moved that Bill C-304, an act to amend the Criminal Code (aiding suicide), be read the second time and referred to a committee.
Mr. Speaker, each year in Canada more than 190,000 Canadians die. We know that some 40,000 Canadians die each year of tobacco related causes and I am very pleased that this House has just passed Bill C-71 which will have an impact on health, in particular young Canadians.
Of those 190,000 Canadians who die each year, some die of heart disease, cancer, respiratory diseases, AIDS and other infections. They die of trauma, genetic illness or a host of degenerative diseases.
Among those Canadians who die each year are a small number of Canadians who unfortunately and tragically suffer terribly. The purpose of the bill before the House today is to amend the provisions of the Criminal Code of Canada, specifically section 241 of the Criminal Code, to allow individuals who are terminally or incurably ill, who are suffering terrible anguish, pain or indignity who cannot be assisted by palliative care, to seek the assistance of a doctor to end that pain and suffering.
The last time I introduced this legislation was September 21, 1994. Earlier that same year, on February 12, 1994, Sue Rodriguez died. Sue had fought a long and courageous battle, a long and courageous battle in Parliament through parliamentary commit-
tees, in the media, publicly through a variety of public fora and of course in the courts to change the criminal law.
On September 30, 1993 the Supreme Court of Canada ruled against her petition. By the narrowest possible majority of five to four, the Supreme Court of Canada upheld the constitutionality of section 241 of the Criminal Code of Canada. Before that the British Columbia Court of Appeal, again a deeply divided court with the chief justice of the court dissenting, upheld the constitutionality of that law.
What every judge of the supreme court clearly argued, what each of the three judges of the B.C. Court of Appeal powerfully and eloquently stated, was that this issue, this complex, difficult and in some cases agonizing issue, is one which must ultimately be resolved by the Parliament of Canada, which must ultimately be decided by the elected representatives of the people of Canada.
In the days following the death of Sue Rodriguez the Prime Minister of Canada and the Minister of Justice both promised in this House and elsewhere that there would be a free vote in the House of Commons, that each member of the House of Commons would wrestle with their conscience, would listen to the arguments of their constituents and others and would be allowed to vote on this change in a free vote.
In my speech on this bill previously in September 1994, I reminded the government of that promise. I reminded the government of the commitment that was made, the solemn commitment of the Minister of Justice, the Prime Minister and of many other members of the government to allow this House to vote on that issue. I suggested that there might be a vote on that issue hopefully by June 1995.
Here we are over two and a half years later, and after those promises were made what we see is once again betrayal, once again another broken Liberal promise.
There is a very important and fundamental principle here. Canadians are entitled to assume that when a minister of the crown, when the first minister, the Prime Minister, promises that the House of Commons will be able to vote, surely they are entitled to believe that promise, to take the Prime Minister at his word, to take the Minister of Justice at his word.
That has not happened. When I questioned the Minister of Justice last fall on this issue it was very clear that the House would not be allowed to vote in a free vote or any other vote on this issue in this Parliament. Shame on the government of Canada.
I hear one of my colleagues from the Reform Party agreeing, the member for Elk Island. Whatever one's perspective on this issue, surely we as members of this House should be given an opportunity to voice that perspective, to vote according to our conscience on this issue of how we live and how we die.
What has happened in the meantime since the last debate in this House in September 1994? Too many terminally or incurably ill patients have suffered, in some cases terrible pain or anguish or indignity, or they have been sedated to the point of pharmaceutical oblivion, or in some cases they have chosen to take their own life prematurely because they did not want to face those terrible choices. In some cases they have been assisted, assisted by a loved one, by a family member or by a doctor to end their life in some cases in defiance of the criminal law.
I recall the case of a gentleman from Windsor, Austin Bastable, who chose to leave his country. I say chose to leave his country. He felt he had no choice other than to leave his own country because he was not able to obtain the assistance he sought to end his suffering at the end of his life.
Under the present provisions of the Criminal Code of Canada for an individual who is one of those individuals, and I believe it is a very small number, who is terminally or incurably ill, who has sought the assistance of a physician, who has sought palliative care, pain management, that individual for whom palliative care or proper pain management simply and unfortunately did not respond to their suffering, what are their choices?
Yes, there are Canadians in that situation. Fortunately through good palliative care there are only a small number of Canadians who cannot be assisted. But even the Canadian Association of Palliative Care Physicians and others acknowledge that there are a small number who cannot be assisted by palliative care, who will suffer pain, anguish, profound indignity.
Under the existing provisions of the Criminal Code, those people, in the final few months of their lives, face one of two choices. I remind this House that suffering in many cases is shared by their families and loved ones. Either they continue to suffer or be sedated into a state of complete stupor or pharmaceutical oblivion, as one of the witnesses to the Senate committee recently said.
For some Canadians those choices are simply not acceptable. It is for that small number of Canadians that I believe another option should be made available. One of those Canadians was Sue Rodriguez. It is because I believe the other option, the other choice should be made available, with very strict safeguards to be sure, that I am presenting once again this private member's bill to amend section 241 of the Criminal Code.
I believe it is profoundly unjust and inhuman to force people to make that choice between suffering and anguish on the one hand and complete stupor and sedation on the other.
There have been some developments both in the law and in Parliament since the last debate in this House. The Northern Territory legislature in Australia became the first jurisdiction in the world to legalize, again with strict safeguards, changes in the law to allow for choice in dying.
