House of Commons Hansard #21 of the 43rd Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was quebec.
Jeremy Patzer Conservative Cypress Hills—Grasslands, SK
Mr. Speaker, while we are debating this, one thing we need to remember is that people want to see stronger mental health and palliative care supports. It is incumbent upon us to take those requests seriously. Ultimately, if we were to more seriously address mental health, social issues and palliative care, fewer people would feel this is their last resort.
As far as specific amendments go, we need to look at the provisions, such as the 10-day wait, which need to stay in the legislation.
Matthew Green NDP Hamilton Centre, ON
Mr. Speaker, I appreciated the hon. member bringing up the nuances, and I particularly appreciated his calling out the potentials for ableism in the agency of patients.
One of the challenges created by the current medical assistance in dying legislation is a requirement for final consent at the time the assistance is rendered. This forces those who have already been assessed and approved for medical assistance in dying to make a cruel choice. When faced with a possible loss of competence that would make them unable to give consent, they are forced to either go earlier, or risk not being able to receive the assistance they need to avoid living with intolerable suffering.
Audrey Parker campaigned to make Canadians aware of this, and Bill C-7 would fix this by creating a waiver of final consent. Does the hon. Conservative member support Audrey's amendment to help those facing the end of life avoid this cruel choice?
Jeremy Patzer Conservative Cypress Hills—Grasslands, SK
Mr. Speaker, I will reiterate that, ultimately, the review period was more or less was skipped, which has prevented everybody from having the opportunity to hear more and learn more about the different issues and perspectives people like Audrey have with the bill. The more we can learn before we are forced into legislating this, the better.
Unfortunately, whether it was through prorogation or other means, we have been asked to skip these very important aspects, such as consultations and review processes, which are so vitally important when we are dealing with issues such as medical assistance in dying.
Bob Zimmer Conservative Prince George—Peace River—Northern Rockies, BC
Mr. Speaker, I am the son of two elderly Canadians. My dad is 86 and my mom is 76. I am very concerned about our seniors' access to health care and that they will be put in a position where they have to make a decision between care and maybe ending their lives as a result of this pressure. This concerns me deeply, as it concerns many Canadians across the country.
Would this proposed legislation adequately protect those individuals in Canada?
Jeremy Patzer Conservative Cypress Hills—Grasslands, SK
Mr. Speaker, the way I see it, no, I do not think it does. It is opening the door for those subtle suggestions that, quite honestly, for a person in a tough state, might be seen as a lot of overt pressure. They may be willing to take on advice like that, even though they maybe do not want to, because of the pressure on them. I think it is important that we consider those protections in this piece of legislation.
Again, we need to ensure that we are focusing on high-quality palliative care going forward.
Dane Lloyd Conservative Sturgeon River—Parkland, AB
Mr. Speaker, today I am speaking in opposition to Bill C-7, an act to amend the Criminal Code regarding medical assistance in dying. I am also rising to raise the alarm and call on the government to put an immediate halt to medical assistance in dying in Canada's prisons until a full investigation can take place and legislative amendments can be made.
I believe, as a Conservative, my role is to be someone who stands athwart history yelling “stop” at a time when no one else is inclined to do so. History has shown us the consequences of people not speaking up in opposition to issues that may even have seemed overwhelmingly popular at the time.
Today is one such case, where years from now we may look back at these debates and wonder how we could push forward with such radical legislation and changes to our societal values. That is why I am speaking out today, despite the consensus, which appears to reign in this House, that medical assistance in dying on demand is the way to go.
Dr. Ivan Zinger, the head of the Office of the Correctional Investigator of Canada, released a deeply disturbing report this past June. I presume the government has had access to this report for months, but it was just tabled yesterday in the House of Commons. The correctional investigator raises some serious allegations, citing three cases of prisoners undergoing medical assistance in dying that raise, as the report states, “fundamental questions around consent, choice and dignity.” His office also found serious omissions, inaccuracies and misapplications of the law and the policies surrounding medical assistance in dying.
In one case, a prisoner who was terminally ill and serving a non-violent two-year sentence was denied parole and any opportunity to serve out his remaining days in the community. The inmate wished to explore the possibility of a compassionate parole, but after being denied the opportunity to do so, he sought an assisted death. Before receiving his assisted death, the prisoner repeatedly sought an opportunity to seek out an alternative to MAID in prison. He was repeatedly denied the opportunity to do so. Therefore, he was left with what he felt was no choice but to seek out medical assistance in dying. He was later granted that.
