Debates of May 31st, 2016

Criminal Code

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, I am humbled to stand in this place and take this opportunity to speak to Bill C-14, an act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying).

I will be splitting my time with the member for Kenora.

I know that this issue is very personal to Canadians. It is about quality of life and dignity. It is about autonomy. Most of all, it is about compassion.

I listened to many people in the constituency of Brampton South on this issue. I heard support from most people in my riding. I also heard sincere and heartfelt concerns, particularly from our Orthodox-based communities. I appreciate their conviction, and that they have raised their voices with respect to this important issue.

I will use my time today to explain why I will be voting for this important legislation.

My heart goes out to all of those suffering and their family members, who are facing circumstances I cannot imagine. I think we can agree that it is those who are suffering, and their families, who this debate should be about. I hope that hon. members will not forget that fact. We must lean toward a compassionate approach for those who are affected. This is a serious matter and a complex issue. Therefore, we must find the right balance.

Our government must address this now. The Supreme Court made a unanimous decision, and soon there will be a legislative vacuum.

I think we can agree that a patchwork approach by the provinces would be the wrong approach. We would be ignoring our responsibility to show national leadership on this matter.

The framework laid out in Bill C-14 provides a solid, focused and detailed plan, which will meet the June 6 deadline set out by the court. Let me explain why.

Permitting medical assistance in dying will extend more control to eligible terminally ill patients on how to live out their last days. This legislation also provides important safeguards and limitations. It requires the Minister of Health and the Minister of Justice, in consultation with the provinces, to create regulations that will protect all of those involved.

By permitting medical assistance in dying for competent adults, whose deaths are reasonably foreseeable, I believe we are striking the right balance between the patients' autonomy who seek this medical assistance and the interests of patients in need of protection.

It is important to note that this bill does not stand alone. I would point out the critical work of improving palliative care in this country. The ideas of medical assistance in dying and a strong palliative care system are not in conflict. Rather, the two are complementary and are both important issues to address. That is why I am proud that the Minister of Health has recommitted to home care and palliative care improvements in response to a question that I asked during question period on May 2. In her reply to my question, the minister quoted Dr. Atul Gawande, who talked about how people want not only a good death but a good life to the very end. The minister reiterated her commitment to palliative care and providing dignity when Canadians are suffering. She announced how she will work with the provinces to ensure the high quality care of all Canadians. She also brought up how the Government of Canada is committed to an investment of $3 billion over four years to support that goal of palliative care and home care improvements. I commend this step forward.

We cannot view assisted dying legislation separate from investments in our health care system. Quality palliative care is a critical priority of this government. Indeed, as our government renegotiates the health accord with the provinces, I look forward to seeing palliative care discussed. The work with the provinces, territories, and stakeholders is essential to providing options to end-of-life care.

My background is as a research coordinator and diabetes educator. I know how the roles and views of physicians and nurse practitioners are vital to this issue. As a member of the health committee, and someone who worked in the health care field for almost 20 years, I understand the importance of consulting the people on the front lines. Physicians and nurse practitioners are central to the end-of-life process. Their conscience rights will be respected in this legislation. We are working on the best way to ensure their views are always taken into account.

The rules in this legislation are clear and eligibility has been carefully defined. I want to be clear. There is nothing in the legislation that would compel any medical practitioner or authorized nurse practitioner to provide medical assistance in dying. The legislation is meant to balance access to medical assistance in dying while respecting the personal convictions of health care providers. This is about finding the right balance.

Canadians are looking to their doctors and nurses to provide health care and to help them maintain their quality of life. However, when the quality is no longer attainable, Canadians want to know that their health care providers will also help them when their choice is a dignified end to their lives.

We have struck the right balance in my view by having proper procedural safeguards. Access to medical assistance in dying would only be available to those who meet the following conditions: be a mentally competent adult who is at an advanced state of irreversible decline in capability; have a serious and incurable illness, disease, or disability; experience enduring and intolerable suffering; and whose death is reasonably foreseeable.

It will also remain a crime to assist a person either in dying or in causing a person's death in a situation other than lawful medical assistance in dying. Protective measures are a key part of the legislation to ensure that eligible patients have given informed consent. Patients have to make a written request for medical assistance in dying and have it signed by two independent witnesses. Two independent medical opinions have to confirm that the patient meets all the criteria. These first two criteria are intended to ensure that requests for medical assistance in dying are truly voluntary, that they reflect the wishes of the patient, and are not made as a result of external pressure.

