Justice Committee on Nov. 23rd, 2020

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

Thank you, Madam Chair.

I would just note that my comments were highly relevant to the amendment. They were certainly not repetitive in any way of anything that I had previously stated. I would hope that members of the government would take heed of the concerns expressed by the UN special rapporteur on the rights of persons with disabilities.

In that regard, in connection with the amendment that Mr. Manly has put forward, the special rapporteur stated:

I am extremely concerned about the implementation of the legislation on medical assistance in dying from a disability perspective. I have been informed that there is no protocol in place to demonstrate that persons with disabilities have been provided with viable alternatives when eligible for assistive dying.

I believe Mr. Manly's amendment is a step in the right direction to addressing the concerns raised by the special rapporteur with regard to Canada's international obligations under the UN convention, which Bill C-7 expressly acknowledges in its preamble.

Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Cooper.

We'll call the question on amendment PV-2 at this time.

(Amendment negatived: nays 7; yeas 4 [See Minutes of Proceedings])

We now go on to amendment CPC-6.

Mr. Moore, would you like to move this amendment and speak to it?

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair. I was just going to move it, but I'll speak to it then as well, per your invitation.

What CPC-6 does is it.... To back up a bit, as you know, in Bill C-7, we have two tracks, one where death is reasonably foreseeable and one where death is not reasonably foreseeable.

We've already dealt with the fact that we have not defined “reasonable foreseeability”. On the track where death is not reasonably foreseeable, there are a number of safeguards that are in place.

On the track where death is reasonably foreseeable, we know that the 10-day reflection period that Parliament included in Bill C-14 is being eliminated. On the track where death is not reasonably foreseeable, the government has put in place a 90-day reflection period. It's interesting that on the one hand there's a reflection period being eliminated and that, on the other hand, there's a 90-day reflection period.

Our amendment CPC-6 would ensure that rather than “90 days”, there are “120 clear days between the day on which the first assessment under this subsection of whether the person meets the criteria set out”, and the point when they can receive medical assistance in dying. In effect, it extends the reflection period when death is not reasonably foreseeable.

The basis for our proposing this is based on testimony that we heard. All of us, as members of Parliament, know that access to health care is an issue probably in all of our ridings and among all of our constituents. Particularly now with COVID, we're seeing even more delays in the system.

I mentioned them before, but the Canadian Society of Palliative Care Physicians specifically points out that under the proposed two-track system, where death is not reasonably foreseeable, the 90-day assessment period may not provide sufficient time for a person to receive appropriate palliative care or other supports needed to reduce suffering and live with dignity.

We also heard from other physicians who are specialists. We heard from MAID assessors quite a bit. These are specialists who deal with any variety of injury as well as sicknesses that people who may now be eligible for MAID would have to be dealing with. The feedback we had from those physicians as well as the physicians who deal with palliative care is that 90 days may not be sufficient. Upon studying this and consulting, and then based on the witness testimony we heard, we proposed this amendment that would increase this by a modest amount.

Is 120 days the exact right number? Is 90 days the right number? We don't know. What we do know from the testimony we heard about the 90 days is that it's not enough. Therefore, 120 days is a step in the right direction.

I mentioned the physicians who deal with palliative care, but we also received a submission from Physicians Together for Vulnerable Canadians. That is the submission that had over 800 signatures, not from MAID assessors but from physicians who deal with any variety of sickness that people may be dealing with. I want to draw the committee's attention to the second page. They say, “We live in a country where the wait time to see a psychiatrist...is 4-8 times longer than the 90-day waiting period”. Just for psychiatric care, the waiting list puts someone beyond the 90 days. What they're saying is that for situations where death is not reasonably foreseeable, the 90 days is woefully inadequate.

We've heard testimony that people within that 90 days can have ups and downs. The government acknowledges that some period of reflection is appropriate when death is not reasonably foreseeable, but what we're hearing overwhelmingly from physicians and from palliative care physicians is that 90 days is not an adequate reflection period.

