Indigenous and Northern Affairs Committee on March 26th, 2026

[The Chair, Liberal, Terry Sheehan]

Good morning, everyone. I'm going to call this meeting to order.

Welcome to meeting number 27 of the House of Commons Standing Committee on Indigenous and Northern Affairs.

We recognize that we meet on the unceded territory of the Algonquin Anishinabe people.

Pursuant to the order of the House, the committee is continuing its study of Bill S-228, an act to amend the Criminal Code on sterilization procedures.

Before we begin, I would like to remind anyone watching our proceedings that there is a helpline, the Hope for Wellness Helpline, which is available 24-7 to all indigenous people across Canada at 1-855-242-3310. If anyone is experiencing any distress during our proceedings, I encourage them to call that number.

I'd like to welcome our witnesses on the first panel.

As individuals, we have Dr. Lisa Richardson from the University of Toronto, and Professor Karen Stote, associate professor, women and gender studies, Wilfrid Laurier University. From the Association of Obstetricians and Gynecologists of Quebec, we have Liliane Brassard, vice-president. From the Collège des médecins du Québec, we welcome Dr. Mauril Gaudreault, president, by video conference, and Linda Bélanger, director of legal affairs and assistant secretary, by video conference. From the Federation of Medical Women of Canada, we have Dr. Modupe Tunde-Byass, obstetrician-gynecologist and professor, faculty of medicine, University of Toronto; and, from the National Association of Women and the Law, we have Amanda Therrien, feminist lawyer and researcher, by video conference.

After, we will proceed to questions.

To the people online, you can raise your hand, and the clerk and I will see you.

Everyone has been video tested, so I hope everything works well.

This is a reminder about interpretation. You can either keep the earpiece in the ear or place it away from the mic on those little spots on your table, and make sure your mic's off for the health of our interpreters.

Everyone will have five minutes, and we will begin with Dr. Lisa Richardson as an individual.

Please proceed.

[Dr. Lisa Richardson, Professor, Temerty Faculty of Medicine, University of Toronto, As an Individual]

Good morning, and thank you, Mr. Chair and honourable members of the standing committee.

My name is Dr. Lisa Richardson. I'm Anishinabe on my mother's side, a member of Wiikwemkoong Unceded Territory.

I'm an internal medicine specialist practising at Toronto General Hospital and a professor of medicine at the University of Toronto.

I have numerous roles in indigenous health, including as a founder of the National Circle for Indigenous Medical Education, the strategic lead in indigenous health at Women's College Hospital, and chair of the indigenous health committee and council member at the Royal College of Physicians and Surgeons of Canada.

Thank you for the opportunity to discuss the importance of Bill S-228 with you today.

It is, unfortunately, well documented that indigenous women, girls and two-spirit individuals have been either forced or coerced into sterilization when it is not in their best interest or choice, nor is it medically necessary. This practice has been studied extensively and exposed by the Honourable Senator Yvonne Boyer, who introduced the bill, among others.

This amendment to the Criminal Code makes clear to women that consent should always be free, prior and informed and that they can withdraw their consent at any time without coercion. Explicit criminalization of forced and coerced sterilization is an important step toward holding individuals accountable.

What is equally important, however, is access to high-quality reproductive care for indigenous women and two-spirit people. There must be expansive and culturally relevant educational materials to facilitate informed decision-making for patients and dedicated indigenous supports such as patient navigators and traditional healers.

Our health care system needs more indigenous physicians, midwives, nurses, social workers and others, who not only provide culturally safe care for indigenous peoples but who are leading health system transformation.

Hospitals must track and share reported instances of racism as quality indicators. All medical learners and practising physicians must hear the stories of survivors of forced and coerced sterilization. They must understand the numerous components of the consent process: that it is free; that consent is given voluntarily, without pressure, coercion or manipulation; that it is sought in advance of any medical intervention, allowing time for understanding and decision-making; that it is informed, in that information is provided on the nature, risks, benefits and alternatives; and that it is culturally safe, in that health care is provided in a way that respects the culture, values and beliefs of indigenous people, recognizing the necessity of non-discriminatory care.

