Indigenous and Northern Affairs Committee on March 24th, 2026

[Jamie Schmale, Conservative, Haliburton—Kawartha Lakes, ON]

Thank you to all of the witnesses for sharing their stories and for offering words of encouragement and support as this bill makes its way through the process here.

Of course, thank you to Senator Boyer for continuing to push to introduce it in the Senate multiple times and to get it to the House. She's been a real leader and a real voice for those who want to see changes made to our criminal justice system to ensure that sterilization without consent is treated as it should be in the Criminal Code.

It pains me to hear the stories that were told, but the powerful stories that were told have helped us, as parliamentarians, get to the point we have already. For those who might not have known, it did receive unanimous consent in the House to push it to committee without waiting for a vote, which would have delayed this bill even more. I want to thank our colleagues from the Bloc and the Liberal Party as well. Jaime Battiste did bring that up in the House. It kind of surprised us all, but there were negotiations behind the scenes that kind of worked toward making that happen. I can say nice things about Jaime because he's not here, so that helps.

Maybe I'll just get in a few questions here. I know our time is short and there's so much to talk about.

It was mentioned many times during the conversation here today that it's about creating that balance. It's about creating a balance that ensures there are protections for health care professionals who need to make a snap decision in an emergency situation, but also punishment, potentially, for those who go beyond that scope, including sterilizing without consent, as we heard in the stories from a number of people at this table today.

Maybe I could ask Dr. Burnell first, and then we'll go to Harmony Redsky or Dr. Wilson.

Do you agree that it creates that healthy balance between protections for health care professionals and ensuring we're not seeing a reoccurrence of some of the stories we've heard today?

[Dr. Margot Burnell]

I believe this bill as presented does in fact do that. It provides the clarity that is required for physicians to undertake these procedures with respect to, for the most part, an elective procedure where patients are seeking sterilization or a discussion about birth control options. In that forum, there is time to go through the pros, the cons, the risks, the benefits and what the options are, which allows them to reflect and make the decision that's best for them. They can go away, reflect and bring their support person or their partner to those appointments. They then have the opportunity to have a really fulsome discussion about what their goals are with respect to their reproductive health and have autonomy over those decisions.

The balance for physicians at section 45 is still present. In an emergency procedure, where it was not anticipated, this may be part of what would happen where it's about the life of the individual or where significant harm to the individual is present. This provides the backbone and the recourse that says they did it with the best of intent to save the mother and prevent illness or long-term morbidity. That is covered in section 45, so I think this is an appropriate balance.

[Harmony Redsky]

I'll echo that. From what we have seen with the registry and those who have come forward to the registry, there is a stark contrast between what is forced and coerced and what is a life-saving procedure. At the expert panel, we have reviewed cases and applications that have come forward that have involved a life-saving procedure in an emergency. Some of those have not made it into the registry because the criteria were not met for forced and coerced sterilization. I just wanted to say that.

The purpose of the bill is not to punish physicians for performing perfectly lawful procedures. It's for women who did not consent and do not consent in what are predominantly vulnerable circumstances, such as childbirth, being completely unconscious and other situations like that.

[Dr. Don Wilson]

As an obstetrician-gynecologist in practice, if this bill passes, I won't be changing my practice, because there's nothing for me to change if I'm not engaging in forced or coerced sterilization.

I also think that the bill will be an extremely important one and will be a catalyst for a much larger discussion in the profession of medicine, particularly in the discipline of obstetrics and gynecology, about how we engage in the process of informed consent with patients to ensure that it is valid.

We don't really have anything to worry about in the way this bill is written if we're not engaging in those coercive practices.

[Jamie Schmale, Conservative, Haliburton—Kawartha Lakes, ON]

How much time do I have?

[The Chair, Liberal, Terry Sheehan]

You're out of time, but you're the sponsor of the bill, if you want to take a little liberty.

[Jamie Schmale, Conservative, Haliburton—Kawartha Lakes, ON]

Thank you, Chair.

I appreciate the work that's been done. The work that the survivors circle has done behind the scenes across the country to elevate the voices of those who have been harmed is unbelievable.

It's been amazing getting to know a lot of people from across the country who I probably never would have crossed paths with. There are some pretty remarkable people across this land, and I've been touched to be able to speak with them and learn more about them. It's been an interesting journey, and I hope we're able to get this across the finish line for you. I know many of you have been trying for many years and were so close. The fact that you're here today speaks to that passion and speaks to the motivation that we, as parliamentarians, have to get this done.