This raises important questions on whether the government is adequately supporting Canadians, including Canadian prisoners, who are facing difficult end-of-life decisions, especially decisions where the power imbalance is so huge.
In another case, a prisoner, a dangerous offender with a terminal illness who was suicidal and suffering from mental illness, also received an assisted death. When prisoners are in a hopeless situation and disempowered, it is no surprise they would seek an assisted death.
In response to these cases, Dr. Zinger points out, “the decision to extend [medical assistance in dying] to federally sentenced individuals was made without adequate deliberation by the legislature.” He is talking about us. He also claims there is no oversight mechanism in the Canadian correctional services to ensure accountability or transparency for medical assistance in dying deaths in correctional institutions.
Given that the above cases were restricted to those with terminal illnesses who qualified under the previous requirement of death being reasonably foreseeable, I find it very concerning the government would be removing this requirement without first acknowledging and investigating the serious concerns and allegations of the corrections investigator.
The corrections investigator is actually calling for an absolute moratorium on all medical assistance in dying procedures in Canada's correctional institutions. Until such a time as we can craft legislation that protects the lives of vulnerable prisoners, who are clearly making a choice in a situation of severe duress, we should clearly consider holding off, or at least placing a moratorium, on medical assistance in dying in Canada's prisons.
This brings me to my next concern with this legislation, which is the need to protect the lives of vulnerable people like the disabled, the elderly and the mentally ill. When this legislation was originally considered a few years ago, Canadians were assured by the government that the legislation would protect the vulnerable. Restrictions that were put in were meant to protect people from being unduly coerced into making a decision to seek MAID. They also exist to encourage people to seek out alternatives before seeking an assisted death.
Everyone can sympathize with somebody nearing the end of their life who is in intolerable pain and seeking out an assisted death, but what Canadians did not expect four years ago was that today the government would be expanding this legislation to allow those who are not terminally ill or near death to qualify.
This raises important concerns for disabled people and those with mental illnesses. Many of them are not close to death and will now be eligible to seek an assisted death. The government has washed its hands of responsibility for restrictions and has left it up to individuals to make this choice for themselves. Choice has been enshrined as the overriding principle of medical assistance in dying legislation, while little or no concern is being given to the factors that can go into those choices.
Similar to the cases that I cited in our prisons, many elderly, disabled or mentally ill Canadians have been isolated for many months from loved ones in Canada's troubled long-term care centres. I wonder how many decisions to access MAID would not have otherwise been made had the situation in long-term care been addressed or how many decisions to access MAID would have been made if Canada had an effective system of palliative care centres for people to live out the remaining days of their life in comfort and peace.
We know from the government's own annual reporting that there is a significant number, and even one is too many, of Canadians, who did not have access to palliative care, who received an assisted death. No Canadian should be forced to choose an assisted death without the opportunity to access palliative care.
The government's annual reporting also revealed that in 2019 alone, 87 Canadians with disabilities received medical assistance in dying but were denied access to critical disability support services. That is simply unacceptable. Canadians with disabilities deserve better.
I am concerned that every time we remove a protection on medical assistance in dying, we are blurring the lines between an assisted death that is acceptable and constitutional and an assisted death that is not. I do not believe, for many in the House, that there is a single assisted death case that would be unacceptable. I challenge members to tell me what they think is unacceptable.
The consensus among most parties in the House, and most members, seems to be that we need to affirm individual choices. I think we can all recognize that no choice is made in a vacuum. Choices are made with a variety of factors, such as people's socio-economic status, the quality of their life, their relations with family and friends, their mental state and their physical state, and the list goes on. Simply boiling down this argument to a matter of individual choice ignores the very real factors that can go into making someone make the decision to seek out medical assistance in dying.
For example, do people feel they are a burden on their family or society? Do they feel there is no alternative to the pain they are feeling? Are there monetary reasons at play? A recent article in MoneySense magazine was advising readers on how to maximize their pension and life insurance benefits if they chose to undergo medical assistance in dying. Where we have come in our public discourse in four short years is shocking to me.
Given that I have outlined a number of factors in determining what factors could be behind someone's decision to seek out MAID, I would ask this. What provisions is the government putting in place to ensure that people's lives are being affirmed and that they are receiving the support they deserve? The fact is that I believe the government is ignoring the very important role that social workers can play in these decisions. By limiting the decision for medical assistance in dying between a doctor and a patient, the government is ignoring the fact that doctors are not always equipped to recognize situations where socio-economic factors or other factors could be at play in the decision. When the government takes away the requirement for two witnesses, it also creates a huge power imbalance, where essentially only one person, the doctor and the patient, is making the decision. There is very little accountability.
