House of Commons Hansard #74 of the 42nd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was citizenship.

Topics

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

10:55 a.m.

Liberal

Jody Wilson-Raybould Liberal Vancouver Granville, BC

Mr. Speaker, certainly I acknowledge my colleague across the way for his ongoing commitment and discussion on this important issue.

My words today were in speaking to a motion to the other place in terms of their thoughtful considerations with respect to Bill C-14.

The member opposite speaks to the risks, speaks to the broadening of the criteria in terms of one of the amendments that was sent back. What I was expressing in my comments were the serious concerns that we have. If we were to broaden the eligibility criteria, there would not be the necessary safeguards in place to account for that broadening of the criteria.

What I sought to articulate in my comments were examples highlighted from other jurisdictions, factual examples where a broad criteria has resulted in patients accessing medical assistance in dying in the cases that my colleague across the way speaks to, in terms of individuals who are suffering from mental illness alone. Recognizing that there are other remedies, certainly, we trust medical practitioners to perform their duties responsibly in servicing their patients in the best and most appropriate manner.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Liberal

Anthony Housefather Liberal Mount Royal, QC

Mr. Speaker, I want to thank the Minister of Justice for her very carefully considered and very appropriate and thoughtful review of the Senate's amendments.

I want to come back to the issue of “reasonably foreseeable”. The minister recognized that in the event that “reasonably foreseeable” were to be removed from the law, we would be changing the law in such a manner that different people who were never intended to be covered by the law would suddenly have grievous and irremediable illnesses.

One example might be someone who recently became a paraplegic, whose mental process, whose acceptance of their new circumstances, may be very different if they waited a year. The waiting period in the bill is 10 days. As such, does the minister not believe that if we were to change “reasonably foreseeable”, we would need to drastically extend the waiting period for some categories of people?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Liberal

Jody Wilson-Raybould Liberal Vancouver Granville, BC

Mr. Speaker, around reasonable forseeability and expanding the eligibility criteria with respect to medical assistance in dying, there are any number of situations that could arise with a broad eligibility criteria such as the member suggested, for example, looking at persons who have recently become disabled in a car accident and have become quadriplegics.

We have considered all of the different machinations in what safeguards should, and need to be in place, and the risks associated with a broadening of an eligibility criteria. For a recently disabled person, I would submit that a 10-day reflection period is not a substantive reflection period to respond to such a circumstance. We need to proceed with caution.

We will have a continuing conversation as a country, and we will ensure we continue to have these discussions.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, the minister puts a great deal of stock in the reasonably foreseeable provision. “Reasonably foreseeable” in this context is not a recognized legal term or medical term. The minister herself has said in previous debates that it does not mean terminal. Therefore, given the alleged significance of this criteria, this safeguard, so to speak, could the minister tell us what “reasonably foreseeable” means?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Liberal

Jody Wilson-Raybould Liberal Vancouver Granville, BC

Mr. Speaker, in the compressed timeline I have to respond, I have spoken to “reasonable foreseeability” in the chamber.

“Reasonable foreseeablity” is something that has been used quite regularly in the Criminal Code. We placed it in the legislation to inject what we feel is a necessary flexibility to provide medical practitioners with the ability, based on their direct relationship with their patient, to determine when that patient would be eligible for medical assistance in dying. In other words, they would determine when their patient's death has become reasonably foreseeable.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Resuming debate, the hon. leader of the opposition in the House.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, I rise on a point of order. I believe Standing Order 62 provides for the member who rises first to be recognized.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

I would have to check the standing order that the hon. member references. At the time of resuming debate, members rise in their place to be recognized, and we do have a list, as the member understands quite well. I recognized the hon. opposition House leader as he was rising in his place. That is the customary way that we proceed.

Therefore, I recognize the hon. opposition House leader, and he will begin his remarks now.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:05 a.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I suppose I caught your eye first. That is the way it normally works.

Before I begin my remarks, under the parameters of the debate, I have an unlimited time slot. I wonder if I could get the unanimous consent of the House to be deemed to have a normal 20-minute speaking slot and I would share that time with another colleague.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:05 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Is that agreed?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:05 a.m.