Wherever you stand on the issue of assisted death where death is not reasonably foreseeable, ensuring we have the right safeguards should be something that we can all agree on, and the evidence we're seeing is that 90 days is not satisfactory. That's why our amendment would increase it to 120 days, which still may not be adequate, but we are proposing a number that recognizes that 90 is not enough in the hope that members of the committee would see it for what it is. It is a reasonable effort, where death is not reasonably foreseeable, to provide further safeguards for people who are at a very vulnerable point in their lives, to make sure they get the medical assistance that they can get and that we have more time for the provision of health care services to take effect—let alone to see those specialists—but also to have some movement towards recovery, hopefully.

We heard testimony at committee about individuals involved in a significant accident, for example, and someone who could be rendered paraplegic. This 90 days is not going to give them the time to see what opportunities they could have. That is why I'm asking that committee members consider this very reasonable amendment to increase from 90 days to 120 days the reflection time when death is not reasonably foreseeable.

I thank committee members for their consideration, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Moore.

I have Mr. Garrison next.

Go ahead, Mr. Garrison.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thanks very much, Madam Chair.

I want to start by cautioning my fellow members of the committee to stay away from inadvertently implying that because we have differences on how to implement the court decision that took away “reasonably foreseeable”, it somehow indicates that some of us either care more or care less about sectors of the Canadian population.

What we're really dealing with here is a situation where removing “reasonably foreseeable” has not taken away the very high bar that's been set for receiving medically assisted dying. A person must still suffer from an incurable condition, they must be in an advanced and irreversible state of decline and they must be in intolerable suffering.

Specifically with regard to this amendment, the 90 days for assessment is a minimum—not a maximum—assessment period. By increasing this to 120 days, we run the risk of enforcing another 30 days of intolerable suffering on someone who has been assessed, has made their decision and is dealing with end of life. This is not about suicide. It never is about suicide. It's about people dealing with the hand they've been dealt by nature, for whatever reason, and then trying to make certain that they have autonomy over their end of life.

I'm very much opposed to extending what is now a 90-day minimum for assessment to an arbitrary 120 days, since obviously the assessment could take longer and would take longer under the decision of both the individual and the professionals providing care if necessary.

Thank you.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Garrison.

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

Go ahead, sir.

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

Yes, I will be very brief, Madam Chair, as Mr. Garrison made virtually all the points I was going to make.

I appreciate Mr. Moore's comments. I do. Everybody has taken the time to inform themselves on this issue and on this piece of legislation.

What is required in the bill is to find a balance, and I believe that 90-day deadline does just that, because the risk is not in extending it. The risk is the other way around.

As Mr. Garrison has rightly pointed out, extending it could put somebody in further jeopardy, depending on their condition, but if more time is needed, the risk is eliminated because a physician conducting the MAID assessment has the option to extend the assessment. That risk is eliminated, so I agree completely with what Mr. Garrison said. For that reason, I'm opposed to the amendment.

[The Chair, Liberal, Iqra Khalid]

Thank you.

I have Mr. Lewis next on the list and then Mr. Cooper.

Mr. Lewis, go ahead.

[Chris Lewis, Conservative, Essex, ON]

Thank you, Madam Chair.

I certainly appreciate the opportunity to once again speak to this CPC amendment. Madam Chair, this has been something else.

However, I would like to speak to this amendment. It's to extend the assessment period from 90 days to 120 days for those seeking medical assistance in dying whose death is not reasonably foreseeable. The decision to receive medical assistance in dying is incredibly complex and utterly irreversible.

An additional 30 days would add an extra layer of security to reduce the risk that someone would be choosing medical assistance in dying without proposed support or information, or because they have some other unmet need in their life. Line 8 of page 5 in clause 1 of Bill C-7 reads:

ensure that there are at least 90 clear days between the day on which the first assessment under this subsection of whether the person meets the criteria set out in subsection (1) begins and the day on which medical assistance in dying is provided to them

The proposed amendment here is that this 90-day period be replaced by 120 days. In order to legislate responsibly on medical assistance in dying, we need to ensure that every patient making a decision for assisted death has adequate time to consider their decision and weigh it against the other options for care and pain management that are made available to them.