Also, for those at home who may be watching, this shows that parliamentarians do work well together from time to time, and we can get things done in Ottawa. There's not always that combative approach you see on TV. There is actually some good work being done behind the scenes, and we're moving the mark here to make this a better place to live.

Thank you, everyone, for your passion, your remarks, your work and the collaboration we've achieved here today and in the past few weeks.

Thank you, Chair, for that very nice extra time that I got. We will have to continue this in future meetings.

[The Chair, Liberal, Terry Sheehan]

You made good use of it. Well said, my friend.

Dr. Hanley, you have six minutes, please.

[Brendan Hanley, Liberal, Yukon, YT]

In the spirit of collaboration, I want to thank you all for your courageous testimony and for being here. Again, I thank Senator Boyer, who I know is still in the room, and also Mr. Schmale for championing this incredibly important issue.

Again, as parliamentarians, we have to ask the difficult questions, and we have to make sure we are fully considering the benefits and the potential unintended consequences of introducing legislation, particularly when it involves the Criminal Code.

I want to again bring us back to some themes similar to those raised in Mr. Schmale's questions to you about how we ensure that the right balance is struck in this legislation, should it pass. In particular, I want to point out, again, the briefs that we've received from some medical groups, including the SOGC, the Society of Obstetricians and Gynecologists—which, as you know, Dr. Wilson, is a highly respected organization—and the Federation of Medical Women. Both of them are at pains to point out how much they support the spirit and the intent of this bill “to ensure that coerced sterilization...is finally stopped”, as the SOGC says, “and that those who perpetuate these assaults against women are held to account.” I think we're all clear on the intent, but the SOGC brief in particular does point out “significant concerns about unintended consequences [that the SOGC believes] this bill could have on women’s access to reproductive care”. They also point out that a “legislative instrument” may not be the right tool for the problem that exists.

I'd like Dr. Burnell and Dr. Wilson in particular—and any others we might have time for—to just comment on how we can address these concerns that are coming from the medical groups. What do you recommend, what do you advise, in how we can meet those concerns?

Dr. Burnell, perhaps you can start.

[Dr. Margot Burnell]

Thank you for your question.

This bill really is one that we hope will never be tested. We've heard from the members today their compelling stories of what's going on within the institutions in this country. Our responsibility is to protect the autonomy and decision-making of women with respect to reproductive justice. The elements that will go toward this will be education, both of patients and physicians; defining the requirements of informed, prior and free consent; and allowing a dialogue between patients and their health care professionals.

I would echo what Dr. Wilson said: If you are complying with prior, informed and free consent, you will not need to adjust your practice.

[Dr. Don Wilson]

Before I was invited to be a part of this, I had heard some of these concerns, because I am a member of the SOGC myself. There are a couple of things that I would like to point out.

One of the arguments as to whether this bill is truly necessary was that we already have mechanisms in place to address scenarios of forced and coerced sterilization. My question is, when have those mechanisms ever resulted in justice for those people who have gone through the process of forced or coerced sterilization? The current systems are inadequate. As one of our survivors has pointed out, there are strong protections in place for physicians who face legal challenges, whether it be malpractice, negligence or claims against them for whatever reason. The CMPA exists. Interestingly, obstetrician-gynecologists pay one of the highest rates of premiums for that coverage, mostly because of obstetrical issues. As far as I'm aware, I've not heard of any patients who have ever received justice from current mechanisms.

I mentioned in my earlier discussion that I think this law will result in conversations that would not have otherwise been held in the profession of obstetrics and gynecology. It will force the profession to step up and address how we obtain consent for these procedures for patients. It will also highlight the importance of it not only to the physicians who perform these, but to all of the associated team members who are involved as well. I can't do a surgery without an anesthesiologist. I can't do a surgery without operating room nurses. I can't do a surgery without patients being admitted to a day surgery unit or a labour and delivery unit. It will impact the entire health care system. I think we are past the time of addressing adequate informed consent, not just for sterilization procedures, but for many other medical interventions and procedures.

As a physician, I've heard many times from patients when I have gone through my usual practice of talking about a proposed intervention that I was the first physician they have ever had who took the time to explain the process to them. That should not be the case. It should be quite universal that physicians take the time to explain the procedure, the risks, the alternatives, the potential complications and the sequelae of whatever we are proposing, and it doesn't always happen.

I think it's time to.... This will be an impetus for the profession to step up and find ways to do better. I mentioned in my earlier presentation that there are realities in medicine that make it extremely difficult to meet that bar. There are time pressures. There are volume pressures with lots and lots of patients in labour at the same time. It does not excuse us from trying to reach that bar.

