Evidence of meeting #16 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 amendment.
A video is available from Parliament.
9:05 a.m.
Liberal
The Chair Liberal Anthony Housefather
Is there any further discussion or debate?
If not, I'm going to go back to Mr. Falk to close.
9:05 a.m.
Conservative
Ted Falk Conservative Provencher, MB
I find it interesting that my colleagues opposite think they're going to trust and hope that this happens, but they're not going to make a stipulation in the bill that it has to happen.
It doesn't put an undue restriction or barrier on anything. It's a consultation to make sure that the person is aware of the available options in palliative care. There are two primary concerns: addressing pain, and dealing with fear and anxiety. Both of these can be dealt with effectively through proper palliative care.
I think it is only proper to allow a person to make that decision with the full understanding of all options. I don't think we should leave it to chance.
9:05 a.m.
Liberal
The Chair Liberal Anthony Housefather
Now we'll move to a vote on CPC-17.3.
(Amendment negatived [See Minutes of Proceedings])
We'll move to the next one, CPC-17.4. I believe this one relates to the nurse practitioner, Mr. Falk. Correct?
9:05 a.m.
Conservative
Ted Falk Conservative Provencher, MB
It does apply to a nurse practitioner, so I will be withdrawing it. One of the reasons given yesterday for leaving nurse practioners in the list of individuals who have the ability to make these life-ending decisions for people, and to help them in that process.... It calls for life-ending decisions to be delegated to a nurse practitioner, yet we don't even allow nurse practitioners to ask for an X-ray or to issue a narcotic drug, but we're willing to give them the ability to assign death.
There's something intrinsically wrong with that. I don't want to minimize the value of nurse practitioners or the work they do, but if they can't even call for an X-ray, maybe calling for death is a little bit out of their scope.
9:05 a.m.
Liberal
The Chair Liberal Anthony Housefather
Thank you very much. I appreciate that comment.
We'll now move to PV-6, Ms. May.
9:05 a.m.
Green
Elizabeth May Green Saanich—Gulf Islands, BC
What we're proposing to do in PV-6 is make changes after line 23 on page 6, inserting essentially a new section altogether. If people are looking for where it inserts, it's a standalone after paragraph (e). It is, as you can see, set out to ensure that:
If the person meets all of the criteria as set out in subsection 2 also suffers from a cognitive impairment or psychological condition, the person's capacity to provide informed consent has been assessed by a regulated health care professional whose scope of practice includes the assessment of such impairment or condition.
As members of the committee may recall, this is based on a recommendation from the Canadian Psychological Association. The concern was that if someone has both a cognitive psychological and physical condition, that makes it difficult to assess their capacity to give consent. They shouldn't be excluded from this framework, but should have the specific mental health professional who has competence in that field.
Just to underscore part of their evidence, while I have time:
The assessment of a person's capacity to give informed consent particularly when that person has a concomitant psychological or cognitive disorder must be left to those regulated health professionals with the training and expertise to undertake these kinds of complex assessments.
My amendment seeks to address that concern of those health care professionals.
9:05 a.m.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
This is similar to an amendment we turned down yesterday, and I think for the same reason. I will vote against it today because I think that medical practitioners, or nurse practitioners, who can identify a person as having a cognitive impairment such that this new provision would be activated, would also be competent to know whether they were capable of judging that impairment and whether or not to bring in a consult. I think it's well within the current framework to expect a nurse practitioner or a physician to bring in the necessary consultants anyway. I will vote against it.
9:10 a.m.
Green
Elizabeth May Green Saanich—Gulf Islands, BC
If one regards that as an implied obligation of a health care professional, and I think there's some question as to that, there certainly is no harm in making what you see as implicit and acceptable, explicit and required. There is no harm done by ensuring that such a potential gap in the framework is addressed at this stage. I would hope that members would consider accepting this amendment.
9:10 a.m.
Liberal
The Chair Liberal Anthony Housefather
Any further comments?
(Amendment negatived)
We will move to, I believe, CP-17.5.
9:10 a.m.
Liberal
9:10 a.m.
Conservative
9:10 a.m.
Liberal
The Chair Liberal Anthony Housefather
Yes, I do.
We're going to move past 17.5 and we move to Liberal-4.
Mr. Bittle.
9:10 a.m.
Liberal
Chris Bittle Liberal St. Catharines, ON
I'd like to amend it to include the language in G-1, which is found at page 71 of our package. It would say:
Ensure that there are at least seven clear days between the day on which the request was signed by or on behalf of the person.
9:10 a.m.
Liberal
The Chair Liberal Anthony Housefather
Would you be able to, as part of the procedure, give us something, or write it down and hand it to the clerk?
9:10 a.m.
Liberal
The Chair Liberal Anthony Housefather
Can you just read it one more time, Mr. Bittle to make sure we're correct.
9:10 a.m.
Liberal
Chris Bittle Liberal St. Catharines, ON
It reads:
Ensure that there at least seven clear days between the day on which the request was signed on or behalf of the person.
It is LIB-4 and G-1.
9:10 a.m.
An hon member
Mr. Chair—
9:10 a.m.
Liberal
The Chair Liberal Anthony Housefather
We normally let him introduce his motion, and then we would move to you.
Mr. Bittle.
9:10 a.m.
Liberal
Chris Bittle Liberal St. Catharines, ON
We've passed a robust definition of “grievous and irremediable”. There are significant steps that an individual must prove before they're able to access medical assistance in dying. We've heard from witnesses that this isn't a decision that people come to lightly, that it's something they've agonized over, potentially for months, whether it's something they wish to take advantage of. If they have an incurable illness, if they are in an advanced state of irreversible decline and is enduring suffering and their death is reasonably foreseeable, why are we requiring them to wait over two weeks to access this treatment? In my mind that's cruel. I believe there are valid public policy reasons to have a waiting period, but the longer the waiting period, the less likely we are to treat people like adults. I believe seven days is a more reasonable number to allow people to change their mind and in an extreme situation allow an application to be delivered to a court, while still providing all the safeguards while reducing the period of suffering an individual must endure.
9:10 a.m.
Liberal
Colin Fraser Liberal West Nova, NS
Mr. Chair, I'm just wondering about the procedure here, because I know that Mr. Bittle proposed an amendment. I would like to propose a subamendment for debate purposes. Whether that is in order or not, I don't know.