Finally, I want to raise the concerns of Dr. Leonie Herx, who is a chair at Queen's University and one of 750 doctors from across Canada who have urged the government to stop this legislation. In her words:
(MAiD) was intended to be a last resort when all other measures had failed and someone had irremediable suffering close to the end of life. (Bill C-7) makes death on demand available to anyone who wants it. It’s a radical shift for medicine.
I call on the government to heed the concerns of the 750 doctors as well as the report from the corrections investigator and immediately move to place new restrictions and protections on medical assistance in dying to ensure that vulnerable people are protected. We have a responsibility. Every Canadian life matters. We cannot get this wrong.
Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons
Mr. Speaker, the member referenced dying on demand. I know a couple of Conservative members of Parliament have used that sort of terminology. That undervalues the immense contributions, at a very difficult time in a person's life, of the people around them. I am talking about medical doctors, social workers, most importantly, family members and others. The infrastructure is there. There is no doubt, as some people have talked about, including myself, that we need to look at palliative and hospice care and other ways to ensure a quality of life when the end approaches.
When members talk about dying on demand through this legislation, they do a disservice to those who are there in those very precious moments at the end of a person's life. I wonder if the member could provide his thoughts about the advisers, in particular, health care professionals and social workers. I have had that experience on two occasions, for both my father and grandmother. I valued and appreciated the feedback that I got from health care professionals back then.
Dane Lloyd Conservative Sturgeon River—Parkland, AB
Mr. Speaker, these are not necessarily just the words of Conservative members in the House. These are the words of Dr. Leonie Herx and 750 doctors who have raised the alarm with the government. This is a term they are using. The fact is that the government is removing restrictions on the number of witnesses that need to be involved. In some cases, people who have a reasonably foreseeable death can request assistance in dying and receive it on the same day.
When we get rid of these reflection periods, it seems that the goal of this policy is to ensure that as many people can access an assisted death as possible. We need to look at this from the other perspective and ask how many people we can divert away from an assisted death through better palliative care, better pain management and better mental health supports. That is what we should be looking at, not trying to speed up and increase the number of people accessing medical assistance in dying.
Kristina Michaud Bloc Avignon—La Mitis—Matane—Matapédia, QC
Mr. Speaker, I thank my colleague for his speech. I appreciate the approach he took in talking about the situation in correctional institutions.
Then again, I heard him refer to this bill as radical. Personally, when I think of this bill, I think of compassion. I cannot help but think of Nicole Gladu and Jean Truchon, who honourably fought for their cause before the courts.
Would my colleague agree that, as legislators, we need to do everything we can to ensure that other people suffering from degenerative, incurable diseases are not forced to go to court to challenge the terms and conditions of medical assistance in dying?
Dane Lloyd Conservative Sturgeon River—Parkland, AB
Mr. Speaker, I apologize to the member for not answering in French, but I am working on it.
We are all here because we care about vulnerable people and people who are sick and suffering, but it is important that we do not all buy into this consensus. When we all get on the train and buy into the same consensus, we lose the opportunity to raise very important points. That is what I and a number of my colleagues are trying to do. We are trying to point out the flaws in this legislation, which I would say is radical because just five or six short years ago, we did not have legalized assisted dying in Canada and here we are today, already passing the second piece of legislation.
Nobody could have imagined six years ago that we would be allowing people without a terminal illness to receive an assisted death. That is what we are debating today, that basically anyone who has a grievous or irremediable condition, even if it is not terminal, should be allowed to receive assistance in dying, and I do think that is quite radical.
Mel Arnold Conservative North Okanagan—Shuswap, BC
Mr. Speaker, it is an honour to rise and speak in this House on Bill C-7, an act to amend the Criminal Code, medical assistance in dying.
Each and every time that I speak in this House, I am reminded that the opportunity has been entrusted to me by the citizens of North Okanagan—Shuswap, first in 2015, and again in 2019. It is roughly five years now since I arrived in this place for the first time and I still remember the anticipation I experienced as I approached my work as a member of Parliament. I still carry great appreciation for the opportunity to serve the people of North Okanagan—Shuswap and, indeed, all Canadians.
Each and every member of this House has been entrusted by their constituents to represent all constituents, and this is a responsibility that I hope all members keep as a guiding principle as we undertake our work. I do not think anyone could be fully prepared for what the role of being an MP entails and the unexpected situations that arise, but I will say that I came here with an open mind, eager to listen and committed to doing my very best to represent the constituents of North Okanagan—Shuswap.
