Debates of Oct. 19th, 2020

Criminal Code

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Madam Speaker, there needs to be clarity in that regard. We are hearing stories, but, as was mentioned, these things are not being brought forward and prosecuted or there are not enough safeguards in place to ensure people are not being coerced in that way. I have had individuals come to me in tears over that very issue. It is becoming commonplace that this is naturally something that is offered to a lot of individuals who are in end-of-life scenarios.

Palliative care is an opportunity for individuals to live their life thoroughly to the end, along with their family. When individuals make that choice, they should not be coerced. We really need to be careful of this.

[Anthony Housefather, Liberal, Parliamentary Secretary to the Minister of Labour]

Madam Speaker, I will be sharing my time with the hon. member for Oakville North—Burlington.

This is a very difficult bill and subject for us to deal with. In this case, the sanctity of life, something that all of us cherish, conflicts with the liberty interests protected under section 7 of the charter. This is one of those difficult times where we have to recognize that our own religious views, our own moral views are not the ones we can simply impose on Canadians. We have to recognize that charter rights are sacrosanct. Sometimes, as a member, those are difficult moments.

I personally have said before that I would not choose medically assisted dying for myself. Nor would I encourage family members to avail themselves of the opportunity for medically assisted dying. However, I also fully respect the right of every Canadian to choose for his or herself whether this right should be exercised personally.

In the Carter decision, the Supreme Court of Canada upheld that under section 7 of the charter, there was a certain subgroup of Canadians whose liberty interests were violated by the existing provisions in the Criminal Code on not assisting someone to commit suicide. The Supreme Court in Carter told us that there was a subsection of Canadians, those who were in constant enduring pain and suffering that could not be alleviated by medical treatment reasonably acceptable to them, who had the right to have their death hastened by having medical professionals assist them in doing so.

In the last Parliament, our government brought in Bill C-14. I had the privilege of being the chairman of the Standing Committee on Justice and Human Rights. We heard from a great cross-section of Canadians. We heard from those who represented the disabled community and those who believed in the right to die with dignity. We heard from members of the clergy from all faiths. We heard from university professors, lawyers and doctors. We heard from a great cross-section of Canadians who had very diverse and different opinions.

What we tried to do was craft a law that brought Canadian society together, that protected the vulnerable but yet still afforded everyone the right that the Supreme Court had recognized in Carter, which was the right to decide for one's self whether to terminate one's life in the event he or she was in enduring pain and suffering that could not be alleviated by medical treatment reasonably acceptable to that person.

As well, we had to recognize that when we dealt with the Carter decision in Bill C-14, Canada was at the beginning of a list of countries dealing with medically assisted dying. There were very few countries in the world that had gone where Canada was going. Belgium, Holland, Uruguay and a few American states were, but that was it. Canadian society needed to come to terms with medically assisted dying and learn more about the process before we went too far.

That is why, at the time, I supported a clause in the bill that said that medically assisted dying was limited to those whose end of their natural life was reasonably foreseeable. However, we knew that would change over time and that as Canadian society looked at the experience of medically assisted dying, the bill would come back for review before Parliament and would need to change.

At the justice committee, we proposed a number of important amendments to that bill. We inserted, by unanimous agreement at the committee, conscience rights to ensure that the doctors, nurses and pharmacists whose own beliefs would be offended by medically assisted dying were not compelled to participate in the process. We said that Parliament would need to review some subjects that we were not dealing with, such as the issue of mental illness on its own; the issue of mature minors; and, probably most important, the issue of advance directives for those suffering with dementia.

We also adopted a motion that palliative care had to be part of that review. People should have their death hastened because palliative care treatment is not available to them in Canada.

This bill takes the medically assisted dying regime, Bill C-14, a step further based on the Truchon decision. It held that the provisions we had put in the law about reasonably foreseeable death were not constitutional and that a subgroup of Canadians who may have many more years to live but were in constant pain, enduring interminable suffering, and could not have that alleviated by medical treatment reasonable acceptable to them also had the right to medically assisted dying.

This bill establishes that this group of people also have the right to medically assisted death in Canada, but also imposes additional safeguards on them, namely a 90-day waiting period. We understand that certain people, for example, may suffer a traumatic injury and need time to consider all their options and come to terms with their situation before finally going through with a medically assisted death.

Also, based on the Canadian experience, we are amending the bill to allow certain Canadians who are about to lose their ability to offer agreement to medically assisted dying, because they have lost their capacity to consent, to do an advance consent.

Some Canadians want to access medical assistance in dying knowing that they may still have a few more weeks to live. The only reason they want to access it sooner is that they do not want to lose their capacity to consent to medical assistance in dying.