Our evidence-based approach will include regulating, monitoring, and reporting. This monitoring and reporting system will also be able to signal any issues or unexpected consequences. We want Canadians to see a system that is functioning and preventing abuses or errors. This will build up confidence and allow Canadians to make informed decisions about how the system should operate.

I appreciate how other members have spoken about how we will look to international models in terms of ways to work with the provinces and territories. This end-of-life coordination system will respect the role of the provinces, while providing access and respecting peoples' rights.

I want to recognize the work of the committees and the senators who have studied this matter and made recommendations around this debate. These recommendations and testimony from those on all sides of this issue should be taken into account. There have been a number of informative and heartfelt speeches by fellow members who I also want to take a moment to applaud. I also thank the Minister of Justice and the Minister of Health for their work in introducing the legislation.

Bill C-14 strikes a proper balance in view of the Supreme Court of Canada's decision and provides a needed legal framework. As parliamentarians we have the final say on behalf of the people we serve who elected us to be their voice. This is a debate that engages our morality, our sense of justice, and our compassion. It asks tough questions of our legal and medical systems.

We have talked to one another and heard some touching stories. We have reflected on how this issue affects all of us. It has called on us to hear the stories coming from the prospective Canadians who are suffering. It is often all too easy to forget what we would do if we were in their shoes. We often fail to truly appreciate the perspective and experience of those diagnosed with a terminal illness. Their dignity is challenged more and more as they reach their end.

We need to pass this legislation at the soonest possible opportunity. I hope all members will support the bill with me.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, there is one part of the argument that the Liberals have put forward that makes absolutely no sense to me and that is the firm commitment they have given for $3 billion toward palliative care. They say they have to negotiate the health accord and we have to do this and we have to do that. This matter is too important.

The Liberals thought that education for aboriginals was important and they put it in the budget. Now they are looking at the negotiation process. With respect to the $3 billion for palliative care I do not know if they are trying to keep their deficit somewhere below that $30 billion that they extended it to. It makes no sense that the money for palliative care is not in this budget while they are negotiating with the provinces in terms of how it be spent.

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, I respect that we have heard a diversity of opinions for this bill. Palliative care is about dignity while dying from natural causes. Canadians have clearly indicated that they want to maintain their independence and receive care at home, including at the end of their lives. Recently, federal, provincial, and territorial ministers of health agreed to work individually and collectively to improve home care to better meet the needs of patients closer to home, including those who need palliative care. This is the right plan that provides more options.

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Mr. Speaker, I would like to ask my hon. colleague a bit more about some of the concepts. I am very concerned with the idea of this being a balanced approach, that in this case balance is a logical fallacy here because an evidence-based approach has been ignored so far. I do not understand how that can be compromised in this kind of a profound situation with a bill dealing with something as serious as medically assisted dying.

Is the member at all concerned that there has been no independent legal analysis sought with regard to adherence to the charter? There has not been any. Is that a concern at all in this so-called balanced approach?

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, I thank my hon. colleague for that great question. Yes, the committee did great work. Without federal legislation in place, Canadians would face an uncertain situation. I respect the views, but the job is about representing our Constitution and Canadians' views in this place. It is also about passing evidence-based policies that benefit Canadians. The people of Brampton South elected me to be their voice here, to bring a different approach, and to implement our government's better plan. Bill C-14 is the right bill at the right time. It is the best approach. We need checks and balances. That is why the committee did a great job. Even the CMA said that. The Canadian Medical Association has pointed out that in the Carter decision, the “...parameters are vague in the extreme, and contain absolutely no clinical direction whatsoever”.

The term “grievous and irremediable” which is used by the court is not a medical term, so we need more clarification for that. That is why the committee did great work. We listened to all the consultations and this is the right bill. We have listened to all Canadians, and this is the right bill that we have to bring.

[Bryan May, Liberal, Cambridge, ON]

Mr. Speaker, I want to thank the member for Brampton South for her speech and her contribution to this debate.

The core principle that this debate is about, which is balance, cannot be emphasized enough. This has been mentioned by all sides. I am wondering if the hon. member can speak a bit more about the government's investment in palliative care, as well as possibly elaborating a bit on the work that has been done in each of the ridings to consult.