Some hon. members

Agreed

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:05 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

The hon. opposition House leader.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:05 a.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I will be sharing my time with the hon. member for Sherwood Park—Fort Saskatchewan.

I will be brief. I want to speak to a few of the amendments the government has chosen to accept and also express a few words of caution.

I want to thank the minister for keeping the language as tight as possible. “Reasonably foreseeable” is a much better situation than “grievous and irremediable”. As this is such a fundamental change to our society, we do not want to open the door to assisted suicide in such a manner that a large number of people who may be suffering from physical or mental ailments would have access it.

I understand the slight wording change on the palliative care amendment. It is important that any patient make an informed decision, whether it is about something as simple as a normal medical procedure, but certainly in a situation like this of such a grave and serious matter. In essence, as this may be the last decision some people make, making an informed decision is critically important. Knowing what other options there might to alleviate of pain as well as palliative care are also so important.

I hope the government will work with the provinces in the coming months and years to establish a robust palliative care regime so this type of decision is not made without having real and practical options to extend life in as comfortable a manner as possible, while understanding the significant challenges that are often placed on family members.

I wish the government had included the amendment that dealt with beneficiaries of estates or insurance policies not being able to participate directly in the act of assisted suicide. That is an important amendment to keep. This is going to be a new thing in Canada and we do not know how it will unfold, so having some kind of safeguard in place to avoid pressure being put on people to make this decision is important.

Many members may be familiar with the Terri Schiavo case in Florida. It was a bitter dispute with a lot of allegations all around. One of the facts that came out was that one of the family members pushing for end of life care to be withdrawn from Terri Schiavo was a beneficiary of an insurance policy. That conjures up gloomy images of what might happen to people who do not wish to end their life and are not able to either grant consent or put up opposition to it and have those decisions made for them.

I want to touch on a few comments that are troubling to me. I have heard comments made by government members and the minister about how this is a first step and that this could be expanded in the future. Those types of things very much concern me. The House is taking this decision because of a court decision. The Supreme Court of Canada reversed its original decision that upheld the laws against assisted suicide and has thrown this on to Parliament.

I understand the need that the government had to fill in this legal vacuum, and I commend it for using the language “reasonably foreseeable” and not “grievous and irremediable”. However, I am wary about what might be coming down the pike. It really worries me when people talk about this being a first step. I shudder to think where this might go. If this type of regime is opened up more, people who may be going through difficult times in their life, maybe temporary difficulties, both physical and mental, will access it.

I hope we have created a tight box that will not be expanded. I will be watching in the future and will do everything I can to ensure that this is not expanded, and I hope many of my colleagues will do the same. I do not want to go down the road of what has transpired in some European countries where this is used in a much more aggressive and expanded way. Many times it involves vulnerable people or people with severe disabilities who are not able to communicate their desires and other family members or other caregivers make that decision for them.

Canada could be going to a very dark place if this is a first step. If it is filling in that legal void and we have created a strict enough and a tight enough box around it, then I hope this is as far as it goes. I will be doing everything I can to ensure that is the case.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:10 a.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, I appreciate the comments from the member across the way.

Could the member provide some thoughts on the number of individuals who were involved? We can talk about the decision of the Supreme Court of Canada, and the preliminary work that was done last summer on the issue of assisted dying? We had a joint committee of the House, including the other place. We have had ample opportunity through consultation, even at committee stage with individual members of Parliament. This is a very emotional issue for all of us as we try to deal with the passage of Bill C-14.

Could the member provide any personal insights on the legislation, or about the issue at hand, or provide comment in regard to the amount of individuals who have had, directly or indirectly, an opportunity to participate?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:10 a.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I have voted on this subject a couple of times in the House. It came up through private members' bills. I think a member of the Bloc Québécois, in the 39th Parliament, proposed a bill to remove the restrictions around assisted suicide. It was not as comprehensive as the bill before us. I think it just deleted a clause. This obviously is a more robust response to the issue.

I do take the hon. member's points. Once the House came back after the election, there was a great number of opportunities for members to weigh in on what direction it should take. There was the special committee before the legislation was drafted, obviously debated in the House, the standing committee, and now over to the Senate.

