Justice Committee on Nov. 23rd, 2020

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair.

It's interesting to hear people, different members, giving their opinions. I suppose we're all entitled to our opinions. I would hope all of our opinions are informed opinions.

When we're talking about palliative care, which this amendment does, I think it's important to listen to what palliative care doctors have to say. We received a submission—or at least I did, and I'm assuming other members did—from the Canadian Society of Palliative Care Physicians. I just want to draw the members' attention to one of their significant points. It's their first point. They gave our committee several recommendations, and their recommendations help inform, I think, a number of the amendments we're going to deal with.

In particular, on this amendment, their point is that:

Time is often necessary to ensure careful assessment of an illness, proper diagnosis, impeccable symptom management, and appropriate monitoring of treatment interventions that can provide benefit to a person facing a new illness or situation.

We've heard this many times. They continue:

When a new and often complex reality is being faced, an individual may normally experience an existential crisis and question the meaning and value of their life. With time and support, a person can come to a new sense of normal and find meaning in their circumstance.

Now this is the relevant point, Madam Chair. They say:

This may take many months or even years for some people.

Under the provisions of Bill C-7, for the first time ever, Canadians whose death is not reasonably foreseeable can now access assisted dying. What these palliative care doctors are pointing out is that:

Any professional assessing a patient’s request for MAiD must have access to appropriate consultative support for that patient according to their need.

That means the patient's need, and we have, or we should have, a patient-centric system. They continue:

This may include palliative care, psychiatry, chronic pain specialists...physiatry, spiritual care, and services to support people dealing with mental health issues, substance use disorders, disabilities, as well as physical and social isolation.

We're hearing more and more about isolation in the context of COVID right now. They continue:

This would ensure all reasonable treatment options have been provided to manage physical, psychological, social, spiritual, and emotional suffering.

Here is the relevant point. They say:

Simply having information about the available treatment options is not enough; people need the lived experience of care to make an informed decision.

I'm going to repeat that because it is the exact point of Mr. Manly's amendment. Mr. Manly's amendment is directly on point to what we're hearing. Is it from some random person on the street? No, it's from palliative care doctors, people who deal every day with Canadians who are in this situation. How often, when we see an obituary in the newspaper, do we see that it thanks palliative care doctors for the care they got, no matter what hospital they may have been in? What they say, for emphasis, is that simply having information about the available treatment is not enough. They need the lived experience to make an informed decision.

They say that under the two-track system that we now have, the 90-day assessment period, which we'll get to later with another amendment, may:

...not provide sufficient time for a person to receive appropriate palliative care or other supports needed to reduce suffering and live with dignity. Instead, they may feel that a premature death via MAiD is the only option. This may also lead to people “requesting MAiD” to jump the queue to access these needed services.

We're a big, diverse country. We're dealing with, certainly, a topic that we have varied opinions on. I'm hopeful that what unites us as a committee is a desire to protect vulnerable Canadians.

The people who deal with people in their most vulnerable state are palliative care doctors, the specialists who are informing this committee that they do not think it's enough to mention to somebody, or to hand them a brochure, about what may be available to them. They think it's important that we actually have engagement with a specialist.

Even the government saw the wisdom of this, for those on the second track where death is not reasonably foreseeable, requiring that one of the two doctors making an assessment be someone who has a speciality in the individual's condition. When a person is nearing an end-of-life situation or when a person is looking for what options they have, it's having that consultation with a palliative care specialist so they can tell the individual what services can be offered, in a real consultation.

We're talking about life and death. We heard it over and over. It's not a true choice unless the patient is informed in a fulsome way of all of their options.

[The Chair, Liberal, Iqra Khalid]

Thank you.

[Rob Moore, Conservative, Fundy Royal, NB]

I don't want to see my constituents or any of our constituents, any Canadians, in a situation where they are choosing assisted death because of a lack of information and consultation on the options they have.

Madam Chair, that is why, again, I thought it was important to mention, when we're talking about palliative care issues, what the palliative care doctors are saying. What they are saying is that we should all around this table be supporting this amendment.

That's why I'm pleased to support it.

Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Moore.

I'll just remind members as we're continuing the important debate, as you speak to amendments, it doesn't make sense to keep making the same arguments.

I really appreciate, Mr. Moore, that you are quite adamant and quite eloquent in voicing your opinion and your concerns. However, I would hope that everything is on the record and that we could move things along.