Physicians must be reflexive and understand their own biases. They must attend to and mitigate the power dynamics that exist in the relationship between a patient and provider.

In closing, I would like to highlight the work of the Survivors Circle for Reproductive Justice in supporting survivors of forced and coerced sterilization and advocating for the changes in this bill, as well as that of Honourable Senator Yvonne Boyer.

Thank you. Meegwetch for the opportunity to speak today.

[The Chair, Liberal, Terry Sheehan]

Thank you, Dr. Richardson.

Now Karen Stote, associate professor, has five minutes.

[Professor Karen Stote, Associate Professor, Women and Gender Studies, Wilfrid Laurier University, As an Individual]

Good morning. Thank you, Mr. Chair and committee members.

I've been researching the coerced sterilization of indigenous women for about two decades. I've written two books on the subject, and I fully support the survivors of coerced sterilization and what they want and need. Bill S‑228 is a tool that will help reaffirm existing consent mechanisms in a medical context and make clear that there are consequences if health professionals don't meet their obligations. I echo other voices of those who have appeared before your committee in support of the bill.

I'm here to remind this committee and government that, as some have said previously, we're talking about a colonial solution to an ongoing colonial problem. If we don't go to the source of the problem, the wound will continue to fester. If we don't address the context that leads to coerced sterilization in the first place, indigenous experiences of coercion are at risk of continuing or simply changing form.

Indigenous people were sterilized under eugenics legislation starting in the 1930s. Over 1,200 sterilizations also took place in the north and in federally operated Indian hospitals in the late 1960s and 1970s. At the time, there were problems with informed consent, as well as racism and paternalism on the part of government officials and health professionals. Also, the context was one of colonialism and the undermining of indigenous political and reproductive sovereignty. Western medicine was imposed as a tool of colonialism, and indigenous ways of health, healing and giving birth were undermined.

That context has mostly continued. After 1970, coerced sterilization continued under the banner of family planning. The practice has been a means of population control and a way to control who has access to land and how resources are distributed. Federal changes to the Criminal Code in 1969 decriminalized birth control and made sterilization more accessible, paving the way for family planning activities across Canada. This was significant for continuing coerced sterilization. The change was influenced by international discussions between western nations and corporate interests that were exploiting lands, resources and peoples for profit around the world. That's one reason indigenous experiences here are connected to others in the United States, Central America, South America, Australia, Asia, Africa and parts of Europe, where corporate interests have also been exploiting indigenous lands for profit, and where people have also been coercively sterilized.

My review of 30 years of family planning policy and practice in Saskatchewan, beginning in 1970, shows how the government's concern about poverty and births among young and single mothers at risk most often focused on indigenous women and girls. Family planning was considered by some to be a way to address poverty and reduce government budgets by reducing the birth rate among those relying on social services, without doing much to address why poverty exists in the first place. It was also one way to ensure continued access to indigenous lands for profit, because any poverty that indigenous people experience can't be separated from colonialism.

In 1978, the federal government announced that it would take a more proactive approach to family planning, and the Province of Saskatchewan identified the indigenous birth rate as the most important demographic trend over the next 25 years. That year, registered Indians began to be overrepresented among those sterilized in the province. Between 1970 and 2018, 10,654 registered Indians were sterilized in Saskatchewan. This doesn't include non-status Indians or Métis people.

Sterilization is a legitimate reproductive option when it's consensual, but the historical record is full of indigenous voices raising the possibility and reality of coercion and insisting on reproductive and political sovereignty as necessary to protect against this form of genocide.

Corporations in the Canadian political economy remain invested in exploiting indigenous lands for profit. Colonialism is ongoing. There's a connection between this and systemic racism in health care and beyond, and it's an important part of the context needed to understand why coerced sterilization keeps happening and what transformative changes are needed to stop it.

Criminalization alone won't solve things if business continues as usual in other parts of our collective relationship with indigenous peoples and their lands. I urge you as elected officials and as human beings to pass Bill S‑228. Then have the courage to continue working with indigenous people to end violence against indigenous bodies and lands.

