Justice Committee on May 9th, 2016

[The Chair, Liberal, Anthony Housefather]

Mr. Warawa.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Chair, I would agree with Mr. Fraser. I think he's captured it quite well. This is Carter-compliant and I think Bill C-14 as written is superior to what is being proposed in the amendment, so we will be voting against the amendment and supporting the language of Bill C-14.

[The Chair, Liberal, Anthony Housefather]

Thank you very much.

Members, is there any further comment? If not, I'm going back to Mr. Rankin to close.

[Murray Rankin, NDP, Victoria, BC]

Thank you, Chair.

To the point that somehow Carter was limited to the particular facts of Carter is to ignore, as Joe Arvay told us so clearly, that the B.C. Civil Liberties Association intervened specifically to take it beyond the specific fact situation of the two litigants primarily involved in that case. He also said it goes against the essential elements of Carter. He claims that it was unquestionably unconstitutional and, if left unchallenged, bound to be repudiated by the Supreme Court of Canada. For that reason I fail to understand why it would not be acceptable by this committee.

[The Chair, Liberal, Anthony Housefather]

Thank you very much, Mr. Rankin.

Now, for clarity, we're going to be voting on NDP-2.

(Amendment negatived [See Minutes of Proceedings])

Now we move to NDP-3.

Mr. Rankin.

[Murray Rankin, NDP, Victoria, BC]

I think it has to be withdrawn as a consequence.

I'm not moving it.

[The Chair, Liberal, Anthony Housefather]

Next we get to CPC-9, which is Mr. Viersen, moved by Mr. Falk.

Mr. Viersen.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Thank you, Mr. Chairman.

This amendment is to deal with people who are suffering from mental illness, depression, or the sort, to ensure that they're not suicidal essentially.

In the past when somebody stepped up on the railing of a bridge, we consoled them and we told them to come down because their life had value; it's not worth it. With this bill, I do think that we are to some degree letting them stand there. I'd like to ensure that we talk people back off the edge of the bridge, tell them their lives have value, and ensure that they have the psychological counselling they need, so this is my amendment.

[The Chair, Liberal, Anthony Housefather]

Thank you very much.

Mr. McKinnon.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

I'd like to comment on the use of the word “counselling”. We recognize it as a problem elsewhere. We might want to address that wording. It's confusing. There is counselling in a therapeutic sense versus the counselling referred to in the Criminal Code.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

In this case, that is typically what the word means. I understand there might be some confusion when we use the same word with two slightly different meanings. Counselling services generally are what it refers to.

[The Chair, Liberal, Anthony Housefather]

Mr. Falk.

[Ted Falk, Conservative, Provencher, MB]

I think this is a good amendment. I think it's incumbent on legislation and this committee to recognize that there are instances where people have momentary lapses in judgment. Sometimes those lapses last months, sometimes years. They may think that dying is their only way out, their only solution. That simply is not the case in many situations. I would support this amendment. I think it's a great amendment. People should at least go through the process of determining if there's a psychological issue that needs to be addressed.

[The Chair, Liberal, Anthony Housefather]

Are there any further comments from any members of the committee?

Ms. Khalid.

[Iqra Khalid, Liberal, Mississauga—Erin Mills, ON]

I think that this is more a matter of provincial jurisdiction. The relationship between a medical doctor or nurse practitioner and their patient is not a one-off. It is an ongoing relationship that doctors and patients have. I think it's up to the province to make sure that this relationship is regulated.

I do not support this amendment.

[The Chair, Liberal, Anthony Housefather]

Are there any further comments?

Then I'm going to turn it back to Mr. Viersen to close.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

My argument is the same as before. I feel that in the valleys of life we will make decisions and not see the hope. I think those who don't see the hope should be given the opportunity to hope again.

Thank you.

[The Chair, Liberal, Anthony Housefather]

Now I'm going to move to a vote.

(Amendment negatived [See Minutes of Proceedings])

Next we move to CPC-9.1.

[Ted Falk, Conservative, Provencher, MB]

This recommendation comes out of testimony that we received at committee. At the end of paragraph (d), where it reads “and”, I would like to add “a result of external pressure or lack of access to services required to address the underlying cause of the request, such as palliative care, chronic pain care, and geriatric care; and”.

I think this is a very important amendment because it looks deeper into the situation, rather than just looking at the request. It asks whether, for example, there's an absence of proper palliative care. It asks about the reason for the decision.

I had the good fortune, on Friday night, of attending an event in my riding, where there were three other doctors sitting at the table. One of them and his wife were palliative care experts. We talked a bit about this bill. They said that people in end-of-life situations, even in acute situations of suffering and pain, have two concerns. Their number one concern is their pain. They're scared of the pain in the process of dying, and they want help with it. The other one is that they want help with fear and anxiety in that end-of-life stage. People are quite fearful because they get that drowning sensation towards the end.

They were quick to assure me that both of those issues could be dealt with effectively through physician assistance. They told me they could mitigate the pain and discomfort. They said they could also deal with the fear and anxiety.

I think this amendment is important because it addresses the palliative care aspect. It ensures that people have the opportunity to explore whether there are options for making a different decision, and it asks how their situation relates to palliative care. That's what this is doing. It asks whether it's an absence of palliative care that's causing someone to make this decision.

[The Chair, Liberal, Anthony Housefather]

Is there any debate?

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

With regard to this amendment, while I respect the points made by Mr. Falk, I'm not supportive of this amendment. The word “voluntary” precedes this in the section, and the voluntary request for medical assistance in dying is key.

My belief is it should be left to the health practitioners, the medical practitioner and the nurse practitioner, to assist in making a fully informed consent and making sure that person is giving informed consent, having regard to things such as palliative care, consultation, chronic pain care, and all those types of things.

I don't believe it's appropriate to put it in the bill. I think it's better left to the health care practitioners to have that conversation and satisfy themselves they're receiving informed consent.

[The Chair, Liberal, Anthony Housefather]

Mr. Warawa.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

I appreciate the attempt to deal with the issue of suffering and the need for appropriate palliative care to be offered. I'm just having difficulty dealing with the language and how it connects. We're talking under line 17, page 5, so it would read: “that they have a voluntary request”, this is eligibility for medical assistance in dying under (d), “that in particular was not made as a result of external pressure or lack of access to services required to address the underlying cause of the request such as palliative care, chronic pain”.

It's saying you do not have access to this, and I think the language is confusing. The special committee and committee members have heard numerous times of the importance of palliative care. We heard from CMA that 70% of people who need palliative care don't have it. We've heard from the government there's a plan to deal with the provinces, and short of an amendment to the Canada Health Act requiring palliative care

I appreciate the attempt, but I don't know if this is going to change what is hoped for, and maybe another part of the bill would be a better part to deal with this. The language is confusing, and I don't think it will get the hoped for results. I'll abstain on this one.

[The Chair, Liberal, Anthony Housefather]

Is there any further debate? May I turn back to Mr. Falk to close?

[Ted Falk, Conservative, Provencher, MB]

This is an amendment that addresses the whole issue of palliative care and whether that was an underlying cause. It's like another box in the checklist. You tick off the box, yes, I've asked that question. I've investigated that particular aspect of the situation and a lack of palliative care is not the situation, so then a person would continue to qualify.

That's all it is, and I respect my colleague's comments here. I'm less than thrilled with the wording as well.