Debates of May 2nd, 2016

Criminal Code

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, I hope that the committee will continue the work when the bill gets there.

One of my frustrations is that many of the thoughtful recommendations that were brought forth by the last committee were not put into this bill.

I would like to see a review of the wonderful recommendations that were already made, and to make sure that we do not repeat the work that was already done.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, this is a difficult topic, and I am generally in agreement with what the member has put forward.

We heard earlier from the parliamentary secretary to the Prime Minister that there would be a possibility for amendments. I am wondering whether the hon. member for North Island—Powell River has considered amendments from her party, and whether we have any indication that the Liberal government will in fact entertain amendments that come from opposition members of Parliament.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, it is very important that all voices be heard strongly in this process.

For me in the work that I am doing, speaking with my riding has been very powerful. People are concerned. People are very supportive. Some people are very unsupportive of this process.

It is important that the government continue to do its work, to make sure that the voices are heard, so that the voices of the ridings across this country are heard.

[François Choquette, NDP, Drummond, QC]

Mr. Speaker, I want to congratulate my hon. colleague on his excellent speech. It was very well delivered and very well explained. Truly, I could not have done better.

I also want to thank my hon. colleagues from Saint-Hyacinthe—Bagot and Victoria for their excellent work on this special committee to arrive at the findings we have here.

What struck me most in my colleague's speech was the issue of palliative care. The NDP worked very hard to put in place a palliative care strategy. In my riding, we have Maison René-Verrier, which does excellent work for people who, sadly, are at the end of their life. It is very important to support those people, to be very close to them, and to help them get through this stage we must all go through.

I would like my hon. colleague to say a bit more about the importance of providing palliative care. Unfortunately, the Liberal government still has not delivered on its promises on palliative care.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, that is an excellent question.

Palliative care is so important. We do have an aging population, and as people get to that part of their life, they want to know the services are there for them. I represent a vast riding with many rural communities. We face many challenges in helping people stay in their communities for a period of time as they age.

Having a Canadian strategy that really engages the provinces and territories to work collaboratively to meet the needs of constituents across this country is imperative. We have already had a vote on a motion that the member for Timmins—James Bay presented and that was nearly unanimous.

In this House, we know palliative care is important. I hope we continue our work to make sure that service is delivered.

[Chris Bittle, Liberal, St. Catharines, ON]

Mr. Speaker, I am pleased to have an opportunity to participate in the second reading debate on Bill C-14, the proposed legislative approach to medical assistance in dying in our country.

This is a historic bill, and it tackles an issue that is of great interest and importance to many Canadians. It is also one that raises divergent and deeply held personal views, which is why broad consultations with a variety of groups and organizations were essential before reforms could be developed and considered by Parliament.

Members are aware that a special joint committee of the House of Commons and the Senate recently studied this issue, in January and February of this year, and in the context of that study, had the opportunity to hear from 61 witnesses and consider over 100 written briefs.

Other recent consultation initiatives were undertaken by the federal external panel on options for a legislative response to Carter in Canada, from July to December 2015, and the provincial and territorial experts advisory group on physician-assisted dying, from August to December 2015. Each panel met with representatives of dozens of stakeholder groups and received numerous written submissions from key organizations, including the medical sector, disability rights groups, legal and civil liberty organizations, and faith groups. Furthermore, many of the organizations that were consulted held extensive consultations with their own membership, some over the span of years, and shared the benefit of those with these panels.

Of course, we are also indebted to the years of consultations undertaken by the provincial government in Quebec leading up to its own legislation in this area. The extensive work that those in Quebec undertook was carefully considered, and I thank them for their leadership on this issue. It informs this proposed legislation as well.

The broad and in-depth consultations that have occurred over the past year across this country have undoubtedly enriched the policy development process that has led to the introduction of Bill C-14. I am pleased to see in the document entitled “Legislative Background: Medical Assistance in Dying (Bill C-14)” which accompanied the bill and was tabled in this place by the Minister of Justice, that the development of the proposed legislation was informed by the evidence before all levels of court in the Carter case by available Canadian and international research, social science evidence, governmental reports, and parliamentary studies.

That document also tells us that it was informed by the experience of existing international medical assistance in dying regimes around the world, as well as by numerous recent consultation activities on medical assistance in dying, including the work of the special joint committee, the federal external panel, the provincial-territorial expert advisory group, the work of the Canadian Medical Association and the College of Family Physicians of Canada, as well as the work of the provincial colleges of physicians and surgeons.