Thank you for listening.

[The Chair, Liberal, Terry Sheehan]

Thank you very much.

Next we have Liliane Brassard, from the Association of Obstetricians and Gynecologists of Quebec.

Please go ahead.

[Liliane Brassard, Vice President, Association of Obstetricians and Gynecologists of Quebec]

Good morning, Mr. Chair and members of the committee.

My name is Liliane Brassard, and I am the vice-president of the Association of Obstetricians and Gynecologists of Quebec, or AOGQ. We represent more than 500 dedicated medical specialists committed to delivering safe, accessible and, above all, quality care to women.

I want to be clear from the start: We fully recognize the serious and unacceptable injustices inflicted on indigenous women, vulnerable women and other groups of women, including forced sterilizations. There is no doubt that these practices seriously violate women's dignity, bodily integrity and fundamental rights. They must be condemned and penalized, as provided for by the law, and victims must be able to seek justice. The AOGQ fully supports the bill's intent in that regard. However—and this is the crux of our message today—we are extremely concerned about how the bill proposes to achieve that objective. Unfortunately, in its current form, Bill S‑228 is likely to do the opposite of what is intended.

Why? It is crucial to point out that forced sterilization is already a crime in Canada. It is captured under the current legal framework. The problem isn't a legislative gap. The problem is actually a deficiency in the investigation and prosecution of these cases and, above all, a lack of effective supports for victims.

Instead of the government's creating a new offence, we recommend issuing clear directives to the appropriate authorities to ensure that cases are thoroughly investigated and effectively prosecuted. It is also important to strengthen training mechanisms for health professionals, supports for patients, reporting and victim supports. Furthermore, better coordination between federal and provincial authorities is needed. These are the things that will actually make a difference.

Conversely, we see three major problems with the bill.

First, it risks undermining the bodily autonomy of patients. For many patients, sterilization is a free and informed choice, one they fully consent to. However, in broadly defining sterilization as an act that wounds or maims a person, with no clear exception for procedures performed with consent, the bill will likely lead to confusion and patient stigmatization. As a result, patients who truly wish to receive such care may be reluctant to seek it.

Second, the bill risks having a deterrent effect on physicians. The bill introduces a broadly worded criminal offence, with no explicit reference to consent. The word “consent” does not appear anywhere in the new offence. In criminal law, uncertainty leads to hesitancy. In medicine, hesitancy hurts patients. Take, for example, ectopic pregnancies. An ectopic pregnancy is a pregnancy that occurs in the fallopian tube and can put the patient's life at risk. When surgical intervention is necessary, it's an emergency. The patient is experiencing severe blood loss through the fallopian tube. Currently, the recommended treatment is to remove the fallopian tube, which is completely damaged. In the absence of legal clarity, physicians could hesitate to remove the fallopian tube out of fear of being prosecuted, because the procedure is likely to result in sterilization. As a result, patients could receive less than optimal care and experience more complications.

Third, we believe the bill risks diverting attention from the real problem. The creation of a new offence may lead victims to believe that this practice wasn't previously considered a crime, which is completely false. The real problem is the inadequate enforcement of the existing law. Adding an offence without fixing the problem will make absolutely no difference on the ground.

The AOGQ fully supports the bill’s objectives of protection and justice, but protecting women also means not choosing a solution that reduces access to care, undermines patients' bodily autonomy or causes adverse effects.

The most responsible solution is the rigorous enforcement of existing provisions, along with concrete measures to ensure that perpetrators are actually prosecuted and penalized.

What these women have gone through is unacceptable. Recognizing that is crucial, but so is using the right tools to make sure it never happens again.

Thank you.

[The Chair, Liberal, Terry Sheehan]

Thank you.

We will now hear from Dr. Gaudreault, the president of the Collège des médecins du Québec, for five minutes.