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, the Minister of Health has been very clear. She committed in this House, in response to the question I asked on May 2, to invest in palliative care. As part of a multi-year health accord, the federal government has committed to providing $3 billion over the next four years to improve home care, including palliative care. The minister is working with the provinces and territories. Palliative care is more about dignity while dying from natural causes. That is the right plan. Our health minister is very keen to implement that, and that is what we are doing.

[Bob Nault, Liberal, Kenora, ON]

Mr. Speaker, it is an honour to have this opportunity to speak to this legislation and enter this debate. First, I want to thank the leadership of all the parties for making this a free vote. This is such an emotional, difficult, and personal debate. Having had the opportunity to sit in the House since the eighties, I have had the opportunity to be involved in many debates. From my experience, this is one of the most difficult debates that as a parliamentarian I have entered into.

I want to be clear, as we start this discussion, that I support the legislation, and I will lay out to some extent the reason why I feel this way. This decision has to be based on our own personal life experiences and some would say, our own values. However, the reality is that all members in this place come from different parts of Canada, come from different experiences, and have different understandings in some respects of what we are entering into.

We all have to keep this in mind. This is fundamental societal change. This is fundamental because we are moving to allow individual Canadians, people who we love, who we are close to, who are our neighbours, our friends, the ability to have medical assisted dying. It should be one of those debates that should not be taken lightly. Nor should it be a debate where we talk specifically about what the lawyers or the courts are saying. Yes, we have a court case to deal with and the Supreme Court has told us what its sense is, that in fact people have a right to assisted dying. However, we should not diminish the importance of what that may do to our country over the long term.

I want to use my experience as a member of Parliament to explain the rationale for being extremely careful and diligent in our decisions as we move forward over the next number of years.

I represent a riding that probably has the most suicides of anywhere in Canada. Over the last decade, I have watched hundreds of young people take their lives, people who I know their families, their moms and dads, and have watched with some horror as they have made that kind of decision. Yes, it is a little different than what we are debating today, but it defines how we feel about the objective of allowing people to make that ultimate decision of taking their own life with the medical assistance of others.

We should in some regard be careful not to assume what is being said by others in the House, for example, that the legislation does not go far enough, or that it may be not charter compliant because it is too restrictive, or that it goes too far for some people who have made equally compassionate arguments in the House. This decision has to be based on where we think we want our society to go. It is not up to the courts to define and to suggest, as some have suggested even today, that we have not gone far enough so therefore we have to go all the way to a particular place because it may not potentially be compliant with the charter.

I sat in cabinet for a number of years and I have seen many legal arguments put to cabinet on different issues by legal counsel and on many occasions. On many occasions I have had the opportunity to see the decision made right or the decision made wrong, or the advice to be given not exactly as we had anticipated. Therefore, we cannot stand in this place and assure Canadians that this legislation is absolutely perfect one way or the other.

That is why I like the approach the government has taken. It has taken an approach that it is very restrictive. It gives society time to look at the other areas that we may consider, as parliamentarians, to allow people to take their own life, for example, minors.

As I said, I have had the experience of watching many young children take their lives. To talk about minors who are willing to take their lives and make it legal and easier, if I could put it in those terms, is not something I totally support. I am very concerned about that.

I am worried about the whole issue of advance requests. It is hard to predict the situation a person will find themselves in, so we need to have more study of the whole issue of advance requests, and minors and mental illness.

I support the legislation, not because the leadership told me to do it. I do not tend to work that way and never have. I think it is the best approach for something that would fundamentally change our society forever.

We have to remind ourselves as we stand here, and when we vote tonight, that someone close to us very soon will use this legislation. It may not be as comfortable and as simple as some people have made it sound. We have had this discussion today.

The legal framework is important. It is important for the Senate not to get into this discussion about whether or not it goes far enough. The reality of it is that if it is a framework that allows us to get the compliance we need through the charter, we should move forward on it. I want to make this clear. I do not care which legislation we would pass, the one the NDP seems to favour or the one the Conservatives seem to want to have, and I am not sure exactly which way that would go. That legislation will go to the Supreme Court to be tested as we move forward. It does not matter which legislation we pass because this is such a fundamental change to our society, there is no doubt people will go to the Supreme Court to test the reality of the legislation.

Here is the reality we face. Under the legislation, we allow mentally competent adults who are in an advanced state of irreversible decline in capability, have a serious and incurable illness, disease or disability and are experience enduring and intolerable suffering caused by their medical condition, and whose death has become reasonably foreseeable, taking into account all of their medical circumstances, to seek assisted dying. That is a pretty large amount to start with.