Personally, I want these people to be able to continue to live and spend those last few weeks with their families. I do not want them to end their lives prematurely because they are worried about losing their capacity to consent to the procedure.

The amendment to the law, this bill that is before us, gives hope to this group. These people will have permission to sign a contract with their doctor indicating that they want to put an end to their life on a specific date, even if they lose the capacity to consent to medical assistance in dying in the meantime.

However, there is still a safeguard in the sense that if people who have lost their capacity to consent show through any action or words that they no longer wish to end their life, the doctor must then stop the procedure.

I strongly support the bill. I think Canadian society has evolved with respect to how we see medically assisted dying. As Canadians, we now have seen where the procedure works and where it does not work. We have seen which groups have been positively impacted and which groups have been left out and where we can improve on the procedure.

Following a great deal of consultation and national interest and seeing a change in how Canadian opinion sees medically assisted dying, this bill is the right one at the right time.

[Michael Cooper, Conservative, St. Albert—Edmonton, AB]

Madam Speaker, I had the privilege of serving with the hon. member for Mount Royal on the justice committee when we studied Bill C-14

The member rightfully talked about the process in which we heard from a diverse range of viewpoints. It is ironic that this legislation circumvents that opportunity to hear from a diverse range of viewpoints by pre-empting a legislative review, which should have started in June.

The hon. member will know that this decision goes well beyond the scope of the Truchon decision. One such area is with respect to advance consent, to which he alluded. Arguably this goes beyond the scope of the Carter decision inasmuch as Carter stated not once, not twice but on three occasions that a patient must clearly consent.

How can the hon. member defend that with respect to legislation that arguably goes beyond the scope of Carter? How can consent be truly meaningful if it is not contemporaneous?

[Anthony Housefather, Liberal, Mount Royal, QC]

Madam Speaker, I want to say how much I enjoyed serving with my hon. colleague from St. Albert—Edmonton. He always brings a great deal of intelligence and rational thought to these situations.

First, as the House knows, the government and Parliament are not limited to simply creating a law that repeats the Carter decision; Parliament is perfectly entitled to go forward further and protect liberty interests that were not recognized in Carter. Nobody excludes the right of Parliament to go further than Carter.

Second, I believe that the legislative review on the subjects that we were supposed to review will continue to proceed. This law is a separate piece of legislation dealing with other subjects.

Finally, I would say that, regarding the issue of capacity to consent in advance to medically assisted dying, this is simply for somebody whose death is already foreseeable, coming up in the very near term, to agree with their doctor to end their life if they have lost the capacity to consent to further prolong their life, because otherwise they would make that decision more prematurely. I support it for that reason.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Madam Speaker, the Bloc Québécois agrees with the proposed amendments and welcomes them.

The issue that has not been addressed and that I think is important is advance consent. I would like to know where my colleague stands on that issue.

Would it not be a good idea for people who meet the criteria set out in the act to be able to give their consent in advance, as we do with organ donation, in the event that they are diagnosed with a degenerative disease? Is that an issue that was examined? If so, what is my colleague's position on that?

[Anthony Housefather, Liberal, Mount Royal, QC]

Madam Speaker, I thank my hon. colleague from Rivière-du-Nord. He always provides an intelligent perspective to the debates.

To me, this is one of the three issues Parliament has to address. The first is the issue of mature minors, the second has to do with psychological illnesses only, and the third has to do with advance directives. I agree with the way in which the bill allows certain people to make an advance request.

The issue of advance directives is very complicated. If we allow people to give such a directive in advance, then we must put in place very clear and precise guidelines. This will certainly be part of our discussion during review of the legislation.

[Pam Damoff, Liberal, Parliamentary Secretary to the Minister of Indigenous Services]

Madam Speaker, it is a pleasure to follow the wise words of my colleague, the member for Mount Royal.

I am pleased to speak in favour of Bill C-7, an act to amend the Criminal Code, medical assistance in dying. As hon. members know, this bill responds to the Superior Court of Québec decision that struck down the eligibility criteria that naturally occurring death be reasonably foreseeable.

In the last Parliament, I spoke during debate on the original MAID legislation. At that time, I talked about the need for us to have conversations with loved ones about death and dying. “Death” is a word that elicits strong emotions. We celebrate life, we embrace life and we talk about living. However, we avoid talking about death. We shy away from those conversations because they make us uncomfortable. I know there are those who feel this legislation goes too far. However, regardless of where people fall on this legislation, I think we can all agree that the way we deal with and talk about death needs improvement.

Whether a grievously ill patient chooses to die at home or in a palliative care facility or chooses medical assistance in dying, we should be having these conversations sooner and lovingly assisting those who are ill in the end of their life. These decisions are often made during a health crisis. Ideally, each of us should be engaged in advanced care planning.

