Justice Committee on Nov. 17th, 2020

[The Chair, Liberal, Iqra Khalid]

Madam Findlay, I have you next on the last.

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

I am a little confused, to be honest. I am just trying to understand this.

This amendment speaks to palliative care. We heard a lot of testimony on that. In the section that the amendment is sought for, it does speak to being eligible for health services funded by any government in Canada. The law as it is already speaks to the type of health care available. This is just being a little more specific.

I realize I am a new member of this committee since prorogation, but when we considered Bill C-3 as a committee, concepts were added on systemic racism based on committee testimony, some of which I had not heard as a present member of the committee. People kept referring to testimony of last February. It certainly wasn't in the original text and you didn't rule that inadmissible.

I am really confused here. This seems to me to be an amendment within the scope of health services funded by a government in Canada. We went way further, in my opinion, when we not only entertained, but adopted changes in Bill C-3.

I wonder if the clerk, or you as well, could comment on that.

[The Chair, Liberal, Iqra Khalid]

Thank you for that, Madam Findlay. Our legislative clerk did go into some detail with the explanation. I can refer this back to the legislative clerk, but you all have the option of challenging my ruling. If that is the case, you are welcome to do so. I will refer this to the legislative clerk to provide further clarification.

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

I understand that, but I didn't want to challenge the chair until I heard from the clerk again on my point about health services funded by a government in Canada.

[The Chair, Liberal, Iqra Khalid]

Go ahead, Mr. Clerk.

[Philippe Méla]

You're referring to a section of the act that is speaking about palliative care. However, what you have to look at is the bill. What is the scope of the bill? The scope of the bill was adopted at second reading by the House. If you look at the bill, rather than the act, you would see that the level of palliative care that a patient would have access to is not dealt with in the bill. That's the problem here.

It's not palliative care, which is indeed dealt with, as you pointed out, in the Criminal Code. It's the fact that it's not dealt with, even though witnesses came and talked about it. It's not addressed in the bill as far as the level or type of palliative care that you would obtain. That's what makes it inadmissible.

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

I would challenge the chair's ruling on this. When I think back to the testimony—which we didn't have enough of, frankly—palliative care was at the centre of much of the testimony we heard. With respect to Bill C-3, the social context was given as the reason to include a much broader range of discussion.

[The Chair, Liberal, Iqra Khalid]

Thank you, Madam Findlay.

Should the chair's ruling be sustained?

(Ruling of the chair sustained: yeas 7; nays 4)

The ruling is sustained. I ruled the amendment inadmissible, and it remains as such.

Mr. Moore, are you going to speak to CPC-1? Is that why you are raising your hand?

[Rob Moore, Conservative, Fundy Royal, NB]

No, it's not, Madam Chair. We've heard a great deal of discussion around palliative care. I respect the reasons you came to your ruling. To be very clear, subclause 1(7) of the bill mentions palliative care. It says:

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 40 with relevant professionals who provide those services or that care;

How can we on one hand say the bill does not deal with palliative care, when palliative care is mentioned in the bill?

[The Chair, Liberal, Iqra Khalid]

Mr. Moore, my understanding, as we've had quite a healthy discussion on this....

I have ruled and the ruling was sustained. I would like to carry on, if that's okay.

Mr. Moore, I'll come to you to move CPC-1 at this time.

[Rob Moore, Conservative, Fundy Royal, NB]

Actually, I think it's important that we have clarity on these things. People have taken the time to make amendments. Some of the rationale that's being used to exclude them runs completely counter to what's in the bill. I think it's important that we have some clarity on that. It impacts how we move forward.

[The Chair, Liberal, Iqra Khalid]

We have answered all questions by all members, and at this time I have ruled. We voted on the ruling. We need to go forward. Maybe we'll answer further questions when we get to CPC-1.

I'll ask you again, Mr. Moore, if you'd like to move CPC-1 at this time.

[Rob Moore, Conservative, Fundy Royal, NB]

Yes, I would like to move CPC-1.

[The Chair, Liberal, Iqra Khalid]

Go ahead, sir.

(On clause 1)

[Rob Moore, Conservative, Fundy Royal, NB]

CPC-1 is being moved because of some of the significant testimony we heard from health care providers. I reference a letter that was sent to committee members that was signed by, I think, upwards of 900 health care providers, many of whom are concerned about the relationship between a patient and their doctor, which is the ultimate trust relationship. There's no more important relationship, certainly, that's not a family relationship, than the relationship between a patient and their doctor.

Many doctors, with this significant expansion to the assisted dying regime, have raised with us their concerns about the provision of assisted dying as it relates to them in their profession. These are hard-working individuals who help make our community and our society better. They help to heal people. That's what they do. That's what they want to do, but they're concerned about the impact of this legislation on their ability to do that, and principally on the relationship they have with their patients.

This amendment, CPC-1, would provide for conscience protections for physicians as it relates to this expanded assisted dying regime.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Moore.

