Mr. Speaker, it is a privilege for me to speak to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying. As parliamentarians, it is so important that we are mindful that the decisions that are made in this place have a real-life impact on Canadians, and the life-and-death implications of this particular legislation only make it more important that we approach it with great seriousness and sensitivity.
I approach this subject through the lens of placing tremendous value on every single person's life, and through my own deeply held conviction that every life is valuable and worthy of protection until the point of natural death. As demonstrated throughout this debate, we, as members of Parliament, hold diverse opinions on this subject and many of us approach it with deeply held convictions. The diversity of viewpoints is undoubtedly a reflection of the diverse views among Canadians.
Where I hope we can at a minimum find common ground, is on the importance of protecting vulnerable Canadians. That is why, to me, it is so important to have the opportunity to speak to this legislation: If that is our shared goal, there are significant areas where this legislation misses the mark.
This legislation takes many steps to broaden the eligibility for medical assistance in dying and removes safeguards that were previously put in place. While I recognize that this legislation is in response to the Quebec Superior Court decision in the Truchon case, the legislation introduced by the current Liberal government goes much further than the court decision required. We know that many Canadians were disappointed that the Liberals chose not to appeal the Quebec Superior Court decision to the Supreme Court of Canada. Among those who were vocal in their plea to the justice minister to appeal it were physicians from across Canada and many advocacy groups for Canadians with disabilities.
It is disappointing that the decision was not appealed, but perhaps it is even worse that the Liberals took this opportunity to make significant changes to the legislative framework of MAID prior to the mandated parliamentary review. The medical assistance in dying law that came into effect in 2016 required a parliamentary review of its provisions and of the state of palliative care in Canada. As you know, Mr. Speaker, this review was scheduled to start this summer. The significant changes proposed in Bill C-7 undermine the parliamentary review that has yet to commence. They also undermine our ability as parliamentarians to review changes to MAID with the full knowledge of a comprehensive review.
The Truchon decision struck down the “reasonably foreseeable natural death” criterion, but in considering the proposed legislation we are also considering many legislative changes outside the scope of that decision. We are putting the cart before the horse by forging ahead with fewer safeguards when the personal experiences shared, and the concerns raised by Canadians and relevant stakeholders, should give us all reason to pause in loosening safeguards.
We, as parliamentarians, have a responsibility and a duty to ensure that medically assisted deaths are not driven by lack of access to palliative care or by economic or social vulnerability. Ensuring adequate access to health care services and supports should be our number one priority. Palliative care is a main component of that. Through pain management and psychological, emotional and practical support, palliative care helps to reduce suffering and improves the quality of life for a person with a life-limiting illness. Ongoing gaps in access to, and quality of, palliative care in Canada need to be addressed. With an aging population, the demand for palliative care is increasing. As it is, there are not nearly enough health care providers who specialize in palliative care. If the existing gaps are not addressed, they will only grow.
A 2018 report by the Canadian Institute for Health Information found that while 75% of Canadians would prefer to die at home, only 15% of Canadians had access to palliative care or home-care services. Quality palliative care offers an individual facing a life-limiting illness dignity in living.
In addition to palliative care, we should also be looking at access to, and the quality of, other supports like long-term care, disability support and counselling. If we cannot first ensure dignity in living, there cannot be dignity in dying.
We know that medically assisted deaths are most common among seniors. While that might be expected, given the realities of aging, we must also acknowledge the potential for vulnerabilities. We owe it to Canada's seniors, who have helped build and shape this country, to ensure that they are cared for in their older years. We know that it is families and friends who most often take on the caregiving role. In fact, when options like palliative care are unavailable, caregivers step up to support them.
We need safeguards in place to ensure that seniors are not choosing medically assisted death because they feel like they are a burden on the health care system or a burden to their friends or their families. Ultimately, the best safeguard we can put in place to protect vulnerable seniors is to ensure that they have adequate and appropriate supports for a good quality of life. Without these, there is no real choice.
To help ensure that seniors, and any individuals for that matter, are not led to choose MAID out of concern that they are a burden, it is important that they do not feel pressured to do so. First-hand accounts from Canadians who have had medically assisted death suggested, without them seeking it, are extremely troubling. Offering MAID to someone who has not sought it sends a message. When a person is at a low point or in a fragile state of mind, prompting them to pursue MAID may suggest to them that their life is less valuable or has lost value. It might also suggest that they are a burden to society or to their family.
As legislators, we should be looking to ensure that no person is counselled or pressured into MAID. Unfortunately, the legislation before us takes a step further away from ensuring that, perhaps unintentionally. It does this by no longer requiring that there be two independent unpaid witnesses. If passed, it would require one single witness. This independent witness could also be a paid personal or health care worker. This leaves the door open for individuals to be presented with the option of MAID unprompted, in the presence of no other witnesses.
The same individual who counsels a vulnerable person to consider MAID could also serve as one of their independent witnesses. In a vulnerable state, a person could easily be made to feel that they are a burden, and that prompting could lead them to feel pressured to end their life. With the absence of a second witness, this decision could be made without the knowledge of the individual's family.
The proposed legislation also significantly broadens eligibility by allowing for advance consent. Advance consent would allow a medical practitioner to proceed with MAID without a person's consent immediately before administering it. While consent is deemed invalidated if a person demonstrates, by words or gestures, refusal or resistance to a procedure, this assessment is solely up to the practitioner administering it. This leaves space for errors. By solely placing that responsibility on practitioners, it does them a disservice, just as the absence of conscience rights for health care workers in the existing or proposed legislation does them a disservice as well.
There is a finality to death. We cannot afford to leave room for error. As legislators, we have the responsibility to think about how every individual will be impacted by this legislation, because every life is valuable. We have to be mindful of not reinforcing negative stereotypes about illness, age or ability. We cannot undermine suicide prevention efforts or devalue human life. We have to ensure that meaningful alternatives to MAID not only exist, but that they are readily available. Above all, we have to first ensure the protection of vulnerable Canadians. We cannot allow individual autonomy to outweigh their protection.