I would like to share the story of Bob Lush, an incredible man, respected lawyer and my friend. Bob and his wife Maureen shared a love and bond that was obvious to all who met them. Bob died on March 17. This summer I had lunch with Maureen and she shared with me the decision they took to use MAID. With Maureen's permission, I would like to share Bob's story.

Bob had been diagnosed with multiple system atrophy and pulmonary fibrosis. He also exhibited symptoms of Parkinson’s. While his body was failing him, his mind was as sharp as ever. Over time, these serious health issues would worsen, which led his doctors to tell him that he was palliative and that there was nothing more they could do. A palliative care nurse asked if they had thought about MAID and provided them with a brochure. It was not an option they had considered before, but Bob and Maureen together decided that this option would be the most loving way for Bob to leave this earth. I cannot possibly put into words the tremendous love these two shared.

Maureen described for me Bob's last days. They chose March 17. All medical equipment was removed from Bob's room and it was filled with flowers and candles. They loved listening to James Taylor's “American Standard” album, and it was playing. Maureen and Bob's son John were by his side. As Moon River played, the doctor administered the MAID drugs. Bob closed his eyes and peacefully, painlessly and humanely passed away. To hear Maureen describe it, I could hear both the love in her voice and the sadness of losing Bob, but she had no regrets and, in fact, wanted Bob's story to be shared so that other families could consider this option for their loved one, if it was the right decision for them.

The legislation before us here today would update our MAID laws in several ways. The bill would maintain existing safeguards and ease certain safeguards for eligible persons whose death is reasonably foreseeable. New and modified safeguards would be introduced for eligible persons whose death is not reasonably foreseeable. Persons whose natural death is reasonably foreseeable, who have been assessed as being eligible for MAID and who are at risk of losing capacity, can make an arrangement with their practitioners in which they provide their consent in advance, which allows the practitioner to administer MAID on a specified day, even if the person has lost their decision-making capacity.

For persons who choose MAID by self-administration, a person could waive in advance the requirement for final consent in case complications arise following self-administration, leading to loss of capacity but not death. These new safeguards would exclude eligibility for individuals suffering solely from mental illness. It would also allow the waiver of final consent for eligible persons whose natural death is reasonably foreseeable and who may lose capacity to consent before MAID can be provided.

This legislation would also expand data collection through the federal monitoring regime to provide a more complete picture of medical assistance in dying in Canada. These are important changes and ones that have been called for since 2016, when the government responded to the Carter decision with its original legislation.

Since MAID became legal in June 2016, there have been more than 13,000 reported medically assisted deaths in Canada. This figure is based on voluntarily reported data from the provinces and territories prior to November 1, 2018; and the data collected under the new monitoring regime after that date. MAID deaths as a percentage of all deaths in Canada remains consistent with other international assisted-dying regimes.

The government undertook extensive consultation in order to update the MAID legislation. In January and February 2020, the Government of Canada engaged with provinces, territories, Canadians, indigenous groups, key stakeholders, experts and practitioners to receive their feedback on expanding Canada's MAID framework. Over 300,000 Canadians participated in online public consultations between January 13 and January 27 of this year.

It is important to recognize that MAID is not the right option for everyone. We still have work to do to educate Canadians about end-of-life options. When the former Bill C-14 was debated in the House, I spoke about palliative care and the need to educate Canadians about it as an end-of-life option. I was pleased the Senate amended our original bill to include palliative care in the legislation. Our government has worked collaboratively with partners, including the provinces and territories, to develop a framework on palliative care. We are implementing a targeted action plan of providing $6 billion directly to provinces and territories to better support home and community care, including palliative care.

I would like to share once again Bonnie Tompkins' story, a story I shared in 2016 during debate on the original MAID legislation. She is currently compassionate communities national lead for Pallium Canada, a national non-profit organization focused on building professional and community capacity to help improve the quality and accessibility of palliative care in Canada.

When her fiancé, Ian, was diagnosed with terminal cancer, he was adamant that he wanted medical assistance in dying. As is common, his biggest concern was the burden he would place on loved ones as his illness progressed. After he saw Carpenter Hospice in Burlington and was educated on the options available—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

We seem to have lost the connection with the hon. parliamentary secretary.

The hon. parliamentary secretary has about two minutes left.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Palliative care is something that too few people consider, let alone discuss with their loved ones. Just as Bob Lush's decision was the right one for him, so too was Ian's. These are deeply personal and extremely hard decisions that people make as they near the end of their lives.