The consultation process has been robust and comprehensive. This has provided an opportunity for a variety of stakeholders from diverse perspectives to share their views and to reflect the views of other stakeholders who may not necessarily share their point of view.

I would like to briefly outline the considerations that some of the key stakeholders have raised with respect to this issue. One of the key stakeholder groups on this issue, given the active role they will be playing in response to requests for medical assistance in dying, is the medical profession, and by that I mean the various types of health care providers, such as doctors, nurses, pharmacists, nurse practitioners as well as their regulatory bodies.

The importance of this issue for the medical profession was underscored by a representative of the Canadian Medical Association who appeared before the special joint committee and testified that medical assistance in dying is a difficult and controversial issue for the medical profession, that it represents a sea change for physicians in Canada.

Many of the people who spoke from the perspective of the medical profession emphasized the need for clarity in the law so that health care providers are crystal clear about what is permissible and what is not permissible in providing medical assistance in dying, and that federal legislation is needed to ensure national consistency.

I am pleased that the proposed legislation responds to that request for clarity and consistency. Bill C-14 comprehensively sets out who can do what and to whom, and which safeguards are to be complied with. Moreover, as it is a proposed amendment to the Criminal Code, it would apply equally across Canada.

The unanimous decision of the Supreme Court of Canada in Carter focused on the role physicians could play in medical assistance in dying. I am pleased to see that in Bill C-14 explicit exemptions are also included for other types of health care providers, such as nurse practitioners, pharmacists, or other persons who would assist a medical practitioner or nurse practitioner with a request for medical assistance in dying.

This is responsive to the wealth of information received from representatives of nursing to pharmacist organizations in the course of various consultations.

Another important request that was raised by the medical profession was the need to respect the conscience rights of health care professionals who may object to providing medical assistance in dying. I would highlight that the bill makes explicit reference in the preamble to respecting the personal convictions of health care providers.

I will also note that the government has committed to working with the provinces and territories to support access to medical assistance in dying by connecting willing health care providers with patients. To me, this strikes an appropriate balance between supporting patient access or respecting the conscience rights of health care providers, as well as the jurisdiction of the provinces and territories.

Lastly, the medical profession, among other stakeholders, expressed a strong desire for a national monitoring system for medical assistance in dying. I am very pleased to see that Bill C-14 would empower the Minister of Health to make regulations to establish a federal monitoring system, with the associated requirements for health care providers who would be responsible for handling requests for medical assistance in dying to provide information for the purpose of that monitoring.

Several key stakeholders, and in particular disability rights groups, raised the necessity of robust safeguards to protect the right to life of every person in our country. This of course includes people who are ill, elderly, or disabled. Some national disability rights groups also indicated that stringent safeguards were needed to ensure the voluntary nature of a request for medical assistance in dying, free from any pressure or coercion, and based on informed consent, the heart of which was ensuring the patient had the capacity to make the decision in question.

The consultations that have occurred thus far, and the ones that will continue over the coming week, are crucial to ensuring we get this bill right. I am very much looking forward to the testimony that will be presented before the Standing Committee on Justice and Human Rights this coming week, a committee of which I am a member. I am eager to gage the opinions of all sides of the medical assistance in dying debate. I look forward to working with my committee colleagues to bring this bill back to Parliament and have a sound framework in place by the June 6 Supreme Court of Canada deadline.

Parliament has debated the issue of medical assistance in dying on several occasions over the past two decades. Each time, it was not able to support amendments to the Criminal Code to make this a reality for Canadians. The time has come to make this change. I believe this proposed legislation should be passed. I agree with the legislative background paper the Minister of Justice has tabled, and its statements that this proposed legislation strikes an appropriate balance between the autonomy of those seeking access to medical assistance and the interests of vulnerable persons in our society. I would urge all members of the House to support the second reading of Bill C-14.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, I want to thank my colleague for pointing out that a few times tonight reference has been made to “when this bill gets to committee”. It in fact is in committee right now, and the committee has started its work. I understand it has had four hours of study already, and it will continue that tomorrow.

My colleague referred to broad consultation a number of times. He referenced the expert panel. We have the expert panel report. Unfortunately, the Liberal government chose not to accept any recommendations from the expert panel. Therefore, we are somewhat limited with respect to broad consultation.

