Evidence of meeting #6 for Justice and Human Rights in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was maid.
A recording is available from Parliament.
12:35 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
That's wonderful.
I have a question for Dr. Frazee.
First, what part of Mi’kma’ki are you from or calling from today? I'm just curious.
12:35 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
I'm in Kings County, Nova Scotia.
12:35 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
The reason I ask is that I'm calling from Cape Breton. It's the absolute Maritimes thing to do to ask where you're from, so I appreciate your response to that.
Dr. Frazee, as you may be aware, Minister Lametti and officials held consultations with a number of stakeholders before informing Bill C-7. These round tables were issue-specific. They were with ministers, parliamentary secretaries and officials, and there were extensive consultations with disability advocates. I wonder if you can tell us what you know about these consultations and what your impressions were of them.
12:35 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
I was fortunate enough to participate directly in those consultations. I think Dr. Janz has already suggested and indicated that there was very much a predetermined outcome. Given that we were extremely nervous about that predetermined outcome, we invited members of the vulnerable persons standard community to submit duplicate copies of their questionnaire submissions to us so we could tabulate what we call the “voices from the margins”. I would point to—and I could submit to the committee separately—the report we compiled with essentially an overwhelming degree of concern and alarm at the direction Bill C-7 was heading with the removal of the requirement for the reasonable foreseeability of natural death. Given the limits of time, I would simply say that it is not a popularity contest; it's not a question for polling when you are considering whether or not to respect the human rights of part of your population. Of course we're are a minority—a significant minority of Canadians but a minority nevertheless. I think our voices need to be given particular attention, and they are in no way reflected in Bill C-7.
12:35 p.m.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
Thank you so much.
Madam Chair, how much time do I have?
12:35 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
I understand that the disabled are, on good grounds, concerned about removing the reasonable foreseeability of death criterion. However, I would say that it wasn't the government that decided to do this; it was the Truchon decision. As I've heard other people say, basically the reasonable foreseeability criterion is off the table and it was the court, in its Truchon decision, that took it off the table, and our government felt that the Supreme Court would only uphold the Truchon decision. That's one problem.
The other problem is that although I agree with almost everything I've heard from the disabled, there are people out there who insist—and I have spoken to a lot of people who feel it is very important to them—on being able to make such a fundamental choice should it arise for them.
Now this proposed legislation is here. It's before us. The Truchon decision was made. Is there not, in your opinion, any way we could amend the proposal to make it more acceptable to you? There are certainly a lot of safeguards in it, including proposed paragraph (3.1)(g), which requires from a medical practitioner or nurse the following:
ensure that the person has been informed of the means available to relieve their suffering, including, where appropriate, counselling services, mental health and disability support services, community services and palliative care and has been offered consultations with relevant professionals who provide those services or that care;
Hence, there is a requirement to tell people who might be contemplating using MAID about alternatives that would make their lives better.
Could we not amend what is here? Do you have any suggestions, or is the only way we can deal with this to appeal the Truchon decision or use the notwithstanding clause?
That's for anybody wanting to take it on.
12:40 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
Madam Chair, I am not a lawyer but I will say that the legal advice we've have is that it is unprecedented for the Government of Canada to amend the Criminal Code on the basis of a lower court decision.
I'm not sure that I would agree or that the people who have advised me would agree, and in response to the core question I would say that you cannot tinker at the edges of a fundamentally norm-shattering piece of legislation.
I am sorry to say that.
12:40 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you, Dr. Frazee.
Before I go to Monsieur Thériault, it is my oversight that we didn't go to Living With Dignity, Michel Racicot, for five minutes as a witness.
Go ahead, Monsieur Racicot.
12:40 p.m.
Lawyer, Living With Dignity
Thank you, Madam Chair.
As a lawyer and former president of the Living With Dignity network, I thank you for giving us this opportunity to share some observations. I will be very brief, as everything else is provided in our brief.
The Living With Dignity network was founded in 2010. This is a citizen network of over 5,000 allies that is closely following the evolution of end-of-life care in Quebec and in Canada. We have been there for all the stages, including the latest cases such as Lamb and Truchon.
Unfortunately, since the provisions on medical assistance in dying came into force in 2015 in Quebec, and in 2016 in the rest of Canada, we have been seeing increased relaxing of the safeguard measures, be it stemming from court rulings or the interpretation of those who implement medical assistance in dying.
We understand that the Government of Canada must now amend its legislation, but Bill C-7 goes much further by making numerous changes to safeguards that had, however, been deemed necessary in June 2016. I feel it is really dangerous and rushed to do this right now, during a pandemic, when the consequences of the current safeguards have not been analyzed in the review of current legislative provisions, which should begin soon. So we are asking that those safeguards be kept for everyone who is at the end of their life.
Concerning provisions that affect those who are not at the end of their life, we have heard the message from the entire community of persons with disabilities and their advocacy groups. They raised the same issue on Bill C-14 when the Senate proposed removing the end-of-life criterion. They are mostly ignored now, given the proposed amendments.
It is hard to understand how the federal Parliament can adopt the proposed measures, which would make Canada the most permissive country in that area, while making fine statements of principle in the preamble of Bill C-7, as it had done in the preamble of Bill C-14.
