Evidence of meeting #17 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.

On the agenda

MPs speaking

Also speaking

Sharon Harper  Manager, Continuing Care Unit, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
Joanne Klineberg  Senior Counsel, Criminal Law Policy Section, Department of Justice
Carole Morency  Director General and Senior General Counsel, Criminal Law Policy Section, Department of Justice

7:20 p.m.

Liberal

The Chair Liberal Anthony Housefather

Is there any further debate on the subamendment?

Mr. Warawa, you moved, do you want to close on anything?

7:20 p.m.

Conservative

Mark Warawa Conservative Langley—Aldergrove, BC

It's clear.

7:20 p.m.

Liberal

The Chair Liberal Anthony Housefather

We're voting only on the subamendment, which is the motion to change in the subamendment “must” to “may”.

(Subamendment negatived [See Minutes of Proceedings])

We' re now back to the main amendment.

Ms. Khalid, do you want us to close on that one?

7:20 p.m.

Liberal

Iqra Khalid Liberal Mississauga—Erin Mills, ON

I'll reiterate that we do need sound data to make good choices about issues that have been brought up by the special committee, as well as the witnesses that we've heard over the past few weeks.

I'm looking forward to this being carried.

7:20 p.m.

Liberal

The Chair Liberal Anthony Housefather

We're going to move to the vote on the main motion.

(Amendment agreed to [See Minutes of Proceedings])

Do we now vote again because there's a new clause 9.1 being created, or is that just deemed because the motion was the one that created it, and we don't have to vote?

We do not need to vote again.

We will move now to the review of clause number 10.

(On clause 10)

The first one is CPC-32, which is Mr. Viersen.

Mr. Falk, do you want to put it forward? No, okay.

Is there any member of the Conservatives who will put it forward? I'm not hearing any.

Sorry, Mr. Viersen, your motion is not being moved.

We will move to CPC-32.1, or is that the same? It's the same. CPC-32.1 will not be submitted.

We will move to CPC-32.2, Mr. Falk.

7:25 p.m.

Conservative

Ted Falk Conservative Provencher, MB

Just to read it quickly: “referred is to review them and the state of the palliative care in Canada submit a report to”

That's in addition to the report that is going to be provided by this committee.

It is also to provide a report on the palliative care in Canada at that time.

7:25 p.m.

Liberal

The Chair Liberal Anthony Housefather

Okay, that's receivable.

Mr. Falk, did you want to speak at all to your motion?

7:25 p.m.

Conservative

Ted Falk Conservative Provencher, MB

We have heard, throughout the witness testimony at the committee last week, about the need for a proper palliative care system here in Canada. We have heard that most Canadians don't have access to the standard of palliative care that one would expect they should and are entitled to have.

This government is committed to improving our palliative care system and has committed $3 billion to that end. We would like to make sure that money is employed properly. What better way is there to do that than to say we are going to have a review at the same time as a report is established here? It is going to be like a report card to see if the Liberal government has done a good job in doing what they have said they are going to do.

As we have heard from witness testimony here last week, when there are good palliative care options, the request and the need for physician-assisted suicide are greatly diminished. I think that should be the objective of all of us around this table—not to see if we can expand this particular exemption, but to see if we can actually minimize it.

We should get back to the point where Parliament respects the sanctity of life, which is what the Supreme Court said we should do. So far, we have not shown a whole lot of respect for life around this table, and certainly not the sanctity of it. I think a review of our palliative care system at that time would move towards that.

7:25 p.m.

Liberal

The Chair Liberal Anthony Housefather

Mr. Rankin.

7:25 p.m.

NDP

Murray Rankin NDP Victoria, BC

I want to speak forcefully in favour of the amendment. I think it is a very good one. Anyone who has attended any of the hearings at the Senate-House committee or at our justice committee would know how essential palliative care is. We have heard the minister say that she hears that more than anything else. I am entirely in favour of this.

7:25 p.m.

Liberal

The Chair Liberal Anthony Housefather

Thank you very much.

Mr. Bittle.

7:25 p.m.

Liberal

Chris Bittle Liberal St. Catharines, ON

I think all parties are in agreement that we should have good palliative care, and the minister has been vocal about her concern that Canadians don't have access to palliative care.

I think the purpose of this review is to focus on one particular issue, which is medical assistance in dying, and I would be concerned that we would water that down. The minister has committed to this. The government has acted, in terms of $3 billion of new money in the budget. I don't see this as necessary. I see it as watering down the purpose of the provision to deal with and focus on medical assistance in dying.

7:25 p.m.

Liberal

The Chair Liberal Anthony Housefather

Mr. Cooper.

7:25 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

With respect to Mr. Bittle's comments, I don't believe the issues are separate. Palliative care is an essential component of end-of-life decision-making. Indeed, many have said—and I believe the president of the CMA herself has said—that one cannot truly consent to medical assistance in dying unless they have all options made available to them, including palliative care.

We know that in Canada today, somewhere in the neighbourhood of only 15% to 30% of Canadians have access to palliative care. It is absolutely essential that we have a pan-Canadian national strategy with dedicated funding to ensure not only that Canadians have the option of palliative care, but that they have access to palliative care. I think it would be appropriate to include a review with respect to palliative care.

7:30 p.m.