Dr. Mimitha Tresa Puthuparampil is a family doctor from Ontario who submitted a brief to this committee which was originally rejected due to the arbitrary deadline not being communicated to the public. In this brief, and this is important, she says the following:

Moreover, 90 days is not enough time to access and take full advantage of mental health and palliative services for those not facing imminent death. At best, it is wishful thinking. I know the challenges of arranging follow-ups and referrals for my patients, and share their frustration at being told, time and time again, to wait. Time is required to help patients make such a decision; only after receiving the best of what medicine has to offer them.

According to the testimony of this doctor, in our current medical framework it is not realistic for a patient to receive the care they need within the timeline of 90 days. Physicians should always present life as a first option and providing care should be of the first priority. Access to care should always be available faster than access to MAID. At the bare minimum the timeline to access MAID and a timeline to access a proper standard of care should be the same. It would be completely unacceptable to have patients able to access MAID before they can access the care they need. As has been mentioned before in this committee, in some parts of our country it is easier to access medical assistance in dying than it is to get a wheelchair. Why is this government intent on making assisted death available so quickly that MAID is considered a higher priority in terms of this timeline than getting a disabled person a wheelchair?

This is a really neat one. A review of the Canada pension plan disability benefit showed that it takes approximately 120 days to complete the application process, leaving many people forced to file an appeal before obtaining benefits. Again, in the case of people struggling financially, it is easier and faster to receive assistance in ending your own life than it is to receive assistance for desperate financial struggles. If patients who are already burdened with the weight of their physical or financial conditions have to fight an uphill battle to choose life, yet their path towards assisted death is made easy, inevitably many more people will choose to end their lives rather than keep them.

It is critically important that our nation develops a proper standard of care that is easier to access than assisted death. This will prevent people from choosing assisted death for lack of a better care option. In regard to the need for better standards of care, the Canadian Medical Association Journal says:

Previous research has illustrated that individuals with months of high levels of disease burden (physical, emotional and spiritual/existential distress) and the convergence of certain psychosocial factors leads to depression and hopelessness and ultimately to a desire for hastened death. Providing palliative care to those who have already been suffering for months and thus end up distressed and suffering enough to request hastened death is most often providing palliative care too late.

This is an interesting one as well. It states, “This is not even to mention the substantial minority of 22.8% of MAiD recipients in the study by Downar and colleagues who apparently had no palliative care involvement whatsoever at any time before medically assisted death.”

Bill C-7 seeks to expand access to medical assistance in dying to those whose death is not reasonably foreseeable and, in accordance with the statement made by this doctor, we should seek to be as careful as possible with these safeguards.

The Council of Canadian Academies medical experts panel wrote an opinion column for CBC news on “Why the federal government should rethink its new medical assistance in dying law”. I don't believe this has come to this committee yet, so that's why I'm bringing this forward, Madam Chair. It speaks directly to this amendment:

For people whose death is not "reasonably foreseeable," the bill introduces an assessment period of 90 days, combined with an evaluation of eligibility by a practitioner with expertise in the patient's condition. These measures are meant to ensure that people with disabilities and chronic illness are informed of other available treatments or support options outside of medically assisted dying. But unlike any other country in the world, the new bill fails to explicitly require that all reasonable options be made available and tried first, before allowing physicians to end a patient's life.

In other words, the bill makes their dying easier than living. Rather than instilling hope and helping to build resilience by focusing options for living, health care providers will now be asked to discuss an early death.

That speaks specifically to the 90- to 120-day reflection period.

Further, it goes on and points out in a portion of the article that one of the problems with the current medical assistance in dying framework in Canada is how it creates two classes of Canadians. For young and healthy Canadians, suicide is discouraged. We put a great deal of emphasis on and effort toward suicide prevention, and rightly so. There are suicide help lines, mental health care, support groups and a lot of other resources to keep Canadians alive and help them work through the struggles they are facing.