Also, in terms of broad consultation, a number of groups requested to appear before the joint committee that were not allowed to be present simply because of the time pressure. Therefore, to use the term “broad consultation” is a bit of a stretch. However, I certainly hope that in the next week of study at the justice committee there will be broader consultation.

My colleague referred to the fact that this should apply equally across Canada. I wonder if he would agree that if we can apply the access to physician-assisted dying across Canada, we could also at least ensure conscience right protection for physicians and other medical health practitioners, as well as institutions that offer health care, be applied equally across Canada.

[Chris Bittle, Liberal, St. Catharines, ON]

Mr. Speaker, the consultations have been broad. The joint committee heard from over 60 witnesses and received over 100 different briefs. Over the next week, my colleagues and I will hear from 42 witnesses. We have yet to determine the number of briefs that we will receive, but I expect it will exceed the number of witnesses who we are hearing. We are getting a broad variety of opinions from faith groups, medical associations, individuals, and bar associations.

The other issue that my hon. friend brought up was conscience rights, and whether they can be enshrined. This is a Criminal Code amendment at its core. This law would not compel physicians to do anything. We have to respect the jurisdiction of the provinces and the provinces regulate medical professions and so do the independent colleges of physicians and surgeons and colleges of nurses, and so on and so forth. We have to respect the rights of the provinces to legislate in that regard.

[David Graham, Liberal, Laurentides—Labelle, QC]

Mr. Speaker, the member for St. Catharines is right, that the process is not over. There are more people to hear from, more studies to be done, more details to be hashed out.

Would the member like to remind our colleagues what the results of not passing Bill C-14 would be? The Carter decision does not provide us a deadline after which the status quo remains. There are real world results for this being defeated. Would the member like to address the real world effects of this bill not passing?

[Chris Bittle, Liberal, St. Catharines, ON]

Mr. Speaker, the Supreme Court has been clear. It has set for us a deadline of June 6 to pass legislation. This is not a matter of whether medical assistance in dying is to be legal; it is to establish a framework.

I am concerned that should we go forward there will be a vacuum in which there is no regulation. We must act. The Supreme Court has given us an extension of time. We have the time in which to do it. I know it may seem that we are a bit rushed, but we are willing to work extra hard on the justice committee to ensure it gets back to this place in the appropriate amount of time. However, it is imperative that we get this work completed, and get it to the other place so that vacuum does not exist.

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Mr. Speaker, earlier an hon. member talked about respecting provincial jurisdictions.

Does the government know how it is going to ensure that the practice will not be too different from one end of the country to the other? In other words, how will it prevent fragmentation while respecting provincial jurisdiction?

[Chris Bittle, Liberal, St. Catharines, ON]

Mr. Speaker, I believe the bill is set up in an appropriate way that it would allow for the provinces to set up with their own colleges and with their own regulations on how medical assistance would be provided. As the hon. member knows, the provision of health care services in the country is the jurisdiction of the province. We respect that and the bill makes provisions for that. The minister has stated that she looks forward to working with the provinces to assist in a framework across the country.

[Sylvie Boucher, Conservative, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, every one of us has their own story, experiences, destiny, and perspective on life and death.

However, no one, and I mean no one, can be indifferent to the bill we will soon be voting on. It is important to respect the personal and private opinions of all our colleagues on both sides of the House.

Just 15 years ago, we might never have had this discussion or this debate. Quebec paved the way with its end-of-life legislation. After more than six years of countless meetings and many discussions, and not without much debate involving all of society, members of Quebec's National Assembly passed the bill, which became a reality for Quebec.

One of my former colleagues in the House, the hon. Steven Fletcher, introduced two bills on this issue in 2014, thus laying the groundwork for national reflection. In 2015, the Supreme Court also struck down the Criminal Code section that prohibits a doctor from assisting someone to end their life in very specific circumstances.

There is little time left before the Government of Canada puts in place a Canadian law to provide a framework for medical assistance in dying.

A special joint committee was struck, and six weeks of meetings, discussions, and testimony followed. The committee then tabled a report in the House of Commons. In response, a bill was drafted. Now we need to work together to make the bill law.

We must take Canadians' opinions into account. This is not a partisan issue. This is a social issue that should bring people together. First and foremost, we must protect the most vulnerable members of society. It is the Government of Canada's duty to legislate on this very difficult matter. This bill touches our core values. We will never achieve unanimity.