I know this will change our health care system for the next generations. I strongly recommend to members of Parliament not to be too quick to judge what other generations will want to have 50, 100 years from now. We should be very careful about that.

I believe, as most Liberals do, in individual rights. I am not suggesting we restrict those, but the right to choose for people who are competent is fair. Having control and obviously the dignity in dying are very important concepts for me as a member of Parliament.

Today I am pleased to have this opportunity to make these comments. This is not a partisan issue. This will not get any member of Parliament more votes, one way or the other. This is a profound fundamental change in how I will deal with individuals every day with whom I am close. I want to ensure we get it right. If we did restrict it too much this time, I would rather do that than go too far.

[Kevin Sorenson, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, when I first polled my constituents, I found that most of them were opposed to doctor-assisted suicide because they had heard stories about Belgium and the Netherlands, and had seen how it was a slippery slope. However, most of them believe that if these are fairly restricted, there are cases where it may be implemented. How do we stop the slippery slope? That is my question for the member.

Most Canadians want to be assured that doctor-assisted dying is limited to competent adult individuals, and the member spoke about that. They would not want those under the age of 18, who might feel depressed or have mental issues, to access assisted dying. As far as vulnerable people, how we confirm their capacity to consent is another concern.

In the last part of the member's speech, he said that he was a Liberal and that he believed in individual rights. Why do we not have in the legislation conscience rights protections for physicians and other medical practitioners who oppose physician-assisted dying? Right now, in Ontario, it is a requirement—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Order, please. Other people will want to ask questions as well, and it is only five minutes. Therefore, I will give some time for a response.

The hon. member for Kenora.

[Bob Nault, Liberal, Kenora, ON]

Madam Speaker, my colleague has asked a good question. It goes back to my original discussion that we should go slowly and take our time. We should not just let the Supreme Court, or courts, decide what Parliament should decide. We have to make decisions in this place based on what is good for Canadians, in accordance with their beliefs and values. They will be interpreted in the courts, as will this legislation. If in fact, as the member has suggested, we do not allow for conscience rights for members of the medical profession to not participate and if this is considered to be unacceptable to the courts, we will hear that, and we will have further debates.

I have been in this place for 17 years, and my colleague has been here quite a long time himself. We will continue to have this debate, because it is a fundamental change for us as a society. We cannot compare ourselves to other countries, and we should be very careful how we approach that.

[Robert Aubin, NDP, Trois-Rivières, QC]

Madam Speaker, I listened carefully to my colleague's comments.

Two things really caught my attention. The first was at the beginning of his speech, when he commended the leadership of all the parties for allowing a free vote on this bill. Obviously, I also commend that. It seems to me, however, that in addition to a free vote, we should making a more concerted effort to seek the broadest possible consensus in the House. I think that is where our views diverge somewhat.

Furthermore, at the end of his speech, the other point that struck me is when he said that, no matter which legislation we pass, whether it is an NDP, Conservative, or Liberal bill, it will face a court challenge.

My question is very simple: why did the Liberals refuse to refer the bill to the Supreme Court, which would have ensured that it was acceptable?

[Bob Nault, Liberal, Kenora, ON]

Madam Speaker, the use of sending references to the Supreme Court should be used sparingly. I know the opposition tends to like the idea of sending this to the Supreme Court. I am sure it will go to the Supreme Court, but it will go on specific matters, not based on whether we think the overall bill is charter compliant or not.

I firmly believe the bill is charter compliant. I agree with the minister that it does meet the test, and that it will not be the bill we are dealing with specifically, Bill C-14. It will be matters like whether we did not go far enough, and others will challenge that.

I know you are trying to hurry me up, Madam Speaker. I was going to answer the other question. Maybe I will get it in the next go-around.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind members that there are five minutes of questions and answers, which is not a lot of time. If members can keep their questions as short as possible, we can get as many in as possible.

The hon. member for Provencher.

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, I want to start by saying that I will be splitting my time with the member for Selkirk—Interlake.

I want to say right from the outset that I am conceptually opposed to Bill C-14. I believe in the sanctity of life, and I believe that all life, from conception right through to natural death, has value, has worth, and has purpose.

As a sitting member of the committee for justice and human rights, I spent several weeks together with the committee in significant and lengthy meetings examining Bill C-14. We spent long days listening to witness testimony from experts and organizations from all over the country, and then doing a clause-by-clause analysis of the bill. Despite the many concerns voiced again and again by witnesses, there were no meaningful amendments made to the bill.