However, the easy access to assisted death in Canada has the potential of making vulnerable and disabled Canadians feel that their lives are of less value than those of other Canadians. The reason for this is that when they feel suicidal, those thoughts are affirmed to them, and they are presented with assisted death as a viable and good option to relieve them of their pain and their struggles.

In other words, when some Canadians confront temporary suicidal ideation, they will receive suicide prevention. When other Canadians confront temporary suicidal ideation, what Canadians living with disabilities are asking us is the following: Why do some receive suicide prevention while other people receive suicide facilitation? Isn't that something that is communicated about the social and political views of the value of certain people's lives if they are in the category that is offered suicide facilitation?

Further on, and specific to this amendment, we have to recognize that choice is exercised in a social context in which people choose between the realistic options that they have lived and experienced. How is it autonomy when people may not be able to access care before the end of the 90-day timeline? That is why we need to, at a minimum, give people that space of 120 days so that they, at the very least, have the real option of real care put in front of them.

Dr. Harvey Chochinov, professor of psychiatry and family medicine at the University of Manitoba, was one of the witnesses this committee brought forward, and we had the pleasure of hearing from him. He completed a study on terminally ill patients who will live to the end of their lives.

According to The New York Times' coverage on this report:

[The doctor] and his colleagues studied 168 cancer patients admitted to the hospital for end-of-life care. The patients were screened to make sure that they had the mental competence and the physical strength to participate in the study, which involved filling out a questionnaire twice a day—

There's very important information coming up here, Madam Chair.

—a process that [the doctor] said took about a minute—and continued until shortly before death. The participants were asked to rate themselves on 100-point scales measuring pain, nausea, appetite, activity, drowsiness, sense of well-being, depression, anxiety and shortness of breath. They also rated the strength of their will to live.

...Over a 12-hour period, [the doctor] said, the patients' will to live could fluctuate by 30 percent or more. Over a 30-day period, the shifts were even larger, on average up to 60 percent or 70 percent.

“These large fluctuations suggest that will to live is highly unstable,” the researchers wrote.

The study goes on to speak about the very objective that—

[The Chair, Liberal, Iqra Khalid]

Mr. Lewis, I would encourage you to continue to connect your points to the amendment before us, because I'm kind of getting lost trying to take notes of what you are saying, and I don't see how there's relevance here. If you can please get to your point, I'd appreciate that.

[Rob Moore, Conservative, Fundy Royal, NB]

I have a point of order, Madam Chair.

I think we're kind of treading on a little bit of dangerous ground here. We're dealing—if I'm not mistaken—with Bill C-7, which deals with assisted dying in Canada. There are a number of amendments. I think, certainly, that what I heard from Mr. Lewis is on point. We're talking about amendments that deal with assisted dying, amendments that we're dealing with tonight in clause-by-clause. I don't want to point out—or I didn't want to—Liberals' talking about boxers versus briefs the other day in another committee. That, I would agree, would be irrelevant.

[The Chair, Liberal, Iqra Khalid]

We're not.... I completely understand and agree, Mr. Moore. For example, when you were speaking to the specific amendment, you spoke about how you conferred with your colleagues, and you spoke using the terms “we” and “our”, speaking for your colleagues.

You specifically spoke about the intention behind this specific amendment, CPC-6. You spoke about the impact of increasing the days to 120. They were very healthy points. Then Mr. Lewis talked about the disabilities angle, the deadlines and suicide ideation and how that is all impacted by this amendment.

What I am not understanding is what his most current point is about, so I was hoping that he could come to the relevance of the point he was making so that I could better understand it.

Thank you for that point of order, though, Mr. Moore.

Go ahead, Mr. Lewis. You can continue.

[Rob Moore, Conservative, Fundy Royal, NB]

I'm still on that point, Madam Chair. Every member of this committee is an equal. Every member is entitled to participate within the rules as they see fit—every one of us, whatever party background we're from. I don't speak for any member on this committee other than myself. Every member is entitled to speak to these important amendments to what is a very important bill.

