Justice Committee on May 10th, 2016

[The Chair, Liberal, Anthony Housefather]

I would ask everyone to please take their seats.

We are ready to begin.

Ladies and gentlemen, I'd like to call this meeting of the Standing Committee on Justice and Human Rights to order as we continue our work in doing our clause-by-clause review of Bill C-14.

We are currently at page 88 in the legislative package that we received, which would be amendment CPC-21.

I would note for everybody's information that NDP-4.1 that we started to deal with this morning will be deferred, as it wasn't in the appropriate section, until we get to Liberal-8. Then NDP-4.1 will be put forward in a different way, before Liberal-8, thanks to the collaborative work of all three parties. Good job, everyone.

We'll move to Mr. Viersen's proposal, CPC-21. I'd ask Mr. Falk if he'd be willing to move it so Mr. Viersen can speak to it, if he's here.

[Ted Falk, Conservative, Provencher, MB]

I so move.

[The Chair, Liberal, Anthony Housefather]

Mr. Viersen, please go ahead.

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

Thank you, Mr. Chair.

I'm sitting with the friendly company over here.

This amendment is to deal with doctors financially benefiting from providing assistance in dying or assisted suicide or euthanasia, however you want to term it.

We really felt that if this service is to be provided it should be provided out of purely altruistic motives. Therefore, we felt that there should be no material benefit for performing this act of killing somebody, seeing as it is such a profound act.

We felt if this act is indeed driven out of altruistic motive there should be only altruistic motive as the motive.

Thank you for the opportunity to speak to it. That's my—

[The Chair, Liberal, Anthony Housefather]

Thank you very much.

Again, Mr. Viersen, I want to just ask the question for receivability. Wouldn't it be up to the provinces to set a fee schedule for any medical act? Does the federal government have the power to tell a province they can't set a fee schedule for anything that is a medical act? Have you thought about that?

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

Yes, for sure. This comes back to my initial amendment that I brought, the very first amendment we addressed, and the fact that I did feel that this shouldn't be health care. This should be outside of the realm of health care. This may be announced too late, perhaps, but I do think we need to ensure the viability of our health care system, that people's trust in our health care system must be maintained.

I do think this would be one of the great ways that we can ensure that people are confident that when they go to the hospital they will be treated with the utmost respect and care.

[The Chair, Liberal, Anthony Housefather]

I understand, and from a substantive public policy ground, I understand.

May I ask the officials from the Department of Health. Does the federal government have any powers to not allow a province or territory to set a fee under medicare or anything else if this is a medical act?

[Sharon Harper, Manager, Continuing Care Unit, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health]

No, we don't.

[The Chair, Liberal, Anthony Housefather]

I'm going to have to rule this out of order, as not receivable, because it's not within the competence I believe of the federal government. I'm sorry, Mr. Viersen.

We'll move to amendment CPC-22, by Mr. Kmiec, but this is identical to CPC-21, and so I would have the same ruling.

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

He did prepare a statement for me to read. I don't know if I can do that or not.

[The Chair, Liberal, Anthony Housefather]

Again, it's out of order. Is it a very long statement?

Can we ask Mr. Kmiec to email this statement to the members of the committee instead of reading it out? Because, again, it's not in order.

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

All right.

[The Chair, Liberal, Anthony Housefather]

I'm sorry.

PV-10, Ms. May.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Most of my amendments with respect to this point have come directly from evidence and witness recommendations that you had before you. This comes from concerns that were raised by witnesses, but no one actually has put forward this exact language.

I thought this up myself. I put it to you that here's the circumstance, and we've heard it discussed even in clause-by-clause. What of people who are in a small and remote community? You have two problems. You have people who may be related to each other as they are in small practices, they know each other, and it may be difficult to find independent health professionals to provide a truly independent written opinion.

Knowing from friends of mine who are medical practitioners in remote communities, they quite often use video consults. I wanted to make this possible under the law.

It may be that this could be taken as implied, and they could use video consults to obtain consent, but I felt it was worth inserting proposed subsection 241.2(6.1) to say that: “In communities where it is not possible to find another independent medical practitioner or nurse practitioner to provide the written opinion referred to in paragraph (3)(e), the opinion may be provided by recorded video conference by another independent practitioner or nurse practitioner from elsewhere in Canada”.

I hope this addresses the problem that was raised by quite a few witnesses.

[The Chair, Liberal, Anthony Housefather]

I'm going to read in that you meant to say “independent medical practitioner” in the second to last line, because otherwise it wouldn't be consistent. If we can, we'll deem that word was there.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Yes, thank you very much. It was a drafting typo.

[The Chair, Liberal, Anthony Housefather]

Any debate?

Mr. Fraser.

[Colin Fraser, Liberal, West Nova, NS]

I understand the intention of it and respect the intention of it. I do have a concern that it would be infringing on provincial and territorial competency in order to deal with the issue. I know our government has stated they are certainly interested in working collaboratively with the provinces and territories in having a pan-Canadian approach, but there may be some issues with regard to one province, under different jurisdiction, so I'd worry about that.

I also note, and Ms. May alluded to, the fact there's nothing in the act preventing this now, that would make this impossible. For those reasons, I don't support the amendment, even though I do respect the intentions.

[The Chair, Liberal, Anthony Housefather]

Further debate or discussion?

If not, can I just ask the officials, can you clarify there's nothing in the act that restricts it from being done by video conference?

[Joanne Klineberg, Senior Counsel, Criminal Law Policy Section, Department of Justice]

There's absolutely nothing in the legislation that requires a physical examination of the patient by the doctors. There is a requirement for a written second opinion, but nothing requires the physical presence of the practitioner with the patient, or the two practitioners to be together.

[The Chair, Liberal, Anthony Housefather]

Thank you.

Ms. May, I'm going to go back to you for closing.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

I know I can't move amendments to my own motions at this point because they had to be in 48 hours ago. I'm wondering if Mr. Fraser might consider changing “from elsewhere in Canada” to “from elsewhere within the same jurisdiction”. That would avoid any issues vis-à-vis the provinces or territories in which a medical practitioner or a nurse practitioner was licensed.

I ask the question. Otherwise, I suggest this would allay a lot of concerns for people living in remote areas where it is hard to access, independent of each other, more than one medical practitioner and more than one nurse practitioner.

[Colin Fraser, Liberal, West Nova, NS]

I agree that would be more satisfactory, but I don't think it would be satisfactory enough for me to support the amendment. I do believe it would still be up to the ministers of health across the country; federal, provincial, and territorial working together. I note as well, based on the information from the department, that nothing would not allow this now. I think it would be better not to play around with that wording.

[The Chair, Liberal, Anthony Housefather]

As chair, I have the discretion to let you move the amendment however you say you want to move the amendment. I'm okay with your moving the amendment and using the words “nurse practitioner within the same province or territory”, or “within the same jurisdiction” if you want to.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Chair, that would cause us to have us to vote on the subamendment and then vote on the main amendment, and I don't think it would make any difference in the end. In the interest of the committee's time, I'll accept that we put it to a vote as was written.