Thank you, Madam Chair and members of the committee. Good afternoon.
I would like to acknowledge the Algonquin Anishinabe peoples, from whose traditional lands I am speaking to you today.
Thank you, Madam Chair and members of the committee, for responding to CNA's request and extending an invitation for us to speak about Bill C-7. We are honoured and grateful for the opportunity to appear before the committee in the Year of the Nurse and the Midwife 2020. I do not need to tell any of you that it has not been quite the year of celebration that we had planned.
I have worked in health systems for more than 40 years, and 37 of those as a registered nurse. I have had the honour of serving as the CEO of the Canadian Nurses Association since 2017.
CNA is the national and global professional voice of Canadian nursing. We represent nurses living across all 13 provinces and territories and in hundreds of indigenous communities.
Canada’s 440,000 nurses touch the lives of patients at every point of care constantly, and no provider has as much face time with the public, where these really complex, human moral issues arise. The transformative legislative and moral decisions being proposed carry huge impacts for nurses who are responsible to live with them and enact them in their practices every day.
Nurses are an integral part of the delivery of medical assistance in dying and it is vital that the committee hears their voices. We have acquired significant knowledge, perspectives and experience from nearly five years of MAID in practice and have valuable knowledge to inform the impending changes to the legislation.
CNA has been actively involved in work related to MAID for several years and was the key stakeholder when Bill C-14 was passed in 2016, as well as during the consultations in early 2020. CNA advocates for safeguards to protect the rights of patients and nurses, as well as for system-level changes, including better access to palliative care and accountability mechanisms. I will turn briefly to Bill C-7 now.
Overall, CNA believes that the federal government has listened to our initial feedback during the consultation phase earlier this year. We are pleased to see that some of our recommendations were included, such as the removal of the 10-day reflection period, removal of final consent for those who lose capacity and the amending of the legislation to allow for one independent witness.
Regarding the new stream for cases where natural death is not foreseeable, we heard from experts that the proposed safeguards are adequate and sufficient. We emphasize that legal expertise for updating MAID guideline documentation will be critical to ensure that all new items in the legislation are acknowledged and fully understood by patients and practitioners.
In general, while we're supportive of Bill C-7, we believe that further improvements and additional clarification in four areas would strengthen the legislation and provide better care for patients and legal protection for nurses.
First, CNA strongly recommends that Bill C-7 includes an additional five-year review period of MAID by a committee of Parliament.
Second, we recommend removing the wording that stipulates that the practitioner providing MAID does not know or believe they are connected to the other practitioner who assesses the MAID criteria.
Third, we recommend clarifying that practitioners can initiate a discussion on the lawful provision of MAID.
Fourth, we recommend clarifying the proposed “preliminary assessment” clause, which we find confusing and that is causing some concerns among nurses.
Furthermore, we strongly recommend that parliamentarians conduct as soon as possible the broader review of MAID to address important issues beyond Bill C-7.
In concluding, CNA would like to state its gratitude to the Canadian Nurses Protective Society, who has been an important partner in our MAID-related work. We submitted a written brief with more information, and I am glad to try to answer any questions.
Thank you again, Madam Chair, for the opportunity to speak to this committee today.