as being not wise. We will study other countries that have palliative care and assisted dying, where those are offered, and then we're going to be looking into availability and accessibility of both assisted dying and palliative care.
This is such a broad salad of a motion.
I'll say this as well. As we said in our break period, assisted dying is a different issue. First of all, as we all know, it was required because the Supreme Court of Canada struck down a Criminal Code provision, so as a matter of a charter right, they gave the government a certain amount of time to respond from a justice point of view to providing assisted dying. We have a mandatory review in the legislation, and that review, even with the extension.... I expect that legislation will be tabled in the House of Commons by June. It was supposed to be done by mid-March; now I think it's been extended three or four months. I highly doubt that this study will be done.
We haven't even discussed how you're going to study comparatively countries that have palliative care and assisted dying. Are we going to call witnesses from those countries? By definition, it's going to be hard to get witnesses in Canada who really understand how systems work in other countries that have palliative care and assisted dying. We're going to be doing a lot of video conference calling with time zones, or we're going to have to go to these countries. It's not an easy study to do.
I just would caution my colleagues. We appear to have mashed together two different things without adequate examination of what precisely that's going to mean to the practical implementation of the study.
Bloc
Luc Thériault Bloc Montcalm, QC
Excuse me, Mr. Chairman, but we're not talking about two studies. I did say earlier "that the committee undertake a comparative study". I added the word "comparative" at the outset.
Why conduct a comparative study with countries facing these two challenges? Because there is no point in comparing ourselves to countries that are not required to review their criminal codes and extend medical aid for dying to include other realities.
What needs to be relevant and enlightening for us is to determine what the expansion of the act will mean for palliative care. That's, in a sense, our challenge, and that's what the court is asking us to do. We need to answer these questions as we move to expand medical aid for dying—as Bill C-14 did in a way.
How are things going in countries where both services have been offered for years? For us, this is a slightly more recent reality. Is accessibility better or worse? Is the slippery slope argument, which some people use to argue that medical help to die is terrible, true in the countries where these two realities are applied?
I apologize to my colleague, but since we too will have to deal with these two realities, it is all the more relevant to conduct a comparative study. That is the challenge we will have to face as legislators. I hope I am being clear on this.
Conducting a study in which we would compare ourselves to countries that only offer palliative care would be of no use, as it does not correspond to our reality. That's why I think it's important to do it that way. There is already documentation on this. We would have to determine whether we are up to date, whether people who have experienced this situation consider that there have been more or fewer requests, in what areas, and so on. I don't want us to deal indirectly with medical dying. The challenge is to deal with both realities. It seems to me that looking at what is being done elsewhere is relevant, and it does not take a century to do it. I'll stop here.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
I don't think our party is tied to one specific question. I think we want some consensus as to an issue that we can all support. I'd like to think there is a real opportunity with a minority government to do things co-operatively. It seems that if we're not going to act co-operatively at the committee level, we're not going to get much done, but there's certainly an opportunity for both sides to co-operate on issues we have in common. We're just looking to find some common ground.
With that in mind, I agree with Mr. Davies on the fact that, yes, adding in MAID is going to make this a much more complicated, lengthier study. I get the feeling that the Conservatives don't want to go to MAID, and I can appreciate that, so I see that as being a bit of an issue.
I do agree with Mr. Thériault that the two are very connected, MAID and palliative care, almost inevitably. I'm not sure whether we really have to put in a reference to assisted dying, because I think, when you start talking about palliative care, this issue is going to come up naturally one way or the other. I certainly agree with Mr. Thériault that looking at what other countries have done is a good idea if we're to look at best practices and make recommendations.
I don't think we're tied to any one thing, but I'd like to get some consensus. I think we have some flexibility. Although I may agree with Mr. Thériault's premise of putting it in, maybe for the sake of time he would agree to consider making it just about palliative care, and it will inevitably come up. Certainly, in examining palliative care, we should look at other countries.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
No, I'm just in a point of debate at this stage in discussing a way forward that we can all agree on. Hopefully, we can arrive at some kind of consensus in the debate without going repeatedly over the motions.
The proposal was that maybe we could take “assisted dying” out of Mr. Thériault's amendment. Would that be acceptable, with the idea that MAID is inevitably going to be part of the discussions?
Liberal
The Chair Liberal Ron McKinnon
We're running out of time here, and I know that Mr. Thériault has his original motion to make. I believe Mr. Fisher does as well. I'm hoping we can wrap this up.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
I guess, yes, we could make an amendment, which would be just to take the words “and assisted dying” out of Mr. Thériault's amendment.
Liberal
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Well, I'm hoping, just as part of the debate, maybe to reach some consensus as to where we're going without repeated motions and amendments.
Liberal
The Chair Liberal Ron McKinnon
The motion is not to study assisted dying. This motion is to study palliative care and to compare it with countries where palliative care is offered and assisted dying is offered. The motion is not to study assisted dying, so in that respect, I don't see any overlap.
Mr. Van Bynen, you had a comment.
Liberal
Tony Van Bynen Liberal Newmarket—Aurora, ON
It's just a procedure question. This is new to me. When I was in the municipality, we could separate the question into two. Do our procedures allow for that so that we could deal with item number one, which is the original draft, and then item number two, which is the amendment? I guess because we have already approved the amendment, it becomes part of the original motion and therefore cannot be separated. Is that correct?
Liberal
The Chair Liberal Ron McKinnon
Well, we've been asked to do a specific study. It's a study of palliative care, but it's also to see what's going on in other countries where assisted dying exists.