[Mauril Gaudreault, President, Collège des médecins du Québec]

Mr. Chair, Mr. and Madam Vice-Chairs, and members of the Standing Committee on Indigenous and Northern Affairs, thank you for giving the Collège des médecins du Québec the opportunity to share its views on Bill S‑228, which seeks to criminalize forced sterilization.

I have been the president of the Collège des médecins du Québec, or CMQ, for nearly eight years. This is my second and last term, in accordance with our statutes, and I am pleased with what the Senate is proposing. Joining me is Linda Bélanger, our director of legal affairs.

The CMQ wishes to express its full and unqualified commitment to ending this practice. Over the years, the CMQ has condemned the practice, and taken a firm stand against forced sterilization, discrimination and systemic racism. This practice undermines women's integrity, dignity and autonomy.

In the fall of 2022, when Suzy Basile, a researcher at the Université du Québec en Abitibi‑Témiscamingue, released her report on the forced sterilization of first nations and Inuit women, it sent shockwaves across Quebec. The public was outraged and the medical community was shocked.

The CMQ immediately set up a working group. I headed the group and made sure to include researcher Suzy Basile; Marjolaine Siouï, executive director of the First Nations of Quebec and Labrador Health and Social Services Commission; Dr. Stanley Vollant, the first indigenous surgeon in Quebec; and two women physicians who sit on our board.

The working group's report was clear and to the point, laying out seven concrete measures: one, implement an action plan to address sterilizations and abortions forced on first nations and Inuit women; two, add a preamble to the college's code of ethics prohibiting any discrimination based on culture or identity, to ensure that every article is understood in that light; three, make training on cultural safety in health care mandatory for college inspectors and investigators; four, encourage all physicians to take this training; five, review and improve training on consent to care; six, communicate the initiatives implemented by the college to the public and physicians; and seven, work with first nations and Inuit networks to deploy reproductive health awareness tools. Most of these measures have been implemented, and we will take more if necessary.

More broadly, the CMQ co-created basic training on cultural safety in health care, with the help of experts from various marginalized populations and communities that are discriminated against in health care. The training helps physicians learn about the structural biases that give rise to health care inequities and understand how to address them. Our goal is to regain women's trust, the trust of indigenous women, in particular.

The CMQ is fully committed to combatting systems and structures that perpetuate oppression and create power inequalities with members of a population or within care teams. We are focused on making sure that none of our actions ever result in a woman being sterilized unknowingly or against her will.

While the proposed amendments specifically introduce provisions in the Criminal Code, we want to share our two expectations for their implementation.

First, consent should ideally be provided in writing, except in an emergency. We heard about cases where consent was given while the mother was giving birth, even though there was no threat to her health or the child's, under stressful conditions when the mother was highly vulnerable.

Second, communications following the bill's passage must make clear that physicians who perform an emergency sterilization procedure without consent are not criminally liable if the procedure is for the patient's welfare. Otherwise, the bill will deter physicians from performing necessary reproductive health procedures out of fear of criminal prosecution.

Researcher Suzy Basile will soon be releasing another report on sterilizations performed without consent, and early indications show that there are unfortunately more cases. The CMQ will be reviewing the report and taking appropriate action.

In the meantime, we would like to see Parliament pass Bill S‑228, to criminalize forced sterilization for good. The fundamental choice to have or not have one or more children is the patient's.

The CMQ's mission is to protect the public by ensuring quality medical care, which does not include forced sterilization. We will make sure that people are protected.

Thank you. We would be happy to answer the committee's questions.

[The Chair, Liberal, Terry Sheehan]

Thank you.

Next, we'll go to the Federation of Medical Women of Canada and Dr. Modupe Tunde-Byass, obstetrician-gynecologist and professor, University of Toronto.

Please proceed.

[Dr. Modupe Tunde-Byass, Obstetrician–Gynecologist and Professor, Temerty Faculty of Medicine, University of Toronto, Federation of Medical Women of Canada]

Thank you, Mr. Chairman, and members of the committee for the kind invitation.