This legislation today would address concerns about eligibility for MAID and allow more people who wish to use MAID to do so. I want to applaud the Minister of Justice for his leadership on this bill; as well as the Minister of Health; and the Minister of Employment, Workforce Development and Disability Inclusion. I would also like to give a shout-out to the member for Don Valley West, who chaired the committee in 2016 that reviewed options for MAID legislation and that laid the groundwork for where we are today.

It is my hope that all members of the House will support this important legislation.

[Colin Carrie, Conservative, Oshawa, ON]

Madam Speaker, I want to thank my colleague, especially for sharing those personal thoughts with us because this issue we are debating today is a very personal matter.

I wanted my colleague to comment on a statement by her colleague, the member for Mount Royal, who said in his speech that nobody should have their death accelerated due to lack of palliative care.

We know that my colleague from Sarnia—Lambton brought forward a private member's bill that was in response to this decision, that was basically to allow Canadians to live as well as they can, for as long as they can. This private member's bill was dedicated to providing a national palliative care action plan.

I wonder if my colleague could comment on the government's response to providing appropriate palliative care so people do not have to choose medical assistance in dying, considering that approximately 70% of Canadians do not have access to appropriate palliative care.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Madam Speaker, I thank the member for his question, and I also applaud my colleague, the member for Sarnia—Lambton,, for her advocacy on this issue.

One of the problems is that people do not know what palliative care is and what is available, as the story I told about Bonnie Tompkins's fiancé demonstrates. People need to be educated on it, but not going into palliative care does not automatically mean they are choosing medical assistance in dying. That logic is flawed, in my opinion.

There is a need for more education on all aspects of people ending their lives. I think there are conversations that need to be had between families and loved ones so that when or if they become ill, families will know what options are available. As I described in Bob Lush's story, had a nurse not provided information on MAID, the family could never have chosen that option.

Our government is committed to palliative care.

[Mario Beaulieu, Bloc, La Pointe-de-l'Île, QC]

Madam Speaker, the bill proposes removing the requirement of final consent for eligible people whose natural death is reasonably foreseeable.

Would it not be appropriate to allow for advance consent and waive final consent for people with degenerative, incurable diseases? What are my colleague's thoughts on that?

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Madam Speaker, these are indeed very difficult conversation to be having, and that was certainly discussed in 2016. My understanding is that part of the parliamentary review that is to take place on this legislation is about the issue the member has described regarding the people who have a terminal illness and want to provide direction and demands. It is something Parliament needs to look at, and we need to have a fulsome discussion on how we proceed if we choose to proceed on that.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Madam Speaker, I thank my colleague for her very compassionate and heartfelt speech. It was very moving.

I have a question about requiring a person with an incurable disease to obtain permission from a medical practitioner specializing in the disease in order to get access to medical assistance in dying. In the case of people living in rural or remote regions that do not always have the appropriate medical specialists, does this requirement not constitute an impediment?

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Madam Speaker, the question from the member is an important one. One does not have to be in a rural area to not have access to medical practitioners who may have expertise. In speaking with Maureen Lush, I know there is only one doctor in Oakville who is available to perform MAID, and there is no one at all in Burlington.

I think it is very important that people have options and that we remove the stigma of MAID. Hopefully telling these stories will help to educate people on the right option for them and if this is the way they should proceed.

[Alain Rayes, Conservative, Richmond—Arthabaska, QC]

Madam Speaker, I am very pleased to speak to the important Bill C-7. We need to know its origins to understand why we are at this point today.

In 2016, working on Bill C-14 was a rather difficult exercise given that the Liberal government was intent on bulldozing it through. I believe that is the right expression, because the government refused all amendments proposed by the different opposition parties, including the Conservative Party, the NDP and the Bloc Québécois.

The government put pressure on the Senate by giving it a deadline. The Senate wanted to improve the bill before the House voted on it. What was the end result? In September 2019, the Superior Court pointed out that the bill passed by the House was not adequate, especially with respect to the issue of the foreseeability of the date of the person's death.

That is where we find ourselves today. We are in the House debating an extremely sensitive subject, but we have not had much time to consult the experts.

Everyone has a different perspective on the issue, whether they are members of the House or members of the public in Quebec or elsewhere in Canada.

I wrote a speech, but I have decided not to read it. Instead, I would like to share my own experience with my colleagues.

The vote on Bill C-14 was the hardest vote I cast in my first four years in Ottawa.

On the one hand, I had some constituents asking me to vote in favour of the bill, while others wanted me to make sure that the legislation would protect the most vulnerable and honour the conscientious objection rights of medical practitioners. On the other hand, I had constituents going through a very difficult time with a loved one who was suffering and could not access MAID.