I don't think that it's speeding things along at all for these points to continue to be raised because members of Parliament—as far as I've heard—are doing their jobs by raising concerns, whether in favour or against particular amendments. Thank goodness, so far, everything that's been said—and this is on this point, Madam Chair—is relevant to this bill and, in fact, relevant to the specific amendments, unlike, certainly, what we've seen and heard in other committees.

I think you're doing a great job, but so are all the members. I hope that we can continue to have a respectful discourse within the rules that we are provided with as members of Parliament, and not infringe on the opportunities of every single member—nobody speaks for me, and I don't speak for anybody else—to make the points that they wish to on each and every amendment. Those are the rules we have.

Thank you.

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

Madam Chair, on that point of order, I feel like the goalposts keep changing here.

At the risk of my colleague, Mr. Moore, taking back what he said before—that he agreed with me on something—and with all due respect to him, I've never understood it to be a rule that when someone moves an amendment, that he or she is then speaking for every member within that party on that amendment. You took great pains to go through some of Mr. Moore's points, and then you said he used the terminology “we” or “our”. That's very common terminology. I often use the collective “we”, but that doesn't mean I'm presupposing what someone else would say.

This really relates to my earlier point. I don't think anyone, including my own colleagues in the party that I represent, should be put in the position of speaking for me. They probably wouldn't want to do that. I don't want to do that for them. I maintain my right as an individual Parliamentarian to speak. I hope that's not what you were suggesting.

[The Chair, Liberal, Iqra Khalid]

No, not at all.

Thank you, Madam Findlay.

Mr. Lewis, you can go ahead with your comments.

[Chris Lewis, Conservative, Essex, ON]

Thank you, Madam Chair. Thank you to Mr. Moore and Ms. Findlay for their remarks.

Madam Chair, if I was off topic earlier, I certainly apologize. I personally believe that everything that I was speaking about was relevant. That's why I kept to referring back to the 90-day and 120-day periods.

I'm going to end my comments, which may or may not be relevant. In an effort to work with the committee, I'm going to finish it this way, because quite frankly, I feel I'm doing an injustice to my constituents by not finishing up what I wanted to say. However, I'm a team player, and I want to make sure that I'm following the rules.

I'll put it to the committee this way, 90 to 120 days. Let's talk about 90 to 120 minutes, and about things that we could talk about in 90 minutes, and things that we could talk about in 120 minutes. Although I feel as though I'm being muzzled here, let's suggest I got to talk for 90 minutes, and somewhere between the 90th and 120th minute, something else came to me. I saw the light. There was another piece of information that had come forward. That might be enough to perhaps change the discussion, change an idea, change a heart, change a feeling. Who knows what that looks like?

At the end of the day, this is a great amendment. The CPC amendment is a very important amendment. Forget about the minutes. Let's go back to the days, and the reflection period that's needed. Sometimes an extra 30 days could literally mean life and death. It would be a complete injustice to this justice committee if we don't support this amendment.

I will have a lot to say on the remainder of the amendments going forward. If I'm off topic, please remind me, and I'll do my very best to stay on topic, but I will have a lot to say there as well.

Madam Chair, thank you for the great job that you continue to do.

[The Chair, Liberal, Iqra Khalid]

Thank you very much for that, Mr. Lewis. I look forward to your continued comments on these amendments in the order they arise.

I have Mr. Cooper next, and then Mr. Thériault.

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

Thank you very much, Madam Chair.

I want to speak in support of this amendment. I believe it is a modest amendment that would extend the waiting reflection period of 90 days to 120 days. I think this is required in the face of the evidence that we heard. In fact, I would submit that 120 days probably is not enough, but when comparing the 90 days as provided for in the bill versus the modest amendment that we put forward, it is an improvement. What good is a 90-day period when we have evidence that it can take three or four times as long to get psychiatric supports? What good is a 90-day period when one might not be able to access palliative care within the span of 90 days, let alone undertake meaningful palliative care treatment?

Then you ask, 90 days from what day to what day? Under the bill, it's not even 90 days from the time that a request for medical assistance in dying is made. It is 90 days from the first assessment. We will be seeking to address that issue in a subsequent amendment, but I only cite it to underscore the complete inadequacy of the 90-day reflection period as currently provided for in the bill.