However, none of that kind of matters when we are dealing with the original principle that the Supreme Court hoisted it back on to us. Several times in the last decade or so the elected representatives have voted against legalizing assisted suicide. The Supreme Court, in my lifetime, has upheld the rules and laws against assisted suicide and now has reversed itself. This is my beef with the whole question.

It was quite clear, through the will of the elected by Canadians, that Canadians were comfortable with assisted suicide being illegal, that the sanctity of life being upheld all the way through to natural death was an important principle, and that Canadians were afraid of where this might lead to. However, the court, having reversed its decision, has now placed it back on the lap of Parliament, so there are limited options for parliamentarians to take.

The bill is not perfect. I voted against it at second and third reading. I would have liked to have seen more protections for conscience rights for medical practitioners. I wish we had talked more about that. It is not in the amendments that we are dealing with today, so I cannot speak to that. However, it would have been easier for me to support the bill if those types of protections for medical practitioners to reflect their conscience were in it.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:10 a.m.

NDP

Linda Duncan NDP Edmonton Strathcona, AB

Mr. Speaker, I have listened with great interest to the hon. member's comments about what Canadians think. Perhaps he might want to actually contact the governments, including the Government of Alberta. It actually took the time to survey Albertans. It also worked with the College of Physicians and Surgeons, as it has across the country. The College of Physicians and Surgeons of Alberta has issued guidelines consistent with the Supreme Court of Canada.

On the survey of Albertans, 60% of respondents want to support the safeguards put in place by the College of Physicians and Surgeons, which is immediately consistent with the Supreme Court of Canada.

How is it that the member, and frankly the Minister of Justice, keep saying that we should rely on a political body that lobbies on behalf of medical interests in Canada as opposed to the colleges of physicians and surgeons that support the Supreme Court of Canada guidelines?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:15 a.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

Mr. Speaker, I am not familiar with the steps the Government of Alberta took to survey people in Alberta. If it was not a referendum, then I do not know how accurate a reflection of the people it could be. I would not look to the current Government of Alberta to inform basically any of my decisions, especially about something as serious as this.

Let us be honest. We are talking about very complex legal principles. We are talking about medical terminology that touches on many different aspects of different kinds of care.

The will of Canadians was reflected through the House, which is a pretty fundamental principle. Political parties and MPs come here to represent their constituents. We did vote on this several times in my life here as a parliamentarian, and every time we rejected the call to legalize assisted suicide, and rightly so.

I have had people in my family reach the end of their lives and go through very tough medical conditions. However, upholding the principle of the sanctity of life is our job, and it is the medical industry's job to protect life, to extend life. That is a fundamental principle, and if we lose that anchor, I worry a lot of unintended consequences will come down the pike in the foreseeable future.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:15 a.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, it is a pleasure to rise for what will probably be my last time speaking to this particular bill, though I am sure not to this issue in general.

I am going to give a fairly disparate speech addressing a number of different issues that have been raised and loose ends in this conversation.

First, it is important to underline that we do not exist in a legislative vacuum at the present time. The government has, in my judgment, created this sort of artificial sense of fear, this artificial timeline that says we have to pass its bad legislation, in my judgment, just because if we do not do it, there will be no legislation.

June 6 has come and gone. There are provincial guidelines in place. I do not dispute the fact that a better version of a federal framework would have many desirable things about it. I have not certainly opposed the principle of the federal government legislating in this area. We are, after all, talking about the contours of an exception to the Criminal Code. However, in the absence of the federal government having done the detailed work, in terms of actually coming up with a system of checks and balances, a system of safeguards, it may well be—and in my view, it is the case with the present legislation—that we are better off to defeat it, perhaps to bring back a better bill in the future. I will talk specifically about why that is and what a better bill would look like.

However, I think it is fundamental that we recognize the reality that there is not a legislative vacuum. It is not as if people are being killed without some kinds of systems, checks and balances, and safeguards in place. Provinces were ready in a way that the federal government simply was not.

I think we have a failure of process here. I will just briefly outline what that process was.

We had a Supreme Court decision at a time when the Conservatives were in government. We created this expert panel to review and report back, and it would have reported back after the election. It would have been difficult for politicians to be involved in a government consultation process in the immediate lead-up to and during an election. However, we had this external expert panel that was consulting Canadians and that was ready to report back the results of its consultation, as well as make policy recommendations.

