Evidence of meeting #10 for Justice and Human Rights in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was patient.
A video is available from Parliament.
Chief Executive Officer, Canadian Psychological Association
Health care delivery across the country is not always consistent, so it might be hard to imagine the challenges in having this consistent as well.
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
Quebec is already ahead in terms of having implemented their bill. It's unlikely that they will change things in a major way. They will likely be beating their own drum. We will already have some differences there.
At the same time, I think that the federal government standing up and being counted will have an impact across the country and provide a measure of equity, although there may be differences. We should not minimize the importance of what's before us today in terms of getting us to a level of equity, realizing that there may be provincial differences.
I realize I'm skating like a good politician, but that is nevertheless what I think.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Are there any specific amendments that you would propose to ensure consistency amongst the provinces?
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
I'm not a legal....
Director, Professional Affairs, Canadian Pharmacists Association
I would like to reply to your previous question.
We are a volunteer association of pharmacists. While we do not have any kind of regulatory enforcement over the profession of pharmacy, we feel that there's a role for CPhA to build consensus as to how guidelines are put in place so that there is a certain degree of harmonization among pharmacy practices across the country.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
I hope I have enough time for my last question.
To all the panellists, I'm assuming that you have read the bill and understand how it will be administered. I'm wondering if you've taken a hypothetical patient through both physician-administered and self-administered death, through the whole process that is outlined in the bill, and if you would care to share.
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
I have not done that in a systematic manner for the bill.
In the example that I gave in my presentation, I certainly walked through the elements of the bill. If we went back to 2013 and took into account that situation around euthanasia, I feel that it certainly would have been possible.
I recognize the principle of autonomy around assisted suicide. I am concerned about some of the elements that have been discussed here today in terms of the potential alteration of the caring relationship between the provider and the patient once that prescription is given.
The relationship will be altered. The caring element of it will be altered. Ensuring that the right person fills the prescription and that the patient has the capacity to self-administer is another aspect. All this raises questions in relation to assisted suicide, yet the principle of autonomy, I believe, needs to be respected.
I will say that the level of comfort as a provider in that caring relationship is something that creates a little bit more uncertainty for me, certainly.
Chief Executive Officer, Canadian Psychological Association
We haven't systematically taken a patient through it either.
Our role as psychologists is probably going to be a lot more circumscribed than the role of our colleagues who are physicians and pharmacists. I think our recommendations really embody our concern that considerable time and attention can and should be expended, way before any kind of decision is enacted. Our concern is that the bill as proposed may not sufficiently address that.
Liberal
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
With respect to self-administration, what exactly is a pharmacist giving to the patient? Is it just one pill? Is it an injection? How does it happen?
Director, Professional Affairs, Canadian Pharmacists Association
I can only comment on what was done in the state of Oregon, where they have assisted death. There the patient is given two euthanasia kits in case one of the kits is found to be defective. The kit is an inclusive kit that contains two different medications. One is designed to prevent vomiting, and the second one is the barbiturate, which brings upon death. That's my understanding of what is used there.
Liberal
The Chair Liberal Anthony Housefather
Thank you.
I have one last question that relates to something the Department of Justice challenged me to do. I had raised the issue of “reasonably foreseeable” not being sufficiently clear. I had suggested, hypothetically, that a doctor should establish that it is more probable than not, medically speaking, that death was reasonably foreseeable within a certain time—say, one year. They said that medical associations would generally prefer the flexibility of not having it tied to a time period.
Based on your testimony, Dr. Lemire, do I understand that you would prefer having a time period tied to it?
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
Yes.
Chief Executive Officer, Canadian Psychological Association
I'm not sure. I'm not sure how to advise on that, because we would not be involved in making that determination.
Liberal
The Chair Liberal Anthony Housefather
That's true.
I have one last tie-up question. Would you agree that one of the two professionals associated with this should be the primary care physician, as long as this physician does not have a conscientious objection to medically assisted dying?
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
So the circumstance you've given is that the physician does not—
Liberal
The Chair Liberal Anthony Housefather
The physician is not a conscientious objector. He or she is a person who would dispense this. Should the primary care physician be one of the two?
Executive Director and Chief Executive Officer, College of Family Physicians of Canada
I would suggest that the family physician, who has a longitudinal relationship with the patient under those circumstances, is well placed to be one of the providers involved in that caring relationship with the patient. Yes.
Liberal
The Chair Liberal Anthony Housefather
Thank you for taking my question and the questions of the panel. I know it was much appreciated, as was your testimony. Thank you for coming.
We'll give two minutes to get to the next panel, and I'll ask the people in the next panel to come forward.
Liberal
The Chair Liberal Anthony Housefather
We are going to resume.
I want to welcome our new group of witnesses. We are delighted to welcome the members of the Quebec Bar. We have with us Mr. Giuseppe Battista,
who is the president of the committee on criminal law.
We also have with us Mr. Jean-Pierre Ménard, who is a member of the Working Group on End-of-Life Care, and Mr. Marc Sauvé, Director of Research and Legislation Services.
We also have with us Dr. Will Johnston, who is with the Euthanasia Prevention Coalition of British Columbia. Then we have Ms. Françoise Hébert, who is the chair of End of Life Planning Canada. She is accompanied by Mr. Nino Sekopet, who is the client services manager.
It's a great pleasure to have all of you here with us. We're going to start with your statements.
We will begin with the representatives of the Barreau du Québec.
Mr. Sauvé, you have the floor.
Marc Sauvé Director, Research and Legislation Services, Barreau du Québec
Thank you very much, Mr. Chair.
Ladies and gentlemen members of this august assembly, let me introduce myself: I am Marc Sauvé, Director of Research and Legislation Services for the Barreau du Québec. For this presentation I am accompanied by Mr. Giuseppe Battista, who is the President of our Committee on Criminal Law, and by Mr. Jean-Pierre Ménard, who is a member of the Working Group on End-of-Life Care.
The Barreau du Québec, as you would expect, is a professional association of lawyers whose mission is to protect the public. This is done through monitoring the exercise of the profession, but also, from a societal point of view, by promoting the rule of law.
Without further ado, I am going to yield the floor to Mr. Battista, who will discuss certain aspects of criminal law that are raised in our brief. Afterwards, Mr. Ménard will discuss other aspects, particularly the interrelations with provincial legislation.