I would note the words of Dr. Harvey Chochinov, the distinguished professor of psychiatry at the University of Manitoba, someone who has done significant work in this area, having served as the chair of the external panel. When he was asked about the 90-day reflection period, he stated:

The 90-day clock...is very problematic. There have been a number of studies. For example, a Manitoba study actually found that after 90 days of being diagnosed with a major physical impairment, patients reach a peak in their suicidal ideation. They continue to be suicidal, although it wanes, as much as a year later, and thereafter it's still greater than their match cohort, so 90 days is certainly not an opportune waiting time.

The other thing is that we know that it takes a great deal of time for these people to be able to avail themselves of expertise. Patients who are highly at risk, for example those with chronic pain, may have to wait six months or more, depending on what part of the country they happen to live in, in order to get access to care. My specialty is psychiatry. Again, the waiting list for good psychiatric care is in the neighbourhood of months, up to a year, depending on what part of the country you're in.

The 90 days is problematic for all those reasons, which in large measure are data-driven and data-informed.

I think that summarizes the issue with the inadequacy of the 90-day period, and it's on that basis that I would support this modest amendment to extend the period, because I think we have to proceed with caution. We are talking about a procedure that, if carried out, results in the termination of one's life. There is no opportunity to reverse the decision once the procedure is carried out,

I think this amendment's having regard for that is perfectly reasonable and necessary to protect vulnerable persons, again, given the increased risks they face when the reasonably foreseeable criterion is removed. That is the category of patients who would be the subject of this amendment.

Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you for that, Mr. Cooper.

We will now go to Monsieur Thériault.

Go ahead, sir.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Madam Chair.

It is perhaps appropriate to recall the context of this bill. Many things are being said, and at a certain point, they completely confuse the basic issue.

Suicide in Canada is decriminalized. Assisted suicide is still a criminal offence, barring certain exceptions. We did not decide that this evening. Rather, the courts told us that the legislation violated the right to life. There was Bill C-14 and, before that, the Carter decision, which led to Bill C-14. Mr. Lewis says that we are encouraging suicidal people to commit suicide. However, it is quite the opposite.

I cannot fathom how the justices in the Carter decision, who told lawmakers to go back and do their homework, would react. How would Justice Baudouin react to the comments I have just heard, which are an all-out assault on the courts' interpretation that led them to tell lawmakers that the current legislation violates the right to life of people with irremediable conditions and intolerable pain and suffering? The courts are of the opinion that people are currently being compelled to act before they would want to do so, meaning when they have passed the point of what is tolerable for them. According to the current legislation, they are being compelled to commit suicide; that's what the Superior Court said. They are being compelled to end their lives prematurely.

I really want us to try to justify a rather straightforward amendment that we could have voted on pretty quickly, but here we are. We need to respond to the court's ruling with Bill C-7. We must return to the fundamental issue. The court told us not to violate the right to life of people with irremediable conditions experiencing intolerable suffering. They want to live until they have passed the point of what is tolerable for them.

That does not happen after an accident. Someone who has an accident tomorrow morning and becomes quadriplegic might become suicidal and would receive care for that state. Over the course of their care—because we do provide care for people—they could one day decide to request MAID, and that request will then be assessed according to the safeguards set out here.

Out of respect for the work we must do, let's not confuse the basic issue. I know that we are presenting all the arguments we can, but the purpose is not at all to encourage any suicidal state. Let me repeat that suicidal states are reversible. We are talking about access to medical assistance in dying and a person's ability to make that decision, which is not made lightly. People at that stage will have exhausted all other options over the course of their care. Paragraph 241.2(3.1)(g) ensures that people will recognize the full range of care available to them and all options they have.

I'm ready to vote.

[The Chair, Liberal, Iqra Khalid]

Thank you, Monsieur Thériault.

I have Madam Findlay next on the speakers list.

Go ahead, Madam Findlay.

