Debates of May 3rd, 2016

Criminal Code

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, maybe this is a good time to reflect on the many members who have stood in their place to address this bill, many of them referring to personal stories which have provided a great deal of insight into what we are debating here. It is very much appreciated.

The member made reference to the Supreme Court of Canada. We do need to recognize that all nine Supreme Court judges made the decision, and we do have to come up with the legislation. We have known that now for well over a year. There has been some fairly extensive work done.

We now have the bill at second reading. There has been an open door in terms of government and opposition members being able to share thoughts and ideas with the ministers responsible, or to at least bring their thoughts and ideas to the committee.

I am wondering if the member recognizes, first and foremost, the fact that we have to come up with legislation, that there is a deadline of June 6, that the bill has to go through the committee stage, that it still has to go through the Senate, that there is an obligation on all parliamentarians to address the void that has been created by the Supreme Court of Canada, and that is really what the Government of Canada is responding to.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Madam Speaker, of course, we are all aware of the reality we are faced with today by the Supreme Court putting a deadline on it. It is totally unacceptable in my view, yet here we are.

If members take anything from my comments tonight, they should take that the government needs, and we as parliamentarians need, to craft this law to be as protective as it can be for all Canadians right across the board. That is what the Supreme Court actually said, that it should protect Canadians, the most vulnerable especially.

I am here advocating tonight that my fellow parliamentarians take that seriously, and to put in place amendments to this bill, if that is what it takes, and to take the time to get it right, so there is not one life, one disabled individual, one person who falls between the cracks.

That is why we eliminated capital punishment in this country, for the sake of one person being wrongly executed. I am asking for the same courtesy from my fellow parliamentarians.

[Pierre-Luc Dusseault, NDP, Sherbrooke, QC]

Madam Speaker, I thank my colleague for his speech.

Many of his colleagues have implied that doing nothing and using the notwithstanding clause are options in this case, so can the member at least acknowledge that doing nothing leaves us in a legal vacuum, which is not an option?

As parliamentarians, we have a responsibility to address this issue. We must not imply that it would be responsible to simply leave things as they are. We must ensure that people have access to what is now a charter right. Not acting is not an option. Parliamentarians must respond and take action. In this case, we must take action before the Supreme Court's deadline.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Madam Speaker, I will more or less underscore what I just said. I realize we are in this position, where many of us would rather not be.

However, we do have options. There is the notwithstanding clause. That is an option. Whether this Parliament wants to go that route or not will be determined. There are other options, such as to not pass the bill, and in the meantime work on something else. Those are options. I am not personally advocating that.

I am personally advocating the reality that we are here, and we must address the issue, so let us address it in the most restrictive fashion we can so that it is an exception in our society when someone is able to have doctor-assisted suicide or euthanasia. Let us protect society as we have always done. This is about the sanctity of everyone's life.

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Madam Speaker, I rise to speak to this issue, as many of my colleagues have done throughout the day.

It is most certainly a difficult issue that is faced by many individuals and society at large. Like many of my colleagues, I have had many conversations with my constituents and medical health professionals, with doctors who are in support and doctors who are not. The issues and concerns vary with each and every sector. I have heard concerns around protecting the rights of doctors who do not want to participate. I have heard from constituents who adamantly oppose any type of legislation for moral reasons. I have also heard from constituents who have gone through very difficult times and have had family members who suffered greatly. They support legislation being in place.

However, the significantly short amount of time that has been allocated by the court has indeed posed a challenge on many fronts. While some consultations have been undertaken in some communities in some ridings, there has just not been enough time to engage Canadians across the country in a fulsome debate. In fact, in Quebec, it took six years to go through the process. As one of the options, we should request from the court additional time to really address these complex issues, to engage Canadians far and wide, and to get input from many different sides that were not able to come to the committee or appear as witnesses.

I have a great amount of respect for the members in the House who have worked on the committee. I know it was not an easy task for them. I also respect all the members who have really struggled with this issue on many fronts. However, to rush to develop legislation is really of great concern to me.

I am pleased to see the recommendations from our dissenting report that spoke to the issues of mature minors, persons with mental health issues, and advance directives. Some were implemented and some were not. However, there are still issues around conscience protection for physicians and health care professionals.

The protection of the vulnerable really must be a core foundational aspect of the legislation and framework, as eloquently put by my colleague, the previous speaker. Protection for doctors and health care professionals who do not want to participate must be imbedded within the legislation and not within the preamble.