Bill C-14 is called medical assistance in dying, but make no mistake, Bill C-14 is physician-assisted suicide. It is important that we make this distinction. The gravity of the bill should not be undermined by the colourful wording. The bill would change Canada forever, and it would be naive to think that Canada's most vulnerable people would not be at risk under the bill in its present state. This is the most significant social re-engineering bill in the past 25 years, because it changes how we view the sanctity of life.

The Supreme Court was very clear that physician-assisted suicide is not a charter right, but it is an exemption that could be provided on an exception basis providing individuals meet certain criteria. The person must be a competent adult who clearly consents to the termination of life, who has a grievous and irremediable medical condition, including an illness, disease, or disability that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

Bill C-14 clearly goes beyond the Supreme Court decision with a mandate to study making physician-assisted suicide available to mature minors, exploring the concept of advance directives, and providing physician-assisted suicide to mentally disabled individuals. This is just not acceptable.

The committee heard testimony from approximately 42 individuals and/or groups who all have a vested interest in this issue. Over 100 amendments were presented to committee based on evidence from witness testimony provided to committee. Sadly, the Liberals did not present any substantive amendments, and in fact, voted against any meaningful amendments presented by any of the opposition parties. The Conservatives presented many thoughtful amendments that would have strengthened the bill and added important safeguards, as they did last night at report stage. This is a missed opportunity.

Let me highlight just a few of these missed amendments, these missed opportunities.

These amendments included things like assuring that only trained and qualified medical practitioners, in other words physicians, would assess the individual and administer the lethal cocktail that would eventually procure death. The way the legislation is presently drafted, it would allow a person to obtain the lethal drug from pharmacists, take it home, self-administer, and procure their own death. This worries me, and it should worry every Canadian. Witnesses presented testimony that in other jurisdictions that permit this practice, 30% to 40% of prescriptions for death go unused.

What happens to these unused drugs? What if the drugs fall into the wrong hands? What if the drugs were not administered properly? What if they did not take all of it and complications set in as a result? How can we be sure that the individuals were not at some point pressured into it? There are just way too many unanswered questions in the bill.

The bill would also make it near impossible for medical practitioners to monitor and report on subsequent events. Did the patient self-administer the drug or did the patient die from an illness? How do we ensure that we have the correct data to track euthanasia in Canada? These are valid concerns being voiced by Canadians, and it could have been addressed in the amendments that we proposed at committee.

The Liberals are unwilling to consider an amendment to ensure physician supervision during the procedure.

In addition, Bill C-14 allows for nurse practitioners to provide medical assistance in dying. There are substantial differences between a medical practitioner and a nurse practitioner, including the length of time spent training and the ability to prescribe various narcotics, yet suddenly, in this bill, we are affording them the ability to assess an individual's eligibility for physician-assisted suicide and prescribe life-ending cocktails, which is in stark contrast to the typical expectations we have of nurse practitioners.

This goes too far and is another issue we sought to address in the bill. Again, this is a missed opportunity.

We also provided an amendment that would have removed psychological suffering as an eligibility consideration for physician-assisted suicide. This, quite simply, leaves too much room for interpretation. Allowing for psychological suffering as an eligibility consideration is the start of a very slippery slope in terms of who can receive physician-assisted suicide and for what purpose.

We also suggested that “reasonably foreseeable death”, as defined in the bill, would be replaced with imminent death or at least death expected within 30 days. We heard testimony from witnesses on either end of the spectrum raising various concerns about this wording. “Reasonably foreseeable” in one physician's eyes could be completely different in the eyes of another. This will certainly open the door to uncertainty among patients and practitioners, and will definitely lead to subsequent lawsuits.

To further strengthen safeguards, we proposed an amendment requiring that prior judicial review had occurred to ensure that all criteria for physician-assisted suicide eligibility had been met.

Dr. Will Johnston, chair of the Euthanasia Prevention Coalition of British Columbia, came to testify before committee. He said the following:

...although it might be assumed, nowhere specifies that doctors must actually examine the patient, the extent to which they must do so, or the extent that doctors must inquire into the internal and external factors that create vulnerability for the patient.

Dr. Johnston brings forward a valuable consideration. Bill C-14 does not stipulate to what degree a patient should be examined nor does it require examination of the factors creating vulnerability for the patient.