When the new government came in, it removed the power of that expert panel to make recommendations with respect to policy. It only reported on its consultation. When we hear the government talk about this timeline, somewhat misleadingly, it will say that the previous government did nothing to advance this, when it was its decision to remove that essential power of the expert panel to make policy recommendations.

Then we had a motion in this House, in December, to create a joint committee of the House and Senate to review this issue. That panel could have sat during the Christmas break, but it did not. It faced a time crunch when it came back. Then we waited months before seeing any kind of federal legislation. The failure of process was that in every case, in as much as a year and four months is not that much time, we faced a time crunch toward the activities of the committee and toward the activities of the House and certainly the Senate, because we did not more effectively use the panel that was put in place by the previous government. That panel consulted far beyond what the special committee did, far beyond what the justice committee did—in the case of the justice committee, not for any ill-intention, I am sure. I was concerned about the process of witness selection with the joint special committee. There were many people who were even intervenors in the Carter case who were not able to participate in those hearings. In any event, the point is that we had this artificial time crunch that was created, and we see it happening again today.

Again today, the government is trying to create this artificial urgency instead of delving into this substantive conversation. Quebec did this in six years. I am not saying we should, or could, take six years, but having the prudence to have introduced legislation earlier and to have drawn on the wisdom of the expert panel would have been much better because we are in this seeming time crunch. However, I think we need to reject the time crunch the government is creating and, instead, do the diligent work that we need to do to fix some of the big problems in the bill.

We see sloppiness in this legislation, especially around this discussion of reasonable foreseeability. The justice minister just spoke, and I actually share many of the concerns she raised about leaving this wide open, but I think what she neglects is that reasonable foreseeability is not clear enough to be, in any sense, a meaningful safeguard.

I have listened to the minister speak repeatedly about reasonable foreseeability, and I understand that in response to my short question, she did not have enough time to define it fully, even if she had wanted to. However, having listened to her speak many times on this subject, I am not at all clear—and maybe subsequent speeches will provide some clarity—what that term actually means.

Obviously, death is reasonably foreseeable for all of us. This is part of the human condition. We are born and we die. There was certainly nobody on either side of this debate who suggested that natural death is abnormal, bad, or something to be feared. It is a part of life and reasonably foreseeable for all of us. That does not mean that we should not be concerned, though, about policies that would artificially cut short the process of natural life and death.

However, if reasonably foreseeable is so important, then we should actually have a definition. There should be some clarity about what that means. Liberals have said they are not talking about imminent natural death, but at some point in the future. I have quipped before that, when I was learning to drive, my mother thought death was reasonably foreseeable every time we got in the car, but the central point is that death is reasonably foreseeable for all of us. It is part of the human condition.

Therefore, this is very sloppy. It is not a safeguard. We need real, meaningful safeguards. I suggest that the federal government should contemplate safeguards along the lines that the government of Manitoba has brought in, whereby some competent legal authority reviews cases to ensure that legal criteria were met, not a model of judicial review but government lawyers designated for this purpose.

Other provinces have put in place systems that necessarily involve the attending physician, or if the attending physician is a contentious objector, a different attending physician can assess the situation. However, it does not allow someone to just find any doctor anywhere who agrees that someone meets the criteria, but involves the physician or somebody actually involved in providing the person with care to make the assessment. If we look at what the provinces have already done in terms of safeguards, we see these are things that the federal government could adopt.

It is disappointing for me, frankly, as a member of Parliament, to see the government not doing the diligence that provinces have shown is possible when it comes to finding meaningful safeguards within a relatively compressed timeline. The government's approach has been to emphasize sort of an artificial timeline of urgency, but then not actually do the diligent work in advance. It created this time crunch by leaving it until the last minute and then said that it has to be passed or there is a legislative vacuum. There is no legislative vacuum, and again, the important work has not been done in terms of clarifying the safeguards.

I will make a general comment. I find myself repeatedly asking the government for definitions of things. On this issue and a range of other issues, it repeatedly uses words without actually clarifying what the words mean. It is true of the provisions of this bill, but more broadly, it is true of the underlying philosophy of this bill. So much of the motivating arguments for this legislation come from the concept of human dignity, human rights founded on an idea of human dignity. I think we would all agree that human rights have their foundation in human dignity. We give rights to people on the basis of what they are, intrinsically. Yet the government, in the context of talking about dying with dignity, has not told us what it means by dignity.