I want to share a story that really speaks to the issue. I know of a young nurse who just graduated and who recently applied for a nursing position. The interviewer asked her if she would be able to inject a patient who requested to die. The young nurse, who had just graduated, said no, that was something she could not do. Needless to say, the young nurse was not hired. I share this story because within the legislation we need to protect individuals who do not want to participate.

We have failed Canadians as it relates to end-of-life care and providing a robust palliative care system and hospice support. We must institute high-quality palliative care in every community in every province across the country.

I received a handwritten letter from one of my constituents. I was not in this place at the time.

She wrote:

Did you know in June 1995 the Special Senate Committee on Euthanasia and Assisted Suicide advised the government make palliative care programs a priority in the restructuring of the Health Care System;

That was Bill C-545, an act respecting the provision of continuing care to Canadians, a private member's bill. She also noted that only 30% of Canadians have access to palliative care.

She went on to say:

Can you assure that Palliative Care will be available to all citizens of Canada before these same citizens are offered medical assistance in dying?

This is very poignant because, given the legislation that we are discussing and where we are going with it, we need to have a national strategy on palliative care. We need to look at the end-of-life care as a process toward death. This is part of the overall continuum of care. We do not do that now. I think it would be prudent for us to have those measures and plans in place because it is about dealing with people who are coming to the end of their life.

As I said earlier, I believe that a robust palliative care system should be implemented. I also believe that a psychiatrist or social worker needs to be part of the assessment process, and that a palliative care consultation should be undertaken prior to moving to doctor-assisted suicide.

The health minister stated in the House yesterday that $3 billion would be dedicated to palliative care over four years. I was pleased to hear those comments. However, it was clearly an afterthought because that amount was not included in the budget, nor was there any mention of palliative care or hospice care. This is a fundamental flaw that should be rectified immediately.

In light of this legislation, we need to move very quickly to implement a national strategy on palliative care. This is a very complex issue. I certainly have many concerns on a number of fronts with this legislation. We need strict protections embedded in the legislation regarding the protection of conscience and the right to have access to palliative care. I stress that these amendments must be embedded within the legislation.

Of most concern is the possibility in the preamble of including mature minors and those with mental health illness at a future date. While the courts have mandated the development of legislation, it has most certainly not allowed the appropriate time to have a thorough discussion with Canadians across the country. This issue is not one that should be rushed. It deserves thoughtful, respectful consultation and debate with everyone.

[Alice Wong, Conservative, Richmond Centre, BC]

Madam Speaker, my colleague made a very thoughtful speech, and I agree with her in many areas. I know there are a lot of friends in Parliament who keep saying that if we do not pass the bill, there will be no law with respect to assisted suicide.

I know that I am not alone in stating that the time frame set out by the Supreme Court is not sufficient, and that 16 months is not nearly enough time to adequately examine evidence, consult with Canadians, and prepare well-drafted, carefully examined legislation.

What is our responsibility as lawmakers?

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Madam Speaker, fundamentally, our responsibility is to protect the most vulnerable. There are measures within the legislation that do not allow for that. We have been mandated by the court to provide legislation, and it should be the very best legislation that can possibly be put forward. I do not think that we have had adequate consultation with and input from many sectors across the country. I believe it is premature to be at the place where we are right now.

[Pierre-Luc Dusseault, NDP, Sherbrooke, QC]

Madam Speaker, I would like to thank my colleague for her speech.

I heard many members say that they did not have enough time, even though the Supreme Court rendered its decision on February 6, 2015.

Several months went by between the time when the Supreme Court rendered its decision and the time when the new government took office following the October 19 election. We finally have a bill because of the new government's agenda and an extension until June.

If parliamentarians had worked on this issue from the start, it might have been resolved in time to meet the Supreme Court's deadline. Does my colleague not agree?

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Madam Speaker, when the time frame was handed down by the Supreme Court I believe there were preliminary consultations that had begun at that point. I also know that there was an election. During the election, I believe a lot of the work ceased because of the election. Then it was incumbent on the new government to continue developing the legislation.

I go back to the Quebec example that was six years in the making. I go back to other countries that have dealt with this issue, and it was 10 years in the making. Even if there were a continuation of that work for 16 months, it would still not be adequate.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, the member made reference, in answering a question, to seeing her primary job as protecting the most vulnerable.

Does the member not recognize that if the legislation were not to pass, the most vulnerable she wants to protect are going to be that much more vulnerable because there is no law? Would the member not agree that it is better to have this brought forward before June 6 in order to protect the vulnerable?