Finally, given certain court rulings that have undermined caregivers' conscientious objection, especially in Ontario, it would be desirable for the current legislative provisions to be strengthened to clearly stipulate that nothing in this bill can force anyone not only to practise medical assistance in dying or to assist someone in that practice, but also to refer an individual who is asking for medical assistance in dying to a colleague who does provide that service.
12:45 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much, Monsieur Racicot.
I will go on to Monsieur Thériault.
Mr. Thériault, you have six minutes.
12:45 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Madam Chair.
I will be quick, as I have only six minutes.
I first want to say to all the witnesses that I am very sensitive to their plea for better care. It is essential to continue calling for this. As I have already said several times, deficiency, whatever kind it may be, does not have to lead to a disability. A disability is a social issue, but a deficiency is not. So I am very sensitive to this fight and to what you have told us today.
However, the terms must be defined. Mr. Racicot, I really like the name of your network, Living With Dignity. It seems to me that living with dignity is above all about having the ability to exercise at any time our freedom of choice, our free will, our capacity for self-determination, especially in medical decisions. The idea is to be able to give free and enlightened consent without anyone affecting it.
That said, I have seen two issues in your brief's conclusion, and I will read to you the penultimate paragraph:
This legislative project, like those that paved the way for euthanasia in this country, gives the false impression that a person's dignity is essentially dependent on his or her autonomy. By administering medical assistance in dying to the person who requests it, one would supposedly respect his or her dignity (a dignity, however, that is inherent in every person, irrespective of their degree of autonomy). In such a discourse, it is implied that in order to die with dignity one must necessarily die earlier, from a death that is administered, chosen and above all anticipated. What a sad state of affairs.
It is indeed a sad state of affairs. However, the issue is that the Quebec Superior Court itself struck down legislation currently in force that stems from former Bill C-14 and evoked the same reasons—that it was forcing the individual to commit suicide, to put an end to their life before they had even reached their own tolerance threshold, which was violating the individual's right to life.
It should be pointed out that the autonomy discussed here is not physical in nature. I hope that is not what you are referring to. In fact, physical autonomy is only a condition fostering moral autonomy. Psychological autonomy is a necessary condition. When an individual loses their cognitive abilities, they can make no moral, practical or adequate judgment, so they cannot provide their free and enlightened consent.
You will agree with me that physical deficiency has nothing to do with autonomy, as defended here, in this bill. I hope you will not confuse all this.
12:50 p.m.
Lawyer, Living With Dignity
I'm not confusing all this, Mr. Thériault. However, I don't agree with you. We mustn't only look at the conditions in which people exercise their autonomy. We must first and foremost ensure that our society gives those people conditions to live.
I don't know whether you are aware, but I have met a lot of people at the end of their life, including my own wife, as well as some who were suffering from amyotrophic lateral sclerosis, ALS. What I have seen in practice is that, when we take care of people, when we support them, they want to live and not die.
12:50 p.m.
Lawyer, Living With Dignity
I am thinking of Martin Lauzon, who had ALS and has now passed away. He had to fight for months to get a voice activated wheelchair. It would have been easier for him to request medical assistance in dying than to obtain the appropriate care, and that is what we are hearing from everyone suffering from degenerative disease or disability.
I remind you that, in Quebec....
12:50 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
That's not what Sue Rodriguez was saying, or Ms. Carter, or Ms. Taylor, or Ms. Gladu, or Mr. Truchon.
I understand your personal experience, and I agree with you. As I said at the outset, care for disabled individuals must be demanded and improved. However, that is not what we are talking about here.
12:50 p.m.
Lawyer, Living With Dignity
No, but this bill talks about removing or weakening a number of safeguards, even for people at the end of their life, but the legislation should be reviewed.
12:50 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
It is precisely because terminally ill people are suffering needlessly, even though they are receiving optimal palliative care. It is possible for palliative care itself to be a source of suffering. I could provide you with much testimony on that.
12:50 p.m.
Lawyer, Living With Dignity
Listen, the idea is not to make people suffer....
12:50 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you, Mr. Thériault and Mr. Racicot.
Thank you.
We'll move now to Mr. Garrison for six minutes.
Please go ahead, Mr. Garrison.
12:50 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you very much, Madam Chair.
I want to start again by thanking the witnesses and paying tribute to the people from the disability community and their advocates. No change for disadvantaged groups ever comes without the very hard work and very principled stands taken by those people from their own community and from their advocates.
Of course, it's still my hope that these broader issues that are being raised will be dealt with in the statutory review of MAID legislation, because I think they have implications far beyond the narrow focus of Bill C-7.
That said, I have a couple of specific questions. My first question is for Monsieur Racicot.
Given that medical services are quite often limited in rural and remote communities, the question of referrals becomes a question of access to services for many Canadians. You were very clear that you believe that the duty to refer should not apply in the case of medical assistance in dying. Is that a consistent opinion you share for all medical services, or is this specific to medical assistance in dying? In other words, based on their beliefs, can physicians refuse to refer in other areas or is this specific to medical assistance in dying?