I believe in the idea of intrinsic human dignity. Dignity is present in all of us. I know that one member of the other place who was criticizing me in the media suggested that young people cannot understand this issue because they do not spend enough time in nursing homes. I have volunteered regularly in nursing homes for a very long time and, recently, my grandfather passed away in a care facility. It is important for me to believe, but more than that, to know, that he had dignity in spite of his suffering.

Many of us here have seen or been with people as they suffered and died. It is important that we know and believe that people, regardless of their circumstances, regardless of their suffering, have dignity.

Dignity is not conditional on circumstance. Dignity is intrinsic. If the government disagrees with that, if it has a different concept of human dignity, then it should at least define the term.

This work is sloppy, the philosophy is sloppy, the legislation is sloppy, and I encourage members to defeat this bill in every way possible.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:25 a.m.

Charlottetown P.E.I.

Liberal

Sean Casey LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Mr. Speaker, I would like to address the issue raised by the member opposite when he talked about an artificial time crunch and a failure of process.

The Carter decision was handed down on February 6, 2015. Between February 6, 2015, and the federal election, there were was the elapse of eight and a half months in which the Conservatives were in power, eight a half months of the 12 months allotted by the Supreme Court of Canada.

The member opposite said that it was difficult for politicians to be involved in the lead-up to the federal election. My question is why. The politicians in this place, during those eight and a half months, were denied an opportunity for debate in any sort of a parliamentary process, they were denied an opportunity for debate or discussion before a parliamentary committee, and they were denied an opportunity for debate in this chamber.

All the while, it was the Conservative government that was denying that opportunity, specifically by voting against a motion to establish such a process that was brought in March by the Liberals—

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:25 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

You only have five minutes for questions and comments.

The hon. member for Sherwood Park—Fort Saskatchewan.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:25 a.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, I thank the parliamentary secretary for his work on this, although he knows I think there is some sleight of hand involved in that question.

I certainly did not say that politicians could not be involved in the discussion in the lead-up to the election. What I said is that it is difficult for politicians to undertake a formal government consultation in the midst of an election period. I think that is fairly obvious. The approach we took was a responsible approach, where there was an expert panel that was conducting consultations and reporting after the election.

This member and the government have to explain why they cut that process off. It is simply not true to say that members were denied an opportunity for debate in this place, as the member knows, and he in fact alluded to it. There was a supply day discussion of the issue. Supply days are a process and a part of the debate.

The reason there was no government-orders debate at the time was that there was no government legislation. It would have been irresponsible for the government to try to bring forward and pass legislation in the spring of last year, that shortly after—

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:30 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Order. Questions and comments.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:30 a.m.

NDP

Linda Duncan NDP Edmonton Strathcona, AB

Mr. Speaker, I have a very brief question.

I put the same question to another of the member's colleagues in the Conservative Party. I would think it is important, as representatives of certain regions, to pay attention to what the people of our region are saying.

The Government of Alberta took the time to do a survey of Albertans to see what their view was on the various opportunities to legislate in this area, and 60% of respondents replied that they wanted to support the safeguards put in place by the College of Physicians and Surgeons of Alberta, which as the member knows, is the regulatory authority. Those are the guidelines adopted by the Supreme Court of Canada.

My question to the member is this. There has been a lot of discussion on that side about how we cannot do anything until we provide palliative care. In the decade that his party was in power, it did not put any additional dollars into providing palliative care to Canadians.

What would the member like to say to that question?

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:30 a.m.

Conservative

Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB

Mr. Speaker, I will resist the temptation to offer some comments on the Alberta government in the context of that question. I have a great working relationship with my local MLAs, even if we do not agree.

I do want to specifically address the question in terms of surveys. One of the concerns I have with many of the surveys that are done on this issue is that people often misidentify, and questions can poorly identify, the distinction between the withdrawal of treatment and active euthanasia or assisted suicide.

It is regular and supported by everyone here that in a medical environment there would be certain cases—many cases, frankly—where extraordinary measures would need to be withdrawn and the natural process allowed to take its course. That is something that is fundamentally different from the act of killing associated with euthanasia or assisted suicide.