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Madam Speaker, we have good legislation and bad legislation, so depending on the legislation and the amendments to the legislation, we will look at how it protects or does not protect the vulnerable.

There is still a lot of work to do and there are amendments that have to be put in place.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, as others have said before me, we are debating this evening one of the most important issues of our time. It is not just an important issue but a difficult issue. In fact, it is a real constellation of difficult issues and difficult decisions. It is an issue that has been a concern in Canada for decades, including the case of Sue Rodriguez more than 20 years ago. We are talking of it again because of the landmark Carter decision that has instructed Parliament to create legislation to legalize and regulate medically assisted dying.

Like all members of the House, I have received many letters, emails, phone calls, and personal representations from all sides of the issue. Some people are concerned that because of the restrictions in the legislation they would not be eligible for the procedure should they need it in the future; while others are worried that medical practitioners who have ethical concerns would not be able to opt out if they wish.

Obviously we need good legislation that clearly spells out the eligibility criteria for this procedure as well as the regulations around the actual procedure itself. Because of these needs, I am generally in favour of this legislation, but I feel that it is deficient in several regards.

We have to ensure that this bill properly addresses the Supreme Court decision. The last thing we need is to prolong the suffering of grievously ill people through more litigation.

As I mentioned, we also need to ensure that the practitioners who are undertaking these procedures are protected regarding their roles and moral beliefs. Last week in the House, I tabled a petition from many of my constituents on this issue.

We need to ensure that people with progressive illnesses have access to suitable palliative care, as many people have mentioned here this evening. They need access to palliative care, pain management, and home care so that medically assisted dying is not set out simply because other more appropriate actions are not available.

Finally, we need to ensure that this procedure is equally available across the country.

The need for this procedure is clear as was laid out in the Supreme Court decision. One of my constituents has already requested legal access to the procedure, several months ago, without waiting for our action here as his suffering was so great. He waited through the foot-dragging of the previous government, but could wait no longer. Clearly, other Canadians who are suffering through intolerable pain and discomfort will continue to access this service through more complicated legal channels if we do not pass legislation here.

Just last Friday, I met with another constituent who is suffering with advanced progressive multiple sclerosis. He wanted to talk first about federal funding for research into experimental treatments for MS. Because of the advanced nature of his disease he was not able to access the present experimental treatments, but he desperately wanted others to have greater access in the future. However, now that he cannot dress himself, bathe himself, or even shave his face, he feels that life with any dignity is fast slipping away. He is deeply concerned that he would not be eligible for medically assisted dying because his natural death may be years away and not “reasonably foreseeable” as this bill now states. Many experts feel that even Kay Carter, who brought the case before the Supreme Court, would not be eligible for medically assisted dying under the criteria now set out in Bill C-14.

The same constituent also recounted how difficult life is for his wife as he faces his progressive illness. He would like better access to home care services and later palliative care, so that his wife can have respite from his daily care. However, these services are not available equally across Canada. We desperately need a national palliative care strategy and the funding that goes with it to ensure that patients who need this care have access to it. Bill C-14 refers to palliative care in its preamble, but it is silent after that. The government was silent on palliative care in the budget, despite a promise for $3 billion for home care in the election campaign.

Hospice care is also needed across this country, but it is even less available than hospital palliative care. In my riding, there is only one hospice centre and it is five hours by road from the east side of the riding. I have met with an active hospice society on the eastern edge of the riding, but it is struggling to find funding for a hospice, despite a clear need for it and a strong case that it will save a considerable amount of money in the local health care system. This disparate amount of care is a concern to me, since we do not want people choosing medically assisted dying simply because they do not have access to proper pain management, palliative care, home care, or hospice treatment.

Finally, I would like to talk about advance directives. Many people with progressive diseases would like to provide their loved ones and physicians clear instructions regarding their fate if they become incapable of giving those instructions at a later date because of their deteriorating physical condition. The special joint committee that studied this issue made a recommendation to allow advance directives regarding medically assisted dying under certain conditions, but this recommendation is not included in Bill C-14. Certainly advance directives must be crystal clear if they are to be used, but it is an issue that we must face.

To conclude, I feel that the eligibility criteria put forth in this bill may not reflect the Supreme Court ruling that brought us to this point. While we have to be careful to protect the most vulnerable in our society, many Canadians, including the constituent I mentioned at the start, will suffer even more than they are now if we get this wrong.