Circuit courts of appeal in the United States, the second circuit, the ninth circuit, both ruled in favour of choice in dying.
A special committee of the Senate studied this issue in great depth and came to the same conclusion on the issue of assisted suicide as the Supreme Court of Canada. Again, by the narrowest possible majority, four to three, the Senate committee recommended against a change to section 241 of the Criminal Code.
However, I think it is particularly significant to note that the dissenting senators were Senator Joan Neiman who chaired the committee, a very distinguished senator who no longer sits in that place, Senator Sharon Carstairs and Senator Wilbert Keon, one of the most distinguished heart surgeons in Canada, who in the end supported the change in law which my bill would seek to achieve.
The committee members heard from many witnesses and made a number of profoundly important recommendations. Many of the recommendations I agree with. They recommended that governments make palliative care programs a top priority in the restructuring of the health care system. They recommended that the Criminal Code be amended to clarify the practice of providing treatment for the purpose of alleviating suffering that may shorten life. They recommended that the Criminal Code be amended and necessary legislation be enacted in order to explicitly recognize and clarify the circumstances in which the withholding and withdrawal of life sustaining treatment is legally acceptable. They recommended that provinces move ahead on advance directives.
As I said, a minority, three of the seven senators, recommended changes to section 241 of the Criminal Code as well as voluntary euthanasia for competent individuals who are physically incapable of committing assisted suicide.
Recently Senator Sharon Carstairs presented a bill in the other place, Bill S-13. I commend Senator Carstairs for her leadership on this issue. Her bill would provide that no health care provider who honours the wish of a competent person for the withholding and withdrawing of life sustaining treatment would be guilty of an offence under the Criminal Code.
We are told by a number of people that is the existing law and yet Dr. Wilbert Keon, who seconded Senator Carstairs and who strongly supports her bill, has said that there remains great uncertainty in the law in this area. He said that many doctors are looking for more definition and more direction from society as to how the subject should be addressed. He said that dying patients are suffering needlessly because their doctors do not want to provide adequate sedatives to reduce pain just in case the drugs themselves cause death and they find themselves facing criminal prosecution.
We should listen to the very powerful plea of Dr. Keon and others to at least take this modest step. When the bill ultimately comes to the House of Commons I hope members will see fit to support that change.
I am somewhat discouraged. If members of the government were not prepared to support a very straightforward proposal to effectively codify the existing law, it is clear to me the proposal to amend section 241 of the Criminal Code is still some way off in terms of support from the Government of Canada.
The Liberal politicians in this case and others are way behind the public. I commend the leader of the Reform Party, the member for Calgary Southwest, who some time ago canvassed the opinion of his constituents. In his survey he found that 82 per cent of his constituents supported this change in the law. The leader of the Reform Party has said that he would vote in respect of the recommendations of his constituents on the issue.
The fundamental issue is one of personal autonomy, the right of a competent adult to make this choice for himself or herself. There are a variety of models before the country. I do not have the time to outline them now.
The Right to Die Society, for example, has put forward a proposal by Dr. Eike-Henner Kluge that warrants serious examination. Dr. Stanley Rosenbaum on behalf of Choice in Dying and a number of people in Ottawa put forward another option. Dying with Dignity has yet another suggestion. There are a variety of proposals. There must be strict safeguards, but at the end of the day choice should be available.
Many doctors believe the law should be changed. A study presented last September to the annual conference of the Royal College of Physicians and Surgeons of Canada by two Calgary doctors, Dr. Douglas Kinsella and Dr. Marja Varhoef, found that a significant majority of doctors supported a change in the law to facilitate and allow physician assisted suicide. That survey was very extensive.
Dr. Marcel Boivert, a very respected palliative care physician at the Royal Victoria Hospital in Montreal, said:
We are playing ostrich if we do not believe that covert, active euthanasia is being practised right now. On Fridays, people who are near dying are having their doses of morphine increased by 50 per cent, 100 per cent or 150 per cent.
Surely it is time to take this issue out of the shadows. It is time to listen to the doctors, other health care workers and social workers like Russel Ogden who pointed out the extent to which this is
happening without any safeguards. It is sometimes horribly botched in the community of people who are dying of AIDS.
Sooner or later our laws will change to end this cruelty. I hope it is sooner. It is clear we cannot rely on the courts. Perhaps it will take a brave doctor to challenge the law. I do not believe in the narrow circumstances that any jury would unanimously convict. We recall it was another doctor who challenged the law on abortion which ultimately led to the Supreme Court of Canada striking down the law.
I urge Canadians who are concerned about the issue to ask candidates in the upcoming federal election where they stand on this important issue.
In closing, I remind members of this House that in her final public words Sue Rodriguez said:
I hope my efforts will not have been in vain and that the Minister of Justice will introduce legislation into Parliament soon so that terminally ill people will have another option available, thereby permitting physician assisted suicide for the terminally ill.
I quoted those words in concluding my remarks in September 1994. I wanted to quote those words again and leave the House with them. As I said at that time, I profoundly hope Parliament will respond to this plea.
I have to ask how much longer we must wait before the law changes. How much longer must we wait before the House is allowed to vote on the issue? How many more people and families must suffer in some cases unspeakable pain, anguish and indignity before the law is finally changed?