One of the problems we routinely see with these surveys is that they often fail to identify the distinction. I would be interested in looking at the back data and the questions in the survey to which the member refers. However, having been in the polling business myself, I have an understanding of those issues.

With respect to palliative care, there are members on our side who can speak to it in greater detail than I can. I simply disagree with the premise of the member's question. Significant actions were taken on palliative care. Yes, there is more work that needs to be done. I and others have called for more work to be done.

However, we supported an initiative to have a national palliative care strategy. I think that was supported by many parties in the last House. The work was begun and needs to continue.

An Act to Amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying)Government Orders

11:30 a.m.

NDP

Murray Rankin NDP Victoria, BC

Mr. Speaker, I am very pleased to rise to address the government's motion on a response to the Senate regarding the amendments it has made to Bill C-14. My personal involvement in this process began in January when I had the honour to serve on a special all-party and Senate committee. My colleague, the member for Saint-Hyacinthe—Bagot, was a very important member of that committee as well. Our mandate was to advise the government on a response that would respect the Supreme Court of Canada decision in Carter, respect the Charter of Rights and Freedoms, and respect the priorities of Canadians.

I have told the House before how very proud I was of the work that we accomplished together, and the spirit as well with which we worked in that place. We knew that the government would not accept all of our recommendations, but each was based on the evidence and faithfully respected the testimony that we heard, testimony of experts who came to us from across this country and reached out to others in the process.

Since Bill C-14 was introduced in the House, I, like many others, have focused great attention on its most surprising feature. That feature was the decision of the government to narrow the declaration of the Supreme Court of Canada to a much smaller circle of eligibility, and it could have proved to be a fatal flaw.

That was the testimony, after all, of the Canadian Bar Association, the Quebec Bar Association, Jean-Pierre Ménard, Joseph Arvay, and later the testimony of Canada's foremost constitutional scholar, Professor Peter Hogg. That was the conclusion, as well, of the courts in Ontario and Alberta. That flaw was important, not only because it fatally weakened the bill against the charter challenge, but also because it would force suffering Canadians to launch a court battle. That flaw was so important and so glaring that it overshadowed much of what was good about Bill C-14. Colleagues who have grown tired of hearing me warn about charter challenges and infringed rights will be pleased to hear little of that from me today, because that fatal flaw has been erased from the bill that is now before the House.

The bill as amended now combines a clear and faithful implementation of the Supreme Court ruling with a system of stringent medical safeguards to individually screen every request for assistance in dying. Those safeguards are based on the evidence received by the all-party committee. They reflect the best practices of other jurisdictions as well as made-in-Canada provisions, which members of all parties have helped shape over the course of this debate.

Without the amendment that came to us from the other place, as Peter Hogg has testified, the bill would not be consistent with the decision in Carter. That was his clear testimony. It also would remove a victory that would be taken from those individuals in Canada who could not comply with the very narrow, and frankly inexplicable restriction, of reasonably foreseeable death. Those individuals have that right as of today until Bill C-14 is enacted. Those rights will be taken away should the motion by the government be passed.

However, I am happy to say that the bill before us today, which contains the language of the Supreme Court decision, would of course be compliant with that decision and with the Charter of Rights and Freedoms. As Professor Hogg has said in the clearest possible terms, if it is not fixed as per the amendment that comes to us today, it will be struck down in the Supreme Court of Canada.

When I speak of Mr. Hogg and I hear the government saying we have different experts in different places, I suppose it is important to remind the House of the accomplishments of that individual. His decisions and his book have been cited over 200 times in the Supreme Court of Canada. By my reckoning, it has been cited 1,627 times in the courts of Canada. To suggest that this professor is just another person with an opinion is really quite disturbing, because the government itself, the Department of Justice, has retained that individual on countless occasions.

For him to say, as he did in the other place, that the bill, without the amendment before us today that would fix the problem, is somehow unconstitutional, that it is just another expert, that lawyers differ, economists differ, whatever, is simply misleading.