My name is Modupe Tunde-Byass. I will be speaking today in my capacity as the president of the Federation of Medical Women of Canada, as a practising OB/GYN and as a Black woman health care provider. At the heart of the Federation of Medical Women of Canada's mission is the promotion of well-being for women plus in both the medical profession and society at large. The FMWC supports and shares Bill S-228's intent to protect reproductive autonomy and ensure a safe, inclusive health care environment, particularly for women from marginalized communities, who have historically been wronged. Indigenous women were disproportionately affected by these egregious acts. The FMWC unequivocally condemns coerced or forced sterilization. I'm also further saddened and disappointed by the inaction and the lack of robust consent process that would have ensured the abolition of coerced or forced sterilization in Canada as a whole.

Upon review and consultation, the FMWC raises the concern about the unintended consequences of the impacts of Bill S-228 on obstetrics-gynecology as a profession and the associated provision of women's health services, including consensual sterilization. Politicization and criminalization of women's health will decrease access and result in a loss of bodily autonomy and reproductive rights. This is what women have fought for.

On gender equity in medicine, as of 2026, over 60% of medical school admissions are women. In 1990, 84% of practising obstetrician-gynecologists were males and in 2020, 64% were females, a fourfold increase. It is projected that over 80% of OB/GYN residents and most practising specialists are now females. This change in demographics is critical, and FMWC members are concerned with the targeted criminalization of a female profession, which is historically male-dominated and fraught with patriarchal, paternalistic and misogynistic legacy, which will cause more women harm. Women are now getting to positions of leadership and are fierce advocates for women's rights and autonomy. FMWC is further concerned that access to women's reproductive health care, which was already in crisis, will be further eroded by criminalization, which would affect current practice and deter women physicians from choosing this specialty.

I spoke to some of my trainees in OB/GYN, and one said, “We are explicitly trained in trauma-informed, non-coercive consent with clear documentation, especially in high-stakes settings like caesarean births.” Another said, “Performing two emergency hysterectomies where partners consented while patients were under general anesthesia. Both patients lived but were upset and one sued after; imagine having a criminal case opened against you in addition to dealing with [a] malpractice lawsuit!!!!!! As trainees we have never heard of this Bill. Forced sterilization is wrong”.

On emergency care risk, medical practitioners performing sterilization procedures without sufficient consent face 14 years in jail. In emergency situations, my question is, who determines sufficient consent? In some cases, consent is obtained from family members. Is this adequate? The threat of criminal prosecution may cause physicians to hesitate during critical split-second clinical decisions, leading to increased morbidity and mortality. These decisions must be made on purely clinical grounds, without the fear of criminal prosecution. Hesitating, even for a moment, can lead to lives lost, as seconds count in the face of active bleeding. Therefore, the potential for hesitation is of great concern. In the U.S., with the overturning of Roe v. Wade, criminalization and legal uncertainty have led to confusion, physician hesitancy and delayed care, and a lack of available women practitioners has led to many documented maternal deaths. We must guard against these scenarios in our country, Canada.

On educational and regulatory opportunity, the FMWC is disappointed that there has been no progress at the national level in developing and implementing a robust consent to prevent coerced or forced sterilization. The FMWC is advocating for the opportunity for comprehensive member education. We are seeking to collaborate with a national commission that comprises indigenous physicians, the Society of Obstetricians and Gynaecologists, regulatory bodies, medical protection associations, biomedical ethicists, midwives, etc., to come up with an urgent consent process while enhancing professional standards that will ensure robust support for health care providers. The FMWC is dedicated to ending coerced sterilization, and it supports the immediate removal of licensure of perpetrators of such acts.

With regard to unintended consequences, marginalized women often have little opportunity to speak to a provider alone and safely for reasons of language and culture, among other things. For example, a woman who—for cultural reasons—is not allowed to make a decision on her own about whether she wants more children may be negatively impacted. These women are already at the highest risk of negative outcomes, and this could further compromise their care, leading to human suffering. We see such women trusting that their provider will listen to them and help them out. While fully informed—

[The Chair, Liberal, Terry Sheehan]

Thank you, Dr. Tunde-Byass. We're over time. You'll be able to get out more information during the question and answer period, but we have to move on to the next person. Could you just close up, and then you'll get more out during the question and answer stuff?

