Evidence of meeting #7 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.

On the agenda

MPs speaking

Also speaking

Clerk of the Committee  Mr. Marc-Olivier Girard
Jennifer Gibson  Director and Sun Life Financial Chair in Bioethics, University of Toronto Joint Centre for Bioethics, As an Individual
Alain Naud  Family Physician and Clinical Professor, Department of Family and Emergency Medicine, Laval University, As an Individual
André Rochon  Retired Justice of the Québec Court of Appeal, As an Individual
Michael Villeneuve  Chief Executive Officer , Canadian Nurses Association
Anne Boyle  President, Canadian Society of Palliative Care Physicians
Harvey Chochinov  Distinguished Professor of Psychiatry, University of Manitoba, Canadian Society of Palliative Care Physicians
Bonnie Brayton  National Executive Director, DisAbled Women's Network of Canada
Catherine Ferrier  President, Physicians’ Alliance against Euthanasia

Noon

Conservative

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

I'm having some concern about what I see as a gap in the logic. For me as a lawyer in British Columbia, if we are writing up a will, two independent witnesses have to sign it to ensure its authenticity and intention—and that's dealing with asset distributions upon death. Under Bill C-7, there's only going to be the need for one independent witness.

Do you see a gap in logic there as I do, or not?

Noon

David E. Roberge

The CBA working group on end of life did not address and discuss that issue specifically. I would refrain from voicing any opinion on this issue at this stage.

Noon

Conservative

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

All right. Thank you.

My next question, Madam Chair, is for Dr. Naud.

Thank you for joining us today.

This committee has heard from several individuals and groups who are concerned about the bill, believing that it may harm both the medical profession and our country's most vulnerable. We've received a letter signed by 800 doctors from across, who have stated:

We watch in utter dismay and horror at how the nature of our medical profession has been so quickly destroyed by the creation of misguided laws. We, the undersigned, declare that the passage of Bill C-7, if left unchecked, will contribute to the destruction of much more than our medical profession, but fundamentally, of a Canadian society that genuinely values and cares for its most vulnerable members.

What do you say to these nearly 800 doctors—obviously your colleagues—who are worried about this bill's impact on both the medical profession and vulnerable Canadians?

Noon

Liberal

The Chair Liberal Iqra Khalid

Answer very briefly, please, sir.

Noon

Family Physician and Clinical Professor, Department of Family and Emergency Medicine, Laval University, As an Individual

Dr. Alain Naud

Thank you, Ms. Findlay.

These physicians represent fewer than 1% of the physicians in Canada. There is a world of difference between doctors who are at the bedside of the patients asking for medical assistance in dying, who are involved, who are committed, who know what they are talking about, who are able to testify that it is a rigorous process, and doctors who will talk about medical assistance in dying, but who have never met a single patient, who have never been involved, and who often show contempt for those patients by refusing to meet with them if they have applied for medical assistance in dying. This tiny proportion of doctors—

12:05 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you, Dr. Naud.

We will now go to Mr. Virani for five minutes.

12:05 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you very much, Madam Chair.

In returning to the position about the person with disabilities, Senator Chantal Petitclerc stated in response to what she heard at committee on Tuesday that the persons who appeared cannot possibly—

12:05 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

I have a point of order.

I'm sorry to interrupt, Mr. Virani.

Madam Chair, do we have a second panel starting at 12 o'clock? Are they waiting?

12:05 p.m.

Liberal

The Chair Liberal Iqra Khalid

Yes.

12:05 p.m.

Conservative

Rob Moore Conservative Fundy Royal, NB

When are we wrapping up this panel and starting the other? We only have an hour for the next panel.

12:05 p.m.

Liberal

The Chair Liberal Iqra Khalid

You're absolutely right, Mr. Moore. As per the discretion allotted to me, I have been feeling over the past number of meetings that we haven't been able to allow our first panels enough time, so I'm trying to move through as much of the second round as I can to be equitable to all parties.

If members will allow, following Mr. Virani, I would like to give Mr. Thériault and Mr. Garrison two and a half minutes each before we move on to the second panel.

Is that okay with everyone?

Thank you.

Go ahead, Mr. Virani.

12:05 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you.

As I was saying, Senator Peticlerc said yesterday in respect to what she heard from the witnesses at committee on Tuesday:

They cannot possibly represent and speak for all persons with a disability. Obviously, because you know they don't speak for me.

Furthermore, she said that neither did they speak for Nicole Gladu or Jean Truchon, the two Montrealers who successfully challenged the provision in the assisted-dying law—who committee members know are themselves persons with disabilities.

I want to ask the former judge Monsieur Rochon and Mr. Roberge a question about the Truchon decision. A witness on Tuesday impugned the integrity of that decision by alleging conflicts of interest and bias in deciding the case and said that, in fact, there should have been a recusal of Madame Justice Baudouin in that case.

Mr. Rochon, as a former member of the Quebec court, do you have any comments on that attack on the Quebec court and its independence?

12:05 p.m.

Retired Justice of the Québec Court of Appeal, As an Individual

André Rochon

Justice Baudouin's decision has not been appealed. In my opinion, it is well founded and is very much in keeping with the principles of the Carter decision.

