Mr. Speaker, it is an honour for me to rise today to speak in support of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).
I would like to start off by first acknowledging that medical assistance in dying is a deeply personal issue for all Canadians, which is tied to both their life experiences and personal beliefs. My background as a registered nurse in an oncology unit helped shape my thoughts and opinions on this matter.
Understanding that this is a very sensitive issue, with proponents on all sides of the debate, within days of this new Parliament, the now-government caucus moved swiftly to strike a joint committee to study the matter and make recommendations, which heard from many Canadians and experts on this issue. After working several days, sometimes well into the evening, the committee made its recommendations to Parliament.
Before I continue, I would like to thank all my hon. colleagues on both sides of the House, and in the Senate, who participated in the special committee and the justice committee for their contributions.
I also know that our minister has worked very hard to craft legislation that would ensure that the priorities of Canadians were met when it came to the issue of medical assistance in dying.
I strongly believe that the proposed legislation finds the perfect balance by reconciling the issue of autonomy of competent adults with the protection of vulnerable people through a thoughtful tailoring of the eligibility criteria and robust safeguards that are essential to preventing error and abuse. It also strikes the right balance by ensuring that conscience rights of physicians and nurse practitioners are protected, and commits to continuing to work with the provinces and territories regarding coordination and jurisdictional issues.
I want to assure members that our government is committed to continued discussions with the provinces and territories on a range of issues, not only related to medical assistance in dying but also to a full range of end-of-life options, including palliative care.
In various testimony given before the House committee, witnesses discussed other regimes where medical assistance in dying has been implemented. In Europe, for example, three countries have legislated access to medical assistance in dying, which is Belgium, the Netherlands, and Luxembourg. In the United States, four states have legislated access.
However, where Canada is unique is in the jurisdictional complexities that we face. In Canada, the federal government has exclusive jurisdiction over criminal law, and health is a shared jurisdiction between the federal, provincial, and territorial governments. Primary responsibility for the provision and delivery of health care services rests with individual jurisdictions. This is why our government has proposed legislation that will be applied across all provinces and territories but at the same time will respect and allow flexibility for jurisdictional roles and responsibilities in the areas of health care.
This brings me to another important issue that cannot be ignored or put aside when talking about enabling access to medical assistance in dying when one is approaching end-of-life care, and that is access to quality palliative care. It is very clear that Canadians are looking to their government for leadership to advance the availability and quality of palliative care within the broader scope of how we address Canadians' needs at the end of their life.
We know that most people at the end of life wish to remain at home as long as possible, as long as they are well supported by the services they need. This is why the federal government is committed to improving palliative care as part of a new health accord, supported by a long-term investment of $3 billion over four years.
Recently, federal, provincial, and territorial ministers of health agreed to work individually and collectively on improving home care to better meet the needs of patients closer to home. However, an agreement must still be reached on how funds will be used to strengthen and transform the health care system. We know that all jurisdictions are working diligently to meet the growing home and palliative care needs of their aging populations. However, we also know that jurisdictions are at different points. Some are well advanced in their efforts, and others are at a more moderate stage. By continuing to work with provinces, territories, and stakeholders, we will bolster each other's efforts for the benefit of all Canadians.
Another aspect that I would like to address when we talk about providing Canadians with that full range of options at the end of life is access. The government is very clear in its commitment to facilitate access to these services and to those providing it. This includes access to this new service of medical assistance in dying.
Our government is committed to respecting the autonomy of Canadians suffering from grievous and irremediable medical conditions. Access to medical assistance in dying would only be available for those who meet the following conditions: be a mentally competent adult who is in an advanced state of irreversible decline in capability; have a serious an incurable illness, disease, or disability, and are experiencing, enduring an intolerable suffering; and whose deaths are reasonably foreseeable.
It will also remain a crime to assist a person either in dying or in causing a person's death in situations other than lawful medical assistance in dying.
With regard to Bill C-14, our government is also committed to protecting the exercise of conscience rights as the proposed legislation also provides exemptions for both physicians and nurse practitioners from having to provide medical assistance in dying. Over the course of this national dialogue, we have seen that the protection of conscience rights for these providers is clearly an issue for many Canadians. Our government has listened and made Bill C-14 more explicit on this issue, and therefore more appropriate for the diversity within Canada.
The bill now reads as follows:
For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.
We trust that this helps to address the concerns some of members may have either personally and/or on behalf of their constituents on the issue of the protection of conscience rights.
Our government is also proposing to work with provinces and territories to create an end-of-life care coordination system. This would have a dual function. It would respect the conscience rights of health care providers, while facilitating access for Canadians to not only medical assistance in dying but a full range of end-of-life options, including palliative care.
The federal government would be prepared to collaborate on developing such a system should provinces and territories wish to participate, so that all Canadians have access to the care they need and deserve. We could also start on this by reviewing the information that we have on assisted dying regimes in other countries to see what they have done, and assessing their applicability to Canada.
Working in the health care field and especially in oncology, I know that health care is about connecting and helping people during their most vulnerable times. This means that we need accountable and transparent regulations to monitor and instill confidence in the appropriate implementation of medical assistance in dying.
This will protect vulnerable patients when they may not be able to do so themselves and help Canadians understand the number of requests for medical assistance in dying, the types of medical conditions that lead to requests, and whether the procedural safeguards in the law are working as intended. It will also work to ensure that high-quality, comparable Canadian data is generated so that any future discussions about changes to the medical assistance in dying system can be based on the best possible evidence.
Therefore, Bill C-14 creates legal obligations for physicians, nurse practitioners, and pharmacists to report certain information for the purpose of monitoring. Regulations will be put in place to guide the information to be provided, to whom, and within what time frame. In the short term, Health Canada is working with our counterparts in the provinces and territories to establish an interim system should the bill be passed on June 6, until a permanent process is in place.
In closing, I would like to once again reaffirm my support for Bill C-14, which I believe is the right approach for medical assistance in dying. It will support and facilitate access for those seeking it, protect our most vulnerable, and protect conscience rights. We know that no one solution can reconcile the diverse perspectives on medical assistance in dying, but we believe we are moving forward together with a balanced approach that is appropriate for Canada at this time.
I thank the Speaker for giving me the opportunity to speak on this very important piece of legislation.