Mr. Lewis, do you have anything to add, based on what you said before?

[Chris Lewis, Conservative, Essex, ON]

First and foremost, Madam Chair, my apologies to the committee. I apologize for my IT issues. I want to thank the IT department for helping me through this—many thanks. I hope that my connection is a little better now, if nothing else.

I have quite a bit to add to this.

One thing I was going to speak to was Dr. Catherine Ferrier, but, of course, my colleague Mr. Cooper already spoke to that.

With respect to what you just said Madam Chair, again, we don't want to add a whole bunch of verbiage to this discussion, but I think it's very important that this committee takes a good hard look at Mr. Manly's amendment. I think it's an amendment that truly speaks to protection of all Canadians. Additionally, this amendment will aid in the prevention of abuse and malpractice, which ought to be a central concern, especially when dealing with individuals whose mental and/or physical states are especially fragile or vulnerable. There will always be the risk of coercion, undue pressure and things of this nature.

However, this legislation should mitigate the risk as much as possible, ensuring that every patient is informed of all available alternatives, including receiving counselling regarding the continued management of their condition with ongoing treatment or therapeutic measures. That should be seen as a basic and fundamental prerequisite for the consideration of the procedure to end one's life.

Madam Chair, I would again ask respectfully that this committee gives a good hard look at supporting this amendment. I think it's a great amendment.

Again, I apologize to the chair and to the committee for my IT issues here. I will certainly have more to say on further amendments.

Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Lewis. I'm glad your IT problems have been resolved. It's good to have you back.

Mr. Cooper, I have you next on the list.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Thank you, Madam Chair.

In my previous comments, I made general reference to the UN Convention on the Rights of Persons with Disabilities. What I would add to that is that Mr. Manly's amendment clearly falls in line with the purported intent of the legislation, inasmuch as the preamble of the legislation provides that Canada, first of all, a “State Party” to the UN Convention on the Rights of Persons with Disabilities and, as the preamble states, “recognizes its obligations under it, including in respect of the right to life”.

If the bill actually does what the preamble states as the intent of the bill, then it is imperative that Mr. Manly's amendment do pass. I would note article 10 of the convention.

What is article 10 of the convention? Article 10 very simply states:

States Parties reaffirm that every human being has the inherent right to life and shall take all necessary measures to ensure its effective enjoyment by persons with disabilities on an equal basis with others.

The UN special rapporteur, again, speaking directly to the issue, that is, Mr. Manly's response—

[James Maloney, Liberal, Etobicoke—Lakeshore, ON]

I have a point of order, Madam Chair.

I'm not a fan of interrupting, and I apologize to Mr. Cooper, but Mr. Cooper is raising points that could have been raised previously. I don't want to impede someone's ability to get their points across, but I don't think it's necessary that people do it multiple times.

If you have something to say, I would suggest that you do it the first time. Unless you have something in response to an opinion that was opposed to what you said to earlier, I don't think it's appropriate that we just give somebody a second chance to prolong the discussion unnecessarily.

[The Chair, Liberal, Iqra Khalid]

Thank you for that, Mr. Maloney.

[Rob Moore, Conservative, Fundy Royal, NB]

On that point of order, Madam Chair, we can talk about “appropriate” all we want, but as you know, each member of Parliament who wishes to speak to these things—I'm sure you're going to let us know, Madam Chair—is entitled to do so, because those are the rules of how we conduct ourselves.

If someone in discussion, as has happened with me on other interventions on an amendment, makes a point that I wish to respond to, much in the same way that Mr. Maloney raised his point of order and now I'm responding to it, we're able to do that as members of Parliament. We're able to speak to these amendments. This is the House of Commons, where members of Parliament give voice to the Canadians we represent. A part of the rules of this place is that every member can speak as often as they wish to these amendments.

So far, from what I've heard, everything has been on point with the amendment we're dealing with.

I just wanted to respond on that point. Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you.

[Arif Virani, Liberal, Parkdale—High Park, ON]

On the same point of order, Madam Chair, I think it's important that what we try to do in this context is that we actually try to have some precision in our commentary. I think the point that Mr. Maloney is attempting to make is not an attempt to limit the debate. It's an attempt to ensure that people focus their commentary, and that if you're going to reply in a second go-round, you do exactly that. You respond to something new that you've heard.