Justice Baudouin affirmed two fundamental principles that underlie her decision and that deserve to be recognized. The first is that this assessment is made on an individual basis. The second is that denying people medical assistance in dying constitutes discrimination against them.

12:05 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you.

Mr. Roberge, do you have any comment on that aspect of the Truchon decision?

12:05 p.m.

David E. Roberge

Not really. Again, it wasn't really within the mandate of the CBA's working group on end of life to address the question you just raised.

12:05 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you very much, Dr. Roberge.

I will turn to Dr. Gibson.

Criticism has been volleyed with respect to the consultation that's happened with respect to Bill C-7. I personally had somebody who participated in those consultations note that these were quite robust and extended to many cities around the country. Three hundred thousand people provided input via a questionnaire, and 125 experts were engaged, of which I believe you were one.

Could you comment from your perspective on the robustness of the consultations with respect to Bill C-7, Dr. Gibson?

12:05 p.m.

Director and Sun Life Financial Chair in Bioethics, University of Toronto Joint Centre for Bioethics, As an Individual

Dr. Jennifer Gibson

In fact, I must confess that I thought it was far more robust than I might have anticipated and probably even more robust than what we saw in previous conversations about medical assistance in dying.

From that perspective, I think there were multiple opportunities for folks to weigh in, but I also think, just looking at the witness list, that the individuals and groups who were being invited to this table.... I'm really noting that the committee is canvassing a diversity of views, which I think is the strength of this process, augmenting what you already would have seen from the consultation process across Canada.

The transparency of these meetings, as well as the reporting, I think serves to provide something that citizens as well as individuals from protected groups can look at to see the extent to which their voices have been heard. I think there has been some seriousness taken to ensuring that diversity of views, at least from where I sit from somebody on the outside.

12:10 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you, Dr. Gibson.

I have one final question for you. Can you tell us from an ethical perspective, since you have a Ph.D. in bioethics, about the notion of, as I think you put it in your opening statement, a 10-day waiting period when people deprive themselves of their sedative drugs, and what that does for their suffering simply for the purposes of holding onto the ability to provide final consent?

We're trying to craft a bill in our legislative regime that alleviates suffering. What does a 10-day waiting period do for those individuals? Can you comment on that?

12:10 p.m.

Director and Sun Life Financial Chair in Bioethics, University of Toronto Joint Centre for Bioethics, As an Individual

Dr. Jennifer Gibson

What I was trying to suggest is that, when we think about introducing safeguards, we need to think further down the road, not just about protection but also about the possible impact and implications.

What we have learned is that the 10-day waiting period had the unintended and inadvertent consequence of extending a person's suffering, specifically individuals who were eligible for MAID and had well-considered views.

The impact on suffering, I think, is the real concern for us when we're thinking about safeguards.

12:10 p.m.

Liberal

Arif Virani Liberal Parkdale—High Park, ON

Thank you very much.

That's all, Madam Chair. Thank you.

12:10 p.m.

Liberal

The Chair Liberal Iqra Khalid

Thank you, Mr. Virani.

Monsieur Thériault, please go ahead for two and a half minutes.

12:10 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Thank you, Madam Chair.

Dr. Naud, some witnesses and some briefs argue that the conscientious objection rights of certain physicians should be justification for Parliament to not require them to refer a patient seeking medical assistance in dying to a physician who provides it. These conscientious objectors do not want to refer or be required to refer those patients to a physician willing to administer the MAID.

Would that not be unethical?

12:10 p.m.

Family Physician and Clinical Professor, Department of Family and Emergency Medicine, Laval University, As an Individual

Dr. Alain Naud

Thank you for your question, Mr. Thériault. It is extremely important and you are quite right.

Conscientious objection is a personal value that a caregiver cannot impose on sick people, let alone vulnerable sick people. Therefore, all colleges of physicians in Canada require their members to transfer a request for medical assistance in dying if they have a conscientious objection. This objection is currently very well protected by legislation and by the guidelines of the provincial colleges of physicians.

I will draw a parallel with blood transfusions. If you are a doctor and a Jehovah's Witness, you are opposed to blood transfusions. If you refuse to give a transfusion to a patient of yours who needs it, or to refer them to a colleague, you are committing serious professional and ethical misconduct.

The same is true with medical assistance in dying. A physician has a perfect right not to participate and this right, which is very well enshrined in current legislation, must be protected. Instead, the bill should impose an obligation to transfer because, ultimately, what is at stake is the patients' well-being, not the protection of physicians' personal, religious or other beliefs.

12:10 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Not all medical students go into neurosurgery or surgery. Medical practice covers many areas. Given the fact that we have only five years of experience in providing medical assistance in dying and in providing choices to the dying and to patients, do you consider that the current training in medicine is adequate?

12:10 p.m.

Family Physician and Clinical Professor, Department of Family and Emergency Medicine, Laval University, As an Individual

Dr. Alain Naud

All medical schools, at least those I know well, in Quebec, have seen great improvements in recent years in terms of medical assistance in dying.

Increasingly, students are becoming aware of this legitimate choice available to patients and I can confirm, since I am with these students, that young doctors starting to practice are very interested in considering and respecting that care.