In addition, we know that this is a complicated matter and difficult to address in legislation. Every individual and every disease presents a different set of challenges. Judicial oversight would ensure that individuals meet all the criteria given their unique set of circumstances and would further protect Canada's most vulnerable people. Again, this very reasonable amendment was rejected.

We also put forward a request that palliative care consultation be included as a criterion for seeking physician-assisted death. Patients would be made aware of all options available to them and ensure palliative care options were understood, offered, and available.

We heard time and again in committee that access to palliative care is a problem in this country. We also heard that palliative care, especially chronic pain treatment and counselling services, is very successful at alleviating the suffering, depression, and anxiety, things that lead people to wish to hasten their death.

The minister spoke on palliative care, and insisted that palliative care and physician-assisted suicide go hand in hand, yet the committee refused to adopt palliative care consultations as a prerequisite component in the bill.

The Canadian Society of Palliative Care Physicians outlined the issue well before committee. They wrote:

In order to ensure that medically assisted death is not our first or only response to human suffering, we need to build in an explicit legal requirement to identify, explore and record the sources of a person’s suffering and attempt to address the motivations of his/her request for death. This should not be undertaken as a screening or determination process, but rather an opportunity to ensure that a person who requests an assisted death is fully informed of available options for treatment.... The Bill should be amended to incorporate a meaningful right for patients to be informed of the full range of available treatments, technologies and supports that could ease their suffering, whatever its source.

Palliative care consultations would protect patients and ensure that physician-assisted death does not become the first response to human suffering. I cannot understand why the government would not want to ensure patients have sought out all other alternatives before requesting physician-assisted death.

One of the things we were very clear about, which the evidence produced over and over again in committee, was the whole need for conscience rights protection, not only for individuals but institutions. This came across as a large concern. We presented several amendments to committee that would have met the concern of many institutions and individuals that may be forced or required to offer this service. These amendments were all rejected, not only at committee but they were rejected here last night at report stage as well. We find that unacceptable.

[Anthony Housefather, Liberal, Mount Royal, QC]

Madam Speaker, I want to congratulate my hon. colleague on the excellent work he is doing as deputy chair of the Standing Committee on Justice and Human Rights. While we disagree about the ramifications or the outcome of the committee hearings, I want to thank him for his part in the process. It is always a pleasure working with him.

I disagree that there were no meaningful amendments made at committee. There were 16 amendments made, including issues of conscience and palliative care. What is problematic is that we talk about the Liberals rejecting them, but the Liberals did not reject amendments that were proposed by the opposition and vote against them. I do not know of any occasion when the NDP, Bloc, and the Green Party agreed with the Conservatives. There were always differences and the Liberals were sort of in the middle, agreeing with some and not agreeing with others. Therefore, I do not think it is fair to say the government or the Liberals rejected the amendments.

I will give one example and ask my hon. friend if he can respond to it. My hon. friend spoke of an amendment that came up at committee related to—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

As I have mentioned, members have to try to keep their questions short so that others have the opportunity to ask questions as well. I will now ask the member to respond.

The hon. member for Provencher.

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, I am not sure what I am responding to, but I also want to make reference to my colleague from Mount Royal. He chairs the Standing Committee on Justice and Human Rights and he does a very admirable job. He serves us and this country well. He seeks to maintain a neutral and unbiased position, and gives us all an opportunity to present our concerns.

However, he is not completely accurate when he states that amendments were considered, because the consideration Conservatives asked for regarding conscience rights, in particular, was to have the bill amended, not merely to amend the preamble. The preamble states that no one shall be compelled by this legislation to perform physician-assisted suicide, but it does not provide specific and implicit conscience rights protection for health care individuals.

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Madam Speaker, I want to ask my hon. colleague to expand on the issue of amendments being addressed. Would he agree that no opposition amendments were accepted that were to the core provisions of the bill and that they were mostly minor or technical clarifications in nature?

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, I want to thank my colleague for that question because she is absolutely correct. There were no meaningful amendments directed toward the core of the bill that were accepted. The amendments that were accepted were minor in nature, or technical. The only substantive amendment of any sort, which is weak, is that there will be a palliative care review conducted every five years, along with a review of physician-assisted suicide legislation. Other than that, there were no amendments accepted by the Liberal government from the NDP, the Bloc, the Green Party, or the Conservative Party that were of any consequence.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, I am going to use an example again. The Liberals promised $3 billion for palliative care. They say they cannot put it in the budget because they have to negotiate with the provinces. I notice that they certainly have not completed their negotiations with the provinces in terms of how the infrastructure money is going to be spent.

