Madam Speaker, I am pleased to join the debate on Bill S-240 and to take this opportunity to respond specifically to comments that have been made by many colleagues so far in this debate.
This bill, as members may know, would make it a criminal offence to receive an organ taken without the consent of the patient. This issue is morally clear-cut, and I think all speakers have agreed to that basic idea.
We are coming up towards the second reading vote, where we will vote on the legislation's principle. Members who have questions about some of the particulars but agree with the general principle should give this bill speedy passage at this stage so that we can make any necessary amendments at committee stage and still ensure that the bill becomes law before the next election. If further delays by Liberal members hold back progress in this Parliament, then we will have to start at square one in the next Parliament.
During previous speeches, members made observations about the extraterritorial application of Canadian law proposed in this case, that under this bill someone would be charged for getting an organ overseas for which there had not been consent. Members have generally agreed that we should be concerned about the basic human rights of non-citizens, and that we should seek to prevent Canadians citizens from violating the human rights of others while abroad.
The Parliamentary Secretary to the Minister of Justice discussed some of the challenges associated with prosecutions involving extraterritoriality. He noted that these cases can be difficult and expensive to prosecute, since they might require Canadian law enforcement to gather evidence overseas. This can be the case with extraterritorial prosecutions, but I would make two observations to counter concerns about the challenges associated with extraterritorial prosecutions in this particular case.
First of all, we should not fail to criminalize bad behaviour just because prosecution is difficult. Even if we are only able to prosecute a small number of cases, the deterrent effect of the law will go a long way. We criminalize child sex tourism already, presumably recognizing the challenges involved in prosecution but also hoping that the law and the possibility of prosecution deter and reduce these crimes.
Second, though, organ trafficking and harvesting is a special case insofar as prosecution should be relatively easier than prosecutions for other crimes where extraterritoriality is involved. Recipients of trafficked organs are a special case because they will necessarily have prior and follow-up medical needs, and the transplanted organ will have a clear physical indication of a transplant. Circumstances related to the transplant will give doctors, and therefore law enforcement, clear indication of whether a person showed gross negligence around verifying that the donor consented.
Let us consider a concrete example and imagine that a patient is on a waiting list for a heart. He says to his doctor, “Doc, great news, I'm going to get a new heart. My cousin set me up. I'm going to Beijing six weeks from today, and I'll come back with a new heart.”
The doctor is perplexed. She replies, “That's not really possible. If there's a heart available for you, they're not going to keep it in the freezer for six weeks. The only way to plan that far in advance would be if doctors over there knew with certainty that someone who is a perfect match will die right before you arrive.”
This is a case where lack of consent is relatively clear, even if the patient may not fully understand at first. If someone is receiving a vital organ from a recently healthy patient in a country where organ harvesting is common, and is being told well in advance when an organ will be available, it becomes absolutely clear that someone else is being executed in order to remove the organ, on a schedule based on the availability of the patient.
In this hypothetical case, there is some very strong evidence already that can help lead to a conviction. That evidence exists based on the medical needs of the patient to consult with a physician here in Canada before and after.
In the scenario I have laid out, ideally, the doctor would advise the patient of what is likely going on. If the patient proceeded to receive the trafficked organ, the doctor would currently have no recourse, legal or otherwise. However, if Bill S-240 passes, a doctor in that situation might stand a better chance of persuading the patient to try a different path.
She might say to him, “You might not know this, but you taking an organ under those circumstances almost certainly means that it is being taken from an unwilling patient, who is being executed in order to get you an organ. Receiving an organ taken from an unwilling source is a serious criminal offence in Canada, even if done abroad. If you proceed with this, any physician who sees you in Canada will be legally obligated to report that you have received a transplanted organ and the circumstances of that transplant will become clear.”
It is hard to imagine a patient proceeding with his original plan after being presented with these new criminal law provisions and a reasonable probability of detection. While this is a case of extraterritorial application of criminal law, the medical realities mean fewer practical challenges.
The parliamentary secretary also mused about whether the reporting provisions in this legislation are overbroad. In an effort to ensure that any case of organ harvesting and trafficking is detected, a doctor is required to report the presence of a transplanted organ in every case. Might a narrower reporting mechanism achieve the same purpose?
The proper scope of the reporting mechanism is a good issue for the committee to study and should not be an impediment to those considering whether or not to support the bill at second reading, but still, l have a couple of observations at this point.
First of all, the parliamentary secretary argued about both the challenges of extraterritorial prosecution and a potential overbroadness of the reporting provision. The broadness of the reporting provision is precisely aimed at responding to what would otherwise be the challenge of prosecution; the one is a partial solution to the other. Further, it should not be particularly complex or onerous for the government to keep track on a list of those who have received an organ transplant, such that it can be verified if an organ was received properly. Requiring that reporting happens in every case ensures that those who participate in organ trafficking would be held accountable.
There are a few other points to make in response to what has been said. The member for Edmonton Centre mused about whether this legislation should include cases in which organs are purchased. He notes, quite correctly, that the bill presumes that a person who sells his or her organs is doing so from a position of vulnerability and therefore the bill proposes not to allow the selling of organs under any circumstances.
I appreciate that the member for Edmonton Centre acknowledges both sides of this question, saying as well, “...I also recognize...the need to ensure that individuals, often from developing countries, who may be vulnerable to abuse given their own economic situation, are protected from potentially exploitative practices.”
Let me make three points in response to this question about whether or not the bill should include a prohibition on purchasing organs abroad. First of all, this is also a subject where the application could be altered at committee. I would be sorry to see these provisions removed from the bill, but their presence should not be an impediment to supporting it at second reading given the possibility of amendment.
Second, the case the member for Edmonton Centre used, wherein a person goes overseas to buy an organ, in an environment with well-defined laws protecting the rights and the safety of the donor, is largely a fiction. There is a very small number of countries in the world where the buying and selling of human organs is legal and they are almost all very poor countries where the levels of health care are not anything resembling a respectable or desirable level. The decision by a healthy and aware person to sell their organ in a safe environment might be an interesting hypothetical for a philosophy seminar, but we should bracket that question and support measures that deal with the overwhelming reality of organ trafficking cases that involve exploitation.
Third, Canada does not allow the buying and selling of human organs domestically, so it is consistent with our Criminal Code to recognize the risks inherent in the commodification of human organs and the inherently exploitive nature of relationships in which people are selling body parts.
A number of members have said that there are no known cases of this practice happening in Canada, but whether or not the taking of human organs without consent has ever happened in Canada, the fact is that here in Canada it is already illegal and the bill deals with international organ trafficking, something we know is big and growing. It would be foolish to assume no involvement by Canadians in organ harvesting and trafficking. We have indeed heard anecdotally from hospitals of people going overseas to receive organs in China, although the particulars of the involvement of Canadians are obviously difficult to quantify. In the absence of a law prohibiting this practice, information about those going overseas to receive illicit organs should be released.
Let us move forward with the bill as quickly as possible and stop the excuses and delays. Let us make sure that we get this done before the next election.