I did not sleep well the night before the vote. I knew that no matter which position I took, whatever I said in the House could be interpreted by the media and by Canadians. Allow me to explain. Some members voted against Bill C-14, and I would imagine that others will vote against Bill C-7. Members voting against the bill are doing so not because they are against it, but because they do not think it goes far enough.

The opposite is also true. Some members voted in favour of Bill C-14 in 2016 because they wanted to make sure people got the bare minimum. No matter which side we took, we had to explain something extremely sensitive, and I do not think a simple yes or no could accomplish that.

I often ask myself, who am I to decide for someone else? As lawmakers, it is our duty to protect the most vulnerable, especially if we remove the criterion of reasonably foreseeable natural death for access to MAID. This is reflected in the questions that some members have been asking in the House. I am sure it reflects the opinion of many Canadians who wonder what would happen if a person wanted to give advance written consent in case their situation changed over time. There is much more to this debate, and I do not think we are done talking about it.

Madam Speaker, I forgot to tell you that I will be sharing my time with the member for Calgary Signal Hill.

I am very concerned about ensuring that this bill enables all Canadians, wherever they may live in this country, to have access to the appropriate resources to make the right decision for their situation. The current pandemic has exposed the weaknesses in our health care systems. I doubt all Canadians in rural areas have access to specialists who can guide them and give them the right information so that they can make a decision based on their circumstances.

I am also very concerned about minors and vulnerable people. During the study of Bill C-14 in 2016, I had the opportunity to hear the testimony of two witnesses who had suffered accidents and endured the most traumatic ordeals a human being can experience. They told me that, had they had access to MAID back then, they probably would not have been talking to me that day because they had been in such a dark place at the time.

I know people who were there for the final moments when someone who was suffering asked for MAID. I am certainly concerned about all that, and it makes me wonder what the best solution is. Is it because we do not have the necessary palliative care resources? Is it because both the federal and provincial governments and health care facilities are making poor decisions? I am wondering about that.

I must say, I feel like we are rushing the process today, because has been quite a while since the courts asked Parliament to modernize this legislation after what happened in Quebec. This is a government that shut down Parliament under the pretext of being in a pandemic, as though we could not do more than one thing at a time. There are 338 MPs. Committees could have continued to sit. We could have heard from experts who could have explained this issue to us properly so we could make the right decision, the best decision.

Again, this is something that will not be easy for many of us. We have differing opinions within our party and elsewhere. However, I would like to note that I am proud of my party for letting me vote freely. I want to thank my leader for allowing this, without any pressure from my organization. I hope that all political parties will offer this choice, because this is a vote of conscience, and it is challenging for us to represent our constituents, who do not all share the same opinion. We also have our own conscience. For some, this is a matter of religion or beliefs, which means we may not all see eye to eye on this file.

Personally, the thing I wrestle with the most is wondering who I am to decide what is best for someone who is suffering. I believe that is what will guide my decision on the day of the vote. I hope that I will be able to make the right decision and that all of us can then work with the government to put all the necessary resources in place to properly inform and educate the public, and provide everything we can to vulnerable people who are going through tough times with loved ones, so that they are adequately supported in making the best decision.

In closing, I hope that next time, we will have more time to talk about people who are not vulnerable, sick or about to die, but still want to express advance consent.

[Arif Virani, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Madam Speaker, I thank the member for Richmond—Arthabaska for his very frank and candid comments.

I would just like to clarify something. He mentioned that the Liberal Party did not accept the other parties' amendments. That is not quite accurate, because during the debate on Bill C-14, we accepted an amendment endorsed by all parties concerning medical practitioners' freedom of conscience and religion.

I would also like to point out that Bill C-7 does allow for advance consent, but not advance directives. The issue of advance directives will be dealt with in the comprehensive review, which will take place every five years.

I would also like to point out that there is a 90-day waiting period to eliminate the impulsiveness my colleague pointed out in his speech. For example, when a minor has an accident, we do not want them to make an impulsive decision on this matter.

Does the member opposite believe that having a specialist is necessary? For example, Mr. Truchon, who was from Quebec just like the member opposite, had cerebral palsy. Our party believes that a physician must have the requisite expertise to treat and advise patients before they make their decision.

[Alain Rayes, Conservative, Richmond—Arthabaska, QC]

Madam Speaker, I thank my colleague for his question and for the clarifications he provided.

I do think that some expertise will be required. This is a very big decision for patients and their loved ones. There is the whole issue of grieving, a whole process. Yes, it makes sense that the doctor would be a specialist in the individual's illness or disability. However, I wonder if everyone will have access to those resources during the decision-making process. The devil is in the details, as they say. This shows just how urgent it is to deal with the matter of medical assistance in dying and, in particular, Bill C-7.