Even so, we have to address concerns that have been raised about a subject that is still sensitive and emotional for all of us. It is our duty to have a frank and open discussion to move the debate forward in response to the Supreme Court of Canada's request.

I think we need to set aside any emotions we might be feeling in connection with such a personal and sensitive subject. We must ensure that the legislation includes guarantees to protect the most vulnerable members of our society as well as the conscience rights of doctors and other health professionals.

As legislators, we must have an open discussion that respects who we are, and we must be free to vote in accordance with what we believe deep down.

We must also make some amendments to ensure that there is an excellent framework for this legislation.

We must respect the rights of the ill, but we must also respect the right of doctors to say no. There is currently a grey area that leaves room for interpretation by the provinces. We must be united as a country on protecting doctors, pharmacists, and institutions. I am talking about all health care personnel.

The Government of Canada must ensure that the people who make use of this legislation are making a clear and informed choice and have all of the information they need to make an informed decision.

There are some concerns, especially in the details of the bill, with respect to the fact that nurses have the same decision-making power as doctors in providing medical assistance in dying.

I remind members that Bill C-14 on medical assistance in dying is the government's response to the Carter decision. In this decision, the court ruled that people have a right to medical assistance in dying if they are adults, if they are suffering from a grievous and irremediable medical condition, and if they have given informed consent.

It is important to consider what “informed consent” means. It must be clearly defined, to ensure that the Canadian public is fully aware of what is involved.

We must also consider and propose solutions for people who want to live, in spite of their illness, and for those who want to be with their loved ones even though they realize they are at the end of their life. I think it is very important that we invest much more in palliative care.

We are talking a lot about medical assistance in dying, but I get the impression that in this debate members are forgetting about the most important thing, and that is the ill person. There is little or no reference to those who will never make use of this legislation.

On a more personal note, I too have had to think carefully about this issue. I carefully weighed the pros and cons. I looked to my own experiences for answers to my questions. I searched my past. I looked at myself in the mirror and thought about my views on life and death. I saw the face of my father, who was stuck in a wheelchair for over six years. Not a day went by when he did not shed some tears. How many times did he tell me that he would rather die than be there, paralyzed, unable to walk or be completely autonomous?

However, I also thought about the time when, of necessity, I ended up supporting my friend Rachel through the terminal stage of her illness. She had AIDS, but she wanted to live at all costs, despite the illness that was consuming her.

Then there is me, both a legislator and a human being, who must, in all honesty, reflect logically on what I myself would do if I were at the end of my life and had to make a choice. There is no obvious answer. However, I dislike aggressive therapy, and everything is already there in black and white.

This debate has forced me to think beyond death itself to accepting it and to the grieving process that is necessary either for the person involved or the loved ones.

The medical assistance in dying legislation is not perfect. There are some things that need to be redefined and a few amendments to incorporate, but we have to keep in mind that the Supreme Court is pressing us to pass legislation by June 6. That is why I am voting in favour of this motion, in order for the bill to go back to committee and for the committee, which is duly appointed, to study the provisions and ensure that all Canadians are protected. They are what matter most here.

[Celina Caesar-Chavannes, Liberal, Parliamentary Secretary to the Prime Minister]

Mr. Speaker, I want to thank my colleague for her impassioned speech on this topic, and especially the examples of her father and friend. I thank her for sharing that with us.

I would ask my colleague to comment further on the importance of this legislation, in particular for other members of communities who are contemplating this important decision in their lives.

[Sylvie Boucher, Conservative, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, I think that this is a social bill. As I said, we must leave partisanship aside and listen to what Canadians want us to do as legislators. A lot of people have concerns about this bill because they do not believe it is sufficiently well framed. That is why if we are required to do this, I want it to be drafted in such a way that it respects all Canadians. This bill must include safeguards for those who are going to use it. Those safeguards are just as important for us, the legislators, but they are especially important for Canadians.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, I thank the member for personalizing the conversation in relation to family members. It is appreciated.

Coming back to the issue of palliative care, I want to thank the Conservative members of the special committee who put a focus in their dissenting report on the importance of palliative care and the failure of successive governments to implement that.

I want to flag again the work that my colleague from Timmins—James Bay is doing on the palliative care issue and the fact that he was able to get the House to agree. It was a rare moment of close agreement a couple of years ago.

I am hoping that the member can talk a bit more about what steps the House and the government might take to bring some of those recommendations around palliative care to fruition.

[Sylvie Boucher, Conservative, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, I would like to thank my colleague for her question.

