Evidence of meeting #38 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 recording is available from Parliament.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
What I'm trying to understand is that you're differentiating between predictive versus treatment.
Conservative
Ted Falk Conservative Provencher, MB
No, there's no differentiation there. If it's required for an individual's specific health care condition, whether it's predictive or prescriptive, the physician would be covered.
December 1st, 2016 / 11:15 a.m.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Sorry, that's not how I read the text that you provided, so please help me in understanding this.
Conservative
Ted Falk Conservative Provencher, MB
If a physician would say, “I need to complete a DNA test on you because I might be suggesting a particular medical treatment or the withholding of medical treatment, but I'd like to really take a look at your DNA to see perhaps how this might negatively or positively affect your health condition by authorizing or withholding a treatment,” that of course would be predictive. Under that circumstance, he's still treating a health care condition of an individual and he would be protected in doing that.
Conservative
Ted Falk Conservative Provencher, MB
It gives broad coverage to all these health care professionals in the course of their duties in treating any health care condition of an individual. It accomplishes what clause 6 was intending to do, but clause 6 gave these individuals much broader protection than what the bill intended. I still believe they should be afforded protection, and that's what my amendment does, but it doesn't give them the ability to....
The whole act is intended to protect individuals who are going to discriminate unjustly against people.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
I will say, and I've said this before, this legislation or any legislation that we look at is not in a vacuum. We must look at the totality. If there are other regulations or other laws in place that already provide those protections to, in this case, patients, I don't think we need to be redundant in providing excessive support for them.
Liberal
The Chair Liberal Anthony Housefather
I'm going to be flexible because we have so few amendments. Continue, Mr. Falk.
Conservative
Ted Falk Conservative Provencher, MB
This amendment would apply very nicely in a situation where an individual goes to see a doctor and there's no reason that would warrant a DNA test, but a doctor says, “I want a DNA test from you.” The individual says, “You know, really, I don't want to have a DNA test on record, because there's a chance it may get abused at some other point in my life or may cause one of my relatives to be negatively impacted by my DNA test. I just have a sore throat. I want you to look at my sore throat.” The doctor might say, “No, I'm sorry, if you don't have a DNA test done, I'm just not going to facilitate looking after you.” This would say that a health care practitioner can't do that, but if they do DNA testing, they are protected.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
By the same token, then, first, that health care professional is under a Hippocratic oath to provide the medical assistance that is required, and second, the rest of this legislation provides safeguards for patients to not be discriminated against if they indeed go ahead and take that genetic test. That's the point.
Conservative
Ted Falk Conservative Provencher, MB
Not to minimize what you're saying, there are lots of professions that take different oaths and commitments to codes of ethics and standards by which they will conduct their business. We don't make laws for the people who adhere to those; we make laws for people who contravene.
Liberal
The Chair Liberal Anthony Housefather
Mr. MacGregor has had his hand up for a while, and again, we'll be very flexible in this debate.
Mr. MacGregor.
NDP
Alistair MacGregor NDP Cowichan—Malahat—Langford, BC
I just want to offer my opinion on the back and forth.
My father is a physician, so I have a bit of insight. I would say that when it comes to a doctor providing care to a patient, they are bound by the Hippocratic oath and they must do that. Patients have rights. If they are not being cared for by their physician, they can certainly take it up with the licensing bodies in each province. However, if physicians feel that providing a good level of care would require a test, they can withhold that care because they would be swimming in uncharted waters, so to speak. The level of care could be completely dependent on that genetic test, so a doctor could rightly refuse and say, “We can go no further until I get that genetic test, because I'm swimming blind here.”
I believe that's just a bit of clarification to illustrate a point.
Liberal
The Chair Liberal Anthony Housefather
I'm going to go to Mr. Bittle next, because he hasn't spoken for a bit.
Mr. Bittle.
Liberal
Chris Bittle Liberal St. Catharines, ON
That's seldom said.
Just to make an analogy to the legal profession, of which many of us around the table are members, and to build on Mr. MacGregor's point, in the solicitor-client relationship, it is a position of trust. If a lawyer recommends x and the client says, “No, I want to do y,” the lawyer is within his or her grounds to fire the client, so to speak.
It is something similar. If a doctor makes a recommendation on the basis of the person's health and the best outcome for his or her health, it is highly regulated by the colleges of physicians and surgeons across the country and we should leave it to them. I think Mr. MacGregor makes a good point.
Liberal
Iqra Khalid Liberal Mississauga—Erin Mills, ON
Could we then refer to our expert witnesses on seeing the effects of the doctor-patient relationship as a whole?
Liberal
The Chair Liberal Anthony Housefather
Definitely.
Before we do that I want to clarify one thing because I think we're differentiating. The colleges of physicians and surgeons and the bars have disciplinary measures and those are not in criminal law. This is an exemption to the criminal law, which is different, so I think we have to keep that in mind, because we seem to be....
Who wishes to answer that?
Mr. Monette, please.
Peter Monette Manager, Bioethics and Science Advice, Strategic Policy Branch, Department of Health
Yes, I'll take a shot at this. As clarification, I'm with Health Canada, not with Justice.
The concern I have with the amendment is that it offers a bit of a problem with interpretation. The original Bill S-201, from our understanding, has quite general provisions for physicians, pharmacists, and researchers, so we didn't have any issues with it. We thought that our practices were exempt.
I think the amendment introduces some issues with interpretation so we do.... As has already been mentioned here, several interpretations have to be done both for the practice of medicine and also for research. We would have to go back to try to find out what all those implications would be, and we haven't had the time to do that.
Conservative
Tony Clement Conservative Parry Sound—Muskoka, ON
With all the implications, it's plain reading of the bill. This is not rocket science. What does “required” mean? Either case law or common sense applies to all these kinds of cases. I don't think we should be hung up that we are faced with an amendment that was not contemplated exactly in the original construction of the bill. This happens all the time. Amendments in other committees pass. Dogs don't start sleeping with cats; Niagara Falls doesn't reverse itself, so let's accept the plain meaning and the reasonableness of those who parse the legalities of laws that are passed by Parliament.
Liberal
The Chair Liberal Anthony Housefather
Thank you very much.
We do pass amendments, so don't worry.
(Amendment negatived [See Minutes of Proceedings])
(Clause 6 agreed to on division)
(Clauses 7 to 10 inclusive agreed to)
Now I believe we have an amendment.
Mr. Fraser.
Liberal
Colin Fraser Liberal West Nova, NS
Mr. Chair, I would propose that we add a clause 11 that relates to coordinating amendments. I believe it's been circulated.
In my belief, the coordinating amendment is necessary in view of Bill C-16, which was previously considered by this committee and is now in the Senate. It ensures that if one of these pieces of legislation comes into effect, and then contemplating the other one, it would give effect to the wording in the Canadian Human Rights Act with regard to the changes that are sought by each bill.
For example, if this bill were to pass and come into effect and then later Bill C-16 passes, the wording we're giving effect to in the Canadian Human Rights Act with regard to genetic characteristics would be wiped out when Bill C-16 comes into effect. This protects the integrity of this bill if Bill C-16 comes into effect afterwards, or vice versa.
Therefore, it's important that we ensure consistency with regard to the effect that we want for each of these bills. That's why I am proposing the amendment.