In the entire context of the approximately 30 minutes we've spent on this discussion, all of two people have raised opposition to the views of the Conservatives. They are Mr. Thériault and Mr. Kelloway. I do not find that, in the secondary submissions that are being made by multiple Conservative members, we're finding people responding to comments made by either Mr. Kelloway or Mr. Thériault.

Perhaps we could have some clarification, because I think it's your role as chair, Madam Chair, to guide the debate in an efficient and appropriate manner so that we can move through these amendments out of respect for the people who are on this call, out of respect for the departmental witnesses and out of respect for House staff.

Thank you.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Virani.

[Rob Moore, Conservative, Fundy Royal, NB]

On that point of order, Madam Chair—

[The Chair, Liberal, Iqra Khalid]

Sorry, Mr. Moore. I have Madam Findlay next.

Is this on the same point of order, Madam Findlay?

[Kerry-Lynne Findlay, Conservative, South Surrey—White Rock, BC]

Yes, it is.

[The Chair, Liberal, Iqra Khalid]

Go ahead, Madam Findlay.

[Kerry-Lynne Findlay, Conservative, South Surrey—White Rock, BC]

I actually find these comments offensive.

I have the right as a member of Parliament, as do all of my colleagues from every party, to make comments in committee on amendments as I choose to make them. I don't believe that any other member here has the right to tell me, “I don't think what you're saying is succinct enough, MP Findlay. I don't think what you're saying is the way I would say it.”

I'm not aware of any such rules. My understanding of the standing committee rules is that we have the opportunity to make comment on these amendments as we go forward, clause by clause. Sometimes our comments are just commentary. Sometimes they're hoping to persuade other members of the committee to see things the way we see them. That is our right. That is our right as parliamentarians, to make ourselves heard.

Sometimes you make an intervention and maybe you think after the fact, “Oh, I should have mentioned that.” Well, you have the right to put your hand back up and finish those thoughts.

I am not aware that there is any rule that says you, Madam Chair, or any other member of this committee, can say that I only have the right to put my hand up again if I have some specific point, and that I must do it in a succinct way so that someone else on this committee decides how succinct I am. That is ridiculous. That is not the way that committee is to proceed. That's not the way that debate proceeds.

If we want to do this in an efficient but also effective manner, we should let people make their points on each of the amendments as they arise to the extent that they wish to. Otherwise, we're going to be sitting here all night, with me saying, “I don't like the way that person said this”, “I don't like the way that person said that” and “I have a comment on whether I think they used the most efficient language.” That is not sustainable, Madam Chair.

Thank you.

[The Chair, Liberal, Iqra Khalid]

Thank you, Madam Findlay.

Mr. Moore, go ahead on the same point of order.

[Rob Moore, Conservative, Fundy Royal, NB]

I'm going to exercise my right to simply say that I agree with everything MP Findlay just said, and it doesn't bear repeating because it was excellent and she made the point. Her understanding of the rules is exactly correct, and in the time we've spent discussing this, we could have been discussing the amendment.

I hope that there are no further interventions about the rights of members of Parliament to speak to each and every one of these amendments and to have a good discussion around the amendments and to make points that they've heard from witnesses about these amendments.

I agree with everything that Madam Findlay just said.

[The Chair, Liberal, Iqra Khalid]

Thank you.

Did you want to speak, Mr. Cooper?

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

I'll speak very briefly to simply say that I first of all agree with all of the comments of Mr. Moore and Ms. Findlay. I think it's important that we have a thorough debate on amendments.

This process has been completely rushed from start to finish. It's been, frankly...not out of any disrespect to you, Madam Chair—

[The Chair, Liberal, Iqra Khalid]

Speak to the point of order, Mr. Cooper.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

I will simply leave it at that. However, my comments are very relevant to the amendment before us, introduced by Mr. Manly.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Cooper.

On that point of order, I will reference page 1059 in the green book, chapter 20. It states:

In addition, the Chair may, at his or her discretion, interrupt a member whose observations and questions are repetitive or are unrelated to the matter before the committee. If the member in question persists in making repetitive or off-topic comments, the Chair can give the floor to another member. If the member refuses to yield the floor and continues talking, the Chair may suspend or adjourn the meeting.

On that ruling with the point of order raised by Mr. Maloney, members, I will encourage you to please keep your comments within that scope, within the scope of the specific amendments, within the scope of what is being discussed, and to please refrain from being repetitive with your arguments.

Mr. Cooper, you can continue. Go ahead.