The Liberals made a promise on something as critical as palliative care. I would ask my colleague if their excuse of still having to come to some sort of conclusion with the provinces actually holds any sway, because I have not received a good answer on that issue from any of the Liberals.

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, that is a great question, because the Liberals did make a commitment to provide funding for palliative care. The doctors and nurses I have spoken to have said that when proper palliative care is available, the need for physician-assisted suicide just about falls down to nil. Had the money been in the budget that was promised by the Liberal government during the campaign, it would have helped to address that concern.

If we could provide proper palliative care for individuals, it would address the two basic fears that people told me they have at end of life. Number one is whether the pain can be controlled and number two is whether they can be helped with their fear, and both of those things can be addressed through proper palliative care.

[James Bezan, Conservative, Selkirk—Interlake—Eastman, MB]

Madam Speaker, I rise somewhat concerned today that I am finally, for the first time, able to speak to Bill C-14. We are at third reading. This bill has been rammed through the House. The Liberals have brought in closure time and again with this bill. Every time it was debated, whether at second reading or report stage, I was not available, or the time was so constrained and the list of speakers of the members of Parliament was so long, that I could not get on the list. Finally, I am able to speak today to Bill C-14 to reflect my concerns and those of my constituents on this bill.

When closure is used in dealing with issues of conscience like we are dealing with today with respect to physician-assisted death or doctor-assisted suicide, whatever we want to call it, we need to take the time to have the debate. We need to have the discussion among parliamentarians and talk to the appropriate experts to ensure that we get this right. If the Liberals rush this bill through the legislative process in the House and if they try to do it in the Senate, I can guarantee that mistakes will be made and this bill will be facing court challenges in a relatively short period of time.

I also have to reflect what my friend from the riding of Provencher said today. It is extremely disappointing that so many reasonable amendments were presented by members of the opposition parties, and not one of them found their way into this bill at report stage last night. That truly is disappointing.

In my riding of Selkirk—Interlake—Eastman, the topic of physician-assisted suicide is divisive, as it is right across the country. The majority of constituents who have contacted my office have been opposed to this policy, on two fronts: first, many people have deeply held moral, ethical, and religious beliefs that are strongly against assisted suicide; and, second, many believe that the policy will be used prematurely to end the lives of those who have become a burden to their families, society, or the medical system.

It is important to note that the Liberals broke a key election promise to invest $3 billion into long term care, including palliative care. Access to palliative care is an essential part of end-of-life decision-making. There was unanimous agreement on the Special Joint Committee on Physician-Assisted Dying and among stakeholders, including the Canadian Medical Association, on the need for a pan-Canadian strategy on palliative care, with dedicated funding. This would be an important step forward for Canada. It is something that the Liberals have glossed over in favour of introducing this legislation in a very careless and expeditious manner.

Many medical doctors, nurses, and health care professionals are conflicted with the ethical and moral conundrum that assisted suicide presents, as it runs counter to the modern adaptation of the Hippocratic oath. The University of Ottawa captures the challenge of this principle. It states:

Given the complexity of medicine in the 21st century, an ancient oath cannot possibly encompass current values. Therefore, the significance of the Hippocratic Oath does not reside in its specific guidelines, but rather, in its symbolism of an ideal: the selfless dedication to the preservation of human life.

I would stress “the preservation of human life”.

Although the Canadian Medical Association in the last year has turned its back on its previous position on physician-assisted suicide, the Supreme Court of Canada went to great lengths and grasped at straws to change its position from its previous rulings as to whether there should be exemptions offered for physician-assisted suicide.

The Canadian Medical Association is a member of the World Medical Assembly, which adopted a resolution back in 1992 on this. It revised it slightly in 2005, but reaffirmed it in April of 2015 in Oslo. It states:

Physician-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient.

Quite clearly, the World Medical Association, doctors and physicians from right around the globe, is saying that this is unethical.

As has been pointed out, we are quite concerned from our side, and I am in particular, about the charter rights under sections on the freedom of conscience. As has been noted, there was a minor amendment made to Bill C-14 in the preamble to allow for the protection of individuals but not of institutions. Is it strong enough to be considered legal in a case that goes before the courts, the Canadian Human Rights Commission, or one of the provincial human rights commissions, if section 2 is defined in the preamble but is not actually in the clauses of the legislation itself?