[Dr. Modupe Tunde-Byass]

Okay.

In closing, FMWC recognizes the impacts of forced and coerced sterilization in indigenous, Black and marginalized populations. Criminalization will not address the structural racism and systemic discrimination that enable egregious acts to occur in the first place and to continue to impact equity-deserving populations today. With the lack of clarity and the unintended consequences that surround Bill S-228, it is advisable that extreme caution is taken in passing this bill. The FMWC favours universal education, robust consent and public awareness as more effective tools than criminalization.

Thank you so much.

[The Chair, Liberal, Terry Sheehan]

Thank you very much.

Next, we have, from the National Association of Women and the Law, Amanda Therrien, feminist lawyer and researcher.

Please proceed.

[Amanda Therrien, Feminist Lawyer and Researcher, National Association of Women and the Law]

Thank you, everybody. My name is Amanda Therrien. I'm a staff lawyer with the National Association of Women and the Law. For those of you who may be less familiar with NAWL's work, we are a feminist law reform organization with more than 50 years of experience in working to advance substantive equality for women through legal education and policy reform.

I'm here today to discuss Bill S-228, which seeks to address the practice of forced and coerced sterilization in Canada. We're here today to share some recommendations and potential amendments to the bill to ensure that it addresses forced and coerced sterilization without introducing unintended harms.

Our first point of concern regarding this bill is that it is not fully gender-inclusive. As drafted, the bill focuses on female reproductive anatomy: the fallopian tubes, the ovaries and the uterus. Although we recognize that forced and coerced sterilization has been largely used against indigenous women, men—particularly disabled men—intersex people and non-binary individuals have also been targeted. We are therefore recommending that this section instead refer to the reproductive organs of a “person” more broadly.

Second, the bill risks chilling access to gender-affirming care and wanted permanent contraception. This is one of our most serious concerns. A prior version of this bill captured only procedures that were for the primary purpose of preventing reproduction, but this bill goes further. It is capturing any procedure that results in the permanent prevention of reproduction. This is an issue in the context of gender-affirming care. We often see individuals, organizations and governments that are opposed to gender-affirming care describe it as mutilation, as maiming and as being coercive. One of the most common talking points is around the supposed loss of fertility. A broadly worded Criminal Code provision like this could be used or threatened in ways that create fear and hesitation among providers, which will limit access to this life-saving care.

A similar concern exists when it comes to consensual permanent contraception. As mentioned in our brief, the concern surrounding access to wanted contraception was previously raised when Bill S-250, was being studied during the last session. Dr. Diane Francoeur, CEO of the Society of Obstetricians and Gynaecologists of Canada, noted that it is still incredibly difficult for women to obtain permanent sterilization in Canada and that there's currently a three-year wait-list in Ontario for this procedure. Unfortunately, this is no longer a theoretical concern. Following the bill's passage through the Senate, a physician contacted NAWL to advise that their hospital was instructing them not to provide permanent contraception to women. We believe this change was at least in part a response to this bill.

The consequences are significant. It means fewer providers, more gatekeeping and more barriers, particularly for women who are rural and remote, as well as women navigating reproductive coercion or family violence who may need access to permanent contraception safely and discreetly.

Our solution to this is twofold. First, remove the phrase that refers to “any other procedure performed on a person that results in the permanent prevention of reproduction”. It is overly broad and creates legal uncertainty far beyond what this bill was meant to capture. Second, add a clear safeguard stating that nothing in this section limits access to contraception or gender-affirming care, with the consent of the person.

Finally, if I can raise a more technical point, this bill may make forced sterilization harder to prosecute—or at least more confusing—rather than easier. Under the current state of law, without this bill, non-consensual surgical procedures, including sterilization, constitute aggravated assault. In order to prove aggravated assault, you do not have to prove that the impairment was permanent. However, if we look at the definition of sterilization procedure in Bill S-228, we see it defined as “any...procedure performed on a person that results in the permanent prevention of reproduction, regardless of whether the procedure is reversible”.