At this time, I would like to give a ruling on CPC-1. Bill C-7 amends the Criminal Code to render medical assistance in dying more accessible to patients requesting it. CPC-1, this specific amendment, seeks to create a new offence against a person who would compel a health professional to offer the service of medical assistance in dying. This is a new concept that is not envisioned by the bill.

House of Commons Procedure and Practice, third edition, states the following 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.

In my opinion, amendment CPC-1 is creating a new concept that is beyond the scope of the bill. Therefore, I rule this amendment to be inadmissible.

This ruling also applies to CPC-10, but we'll get there shortly.

I will give the floor to the legislative clerk to explain this a little further for members' clarity as well.

[Philippe Méla]

Thank you, Madam Chair and Mr. Moore.

CPC-1 basically adds to proposed new section 241.5, which is described in CPC-10 on page 19 of the package.

As you point out, it basically criminalizes the activity of compelling health professionals to provide medical assistance in dying. The bill does not create a criminal regime. Unlike Bill C-14, which was creating a new criminal regime for all sorts of activities related to medical assistance in dying, Bill C-7 doesn't do that. Therefore, the amendment would go beyond the scope of what the bill does.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Clerk.

Mr. Moore, is your hand raised on this specific matter?

[Rob Moore, Conservative, Fundy Royal, NB]

Yes, it is. It's very clear that this amendment deals with something that is very topical to Bill C-7. It deals with the physician-patient relationship. It's a necessary amendment, in light of the testimony we heard on Bill C-7, so I do need to challenge the chair's ruling in this regard.

[The Chair, Liberal, Iqra Khalid]

Thank you for that, Mr. Moore.

We'll go to the clerk to call the question on whether to sustain the ruling.

(Ruling of the chair sustained: yeas 6; nays 5)

The ruling is sustained.

We will now carry on to our next amendment in the package, which is PV-1. Because it is moved by Mr. Manly, my understanding is that all of these PV amendments are deemed moved in the committee, because he is not a permanent member.

Mr. Manly, I'll turn to you to speak to PV-1 at this time.

[Paul Manly, Green, Nanaimo—Ladysmith, BC]

Thank you very much, Madam Chair.

The amendment is with regard to people who are seeking MAID when:

(c) they experience enduring physical or psychological suffering that

(i) is caused by that illness, disease or disability or that state of decline,

(ii) is intolerable to them and cannot be relieved under conditions that they consider acceptable, and

(iii) is not the result of deprivation, social disadvantage, lack of support or perceived discrimination.

In my discussions on MAID with the local disability community, there were concerns raised. I was sent this amendment by the executive director of the Nanaimo Association for Community Living, Graham Morry. This was also an amendment that came through Inclusion BC.

In my community, in my office, every day I see people who are homeless. There is a large homeless camp behind my office, and when I go by I see people in wheelchairs and walkers, and I know there are disabled people in that camp. The health issues they face continue to degrade their health because of their deprivation, because they are homeless. People in my community wanted to ensure there was more of a safety net in place for people with disabilities.

I believe this bill does protect people with disabilities, but the language needs to be clearer, so that people feel satisfied they're protected.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Manly.

Mr. Virani, go ahead on PV-1.

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

Thank you very much, Madam Chair.

Mr. Manly, welcome and thank you for the contributions you're making to the debate by proposing amendments.

I'll confess that this is a difficult one. Obviously, all of us have some sympathies for the issues you're highlighting—deprivation, social disadvantage, lack of support and perceived discrimination. There's no doubt about that, but the concern I would outline is about the autonomy of the individual.

I don't deny that the suffering people experience can be exacerbated by the factors you outlined, but what I'm concerned about is that if we were to proceed with this kind of amendment, it would effectively bar access to MAID for persons who are suffering intolerably if they also happen to be suffering as a result of their discrimination or social disadvantage. That, to me, would undercut their autonomy and dignity.

We have to address the ills you're identifying, there's no doubt. Those stakeholders who communicated with you are highlighting very important, pressing causes, but I think the way we address those ills is through societal changes and through additional supports, not by denying people in that situation access to MAID if they are otherwise eligible, make a voluntary request and give informed consent.

On that basis, I would not be supporting this amendment, but I thank you for offering it up.

[The Chair, Liberal, Iqra Khalid]

Thank you, Mr. Virani.

I have Mr. Moore next on the list, on PV-1.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Madam Chair, and thank you for this amendment.

I think this is a sound amendment. It speaks to some of the testimony we heard. I know I keep referencing back to the testimony, because that's important in how we do our job as members of Parliament and members of this committee. We had very limited testimony, but in the testimony we heard for four days, and then in the written submissions that have come in, we heard over and over that lack of support...someone cannot make a true decision. These decisions aren't made in a vacuum, so their choice is not a true choice if, as referenced in our amendment, the palliative care options aren't there.

This amendment says, “enduring physical or psychological suffering that...is not the result of deprivation, social disadvantage, lack of support or perceived discrimination.” I think this is an amendment that is well thought out. I'm glad it was brought forward. Based on the witness testimony that we've heard, particularly around vulnerable Canadians, Canadians who don't have some of the opportunities that we may have, I think this is one worth supporting.

Thank you.