Justice Committee on Nov. 17th, 2020

[The Chair, Liberal, Iqra Khalid]

Does that answer your question, Mr. Moore?

[Rob Moore, Conservative, Fundy Royal, NB]

That's great. Thanks.

[The Chair, Liberal, Iqra Khalid]

Thank you.

I have Mr. Maloney next on the speaking list.

Go ahead, Mr. Maloney.

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

Thank you, Madam Chair.

Mr. Moore, was addressing the same point I was going to raise. The only thing I might add is that, in anticipation of this maybe happening again during the course of our discussions, it might be helpful to have the clerk or the legislative clerk provide us with the information in the analysis he provided to you in insisting you make a ruling before we vote to overturn it. I'm not suggesting that anybody's vote would have been different or the outcome of the vote would have been different in this particular case. I just think it's best that we're all fully informed, or as fully informed as possible, before we vote to overturn a ruling of the chair.

[The Chair, Liberal, Iqra Khalid]

Thank you very much for that, Mr. Maloney. I'll make sure that in any future rulings we do just that.

Ms. Lewis, I have you next on the list. Go ahead.

[Chris Lewis, Conservative, Essex, ON]

Thank you, Madam Chair.

Good morning, colleagues and members of the committee. I have a couple of comments and then a question for the legislative clerks.

Mr. Garrison, specific to you, sir, with regard to this amendment I know that during your second set of remarks you mentioned the risk of constraining conversations, which I find a little bit mind-boggling only because I believe you voted, sir, against additional meetings specifically on the motion I put forward to allow for more witnesses with disabilities, including indigenous. They were very interesting comments on that front.

Specifically to my question, Madam Chair, through you to the legislative clerks, I believe I understood the answer with regard to the Speaker getting “final say” but I'm wondering if it would also not go to the members of the House to rule on that. If I could please get some clarification I would appreciate it.

[The Chair, Liberal, Iqra Khalid]

Thanks, Mr. Lewis.

I'll just remind you to not address members directly. Just to keep the decorum of the committee, please refer to me instead.

[Chris Lewis, Conservative, Essex, ON]

My apologies to the committee member.

[The Chair, Liberal, Iqra Khalid]

Thank you. I appreciate that, Mr. Lewis.

I will just refer it to our legislative clerk then.

[Philippe Méla]

Again, to restate what I stated just a minute ago, if the amendment were to be adopted today, this amendment would be placed in the report that will be tabled in the House at a later date. At that point, a member of Parliament could raise a point of order to the Speaker of the House and say, “Mr. Speaker, I believe there are some amendments that were ruled inadmissible in committee that are presently in the report.”

At that point, the Speaker would turn to us for our analysis of the said amendment, an analysis that would be the same as the one we provided to the chair of the committee. At that point, it would be up to the Speaker to decide if, indeed, basically, he agrees with us or not. If he does, usually the course of action is to remove the amendment from the report and then ask for a reprint of the bill without the amendment in it.

[The Chair, Liberal, Iqra Khalid]

Thank you for that. We'll go to Mr. Garrison.

You're next on my list, Mr. Garrison. Please go ahead.

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

Thank you very much, Madam Chair.

In response to the question from Mr. Lewis, he knows full well that I have argued very strongly that all of these issues need to be aired before a special committee of the House in the statutory review, and in no way have I suggested that these issues should not be discussed further.

That, of course, is quite a different issue from the one I was referring to, and perhaps in my remarks I should have included not to constrain “lawful” conversations. In the advice that we heard from department officials, what they have said is that this amendment does not change the law in this case. It simply clarifies that having lawful conversations between medical professionals and patients is allowed, whether or not they have initially raised the question of medical assistance in dying.

Again, the chill that we're placing here on the relationship between patients and those who provide their care is what I'm trying to address, and I'm trying to make sure that relationship is not damaged inadvertently by a misunderstanding of what a lawful conversation is.

Thank you.

[The Chair, Liberal, Iqra Khalid]

Thanks very much for that, Mr. Garrison.

Having exhausted the speakers list, I'll call the question on NDP-1.

Is there any will for a recorded vote or is it on division?

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

I'd like a recorded vote, please, Madam Chair.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Cooper.

(Amendment negatived: nays 9; yeas 2 [See Minutes of Proceedings])

We'll now move on to BQ-1.

Mr. Thériault, do you want to speak to that or move it, please?