[Martin Champoux, Bloc, Drummond, QC]

Madam Speaker, this is a particularly meaningful day to talk about this sensitive issue. Yesterday, October 18, marked the first anniversary of the passing of my aunt Claire, who chose to access medical assistance in dying. She was not looking to end her life, but she simply wanted to choose how she would put an end to her suffering and to do so with dignity. I think that the word “dignity” is important, because that is what we are talking about here.

I heard the speech by my colleague from Richmond—Arthabaska, and I appreciated the considerable sensitivity he showed in expressing his concerns. The topic of palliative care is a very important one.

If every patient across the country had fair and equal access to palliative care, would my colleague agree to remove the element of final consent, so that people with degenerative diseases could make a decision several weeks or months in advance, or even years, before their unforeseeable, yet inevitable, death?

Could my colleague speak to that?

[Alain Rayes, Conservative, Richmond—Arthabaska, QC]

Madam Speaker, I thank my colleague for his question.

At the end of my speech, I talked about reflecting on the notion of who am I to decide on behalf of someone else going through such a terrible ordeal. I had those discussions, that very debate, more than once with friends over dinner. Some of those friends were going through this situation with their mother or father, or a brother or sister. This is what is really giving me pause right now.

Ultimately, I should allow these individuals to have access to this resource. I am not sure “resource” is the right word; I should say, people should have this as one of their options.

I do want to ensure, however, that the government does everything it can to protect vulnerable people if the time ever comes in their life that they want to end it. It should not have to come to that, and that is what I am wrestling with at the moment.

Ultimately, I hope to be able to let go and vote in favour of this bill, as my colleague mentioned earlier, to let everyone decide for themselves.

[Ron Liepert, Conservative, Calgary Signal Hill, AB]

Madam Speaker, it is an honour to participate in the debate on Bill C-7, which will amend the Criminal Code.

As someone who travels four or five hours to get to Ottawa on a regular basis, often I sit in Parliament and ask, “Do my constituents really care about what we are talking about?” I am pleased today to participate because I believe that this is a subject matter that every Canadian feels strongly about, one way or another, and that potentially could impact every Canadian. I feel very honoured to participate in this debate today.

We are doing so because the Supreme Court deemed certain provisions of the original medical assistance in dying legislation, MAID, to be unconstitutional. That provision, deeming death must be reasonably foreseeable, is being withdrawn in Bill C-7. The second important piece of this bill is the removal of the 10-day waiting period. In my remarks today, I want to address both of those changes.

First, I would like to state at the outset that I support the bill. In contrast to some others who have spoken, I do not believe the government should have appealed the Supreme Court decision. While I commend the government for finally bringing forward this legislation, it is unfortunate that the Liberals are only acting when being made to do so by the courts. This is somewhat of a repeat of four years ago when the government was forced by the courts to introduce the original MAID legislation.

Those suffering near the end of life should not have to resort to the courts before government acts. I guess one could say, however, that late is better than never, and it is certainly better than endless appeals of the decisions.

Four years ago when the original bill was introduced in the House, I made a special effort to obtain the collective views of my constituents. While I personally supported the original legislation, I also wanted my vote to reflect the feelings of my constituents. I reached out extensively to survey my constituents through phone calls, emails, Facebook and direct mail.

The responses at that time were from all age brackets and all demographics. The end result was 77% of several thousand respondents supported the legislation. Ironically, that number is awfully close to the percentage of support I received in the general election just one year ago. I am confident that a similar survey today would yield the same results, and the majority of my constituents would be supportive of the changes being proposed in the bill.

What I heard from constituents reflected my own personal views. While I respect some deeply held views from constituents who do not support MAID, I am of the belief that I, and only I, should determine how much pain and suffering is reasonable for me when end of life is near. I do not believe any institution or government should deny me my constitutional right.

Some medical professionals do not support MAID, and that is their constitutional prerogative. Those advocating against these changes feel those rights are not adequately protected in the legislation. That may be legally correct, but medical professionals not wanting to administer MAID clearly have a professional responsibility to refer patients. In Alberta, the website for Alberta Health Services has a listing of doctors who are willing to perform MAID. If it is the view of a medical professional that he or she is not prepared to perform MAID, they can make a referral.

The second important piece of this bill is removing the 10-day waiting period. I also support this. The contention that someone who is suffering to the extent that they ask for MAID one day will simply wake up a few days later and change their mind, I do not agree with. In my view all the 10-day period provided for was additional suffering and an opportunity, for those who oppose MAID on fundamental principles, to try to change the patient's mind. In my view, both are wrong.

I am sure most MPs are receiving the same emails I am getting, many from constituents asking that I support the legislation and others who are opposed. I have no issue with those opposed to MAID. Where I do take issue is with some of the rationales that are being used. Medical professionals' conscience rights is one, and I have spoken to that.