We are talking at length about medical assistance in dying, but the need for palliative care is also great. I used to provide support for people who were dying and suffering. We need palliative care so that people who wish to continue living despite the illness consuming them can live in a supportive environment where they are properly cared for and find relief from their illnesses.

Some of them want to live more than anything, whereas others want to die. We have to look at both sides of the coin. We should have this debate because it is not a partisan debate but rather a societal debate.

[Gérard Deltell, Conservative, Louis-Saint-Laurent, QC]

Mr. Speaker, we were very pleased and moved to hear our newly elected colleague, who has also served in other sessions. It is clear that she is experienced.

Are people in my colleague's riding talking about this issue? What are they telling her?

[Sylvie Boucher, Conservative, Beauport—Côte-de-Beaupré—Île d’Orléans—Charlevoix, QC]

Mr. Speaker, I would like to thank my colleague for his question.

Yes, they are obviously talking to me about this issue. I see both sides of the issue, and they are very well defined. When I visit the urban part of my community, people tell me that they are in favour of this bill. When I visit the rural part, people are starting to ask some good questions that make me think about the importance of representing both parties in this bill: the people who are at the end of their lives and the people who want to live. That is what is missing in this bill. Quite frankly, palliative care has been forgotten. Therefore, I am hearing one thing from the urban population and another from the rural population.

As legislators, we want a law that benefits all Canadians, whether they have the right to die or not.

[Larry Bagnell, Liberal, Yukon, YT]

Mr. Speaker, I am happy to rise on this very important debate. It affects all of us, including my wife Melissa, my seven-year-old daughter Aurora, my four-year-old son Dawson, me, and everyone. Not all bills affect every Canadian, but this does. It is a very critical debate.

When this first came up in the House, I voted against it, because sadly there is much elder abuse in Canada, people who take advantage of those with less capacity. I encourage all legislatures, all four levels of government in Canada, all government workers, and all journalists to do everything in their power to work to eliminate elder abuse. That includes the protections needed in this particular bill.

I was also not comforted by what happens in some European countries with legislation. Many people are assisted in dying without their consent.

I have now been convinced by six items. First is the great care that was put into the protection provisions of this bill. There are two doctors or nurse practitioners, totally independent from each other, who are needed to approve the consent.

Informed consent is needed, and again at the time that the act will be carried out. The person must be suffering from intolerable pain. They must provide written consent. They must be in the process of dying, and there must be a 15-day waiting period.

There must be a five-year review of this bill, with the additions that many people might be suggesting during this debate.

Also, I have been convinced by the overwhelming support of my constituents who have contacted me, saying that people should have assistance in choosing the time to end their intolerable suffering.

I have also been convinced by the government's strong conviction, ensuring that there is good palliative care, so that the lack thereof is not what forces the choice of this other decision under this law.

I am also convinced by the cautious approach the government has taken to ensure that such a major life-and-death decision is done right.

Finally, I am convinced that there will be no sanction against health care workers who do not want to participate. I talked to a very experienced medical administrator who suggested that it could be up to 90% of doctors who would choose not to participate. For the provincial and territorial governments, that will provide an administrative challenge for those very small communities that may only have one practitioner.

I have asked my constituents, through the newspaper, to give me feedback. I received very heartfelt thanks and heartfelt views on all sides of this legislation, similar to what I am sure the other 338 members of Parliament have from many of their constituents. Of course, they were not all the same.

I have not had any bad experiences, as a number of MPs have had. However, I was moved by the sad stories of those who did, primarily with family members.

I remember a call from a mayor who told the story of the terrible suffering of a family member. It had gone on far longer than was ever needed. There was no benefit to the person. They did not want to be there.

I remember a call from another friend in a very similar situation. They exposed the myth that it was important not to do this in order to have family gathering together for a peaceful end. They outlined how that is a myth because at the end, in that particular case, the person was in so much pain and it was so distracting, the person did not want to or have the ability to see or gather with anyone.

I had feedback from another constituent whose father and other relatives had Alzheimer's disease. It was a terrible end that they did not want to have, and it could have been ended earlier.

Other constituents gave a large number of different views. One person said that if we allowed such suffering to go on in an animal, we would be charged. Another person talked about their husband who had a rapidly deteriorating disease. He wanted to die at home with family and could not. The doctor explained how that was not possible. They had a terrible painful experience in the hospital for their last few days.

