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.
1:10 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you, Mr. Racicot. I appreciate that.
Thank you, Mr. Virani.
We will now move on to Mr. Thériault for two and a half minutes.
Go ahead, Mr. Thériault.
1:10 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Mr. Racicot, you just said that you think medical assistance in dying is not end-of-life care.
The Quebec legislation has managed to include into a continuum of care a request to die stemming solely from the patient's desire and will, when the dying process has already begun and is irreversible. That should happen in a comprehensive context of palliative care.
Let's think of Cicely Saunders and Elisabeth Kübler-Ross. Palliative care is comprehensive support for the dying. It is an alleviation of psychological and physiological suffering. That is care, and a patient in palliative care sometimes gets better. Palliative care can slow down the dying process, which is irreversible, and cause undesirable effects that may be related to pain medication.
Do you think that medical assistance in dying requested by a so-called comprehensive palliative care patient, in the best of cases, is not end-of-life care?
1:10 p.m.
Lawyer, Living With Dignity
I don't consider it care. It is not care to such an extent in the medical and legal sense of the term that Bill 52 amended the Act Respecting End-of-Life Care to clarify that providing a patient with a substance to cause death has become a medical act. That was not previously the case. None of the Quebec legislation on health care ever mentions alleviating.... Although, according to the World Health Organization's definition, palliative care can in no case be an act causing death. Of course, there may be....
1:10 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Sorry, Mr. Racicot, but palliative care is not about letting the person die. It is care provided to alleviate pain, and in the alleviation of pain, a last dose will be administered that will be fatal. It is false to say that palliative care does not cause death. It will end up causing death, as you know very well.
We should wish for all humans on their death bed to be serene and ready to go. They should feel well supported in dying. I wish it to you, in any case.
1:10 p.m.
Liberal
The Chair Liberal Iqra Khalid
No. Unfortunately, we don't have that time.
We now have Mr. Garrison for two and a half minutes.
Please go ahead, sir.
1:10 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you, Madam Chair.
Could you just clarify when this session will be ending? We are considerably overtime. We may have to make some other arrangements.
1:10 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you very much, Madam Chair.
Given that we're drawing to a close here, I'd like to give my last time to Dr. Janz, having heard the questions and the presentations made here today, to make any final comments she would like to make to the committee.
1:10 p.m.
Chair, Ending-of-Life Ethics Committee, Council of Canadians with Disabilities
Thank you.
I think any civil society is based on a delicate balance of individual rights on the one hand and social responsibility on the other. We have seen from our neighbours to the south what happens when individual rights take precedence over social responsibility. A lot of people die needlessly. Do we as a country want to take that approach to MAID? Because that is what Bill C-7 currently does: It makes us into the U.S.
Thank you.
1:15 p.m.
Liberal
The Chair Liberal Iqra Khalid
I'm sorry, Mr. Garrison, but that is all the time you have.
I will go now to Mr. Moore for five minutes.
Go ahead, Mr. Moore.
1:15 p.m.
Conservative
Rob Moore Conservative Fundy Royal, NB
Thank you, Madam Chair.
Thank you again to all of the witnesses. There has been very informed and relevant testimony today. It raises grave concerns with me about the sufficiency of the amount of time the government has put forward to deal with this legislation. I feel that we should be having more meetings of this committee because we're hearing new perspectives now that we haven't heard in previous testimony.
It's been put out there that there's been some kind of unanimity and great support among the medical community, but, Dr. Frazee, we've seen a letter signed by almost 800 doctors who have expressed serious concerns about how Bill C-7 opens up the medical assistance in dying regime in Canada. I want you to comment specifically on something.
Bill C-14 had a number of safeguards in it. After the Truchon decision, the government responded with Bill C-7, but in doing so, it has stripped out a number of safeguards that it didn't have to: the 10-day reflection period, the requirement that there be two witnesses—things that could provide an element of safeguard for those who are engaged in this process. I'd like your comments on that, because I think it's greatly troubling when we see safeguards that were put in place very recently and then, at the first instance, we're stripping them away.
1:15 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
Yes, absolutely. We have been actively documenting—and we can provide ample evidence, anecdotal evidence—cases that come to our attention through the mainstream press and on social media of instances of how, even with the universally applied requirement of the most fundamental safeguard of reasonably foreseeable natural death, we see adverse impacts on people with disabilities. This has led to the raising of a human rights concern, as Dr. Janz mentioned, with the special rapporteur from the UN on the implementation of the Convention on the Rights of Persons with Disabilities.
We know there are problems with the existing law and we also understand that there is a review of that law scheduled at some point in the future, at which point I think we would advocate for much more rigorous and independent monitoring of the current practice of medical assistance in dying to ensure that it is applied and that its effects are equally felt and equally autonomy-promoting. At such a time, it seems really alarming to us—more than alarming, fundamentally wrong—to be removing safeguards, the most critical of which, as I've already said, is the requirement that you be at the end of your life.
1:20 p.m.
Conservative
Rob Moore Conservative Fundy Royal, NB
Dr. Frazee, we heard prior testimony today from Krista Carr from Inclusion Canada. She described this situation now as the “worst nightmare”. That's pretty strong language for those persons with disabilities. What is the government missing here in what I think is an overreach in this response?