Others claim the legislation would take us down the slippery slope of other countries, where euthanasia is available to children and those with mental illness. Clearly those are red herrings because this legislation would do none of that. Others are asking for more study, another delay tactic, similar to appealing the court decisions. It is more work for lawyers, less satisfaction for those suffering.

Increased funding for palliative care has also been raised as an option by those opposing this legislation. Enhancing palliative care is always welcome, but in my view is not directly related to this issue. We are talking here about people wanting to end excruciating pain and suffering. These people are not asking for their pain and suffering to be made more comfortable.

Our health care system must do both things well. It must allow for people to live with dignity and receive excellent care as they reach the end of their lives. In addition, the provision of health care is a provincial responsibility, and I do not believe it should be part of this discussion.

Since the original MAID legislation was passed four years ago, I have taken a special interest in this issue. Unlike some other members who spoke earlier, I have not attended a death where someone has chosen MAID. However, I have had dozens of constituents make a real effort to tell me they experienced MAID with a loved one and that it was very special and appropriate. They personally thanked me, as someone charged with making laws in this country, for making this provision available at end of life for their loved one.

I have not had one constituent call me to say how bad this experience was. In almost all cases, these same constituents have said that society needs to go further. In fact, many constituents seem to believe advance consent already exists. They cannot believe they are not allowed to prepare a legal document, while of sound mind, that would provide their loved ones with guidance in the event they are nearing their end of life but are no longer of sound mind. For that reason, it is critical the minister get on with his public consultation on a broader review of MAID, which was promised some time ago.

The minister needs to find out what Canadians want and not make those suffering take years to go through the court system to get change. Like most things, the Liberals blame COVID. However, there are many ways of seeking input from the public regarding other changes to MAID, and the minister needs to get this discussion moving now.

In summary, I look forward to the bill being studied in committee. I know there will be those opposed to the bill and those in favour making presentations, and all need to be heard. For me personally, I have consulted and listened to my constituents and feel very comfortable voting in favour of the legislation.

[Lloyd Longfield, Liberal, Guelph, ON]

Madam Speaker, the member for Calgary Signal Hill is the member of Parliament for my brother, and I appreciate the effort he is putting forward in reaching out to his constituents to find out what they are thinking on the issue. Our role as members of Parliament is to put aside where we may want to head in favour of finding out from our constituents how we can best represent them.

My question is regarding the speed of reaction. The legislation we introduced last time was a result of a lot of discussion and consultation. The consultations reached 300,000 throughout January of this year. We are being very careful to go one step at a time to avoid slippery slopes.

Could the hon. member talk about the importance of avoiding those slippery slopes by taking the proper amount of time to do the consultations we need?

[Ron Liepert, Conservative, Calgary Signal Hill, AB]

Madam Speaker, I am suggesting we need to launch these consultations that have been promised because there are Canadians who believe this particular legislation could be even further enhanced. The Liberal government needs to get on with these consultations and listen to Canadians.

As mentioned, at the end of the day we are here to represent our constituents. When I did my survey, I did not know how my constituents were going to react. Even though I felt strongly about this particular issue, I wanted to make sure I was representing their views, and I believe in both cases that was the case.

[Rachel Bendayan, Liberal, Parliamentary Secretary to the Minister of Small Business]

Madam Speaker, I will be sharing my time with my esteemed colleague from Argenteuil—La Petite-Nation.

It is with great emotion that I rise in the House to speak to the bill on medical assistance in dying.

First, this bill is the result of a decision handed down by the Superior Court of Quebec. I am very familiar with that court. I had the great honour and responsibility of arguing cases before it in my previous life. Barreau du Québec lawyers have the privilege of working with one of the best courts in the world.

This court rendered a decision and rather than appealing it, the Liberal government said yes. Quebec will once again be leading the way for the rest of the country. Our progressive and forward-looking Quebec will guide Canada. That makes me proud both as a lawyer and a federal government MP from Quebec.

The purpose of Bill C-7 is to ensure that people like Ms. Gladu and Mr. Truchon have the same rights, opportunities and freedoms as those who are facing an imminent or reasonably foreseeable death.

The ruling in Truchon found the eligibility criteria of reasonably foreseeable natural death to be unconstitutional. Our government also agrees that MAID should be available to relieve suffering and pain from serious medical conditions and is now proposing through this legislation to amend the Criminal Code so that Canadians can end their lives with medical assistance if that is the right choice for them. To accomplish this, Bill C-7 proposes to repeal the requirement that natural death be reasonably foreseeable, opening up access to those who are suffering in a wider set of circumstances.