[Luc Thériault, Bloc, Montcalm, QC]

Yes, Madam Chair. Here it is:

A person who requests medical assistance in dying is, until the moment that medical assistance in dying is provided, entitled to the same palliative care that they would be entitled to had they not made the request.

I'll try to address the key issues in our discussions.

When a patient chooses to request medical assistance in dying, they should be entitled to palliative care. Stakeholders came and told us that, in palliative care, sometimes people change their minds because they're well treated. I'm talking about optimal palliative care. It would be a shame if a patient or a dying person who has requested medical assistance in dying were deprived of palliative care at home, in a hospital or in a hospice because of a lack of resources. This possibility exists.

Proponents of palliative care told us that people who receive optimal palliative care, which constitutes support until death, don't seek medical assistance in dying or they change their decision. The dying individual is faced with a choice. However, to make that choice, the individual must have access to both options. Therefore, I think that it's important to make this clear.

Of course, the provinces and territories are responsible for managing end-of-life care. However, within this exculpatory measure that gives a person the right to receive medical assistance in dying, whether or not their death is reasonably foreseeable, it would be worthwhile to establish at the outset Parliament's intent in terms of a continuum of care, given the reality on the ground, all the concerns and the polarization seen during this debate. That's the purpose of the amendment.

I fully understood the explanations given earlier. Our debate regarding Mr. Garrison's amendment led to a good procedural clarification. If we hadn't had a debate and rejected your decision, we might not have received all these clarifications right now.

I hope that I've clearly explained the purpose of the amendment.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Thériault.

I do have a ruling on this. Bill C-7 amends the Criminal Code to render medical assistance in dying more accessible to patients requiring it, but it does not address the level or quality of palliative care as is contemplated in this amendment. This is a new concept not envisioned by the bill. House of Commons Procedure and Practice, third edition, states on page 770:

An amendment to a bill that was referred to a committee after second reading is out of order if it is beyond the scope and principle of the bill.

Therefore, as stated, I rule this amendment inadmissible, and I will refer to the legislative clerk to explain a bit further for clarity.

[Luc Thériault, Bloc, Montcalm, QC]

I do want further clarification. What bothers me about your decision is your reference to the quality of care. This isn't about quality of care, but about a right to palliative care.

[The Chair, Liberal, Iqra Khalid]

I was just referring this to our legislative clerk to provide clarity on this ruling.

[Philippe Méla]

Thank you, Madam Chair and Mr. Thériault.

Bill C-7 doesn't address palliative care in general. It mainly addresses medical assistance in dying. As the chair pointed out, adding the concept of palliative care, which would be debated in terms of access to the same level of quality or the same level of palliative care, would go beyond the scope of the bill.

[Luc Thériault, Bloc, Montcalm, QC]

Okay.

[The Chair, Liberal, Iqra Khalid]

Thank you.

I see a number of hands raised. Is this specific to my ruling or to this amendment?

Mr. Garrison, you're at the top of my list. I'll just test the waters with you.

No...?

Mr. Virani.

[Arif Virani, Liberal, Parkdale—High Park, ON]

Madam Chair, it's substantively about the amendment and the fact that we're dealing again with the criminal law here. It's not germane to your ruling, but it's germane to the amendment.

I think it's not the purview of this legislation—nor probably is it the purview of the federal government—to wade into the type or quality of care, or access to certain types of health care at the provincial level. In my view that subverts the division of powers. I think it should be defeated in any event. I'm not going to opine on your ruling about admissibility.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Virani.

Mr. Moore, is that for the same...?

[Rob Moore, Conservative, Fundy Royal, NB]

Yes, it's on the amendment, Madam Chair.

My concern with this is that, in fact, this has everything to do with palliative care. The testimony we heard on the bill at committee certainly was that the quality of palliative care can have a direct impact on a person's approach to assisted dying.

Witnesses told us about a number of factors that go into that decision. Palliative care was certainly front and centre as a significant factor. In fact, when we talk about a person's choice to pursue assisted dying or not, it was presented to us that it's not a true choice if a person does not have access to palliative care, so I'd disagree.

I think this particular provision amends the Criminal Code. That was what was required when we brought in Bill C-14, and indeed in Bill C-7. It was required that some provisions in the Criminal Code be amended when it comes to counselling someone. The legislation touches on any number of factors dealing with consultation and dealing with the expertise of individual physicians.

It's quite clear to me that this particular amendment should be ruled in order.