Institutions would be exempt, and I know that some members have had conversations with people at some institutions who are very concerned about this. I looked to the St. Boniface General Hospital in Winnipeg, a Catholic-run hospital. They are quite concerned that they, as an institution, will have to violate their own religious and moral beliefs to provide assisted suicide. They believe in the sanctity of life, as many of us on our side do also.

Like most Canadians, I have watched loved ones succumb to lengthy and chronic debilitating illnesses. Dying with dignity is desired by all Canadians. Unfortunately, only a handful of us will die in our sleep with minimal discomfort or pain. I do not believe that we should institute a policy that will provide physician-assisted suicide to every Canadian when they are near their end of life. Dying with dignity does not apply only to physician-assisted suicide. Expanding and improving palliative care services is by far the better public policy, and should be a priority of all health care providers across this country. I am recommitting to working with like-minded Canadians and policy-makers, and parliamentarians right here, who want to enhance palliative care in Manitoba and across the country. My wife Kelly works as a nurse in a personal care home and provides palliative care services all the time. She agrees that strengthening palliative care services will allow more Canadians to die with dignity.

I have met with the Manitoba League of Persons with Disabilities and talked to Carlos Sosa, who is the Manitoba representative on the Council of Canadians with Disabilities. They are very concerned with the way that Bill C-14 is laid out right now because it would do little to address the concerns of the vulnerable and how the law would deal with people in the disabled community. In particular, the bill would not provide for an assessment of vulnerabilities that may induce a person to assist and seek an assisted suicide. It does not have an expedited prior review and authorization by a judge or independent body with expertise in fields of health care, ethics, and law. This was one of the amendments we brought forward last night, and it was defeated.

Rhonda Wiebe, who is the co-chair of the Canadian Council of Disabilities end of life ethics committee, said:

In the Carter decision, the Supreme Court of Canada gave the Government of Canada two assignments (1) develop a regime to provide dying people access to assisted suicide and (2) protect vulnerable Canadians who at a time of weakness may be influenced to accept medical aid in dying. Unfortunately, [Bill] C-14 has some serious gaps when it comes to protecting the vulnerable..... Canada must do enough to protect people like [her] and other Canadians with disabilities who can be made vulnerable by both [their] health conditions and [their] social and economic circumstances.

I am privileged to belong to a political party that allows for free votes on issues of moral and religious beliefs. On policies such as physician-assisted suicide, Conservative members are free to either reflect the will of their constituents or to vote according to their personal beliefs. As someone with very strong Christian values, I cannot support Bill C-14. Bill C-14 needs better protection in place for youth under the age of 18, and safeguards for those who are vulnerable, including those who are dealing with mental health challenges.

[Anthony Housefather, Liberal, Mount Royal, QC]

Madam Speaker, I am sure that my hon. colleague inadvertently stated something that is not correct, which is that conscience amendments were not added to the bill. We did have a conscience amendment that was drafted in conjunction with the member for St. Albert—Edmonton, the member for Victoria, the member for Central Nova, and I, which is in the bill. The preamble was amended and the bill itself was amended. I just want to correct him on that point.

There was a judgment by the Alberta court yesterday, saying that a non-Canadian citizen, not eligible for medicare, was eligible for physician-assisted dying. We have had a judgment from the Court of Appeal of Alberta that stated that a psychiatric patient of 58 years old who was not dying—death was not only not imminent but not even foreseeable—was eligible.

Does the hon. member not agree that without this law being adopted by June 6, and without safeguards in place, such as two opinions, a waiting period, and all of the other safeguards in the bill, that we will be going down a very slippery slope?

[James Bezan, Conservative, Selkirk—Interlake—Eastman, MB]

I do agree, Madam Speaker, that we do not want the slippery slope. We do not want judges, without any background at all in the ethics or medical field, making rulings on individuals in cases like the member for Mount Royal just outlined.

We also know that the amendment that was accepted was rather watered down. Again, it is in the preamble and not in the body of the bill.

We have some options here. The government has options. It can request an extension from the Supreme Court of Canada so we do not have to go for the June 6 deadline. We can work with the opposition members and make this right and accept some of these amendments that we brought forward and are very reasonable, or we could use the notwithstanding clause. There are options out there, but ultimately I ask people to defeat the bill.