Mr. Speaker, I appreciate the member's arguments with respect to the urgency of this issue. However, he may be aware, and I think should be, that provincial guidelines have already been proposed with respect to this, and provinces are bringing in a framework to deal with this at the provincial level.
That does not negate the possible arguments for or against having a federal framework, but I think it is important to acknowledge, in the context of a claim to the alleged urgency of this issue, what the reality is at the provincial level, because if we look at the various guidelines, it actually seems fairly clear to me that a number of provinces have done a much better job of protecting the vulnerable than the framework the federal government has put in place.
I have raised concerns repeatedly in this House about the lack of protection for the vulnerable in this legislation. It is important that we separate out two different issues. There is the issue of the eligibility criteria, which has been fairly contentious in terms of whether it should be terminal, whether it should simply repeat the language of the Supreme Court, and whether it should use other types of language, as the government does in the somewhat ambiguous term of death being “reasonably foreseeable”, but then there is the separate question with respect to safeguards.
I think, especially in this legislation, whatever Canadians and members of this House think of the provisions in terms of eligibility criteria, that there is an absence of safeguards. If we look at what the provinces have put in place, they have, in many cases, done a much better job of providing important safeguards.
One of the models I would like to draw to the attention of members of the House is the law in place in Manitoba. The law put in place there has actually been praised. It was welcomed as a welcome development, even by someone involved in assisting people accessing assistance in dying, with an understanding of the real benefits of this law.
The system that was set up in Manitoba was that it allowed individuals seeking assistance in dying, euthanasia, or physician-assisted suicide, whatever we want to call it, to have their cases reviewed by government lawyers. It did not require judicial review, which has many advantages but is something that some members have claimed is unduly onerous. It instead created a procedure by which government lawyers would review the eligibility criteria and would be able to, in the context of their legal expertise and knowledge, rule on whether the person in fact met the criteria.
The government's legislation contains absolutely no mechanism for advance legal review by competent authority, and we proposed an amendment to that effect in hopes of seeing the government bring it in. Unfortunately, it would not agree to that.
I think the Manitoba law strikes a good compromise. It does not require judicial review, but it does have some kind of apparatus whereby we have review by competent legal authority. Certainly in the case of Manitoba, the vulnerable in Manitoba are better off under the provisions of the existing standards in Manitoba than they would be under federal legislation.
Let us talk about some of the other provinces. In general, the provinces I was able to look at use language around attending physicians. They have protections in terms of conscience, but they are rooted in this idea of an attending physician being in some way involved in the process.
The federal legislation, Bill C-14, makes no reference to attending physicians. It does not require the involvement of the attending physician at all. It simply says that any two physicians can sign off. We could have two physicians in the country that see a particular case one way and every other physician in the country seeing the case a completely different way. That person would still be able to access euthanasia or assisted suicide.
The guidelines, which in their wisdom most of the provinces, at least most of the ones I have had a chance to look at deal with, have a specifically carved out role for an attending physician. I would argue that involving, in the guidelines, specifically the attending physician provides significantly greater safeguards than we would have otherwise.
This speaks very much to the motion the government House leader put forward, because he is claiming that there is some urgency to passing this legislation on the basis of the protection of the vulnerable. However, if we look at the rules that are in place in the various provinces, it is very clear that they may, so far, in terms of the interim guidelines they have put in place since June 6, have a somewhat more liberal interpretation of the eligibility criteria, but on the issue of safeguards, on the issue of the protection of the vulnerable, they are actually doing a much better job.
I have stated before concerns about The College of Physicians and Surgeons of Ontario's policy with respect to conscience. It is evident in its interim policies that it has introduced, as well, a requirement for effective referral, requiring someone to be complicit or to refer for euthanasia, which is gravely concerning to physicians as well as to many other people within the province of Ontario. However, that would not change with the federal legislation, because the legislation would not provide the necessary protections for conscience.
In other provinces, though, we see a better job in terms of understanding processes that can be put in place which protect the vulnerable and also protect conscience. Therefore, generally speaking, they make reference to this issue of having the attending physician involved, but they do not specifically require the participation or an effective referral. In my home province of Alberta, there has been a system constructed whereby there is a sort of central hub where people would go directly, or where someone might be pointed, in order to have their situation addressed or adjudicated in some way.
These systems prevent what I think is one of the very pernicious aspects of Bill C-14, which is the possibility of doctor shopping. It is where a person, or even a member of their family, could shop the case around, and 10 or 20 different doctors could say absolutely not because the person does not meet the ambiguous criteria. It is somewhat ambiguous under Carter, but no less ambiguous under the provisions of the new government legislation.
What is important in this debate is that people have raised the spectre of a legislative vacuum, in that there will be no legislation, no rules in place whatsoever. Well, June 6 has come and gone, and provinces were ready to respond in a way and to an extent that the federal government simply was not. The government proposed the legislation fairly late. It did not seek to get our buy-in on the substance of the legislation. Instead, the government pushed this forward at a late stage and said that we have to pass it now because it is urgent.
Well, provinces have done a much better job here. Now June 6 has come and gone, and we are not in a vacuum. Provinces have developed standards, policies, and procedures, some of which may be better than others; some of which I may agree with more or less. However, if we look at the substance of these, I think we see that there is not at all a legislative vacuum. In fact, the provinces have in some cases been more effective.
The central issue of doctor shopping, the issue of whether or not someone meets the criteria, needs to be adjudicated. It needs to be adjudicated, hopefully once, and may be subject to appeal or review by someone else. However, there needs to be one person or a group of people who have the expertise, legally and medically, who make the assessment, and then that decision is made.
This fearmongering from the government about the absence of a law or a vacuum, I think really misses the point. We have these bodies, colleges of physicians and surgeons at the provincial level, that have the competency and have come up with guidelines, that have recognized, unlike the government, the concerns about doctor shopping that we have raised repeatedly in the House. They have recognized the problems with conscience and said they could try to construct, using their expertise and authority at the provincial level, a system that works better and that provides real protections for the vulnerable.
Whenever we think about the eligibility criteria, and in some cases the interpretation of the eligibility criteria is different at the provincial level, let us provide the safeguards.
One thing I want to briefly mention is that the federal legislation provides immunity from prosecution for someone who has a “reasonable but mistaken belief” that the standards have been met. Therefore, someone could take the life of a person who did not meet the criteria and still avoid prosecution. That is not a protection for the vulnerable. However, in the absence of the legislation, we do not have that exemption. The vulnerable are better protected because there is not an exemption for those who take life without the consent of the patient and without the proper criteria being met.
In looking at the reality of what is in place at the provincial level, it is not correct at all to talk about a legislative vacuum. Therefore, the motion does not have the urgency that is claimed.