On the other side of the issue, I had a nurse contact me who is totally against the bill and did not think we should proceed with it.

Then there were two views related to the people who are left behind in these situations. There were a number of people who, when in this terrible pain and suffering, did not want the suffering of their relatives and friends to go on. They wanted to terminate their lives so there would be no suffering left for their family and friends. On the other side of the coin, a person suggested we did not want to deny family and friends the wonderful ability to care for that person to the end.

Another person suggested that we have to make sure that all publicly funded health care facilities must allow this.

I also had a suggestion from someone who works with seniors, wanting an advance directive, similar to what is in the Yukon Care Consent Act for end of life that exists right now.

In summary, a majority of my constituents were in favour of assisted dying. Some were against it, like a woman from the small community of Haines Junction. Of those in favour, a number of them want some of the suggestions that people have talked about here today. Many were in favour of having advance directives. I would say that is the biggest amendment they would like to occur at second reading.

I want to close with a couple of suggestions for the committee to wrestle with. First is the advance directives. If people have a debilitating disease, they have to give informed consent at the very last minute, but they may not be able to, as they might not be in condition to do so, so it defeats the whole purpose. Perhaps it should be allowed only for those who are not capable at the last minute so that, as has occurred in the past, people with advance directives who in the end did not want them carried out are not taken advantage of.

The second biggest suggestion was related to the description of foreseeable future. On one side it may provide the flexibility that people want to make the right decision at the right time. On the other hand, it may not be enough definition. Medical workers want more definition, so they are not caught on the wrong side of a criminal law suit.

I had a student ask me an interesting question: what if a person suffering from an insufferable physical disease also has a mental illness and therefore could not give the informed consent? I am glad the committee will further study mental illness. I had a number of people suggest that mental health, Alzheimer's, and even mature youth need to be dealt with.

I want to thank my constituents and members of the House for this very non-partisan, thoughtful debate on this life-and-death situation for all of us. Hopefully, in the end we will find the combination that gives the most peace to the most Canadians.

[Bernard Généreux, Conservative, Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC]

Mr. Speaker, my colleague gave an excellent speech. He described his riding, which is very big like mine. Actually, I think his riding is even bigger than mine.

Rural regions often have difficulty obtaining services. In my opinion, offering palliative care would be one way to make up for the lack of services available to people who need help at the end of their lives. I would like my colleague to talk about how increasing services and care at centres designed for that purpose fits in with this bill.

[Larry Bagnell, Liberal, Yukon, YT]

Mr. Speaker, I definitely agree with the member. I am very happy that the minister is so committed to palliative care, which is an important part of this whole process, so that a person does not have to make a decision on assisted death just because good palliative care is not available.

My mother had wonderful palliative care in B.C., and I would hope that is available to all Canadians.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, I would like to discuss further with the member the comments he has heard from his constituents around conscientious objection from health care providers and practitioners.

New Democrats in the all-party committee made a clear recommendation that no health care worker should ever be compelled to participate in assisted dying and that they should be legally shielded from unfair consequences resulting from that personal decision.

Despite my intention to support the bill at second reading and send it to committee, there is still concern that there are no legislative measures to enshrine that recommendation, although we are hearing from the government that it may be interested in non-legislative options.

I would be interested to hear whether the member has further ideas about which side of the regulation that issue might fall and whether he shares my concern that it would be better, for the sake of health care providers, to lock in those protections and guarantees.

[Larry Bagnell, Liberal, Yukon, YT]

Mr. Speaker, none of the health care people I talked with were concerned that their protection was not in the bill, but I certainly hope the committee does look at it.

[Sean Casey, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I thank my colleague, the member for Yukon, for his remarks. Clearly, he has consulted widely through his community and through his riding.

There are a couple of points arising, one is with respect to medical directives.

There has been a lot of discussion around medical directives, but the international experience, certainly in the Netherlands, is that even where they are allowed, most of the time medical practitioners are reluctant to rely upon them; and so, we would be very much forging new ground in that regard in a very compressed timeframe. Perhaps the member would like to give us some reflections in that regard.

The second point, I think, relates more to his riding; that is, in this legislation, there is something that is fairly unique to Canada, which is an enhanced role for nurse practitioners. The goal of the government certainly was, by allowing an enhanced role for nurse practitioners, to ensure access or to provide greater access for rural and remote communities. Perhaps the member would like to comment on whether that is important in an area like Yukon.