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.