We owe that to our patients, and in particular we owe that to those who are the most vulnerable to being subjected to forced and coerced sterilization. This legal backstop, I feel, as an indigenous OB/GYN, will be an important protection for indigenous people who might otherwise be subjected to this.

[The Chair, Liberal, Terry Sheehan]

Thank you very much.

Mrs. Gill, you have the floor for six minutes.

[Marilène Gill, Bloc, Côte-Nord—Kawawachikamach—Nitassinan, QC]

Thank you very much, Mr. Chair.

I'd like to thank all the witnesses for being with us today, including Ms. Étienne, who is participating virtually.

Everyone has testified bravely and generously. I believe we've reached the end of this discussion for this panel. I'll give the witnesses the opportunity to add anything if they see that there are questions that we, as elected officials, haven't asked, but for which answers would be relevant. I'll let them speak as much as possible. It was said that we should give the floor to those who need it, so I'll let them speak without imposing an order or saying who can speak, if they wish to add a final comment, question or suggestion.

Thank you very much. Meegwetch.

[Shelby Ponace]

I have spoken for the truth and reconciliation centre at a lunch-and-learn. That really opened my eyes about consent and coercion and what they mean to me.

Consent requires full understanding, time and freedom from pressure. I was in pain, I was medicated, and I was told I might die. That is not a situation where someone can give informed, voluntary consent.

I did want to make a note about doctors' intent and the impact it may have on patients. Intent matters, because it shapes decisions. Whether conscious or not, bias can influence how providers treat patients. In my case, the comments and actions reflected a lack of respect for my body autonomy and my future.

I also wanted to bring up the big elephant in the room, and that's our work as survivor support workers. I support survivors across Canada, hundreds of survivors. What I hear repeatedly are similar patterns, including pressure, lack of information and lasting trauma. This is not isolated, and it is ongoing.

I don't know if I can mention it, but our funding has been cut. I feel, as a survivor support worker, that we are doing just as much harm as the people who have harmed us. As we open many survivors' wounds, we're no longer able to fully support them with the funding cuts. I find myself disconnecting again and not wanting to keep that relationship going with other survivors, because of the lack of support I can provide. That's something really important to survivors. Once they're heard, they feel seen, and they feel supported. The lack of funding is now going to put them in a darker place.

One of the comments I really want to make here is just how important the Survivors Circle for Reproductive Justice is, as well as our jobs.

Thank you.

[The Chair, Liberal, Terry Sheehan]

Go ahead, Doctor.

[Dr. Margot Burnell]

I'd just like to add that, from the CMA perspective, this really is part of our reconciliation action plan, building upon the apology to indigenous people in September 2024. This is a piece of legislation that has been called upon. We have worked with our indigenous guiding circle and our indigenous leadership within CMA to look at this issue, to hear those stories and to bring those stories forward.

In building trust and in relationship building, again, this is a critical piece of legislation for that.

[The Chair, Liberal, Terry Sheehan]

We have somebody online who would like to add something.

Go ahead. You have your hand up.

[Marjolaine Étienne]

Thank you. This will be my last comment.

In fact, there is a very specific perspective in Quebec, and it's a very important factor. I'm talking about the recognition of systemic racism in health care institutions, in particular.

There is reason to look at the situation from a medical or surgical point of view, but, on the other hand, we mustn't forget that indigenous women have rights, and they must be able to assert them as well, once and for all. The injustices of the past and the truth that's being spoken publicly today through reports and testimony from Quebec women are extremely important.

If we don't work on recognizing systemic racism in Quebec, we're just going to put band-aids on the wound. You know as well as I do that, when it comes to doctors and nurses, if we don't work on the root of the problem, year after year the wound will eventually become infected.

I also want to thank and acknowledge the women who come before parliamentary committees to bravely share their stories. Their testimony echoes what I've heard from indigenous women across Quebec.

[The Chair, Liberal, Terry Sheehan]

Thank you.

Thank you, everyone, for this important sharing of stories. It's really helpful.

Thank you to our two sponsors, MP Schmale and Senator Boyer.

Before I ask to adjourn.... I know it is the will of the committee to get this done expeditiously. Therefore, I would ask the committee to take a look at witnesses for Bill S-2. We will be meeting on Thursday on this one, when we get back, and we're hoping to finish this up, which means that we will then be going into Bill S-2. Please send in your witnesses for Bill S-2 by Friday. This will allow the clerk to start scheduling that.

Chi-meegwetch, everyone. Thank you so much for your bravery, for your spirit and for sharing your experiences.

Do I have permission to adjourn?

[Some hon. members]

Agreed.

[The Chair, Liberal, Terry Sheehan]

Thank you.