Canada's leading constitutional scholar has said in the clearest possible terms that without the amendment that happily is now in the bill before us for debate, it has to be fixed. I termed that testimony a game-changer, because I wondered how on earth a government that has retained this gentleman dozens of times could now turn around and say, as the minister did this morning in her speech, that constitutional scholars just differ and that is how it works.

Happily we have in front of us a bill as amended in the other place that we can support, and that is the good news for Canadians. Some amendments come before us to deal with things like palliative care, an amendment that would require all patients considering medical assistance in dying to get a full briefing on palliative care options.

Another amendment would deal with restricting people who help a person in assisted dying, tightening the rules around what role a person who could materially benefit from the death could do.

Another amendment that comes from the other place would compel the Minister of Health to draft regulations around death certificates and provide greater clarity on what information is collected by medical practitioners.

Another amendment calls for a report to be issued to Parliament within two years on issues that have arisen from the provision of physician-assisted dying. Finally, there are some minor language amendments.

The safeguards in the bill reflect many things. They provide the high degree of care, caution, and scrutiny that is necessary to match a court ruling that was broad in its compassion for the right of suffering Canadians to choose. They reflect the confidence that Canadians have in the skill and judgment of our health care professionals, and they reflect the realities of our vast and diverse country, and the principles of equity that undergird our public health care system, of which Canadians should be so proud.

Much has been said in this chamber about the need to balance respect for the autonomy and protection for the individual. We have heard that so often. The Supreme Court of Canada was unanimous in its analysis of our charter, and it ruled definitively on the question of whose autonomy must be respected on this deeply personal matter of choice.

It was for us, as legislators, then to choose what combination of safeguards might be necessary to screen out from that group those who, by virtue of diminished capacity or external pressure, must be denied this option for their own safety. We consider this question carefully, knowing that excessive caution would have its costs. Excessive barriers would not protect the vulnerable. Rather, they would condemn competent, autonomous, adult Canadians to intolerable suffering by wrongly denying their right to choose.

Neither could the solution be to presumptively deny the autonomy of a whole class of persons granted their right to choose by the Supreme Court of Canada. No matter the rhetoric, to presumptively deny people's autonomy, to assess them not as unique individuals, but to dismiss them blindly as a group, to me, is as deeply patronizing and offensive as it is unnecessary.

The Supreme Court expressed faith in us as legislators that we could devise what they called “a carefully designed and monitored system of safeguards” to address the risks associated with offering the compassionate choice of medical assistance in dying. I, for one, believe the court's faith was not misplaced.

We remember what the Supreme Court of Canada said in Carter:

We have concluded that the laws prohibiting a physician's assistance in terminating life...infringe Ms. Taylor's s. 7 rights to life, liberty and security of the person that is not in accordance with the principles of fundamental justice, and that the infringement is not justified under s. 1 of the Charter. To the extent that the impugned laws deny the s. 7 rights of people like Ms. Taylor they are void by operation of s. 52 of the Constitution Act, 1982.

Here is what the court went on to add:

it is for Parliament and the provincial legislatures...should they so choose, by enacting legislation consistent with the constitutional parameters set out in these reasons.

There are two key points that came out of the Supreme Court's pronouncement. The first is that we did not have to do this at all. The court decision could have stood on its own, as in fact it is doing now, along with the safeguards that the provincial and territorial regulators have put in place. We did not need to do what we have done, but we did, in the words of the court, choose to do so.

The second point, though, is equally important: that we could only do so if what we enacted as legislation was “consistent with the constitutional parameters set out in [our] reasons”.

Here is what Professor Hogg testified in the other place. He said, “In my opinion, [the bill] is not consistent with the constitutional parameters set out in [the Carter reasons].”

The amended bill before us would fix it and be possible for all of us to work in the spirit of collaboration, as we did so effectively in the Special Joint Committee on Physician-Assisted Dying and the Standing Committee on Justice and Human Rights. We wrapped our hands around something that would make Canadians proud, wrapped our arms something that would show the compassion that the Supreme Court of Canada showed in the Carter decision, rather than dividing us on party lines or other lines.