I know that this debate will continue at committee and I hope some of the concerns I and others have raised will be addressed in the few weeks remaining before the June 6 deadline.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I want to ask the member for his thoughts on the timeline. A number of comments have been made about the issue of the timeline and the fact that we did not have to be this rushed. The previous government put in place an expert panel to study the issue and that panel was supposed to report back with specific legislative recommendations.

However, the new government took away that panel's power to report on legislative recommendations, despite the vast consultation that was already happening. It then started a new panel process with a special committee, but even after the special committee reported, the government waited for months. It has put us in the situation of a time crunch.

I would say that we do not have to play the Liberals' game. If they bring forward a piece of legislation or amended piece of legislation that could gain substantial consensus in the House, which addresses things like advance review and conscience protection, then we will be a lot better off and can allow the bill to move forward quickly. Instead, the government has created an artificial time crunch unnecessarily and is even moving to bring forward closure.

Would the member agree that the government should be working more collaboratively, rather than using things like closure and creating an artificial timeline to push this through?

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I was not here in the last Parliament, but it is my understanding that the special expert review panel that was set up was not really judged by many to be completely unbiased and perhaps was not really the best way to move forward. It took many months to even establish that panel. If the government had acted right away, as this Parliament did after the election in October, we might be further ahead.

People brought up the example of Quebec taking six years. Canada did not have the courage to face this question 20 years ago. I mentioned Sue Rodriguez in my speech. If we had taken this action—

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

We were not ready for that 20 years ago.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I would ask members to rise to ask questions and to respect those who have the floor to make a speech or answer questions.

Questions and comments, the hon. Parliamentary Secretary to the Leader of the Government.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, to reflect back, when the Supreme Court decision was made, I believe both opposition parties, the Liberals and New Democrats, called on the government to take action. In fact, a motion was put to the House to try to convince the government of the day to act.

I wonder if the member would comment on the fact that, yes, we have lost the opportunity, but what is really important for us to recognize is that we need to get this thing done in a timely fashion.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I would agree with my colleague across the floor. Given the situation we are in now, the best course forward is to bring this legislation through and make it as good as we possibly can through amendments at committee.

If we do not do that and we miss the deadline, as others have mentioned, we will be without legislation. As I mentioned, a constituent of mine decided last February that he would seek other legal actions to access this service without the benefit of this legislation. That is where we will be if we do not do this.

[Tracey Ramsey, NDP, Essex, ON]

Madam Speaker, the member brings up something that many of us are struggling with, and that is we feel the bill has not gone far enough. Others feel it has gone too far.

Some people feel that where it has not gone far enough are the advance directives you brought up. We know the all-party special committee sought to resolve this and it is our hope that will be done in the committee process.

I wonder if you could speak further to the issue of advance directive?

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I would remind members that the questions are to be addressed to the Chair.

The hon. member for South Okanagan—West Kootenay, a very brief answer, please.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, while advance directives are clearly wanted by many people in progressive illness conditions, the legislation must make these directives crystal clear. We have to ensure these people really want this, the same safeguards that are there for the present directives. It is something that we must face.

[Guy Lauzon, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, I arrived here a very fortunate man 12 years ago, elected by the electors of Stormont—Dundas—South Glengarry. I really believe that since that time this is probably the most complex and sensitive issue I have ever witnessed come before Parliament, for me personally anyhow.

As far as disclosure goes, I am a practising Catholic. As a result of that, I will definitely be voting against Bill C-14. For me, this is a moral issue. I strongly believe in the sanctity of life. In fact, ever since I can remember, I have taught that life is precious, especially a human life, but also an animal or an insect's life. All through my life I have been taught that life is a gift from God and we should respect it as such.

That is not the only reason I will be voting against Bill C-14. Because this is such an important issue, I thought I should get input from my constituents. I took the trouble of sending a survey to 45,000 homes in my riding. The results were: 65% of the constituents of Stormont—Dundas—South Glengarry were against Bill C-14, and 35% were in favour of the bill, with conditions. I read many of the comments of the 35% and those conditions were rather strict. They called for very limited assisted dying.

I want to thank the joint committee. I wish I had been on the committee, but in other respects I am glad I was not. It must have been a very emotional committee on which to serve. I want to thank all the members for the hard work they put into it, especially the members of the Conservative Party, because they issued a dissenting report. Thank God for that dissenting report.

I must give the government credit for accepting some of the issues included in the dissenting report. They were things like limiting it to competent adults 18 or over. That is so important. If we are to have this legislation, at least we should have that as one of the criteria. The other one was safeguards for vulnerable persons. My colleague, the member for Brantford—Brant, spoke about that. He has a son who is in that category. There was also protection for physicians who disagreed. I have had so many physicians in my riding say that they cannot support this and believe they will be in trouble if they do not support it.

