Mr. Speaker, I am extremely pleased to speak today to Bill C-418 tabled by the member for Cypress Hills—Grasslands in 2018.
Bill C-418, an act to amend the Criminal Code with regard to medical assistance in dying, would amend the Criminal Code to create two new offences aimed at protecting the freedom and conscience of health care professionals who object to participating in or providing medical assistance in dying.
One proposed offence would focus on intimidating or threatening behaviour aimed at forcing a health care professional to participate in the provision of medical assistance in dying against their wishes.
The other proposed offence would prohibit an employer from punishing a health care professional because he or she objects to participating in the provision of medical assistance in dying, either by firing the individual or refusing to hire them.
This legislation proposes to build on Bill C-14 that Parliament adopted nearly three years ago. Bill C-14 amended the Criminal Code to legalize medical assistance in dying in response to the Supreme Court decision in Carter v. Canada, 2015.
These Criminal Code amendments created new exceptions for the offence of culpable homicide and aiding a person to die by suicide. The exceptions permit medical professionals to bring about a peaceful death for patients who can no longer endure the physical pain or psychological suffering they experience toward the end of their life.
We must keep in mind the seriousness of this behaviour. Health care providers are being asked to end life. This was not just prohibited by the criminal law until very recently, but also expressly prohibited by medical ethics.
These are just some of the reasons why medical assistance in dying is a deeply personal and difficult issue, implicating many values of the highest order of importance in our society. I am speaking of fundamental societal values, such as equality, individual autonomy, respect for life, protection of vulnerable persons, dignity and compassion.
Medical assistance in dying also implicates the conscience rights of medical professionals. This is the fundamental value that I understand motivates Bill C-418.
In its reports on certain types of requests for medical assistance in dying, which were tabled in the House only a few months ago by the Minister of Justice and the Minister of Health, the Council of Canadian Academies said that a person’s individual life experience, values and beliefs inform their perceptions about the question of medical assistance in dying.
While we all share certain experiences and values, each of us also has our our own unique experiences. This diversity of life experience, as the Council of Canadian Academies alludes to, gives each of us our own unique way of ordering the importance of the values in circumstances when they come into conflict.
Members of the chamber have no doubt seen firsthand this diversity of views in the letters they have received from constituents, or through conversations they have heard from coast to coast to coast. Many may have read the testimonies or written submissions that Canadians and organizations made to our justice and human rights committee while it was studying former Bill C-14.
Canadians have expressed a wide spectrum of perspectives and views on the issue. Some may resonate with our own personal beliefs and some may differ with them greatly. Many consider the question of health care providers' conscience rights and how they might be balanced against the rights of patients who are suffering unbearably and who choose medical assistance in dying.
While former Bill C-14 amended the criminal law to enable health care providers to respond to the wishes of patients who seek assistance in dying, it also made clear that it did not compel providers to provide or participate in the activity. This is stated in both the preamble of the bill and the relevant Criminal Code provisions.
Before this, the question of conscience protections was directly raised before the Supreme Court in the Carter case. In paragraph 132 of its ruling, the Supreme Court addressed several aspects of this question.
First, it explained that nothing in its ruling would compel physicians to provide assistance in dying, because its ruling simply rendered the old criminal prohibition invalid. This is consistent with the approach Parliament adopted in former Bill C-14, namely that in permitting medical and nurse practitioners to participate in medical assistance in dying, the criminal law does not compel them to do so.
The court did acknowledge that a physician's decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief. It concluded by underlining that the charter rights of patients and physicians would need to be reconciled.
Members of Parliament should not forget that medical assistance in dying is a complex issue with many facets and for which there are complementary spheres of responsibility. While Parliament is responsible for criminal law, provincial legislatures are responsible for the delivery of health care services and medical colleges and similar bodies are responsible for the regulation of health care professionals.
Medical assistance in dying is very new in Canada. On the ground, our health care systems and institutions are still adapting to the change. Some new laws and policies in the provincial domain have been developed, while others may still be under development.
ln terms of data, former Bill C-14 required the Minister of Health to put in place regulations for monitoring medical assistance in dying based on mandatory reports from health care providers. After a period of development and public consultation, this regime came into force on November 1, 2018. The first report is expected in 2020. lt may shed light on the quantity and quality of cases where practitioners who are asked to provide assistance in dying transfer care of the patient for reasons of conscientious objection.
In the meantime, Health Canada has released interim reports based on information voluntarily shared by the provinces.
According to the most recent report, released on April 25, 2019, over 6,700 Canadians have obtained an assisted death. That is a rather amazing figure.
There has also been some independent research conducted in Canada. One study, which is entitled “Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study”, found that, in some cases, providers who participate in medical assistance in dying reported that it negatively affected their working relationships with colleagues. This finding is just as alarming as the prospect that practitioners would be physically threatened in order to coerce them into participating.
I ask members of this chamber, and all Canadians, to be respectful of the beliefs, values and perspectives held by others, even when they differ vastly from their own opinions. There is no single right answer when values collide. Our way forward must be a journey in which we engage, listen and try to accommodate, not threaten or provoke conflict.
I am pleased that Bill C-418 again gives us an opportunity to discuss medical assistance in dying and also focus on the vital importance of respecting differences and diversity. I urge all members to approach this bill and ongoing public and policy debates on medical assistance in dying with open minds.