All that the amendment the government announced today it wishes not to follow would do is to ensure that it is consistent with the Supreme Court of Canada and the charter. Much has been said about the fact that we need not follow and put into legislation the precise words of a court judgment. Of course, that is right. The simple path was to put the actual language of the decision into the legislation because that was clear and obvious, and certainly no one could say it would be unconstitutional to do so. Rather, the government wishes to use the words “reasonably foreseeable” natural death, which people on all sides of this place have demonstrated is ludicrous language.

Dr. Douglas Grant, head of the regulatory body for all medical regulatory authorities across the country, has pointed out that the language is vague and unworkable from a medical point of view. The government proposed to take the words of the Supreme Court of Canada, though it did not need to, but at least no one can say they are bad, and substitute words that are incomprehensible to the people, physicians and health care providers, who are being required to implement them.

I cannot understand that. I particularly cannot understand it when to do so would be to take away the rights of Canadians that were hard fought for and won in the Supreme Court of Canada. Why? What do I tell those people who call me and say they have to decide whether to take their own life now, because after this bill comes into force that may not be an option available to them? They won that right in the Supreme Court of Canada. In no way do they feel they are near end of life. They may have 30 more years of excruciating pain and suffering, and how dare we say that they do not have that autonomy as a Canadian individual? However, now the government purports to take away that right.

Please understand that as of June 6, the Supreme Court decision stands alone, carefully governed by rules that apply to health care practitioners from coast to coast to coast. It is not the wild west, as colleagues have already pointed out. We have rules in place that are being enacted and carefully followed. If this motion passes, the moment the current government takes away those rights by saying that people have to have a reasonably foreseeable natural death, they will lose that right.

How can the Liberals possibly argue that this somehow would not deprive Canadians of rights that they won in the court? These are real people. This is real suffering. The government says no, that it has this delicate balance right, and it calls it a public policy choice. Some Canadians think that the government goes too far and some Canadians say it does not go far enough, so it will come right down the middle. That frame is wrong. We are here because we chose to implement a unanimous Supreme Court of Canada decision.

We are not here to say we will pick and choose what we like about this issue.

Can we add additional safeguards? Absolutely, and I am proud of what we did. Can we deal with palliative care? Yes. Can we deal with conscience rights? Of course, and we did, and I am proud of what we achieved.

The elephant in the room is that an entire class of successful litigants have had those rights deprived in this place.

The good news is that we can fix that. We have a path to do that, which comes from the other place. It is language we tried to get through the House before. I do not care where it comes from. I am on the side of suffering Canadians who want the rights that they had before.

It is worth reminding ourselves of a very simple fact. We are not called upon to legalize medical assistance in dying. That was already done by the Supreme Court of Canada and is now the law of the land. Instead, we were invited, if the government chose to do so, to offer the broader framework necessary to give clarity and comfort to all Canadians.

I believe that balance has been achieved in the bill that we have before us, as amended. The words of the Supreme Court are there to speak to whose autonomy must be respected, and the work of all parliamentarians is reflected in the system of safeguards before us. The onus must now be on the government to explain why it proposes to cut the words of the Supreme Court judgment out of the bill we have received from the other chamber.

I know that many of us share a common belief that no one can ever make this difficult choice of medical assistance in dying for another. but by rejecting the ruling of the Supreme Court and removing its words from the bill, that is exactly what the government suggests that we do. I cannot accept that, and on a free vote, it is up to all members to decide whether they can accept that.

I would ask all members in this place to consider the alternative; that is, to accept that what we now have is a balanced bill that bears the marks of the Supreme Court, of Parliament, and of thousands of Canadians who participated in consultations and town halls along the way.

I feel we have in our hands, now, what the special all-party committee set out, in January, to produce; that is, a bill that respects the Supreme Court ruling, respects the Charter of Rights and Freedoms, and respects the priority of Canadians.

We do not need to reopen the debate and cut out the words of the Supreme Court. We do not need to reject the charter fix, which was proposed in this chamber, adopted by the other chamber, and confirmed as constitutional by a most respected scholar on the charter.

I move:

That the motion be amended by:

a) Deleting the paragraph commencing with the words “respectfully disagrees with amendments 2b, 2c(ii) and 2c(iii)”; and

b) Replacing the words “agrees with amendments numbered 1, 2d, 2e, 4 and 5” with “agrees with amendments 1, 2b, 2c(ii), 2c(iii), 2d, 2e, 4 and 5”;