Evidence of meeting #13 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 medical.
A video is available from Parliament.
9:30 p.m.
Liberal
The Chair Liberal Anthony Housefather
Thank you very much for those probing questions, Mr. Rankin.
Ms. Khalid.
9:30 p.m.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Obviously we want to have a balanced and a fair approach to such a sensitive issue, making sure that we protect the rights of vulnerable people and also providing the right to end suffering should somebody choose to.
Mr. Hashmi, I will address my question to you initially. You outlined three recommendations with respect to the bill. You asked for more safeguards, specifically with respect to having a mandatory psychiatric evaluation forming part of the consent. Secondly, you looked at errors and asked that the substance to be administered be provided to only those who are authorized by the Minister of Health and the Minister of Justice. You also talked about conscience rights for the physicians or medical practitioners who are administering.
To begin with, I want to talk specifically with respect to conscience rights. Now, we have heard testimony from other witnesses who have indicated that there is a coroner's report. They've asked that the coroner's report become mandatory. The cause of death outlined in the coroner's report right now is not mandated to be listed as medical assistance in dying. I want the religious perspective on it. Do you think the cause of death being listed as suicide, in essence, is something that faith-based families would be comfortable with?
9:30 p.m.
Spokesperson, Canadian Council of Imams
It could certainly be something that perhaps could be troubling for some. Of course, there are different views and different levels of comfort that people of different faiths have with regard to suicide. If a family finds out that the coroner's report shows that the death was by suicide, it could certainly put them in a situation that they may find uncomfortable.
9:30 p.m.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Would it be hurtful to families, then, who are dealing not only with the loss of a loved one but also with the negative connotations in society as a whole?
9:30 p.m.
Spokesperson, Canadian Council of Imams
I believe so, but different communities and different groups see suicide in different ways. If it becomes something that is known and public and the family find out, or friends, or relatives, or other members of the community find out, then it could be hurtful to the family.
9:35 p.m.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Ms. Downie, in your brief, you had mentioned that the term “reasonably foreseeable” is impermissibly vague. We've heard testimony over the past week that the term is more of a medical determination on a case-by-case basis by physicians, or medical practitioners, as the case may be. Do you agree with that? Do you think a medical determination would keep it open and more inclusive to those who are seeking it?
9:35 p.m.
Professor, Faculties of Law and Medicine, Dalhousie University, As an Individual
I think it doesn't serve the purposes of what Carter was attempting to do, which was to provide access for a certain group of people, because people are disagreeing all over the place. Physicians are disagreeing about what it means. What that tells you is that you are going to go to some physicians who will say, “Yes, you're two years away, and I'm going to read it expansively”, and somebody else is going to be fearful of being charged and read it narrowly, or they're going to be opposed to assisted death and so they will choose to read it very, very narrowly, and say, “maybe a week from death”.
The variability we've seen in the interpretations of the expression among the medical community is absolutely persuasive evidence that this is too vague. It isn't a matter of leaving it to medical determination. It will cease to be vague, and they will figure it out. They will splinter on it.
9:35 p.m.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Right.
We understand at the federal level, and specifically for Bill C-14, that it is an amendment to the Criminal Code, which is what we have jurisdiction over. The administration of MAID would be something that would be implemented by the provinces.
All three witnesses can comment on the following. Do you think the provinces would be able to come up with a consistent approach, specifically the self-regulation of doctors? For those physicians or medical practitioners who do not want to partake in the administration of death, would the self-regulated bodies be able to take ownership of that piece and ensure that everybody's conscience rights are protected?
9:35 p.m.
Professor, Faculties of Law and Medicine, Dalhousie University, As an Individual
I think this is one of the spots where the federal government deserves a lot of credit, because they recognize that this is one of those issues that is absolutely federal and provincial. How do we do this? They have taken it as an opportunity to exercise co-operative federalism. It's a muscle we haven't been exercising a lot recently, but this is one of those moments, and they've taken it. They've said, “We're going to facilitate the development of this together with the provinces and territories”. They're putting their money where their mouth is on the facilitation of development with the provinces and territories. It's a pan-Canadian care pathway.
What that is about is protecting the conscience of providers, ensuring access for patients, and protecting the privacy of willing providers. They've recognized the need for conscience protection, but it's dealing with it in the way that makes a lot of sense in terms of our division of powers, in terms of our history with respect to where conscience is regulated, and with respect to this sense of co-operative federalism. Where we have shared jurisdiction, let's talk, let's do it together, and let's figure it out and not torture something into a federal act. That isn't the way to do it.
I think that's promising for having some harmonization. I hope that group would bring the federation of colleges and physicians, and the surgeons, and the nurses to the table and say, “We're all sitting down here, and we're not leaving until we figure this out together”, because the colleges of physicians splintered within a week of getting together on this, and that's problematic. The nurses, not so much, and that's fascinating.
Let's say that this is the kind of thing that we solve together, and bring those different levels of regulation together to solve it, because everybody shares the same goals. I want to protect conscience, you want to protect patient access as well, and we all want to protect privacy. I think that's how we have to do it.
9:35 p.m.
Liberal
9:35 p.m.
Spokesperson, Canadian Council of Imams
Sure. What's making health practitioners and medical professionals of faith quite nervous is this uncertainty of not knowing how it's actually going to play out. As far as the patient's rights are concerned with regard to assisted dying, yes, the bill is there and everything seems to be quite clear, but when it comes to the rights of conscience, it's not very clear.
We're already hearing complaints from doctors in Quebec, talking about how they're feeling pressured. We heard of one case where there was talk of sanctions against a doctor who was not willing to give an effective referral. It's really troubling to reach where there are actually doctors considering leaving the profession, or that they might have to leave if it doesn't play out to their satisfaction.
I appreciate the efforts that the government may be planning to make, but there should be a lot more clarity at this point with regard to this matter.
9:40 p.m.
Barrister and Solicitor, Justice Centre for Constitutional Freedoms
Not to be trite, but to be respectful, I would like to think that the current legislation would have helped Sue Rodriguez. The supposition, the speculation, that it wouldn't have helped is misplaced. We never know what would have happened. Watching the attorney general's presentation about the meaning of the term “reasonably foreseeable”, and how that means being on a trajectory, that would have put Ms. Rodriguez—who had been told she had 2 to 14 months to live—within the parameters of this bill, in my view.
9:40 p.m.
Liberal
The Chair Liberal Anthony Housefather
Let me thank the members of our esteemed panel. It was very helpful to hear your testimony tonight. I really thank you both for your briefs and presentations, and on behalf of all the members of the committee, thank you again for your incredible patience.
I want to thank the members of the committee and everyone here, especially all the staff, who did an incredible job tonight despite some obstacles.
We will reconvene tomorrow morning at 8:45.
The meeting is adjourned.