As many of my colleagues said, we have to do this. The Supreme Court of Canada has told us we must. However, if we must do it, let us minimize the damage. There is a way to do that. It is called palliative care.

During the campaign, the Liberal Party promised $3 billion for long-term care, including palliative care. However, in the budget, as my colleagues have stated, there was no hint of any money for long-term care and certainly no money for palliative care. It is nowhere to be found in the budget.

The special joint committee and most of the stakeholders who appeared before it, including the Canadian Medical Association, spoke of the need for a pan-Canadian strategy on palliative care, with dedicated funding. They suggested that there be dedicated funding for palliative care if we were to enact Bill C-14.

My Liberal colleagues are in the House. They are going to have a caucus meeting tomorrow, as will we. Money for palliative care should be brought up at that meeting.

I spoke with the manager of the Cornwall hospice today. Cornwall hospice is in my riding. About eight to ten years ago the community came together. We thought we needed a hospice so we raised funds. Now we have a wonderful 10-bed facility that deals with 100 to 150 patients per year.

I had heard through the grapevine, and through reading, that sometimes people left palliative care. I called the manager of this hospice directly and asked if this had ever happened. He said, “most definitely”.

On average, three to four people leave palliative care in a year. Sometimes they are gone for 6 month to 24 months. Imagine if some of those people had chosen the route of Bill C-14.

I was doing some reading on this issue, and it really struck a chord in my heart. I would like to quote something that I read, which is from the Euthanasia Prevention Coalition. It says:

Yet of the millions of mis-diagnoses every year, many are terminal mis-diagnoses. We know this because of the thousands of people who “graduate” from hospice each year.

People leave hospices not only in Cornwall, but right across North America and the world. There are so many examples of people outliving terminal prognosis, from Ted Kennedy living a year longer than predicted, to John Norton from Florence, Massachusetts, who testified before the state legislature. When he was diagnosed with ALS, he would have definitely used assisted suicide were it available. Luckily for John, his family, and everyone who has come to know him, assisted suicide was not state policy. He went into remission, and 60 years later he is urging people to reject assisted suicide. I rest my case.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, we consistently hear the opposition benches talk about a commitment toward palliative care. In fact, there is a commitment, which is in the budget document. The Minister of Health clearly indicated that we would be going into a new health care accord.

In order to accomplish the type of palliative care that Canadians want and deserve, we need to work with the provinces. This is the only way we can ensure that we have good, quality palliative care in every region of the country.

There has also been a commitment of hundreds of millions of dollars by this government toward improving palliative care. We recognize the value and the expectations of Canadians. Would the member at the very least acknowledge that?

We have to agree to disagree. I understand where the member is coming from in regard to this bill. However, we have a responsibility as parliamentarians to pass this legislation. It would be inappropriate for us to do nothing and let June 6 go by, which will leave a lot more people a whole lot more vulnerable.

However, would the member not at least agree that there is a genuine investment in the future of palliative care, especially if we compare this government's nine months to the ten years of the previous government?

[Guy Lauzon, Conservative, Stormont—Dundas—South Glengarry, ON]

Madam Speaker, with all due respect to the member across the way, I would like him to show me the cash.

There was a $3 billion commitment in the Liberals' platform, and all of a sudden it is not in the budget. The member is asking us to trust them, that they are going to have an agreement with the provinces and it is going to be there.

Quite frankly, we should not be passing Bill C-14 until we have palliative care in place. We heard about the gentleman lived 60 years. Imagine if he would have taken advantage of Bill C-14, assisted suicide. However, we have to talk about Bill C-14, which is a different case.

With all due respect, as I said, I would like to see the cash.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Madam Speaker, I would like to thank my colleague for talking about palliative care. In my opinion, that is an important issue that has not been brought up and talked about enough.

It does not make any sense to say that people who are diagnosed with a terminal illness have two choices. One of those choices is not a very good one, so we are going to offer people medical assistance in dying. Meanwhile, the palliative care that is available may be less than optimal, or there may be none available at all.

Many palliative care facilities are non-profit organizations. We can therefore provide them with direct assistance. These facilities need to raise thousands of dollars every year to provide their services. They would like to have bigger rooms to make more space for family members.

Does my colleague agree with me that the choices that are being offered to patients do not make sense? One of those choices is not a very good one, so rather than choosing the best option, people have to choose what seems like the least of the bad options in their circumstances.