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

Thank you.

I want to speak in support of this amendment. I recall that during testimony, Dr. Heidi Janz, who is with the Council of Canadians with Disabilities, gave testimony. She's a medical doctor herself, I believe. She was in a wheelchair. She referred to this as norm-shattering legislation.

I feel sometimes, when we're debating back and forth, that we're getting into a flavour of “this is not that big a deal”. It is a very, very big deal. That's why it's in the realm of criminal law. That's why we can't take it lightly. For the very reason we have laws around capital punishment, where long ago Canadians said we're not going to have capital punishment anymore, which I agree with, was that even if, after some heinous act, it would seem that maybe the state should put someone to death, if we should put to death just one innocent person who turned out to be innocent later or was improperly convicted, that would be a terrible thing.

This is very important legislation. This is a modest amendment. I believe the 90-day provision, as far as I know, is basically an arbitrary number. I'm happy to hear from my Liberal colleagues if it's otherwise, but from what I've heard in testimony before us, it's basically an arbitrary number. We are suggesting 120 days. It's not a big difference, but the difference would allow people contemplating this to have enough time to make sure that they are fully aware of the availability of support, that they have access to care, that they know what care they have access to, and that they have at least the chance to access quality palliative care. We've heard testimony that 70% of Canadians do not have adequate access to palliative care. Maybe they can access this by going somewhere different, or to the next county or next town—I don't know—but it takes time to figure those things out.

I would be very concerned to think that anyone makes these decisions based on inadequate support or not having the appropriate care in a timely enough fashion. We don't like to think that happens, but we know it does happen. We've had people who have been in the news. It's been a matter of comment and a matter of testimony that there are some people who have in fact chosen MAID because they felt they had a lack of care and they weren't sure how to access it or where to get it.

One of the submissions that we were sent happens to be from the Canadian Conference of Catholic Bishops. I should say off the top that I'm not Catholic, but what was said in here seems to me to be very telling:

The pastoral experience of the Bishops has shown that patients are more likely to request...assisted suicide when their pain is not properly managed by good quality palliative care, when their dependence on others to provide assistance and support is not adequately met, or when they are socially marginalized. Palliative care, which has yet to become fully available and accessible in our own country, offers a compelling answer—the only respectful, comprehensive and ethical alternative to what the Government is trying to address through [this] legalization....

I'm paraphrasing here and shortening it a bit. They said that palliative care seeks to alleviate the pain, loneliness, fear, distress, and despair, which [Technical difficulty—Editor] where no such emotional and psychological support is available, to the tragic failure that the option or choice ends up with assisted dying.

Also, the stress here on the COVID-19 pandemic has painfully revealed that fear, distress and despair are not uncommon realities among our fellow Canadians and family members in assisted living and seniors residences. We all know that COVID-19 has disproportionately hurt and disproportionately affected our fellow Canadians in seniors residences. We know. We have stories. We have testimony. We have testimony from military personnel who went in to assist, which was, I think, a very good initiative of the government. They found some of our seniors in deplorable conditions. The distress and the isolation it causes can lead people to make these choices when they might not otherwise.

The 120 days is meant, in my view, to allow the full complement of what might be available so we know that when people are making these decisions they're not doing it prematurely. They're not doing it because of lack of access to care. They're doing it because their situation is truly intolerable, and they've then made a conscious decision to access this end of life. However, it should never be because they haven't yet had a chance to do that. The 120 days just gives them a little more of a chance.

We've heard testimony that there is all kinds of support—health care support, emotional support and otherwise—that is not available within the 90 days. We've also heard testimony that 90 days is a turning point—I think MP Cooper referred to this—often after a catastrophic illness or injury when people can start to accept. Let's give them that chance.

Thank you, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you very much, Madam Findlay.

I'll call the question now on CPC-6.

(Amendment negatived: nays 7; yeas 4)

Mr. Moore, I have CPC-7 next if you would like to move that and speak to it.

[Chris Lewis, Conservative, Essex, ON]

I have a point of order, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Mr. Lewis, go ahead, sir.