Our position was that this should have been appealed. It was a lower court decision in Quebec and it should have been appealed. When you have a brand new bill, as Bill C-14 was, it's the government's responsibility to defend its legislation and at the first instance, it gave up on its own legislation and the safeguards that were in it.
I'd ask you to speak to why this would be described as the worst nightmare for those persons with disabilities.
1:20 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
1:20 p.m.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much for that, Dr. Frazee.
We'll now go on to Dr. Powlowski, for five minutes.
Go ahead, sir.
1:20 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Thank you.
I am, by my nature, not overly enthusiastic about MAID, having spent 35 years trying to do the opposite, providing people with life. That's certainly one of the reasons.
I have worked a lot in developing countries. It seems to me questionably ethical that we're putting all this money into helping people to die here when so many people around the world, but for a few dollars, die in other places.
Having said that, Bill C-7 was drafted after extensive consultation, including with the disabled.
Specifically on the question of removing the reasonable foreseeability of death criteria from the law, we've heard a lot of people today who are against that. To those people, I ask, what do you say to somebody who has a high spinal cord injury and ends up quadriplegic at a young age?
Dr. Goligher, as a fellow emergency room doctor, I'm sure you've seen some horrible injuries—burns, disfiguring injuries. I certainly hope that all those people manage, and we've seen them at least with the specific injury, and we certainly hope their life remains worth living, but for some people that may not be the case. Even though we provide them with all the assistance we can, they can still decide that they don't want to live that life with those disabilities. If, God forbid, this happened to any of my six kids—and certainly if it did I would do my best to make their life worth living—at some point should they decide they don't want to live, and you love them, shouldn't we be giving them the opportunity, should they wish to end it?
What is your proposal, then? Should those people not be given the option?
I throw that to anyone out there.
1:20 p.m.
Assistant Professor, Interdepartmental Division of Critical Care Medicine, University of Toronto, As an Individual
I'd be happy to address that.
There is no question that these patients may suffer greatly, but the thing that never fails to amaze me is the resilience of the human spirit. I have seen many patients with spinal cord injury and one of the things that is well documented in the literature, and as other witnesses have already said, it is that we often and nearly always profoundly underestimate the extent to which those patients value their lives and value other persons.
I have presented reasons why I would not be willing to participate in ending the life of a patient in that condition because it would be treating them as...a means to an end.
Now, it is a free society and some doctors are willing to do this, but if you're going to put this law in place then it needs to guarantee that someone like one of your children, in the terrible scenario that we all fear, which you presented, has all of the potentially reversible determinants of suicidality addressed.
For the patient I spoke of, who was just deeply, profoundly lonely and isolated, we ensure that those kinds of needs and concerns are addressed. This law needs to guarantee that those processes and the infrastructure are in place to meet patients' needs before they arrive at a position where they feel like they have no option left but to seek euthanasia.
1:25 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Does anyone else want to address that question?
1:25 p.m.
Lawyer, Living With Dignity
One thing that is important is to allow people sufficient time to adapt to their new incapacity, to their new disability. Most often—and the evidence that was presented by the federal government in the Truchon case, showed—people, once they have adapted to their new situation, find a meaning to their life, even to the extent of finding much more meaning than people who are not disabled. The literature supports that as well, as I'm sure you know as physicians.
We need time, and the 90-day period is not sufficient to adapt to this new situation when you cannot even get treatment in 90 days.
1:25 p.m.
Professor Emerita, School of Disability Studies, Ryerson University, As an Individual
Madam Chair, I saw Dr. Janz had her hand up and I also—
1:25 p.m.
Liberal
The Chair Liberal Iqra Khalid
My sincerest apologies. I understand the time limitations. If there is information on any questions that need further clarification by witnesses, could you please submit it in writing to the committee through the clerk? We'd appreciate that.
With that, having exhausted our two rounds of questioning, I would like to thank our witnesses for their time today. I will clarify, based on some of the testimony presented by witnesses, that we have established how much time is given for witnesses to be able to make their presentations at committee. We tried to accommodate based on what we could. I really do thank you for taking that time and for working within the confines of our justice committee.
Thank you.
To the members, I have two quick points.
First, the amendments or any proposed amendments you have are due Friday the 13th, by 4 p.m. Please note that if you would like some assistance in drafting amendments, get in touch with the legislative clerk if you have any questions they can answer.
The last thing is that we do have one open slot for this coming Thursday based on how the witness lists ended up landing. We have a written request from the Canadian Nurses Association to be invited, so if I have your consent, we will go ahead and provide that invitation to it to come in.
I see nodding. Just give me a thumbs-up so I can see it.
All right. With that, I thank you once again for a wonderful meeting—
1:25 p.m.
Conservative
Rob Moore Conservative Fundy Royal, NB
On a point of order, Madam Chair, again today we've gone overtime by half an hour. The testimony we're hearing is so important. We're not hearing unanimity; we're hearing different sides. We're hearing people speak with compassion on both sides of what's a really important issue. In light of all of this, I am going to be moving a motion that this committee study this legislation for two more days, two more two-hour sessions, so we can hear more testimony from more witnesses.
I recognize that the government has a timeline it would like to keep to, and I'd like to see us be able to do that, but I really feel that to do our job properly we need to hear more testimony, so I'm proposing a motion that we hear two more days' worth of witness testimony.