Liberal

Ahmed Hussen Liberal York South—Weston, ON

Just in response to that, I am of the view that palliative care is important to this discussion. However, as my colleague has stated, the government has put money on the table with respect to palliative care and other health care-related objectives.

In addition to that, the government has made it clear that they intend to sit down with provinces and territories to reach a health accord, which includes palliative care as a big portion of what they are looking at. I think that is where this needs to be dealt with, not as an added item with respect to the review of medical assistance in dying.

7:30 p.m.

Liberal

The Chair Liberal Anthony Housefather

Mr. Fraser.

7:30 p.m.

Liberal

Colin Fraser Liberal West Nova, NS

I'll pass. I agree with Mr. Hussen.

7:30 p.m.

Liberal

The Chair Liberal Anthony Housefather

Mr. Warawa.

May 10th, 2016 / 7:30 p.m.

Conservative

Mark Warawa Conservative Langley—Aldergrove, BC

I agree with the comments made by my colleagues on both sides of me.

Looking back to previous comments, we just dealt with the advance directives regarding mental illness and mature minors, and we have dealt with conscience protection. The only issue that we are not dealing with in Bill C-14 is palliative care.

We have heard, as has been shared time and time again, that an adult who is in a state of suffering cannot provide consent if they do not have their suffering dealt with. Palliative care could be physical, emotional, or depression related. If you do not give someone palliative care, or at least offer it to them, then that issue is not being dealt with properly. You cannot properly administer medical aid in dying if palliative care is not part of it.

We've dealt with mature minors. We've dealt with advance directives and the mental health issue. This is the time when the government has an opportunity to deal with palliative care. If the government does not support it, then they leave that issue off the table. Other than aspirational commitments, this is an opportunity to make a specific commitment, as they have done with the other issues.

I encourage the government to reconsider and support this.

7:30 p.m.

Liberal

The Chair Liberal Anthony Housefather

Just remember that members of the committee aren't the government.

Mr. Rankin.

7:30 p.m.

NDP

Murray Rankin NDP Victoria, BC

I appreciate what Mr. Hussen said about the health accords, and the fact that we're going to be dealing with that later. I think that's a good point, but to study medical assistance in dying without studying palliative care seems to me to be something that would be very hard to do. They are interconnected, which is the evidence we've heard time and again, and I think they do go together very well.

This is an argument which I appreciate isn't in order, but I'll just put it out there. As you know, on page 134, I have some very specific proposals on palliative care that come out of the committee below. If we could ground at least one reference in the bill to palliative care, I'm told that procedurally it would be easier for those to be considered, so I have an additional reason for wanting this reference.

I don't think it takes anything away. I think it only adds something that many Canadians would be pleased to see in the work that this committee would be doing in the future. I think it adds a lot and takes away nothing.

7:30 p.m.

Liberal

The Chair Liberal Anthony Housefather

Mr. Fraser.

7:30 p.m.

Liberal

Colin Fraser Liberal West Nova, NS

I'll be brief.

We talk about the study that's supposed to commence within 180 days, dealing with advance directives and the other two elements that we've heard about from witnesses. Going forward, it will be essential in determining how we're going to deal with those things, specifically linked to changes in the bill. It is not the same as a study of palliative care. A commitment has been made by the government that there is going to be funding for that, that it is going to be addressed, and that work is going to be done with the provinces. Making it something that would be necessary as far as the study of medical assistance in dying wouldn't be appropriate in my view.

It doesn't mean that it's not going to be part of it. In fact, I agree with the point that palliative care is an important part of the consultation process at the end of life. It's just about whether it would be appropriate to put it in this context, and I don't believe it would be.

With regard to Mr. Rankin's comment, I agree that we are looking at getting some wording in the preamble. If there's a way we can get it in the bill and bring it forward I'd be happy to do that, but I wouldn't agree that it would be appropriate to put it in this part and make it a necessary part of the medical assistance in dying review, which may or may not include that. Hopefully, we'll be able to get it in the preamble in a fashion that everybody can agree on.

7:35 p.m.

Liberal

The Chair Liberal Anthony Housefather

I'd like to ask one of our clerks a procedural question, because perhaps we're all trying to fit a square peg into a circle.

My understanding was that, if there's something we feel strongly about that doesn't go in the bill, there's a way for the committee to do a report or some recommendation back to the House outside of the bill saying that we're interested in this subject. It doesn't fit in the bill, but we think it should be studied.

What is the right way to do that, if we were to decide that palliative care would be that way?

I just want the members of the committee to consider that because we started a review of the bill early, we started a subject matter study of the bill before we actually moved to study the bill itself. We could report the bill back, and then separately, if there's an issue we think should be studied as part of a subject matter study, we could report back on an issue like palliative care, for example. We could say that it's outside of the bill itself, but that the committee deems it important that the minister consider that palliative care is an important alternative, and should work with the provinces. We could do something like that. I just want to let people know that it's something to consider as we go along. This is an amendment that relates to an issue, and we'll vote on it, but that is an option for the committee to consider.

I just wanted everybody to understand that. Let's get back to the amendment itself.

Mr. McKinnon.

7:35 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

I'm inclined to support this amendment. I think there's a lot of merit in the arguments on all sides. It's true we are committing money. We have made a commitment, and both of our ministers have made a commitment. But I don't think there's any problem with reporting at some point down the line on the state of palliative care. I don't think it will water down anything, so I will support this amendment.