The changes to the legislation propose to create two pathways in terms of the procedures that must be followed to assess a request for medical assistance in dying. While I do not have time to get into the details of the two regimes in full, there are a number of points that I wish to highlight today.

For those people who are suffering intolerably from a serious medical condition, but whose death is not reasonably foreseeable, the safeguards put in place emphasize the importance of ensuring that sufficient time is taken to evaluate the request. A minimum of 90 days will be needed so that the person can be assessed by a doctor who has some experience with this condition, which will help to ensure that the person gets all of the information, services and tools that might help them improve their quality of life.

Bill C-7 also creates new safeguards with respect to consent. Individuals requesting an assessment for medical assistance in dying give their consent, of course. Clearly, they also give their consent to receive MAID when they officially sign their request. However, what matters most is consent when MAID is about to be administered. There must be no doubt as to the person's desire to receive MAID at the moment they receive it. Doctors will be more comfortable proceeding under those circumstances.

Depending on their illness, some individuals risk losing their capacity to give consent between the time they are approved for MAID and the day they would like to receive it. Although we expect that most people are ready for MAID rather quickly once their request is approved, some people may wish to wait for a specific event such as a child's wedding or the birth of a grandchild. Those who wish to wait before going ahead with MAID are caught in an impossible situation if there is the risk of losing capacity. Either they wait for their special family event and risk losing their ability to die as they wish, or they move up the date of the intervention and miss a very important moment with their family and friends.

Therefore, this bill will enable individuals in real danger of losing their capacity to consent prior to the day specified for administration of MAID to make special arrangements with their practitioner. Such arrangements must be made in writing. The doctor and the individual must work together to come to an agreement that works for both of them. This safeguard is important for individuals as well as for doctors because they are the ones who bear the tremendous burden of ending someone's life.

The bill addresses another difficult situation.

Let us suppose that, when the day comes, the person has lost their capacity to consent to MAID, but remains conscious and alert, although not competent. Let us also suppose that they act in such a way or make gestures clearly indicating that they do not want to receive MAID. The bill addresses this situation—which we obviously hope will be rare—by clearly stating that the physician must not proceed because, in this case, it is no longer what the person wants.

The concept of freedom of choice, for me, remains central to all of this. I watched my grandmother suffer from Alzheimer's. Not long after I was born she was diagnosed, and when I was very young she used to repeat the same stories over and over again to me, about her own life and the life lessons that she wanted to pass on. She would tell me about how she used to work two and then three jobs, taking shifts overnight in order to buy her family's first home and provide a better life for her children. What that repetition instilled in me was certainly an understanding that my grandmother was probably the strongest woman I knew, that she was a force of nature.

When I was about seven or eight she forgot who I was, she forgot who everybody was, and I had to very painfully remind her every time I saw her. By the time I was 10 she no longer remembered language at all, and it was just humming, which I still somehow found very soothing, comforting and somehow okay. The degradation from there continued; her eyes no longer opened at all, she was in a wheelchair, the humming had completely stopped and when I was 15 the only muscles that worked were reflexive ones. Even if nothing else in her body moved, she would chew food if it was put into her mouth. It took two people to move her from her wheelchair to her bed or to change her, and this situation went on like this for 10 years.

As a teenager I used to wonder constantly what it would feel like to be trapped in a body like that, wondering if that was really the same strong woman in there or not. It was 10 years of listening to hushed voices in the kitchen saying, “...but there's nothing we can do.”

I do not know for sure, of course, what my grandmother would have decided for herself, but I do know for sure what I would want. For those who would decide something different for themselves, or for whom their beliefs are contrary to assisted dying, this framework provides everyone with the freedom to decide for themselves.

It is not a crime under the Criminal Code to take one's own life. It is a crime to take someone else's. The changes proposed would ensure that those people who need and who would like doctors to help them in order to end their life with dignity, at the time that they choose, can do so.

MAID is certainly one of the most challenging social issues in our society, which is made up of people with very diverse viewpoints and needs. I believe that this bill would achieve the right balance between the freedoms and rights of those who are dying and who are seeking a peaceful medically assisted death and our medical practitioners who need a clear framework for timing and consent.

I call on all members of this House to support Bill C-7.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Madam Speaker, when I think about this, and about the importance of choice, I am thinking about the horrible situation that has been uncovered in long-term care homes across this country. I am thinking of a gentleman named Roger Foley from London, Ontario, who has a degrading neurological condition. He is not being adequately supported by our health care system. He is not getting assisted living, and so how can people be truly given a choice when their choice is between living horribly in a health care system that does not support people or having medical assistance in dying?

Would the member not agree that we need to invest more in our health care system and more in improving the lives of our seniors and those with diseases before pushing forward and liberalizing assisted dying?