This introduces a bit of uncertainty. If prosecutors want to charge someone with aggravated assault in the context of a sterilization procedure, are they now going to have to prove that the prevention of reproduction was permanent? The fact that it's not completely clear in this bill is the reason we recommend removing the definition of sterilization procedure. We want to keep the focus on the lack of consent rather than on invasive and potentially contested medical questions.

This would also bring it into alignment with the section on female genital mutilation, which is also a for-greater-certainty clause. It does not introduce a definition of FGM or require a permanent loss of function; it lists only the behaviours that constitute maiming for the purposes of aggravated assault.

The final version of Bill S-228 that we're proposing would be very short. It would therefore read as follows:

268.1(1) For greater certainty, in this section, “wounds” or “maims” includes the severing, clipping, tying, cauterizing, or removal of the reproductive organs of a person.

(2) Nothing in this section shall be construed as limiting the ability of medical practitioners to provide contraception or gender affirming care with the consent of the person.

In closing, what has been missing up until now isn't a legal tool to prosecute forced and coerced sterilization. It's been the political will. This bill, as amended, will hopefully lead to more prosecutions, but the criminal law, without more, will not address systemic racism in our health care system. We need culturally safe care, indigenous-led care, indigenous language services, more accountability from medical regulatory bodies and hospitals that enshrine the duty of free, prior and informed consent in their policies.

The Criminal Code cannot deliver these changes. For this reason, Bill S-228 must be the beginning of Canada's reckoning with forced and coerced sterilization and not its end.

Thank you. I look forward to your questions.

[The Chair, Liberal, Terry Sheehan]

Thank you very much.

With that, we will move to questions.

MP Schmale, you have six minutes, please.

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

Thank you very much, witnesses, for being here today and for a very interesting discussion indeed.

Thank you to Ms. Therrien for outlining not only some issues she has but also some potential suggestions. I think the committee will talk about that as well.

I'll start my questions with you, Dr. Brassard, since you're here. Unfortunately, I'll be asking questions in English. I apologize.

Believe it or not, my French is just as bad as my English—

[Voices]

Oh, oh!

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

—so I'll stay with my first language.

When coming up to the position that your organization has taken and the concerns that you've outlined, did this also include those surveyed from areas in which indigenous populations were in the majority, where people were in community dealing with...and talking with people who may or may not have been affected by sterilization without their consent?

[Liliane Brassard]

Actually, it affects absolutely everywhere in Quebec. We have indigenous communities in many places.

I have to tell you that as soon as Bill S‑228 was introduced, many of our members reached out to us to say they were concerned. As we've often pointed out, many women already have trouble accessing an OB/GYN, and access to reproductive health care adds another layer of difficulty. I practise full time as a gynecologist, in Drummondville. Being the vice-president of the AOGQ is not my only job. I work with women full time. As I often say, many of the services we provide in gynecology and obstetrics affect patients' reproductive organs and can lead to sterilization, even if that is not the primary objective. We are, of course, extremely worried that access to this care could decrease.

We've talked about the issue of consent numerous times. What does consent mean? Is it a signature? Is it the file? Is it the patient's understanding? It's extremely complex.

What's more, the face of medicine in the field is changing. When it comes to the new cohorts in Quebec right now, women make up 92% of obstetrics and gynecology admissions. Women are entering the profession in huge numbers.

To answer your question, I would say, yes, it affects all communities. We are worried about all women in Quebec, indigenous women included, having reduced access to this care. Some fully consenting indigenous women may wish to access sterilization treatment of their own volition, as well.

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

Okay.

Obviously, I'm not a lawyer. I look too normal for that.

[Voices]

Oh, oh!

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

I say that in a room full of lawyers and a panel full of lawyers. Of course, the sponsoring senator is also a lawyer.

[Voices]

Oh, oh!

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

Yes. Maybe we should strike that.

Do we have unanimous consent to strike that from the record?

[The Chair, Liberal, Terry Sheehan]

Stop digging a hole.