Shortly after the 2015 federal election, Bill C-14 on medical assistance in dying was introduced to the 42nd Parliament. In fairly short order, Bill C-14 was debated and passed. As members will recall, Bill C-14 was passed in response to the Supreme Court decision that ruled that adults with grievous and irremediable medical conditions are entitled to physician-assisted suicide, as it was termed at the time.
Over the time that was allotted for debate and committee study of the original Bill C-14 legislation, I took the opportunity to hear from constituents and took what I heard at that time to form my position on the legislation at hand. Since then, I have continued to listen to constituents on all sides of this debate in an effort to ensure that I am aware of their many differing viewpoints. I have heard from many who believe in the sanctity of all human life and believe the time of life and death is to be decided by a greater power than any of us possess. I have also heard from others with various incurable health conditions who want the ability to choose an appropriate time so that they are able to pass with dignity, and the ability to choose when to say a final goodbye.
While listening to and pondering the various personal beliefs and scenarios shared by constituents, I have also reflected on my own personal experience and how fortunate many of us are that we have not had to make the very difficult, personal decision that many Canadians face every day.
I would like to share what weighed heavily on my mind during the debate and considerations, back in 2016, and remains with me today as we revisit this topic in the legislature. My mother had developed dementia over a period of years before her passing. At first, we did not recognize the symptoms or maybe we did not want to actually acknowledge that they were there, but as time went on Mom became more forgetful. At first it was just that she would end up with multiple jugs of milk in the fridge because each time she went to the grocery store she simply remembered that she needed milk and not the fact that she had just bought some the day before.
As time progressed, her memory got worse and eventually she moved into a full-care home where she was safe and cared for. Initially it was only her short-term memory that faded away and she could still remember many things from earlier in her life and about her family, but that gradually changed. One thing we did notice in the last few months of her life was that she no longer used the telephone. It would ring but she was not able to put the pieces together to pick it up and talk to whoever was calling. The phone had been a big part of her life as she would always call all of her children, grandchildren and great-grandchildren on our birthdays, but for a number of months she was no longer able to remember phone numbers, what the telephone was for, or how to start a conversation.
At the time of what turned out to be her last Christmas, we made plans to have her home for Christmas dinner and we all looked forward to the day. Then on Christmas morning, we got a call from the care home. They said she had come down with the flu and would not be able to go out. We managed to get through Christmas Day but were concerned the illness was more than she could take in her frail condition.
The next day we were surprised when the care home called and said my mom was doing much better that day and asked if we wanted to come for a visit. We headed out, knowing that mom might not be looking or feeling her best because she had been ill.
We walked into the room that day and were totally taken aback. She was sitting up, fully articulate and waiting for us. We were shocked when she started conversations like someone had turned back the clock two years on her dementia. She told us how she felt bad she had not been able to go out and do any Christmas shopping for the grandchildren and many other things she had not been able to communicate for months.
When we returned home later that day, our answering machine was full of messages from my five siblings all wondering what was going on with mom. She had picked up the phone and called each of them from the numbers in her head and had extensive conversations with each of them.
We were all in shock from this remarkable recovery of her memory and the restoration of her mental function from what had been considered incurable. Unfortunately, the recovery was temporary and only lasted about 24 hours, but nonetheless it was a complete reversal of her dementia for that period of time. To this day, no one has been able to explain how or why this happened. We wondered, at the time, and still wonder today if there may be a cure just around the corner.
This is only one scenario, and in the time since medical assistance in dying became legal, I have heard from constituents and observed cases where family members have been quite open about their aging parent or terminally ill family member. They have been open about how, at some point, the parent or family member is no longer the person they once were and no longer wants to carry on. I have heard how they want to be able to make the choice and should not be denied that choice.
In considering the legislation before us today, we must consider all of the people and lives that will be affected by our decision. It is a very difficult task when we are not able to hear all of the different scenarios, learn the details about symptoms and reasons for personal choices.
That is why I urge all members to consider what safeguards should be in place and if safeguards are not in the current text of bill, can it be amended so that our decision respects the needs and rights of our constituents and Canadians.
I will continue to open my mind and listen to what I hear from my constituents. I expect I might hear cases like mine where we were fortunate that when mom passed peacefully in her sleep a few months later, we did not have to make those difficult decisions. There are cases where a cure might be found soon for someone who is incurable today. There are cases where there is no hope for recovery and someone wants to ensure dignity is retained.
There are many other personal situations out there and as legislators, we must remember that. We have a duty to consider more than just our own personal opinions or those of the people close to us. We must be considerate of those who will be tasked with carrying out what we legislate. We must guard against any loophole or opportunity for this legislation to be exploited or abused, because we are literally legislating on matters of life and death here. Let us consider all of that in our deliberations.
Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons
Mr. Speaker, I appreciate the member sharing his personal story about his mom. It is quite compelling to hear personal stories or to hear from individuals on all points on the spectrum as to why there is such a desperate need for the legislation and why it is very important we be so careful as we enter into this area, putting the checks and balances in place.
I had the opportunity to listen to all sides, as the member recommends we do, and put aside our personal thoughts, feelings, and maybe even situations, to get a fair assessment of the bigger picture. We have before us legislation that will move us forward. I suspect it will go to committee. Does the member have some very specific amendments he would like to see made to the legislation or is he more content to see it go to committee?
Mel Arnold Conservative North Okanagan—Shuswap, BC
Mr. Speaker, I appreciate the member is willing to listen to all of the personal scenarios that are out there. We certainly cannot hear them all. As he mentioned, there may be amendments moving forward. I do not think this is the correct place to get into exactly what specific amendments should be there. I would expect there would be amendments being moved if this bill gets to committee, and hopefully what comes out of that committee will be a bill that is respectful of the wishes of every Canadian.
Kristina Michaud Bloc Avignon—La Mitis—Matane—Matapédia, QC
Mr. Speaker, I thank my colleague for his very poignant remarks.
I agree with him that we need to take the time to study the bill carefully. The Bloc Québécois was actually relieved that the bill excludes individuals suffering solely from a mental illness from eligibility for medical assistance in dying, since that aspect requires further reflection, study and consultation. We hope this will be completed at the Standing Committee on Health as soon as the motion moved by my colleague from Montcalm is adopted.
I would like to hear more from my colleague on that aspect.
Mel Arnold Conservative North Okanagan—Shuswap, BC
Mr. Speaker, I appreciate the comments regarding the mental health portion being left out of this bill. Certainly, mental health has become a much more talked about issue over recent years. That is a good thing. The mental health aspect, especially now during the COVID situation with people suffering from isolation more than any other time I have ever known and probably any of us have ever known, of medical assistance in dying certainly needs further discussion and may be addressed in further legislation in years to come.
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Mr. Speaker, I also want to thank the member for North Okanagan—Shuswap for his moving commentary on this bill. I want to reflect on what the member for Cypress Hills—Grasslands said, which is that all members of Parliament have sincerely held beliefs on the issues before us in this bill. What I would urge here is for us to make the distinction between the need for the larger review of medical assistance in dying, which was provided for in the original legislation, and that review unfortunately has not started, and what is actually in Bill C-7. While the member for North Okanagan—Shuswap was not really as guilty as some of his colleagues have been of doing this, I think there are some people who by using “death on demand” and “same-day dying” are distorting what is actually in Bill C-7. I think it behooves all of us, in order to have a respectful debate, that we talk about what is actually there. The bill still requires that someone be suffering from an incurable illness, intolerable suffering and irreversible decline, so I would urge all members, including this member, to keep in mind what is actually in the bill.
Mel Arnold Conservative North Okanagan—Shuswap, BC
Mr. Speaker, I certainly agree with the member that the review of the original Bill C-14, medical assistance in dying, needs to take place so there is a proper review of what has been happening since 2016 when it passed. As we move forward with this bill, we certainly need to be cautious and review it, because what we are dealing with here as legislators is the life and death of other people.
The Deputy Speaker Conservative Bruce Stanton
That is all the that we have for questions and comments.
Is the House ready for the question?
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
On a point of order, Mr. Speaker, I am just a bit confused about the process here. Are we proceeding with the question now or is there somebody else is up to speak?
The Deputy Speaker Conservative Bruce Stanton
I thank the hon. member for Sherwood Park—Fort Saskatchewan. There was no time left in the five minutes for questions and comments. I then went to resuming debate and no person rose. Nor did I see any hands raised on the Zoom participants. Therefore, I proceeded to the question on the bill.
Does the member wish to make a speech on the matter?
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Sorry, Mr. Speaker, I do not. I was trying to get a bit of clarification on the process.
The Deputy Speaker Conservative Bruce Stanton
I thank the member for that. That is perfectly fine to do if members are unsure. It is good to check in and we are happy to get it clarified.
The question is on the motion.
As members will know, if a member present wishes to request a recorded division or request that the motion be adopted on division, I invite the member to rise in his or her place and that would signify a recorded division.
And one or more members having risen:
Accordingly, pursuant to order made on September 23, the division stands deferred until Thursday, October 29, at the expiry of the time provided for Oral Questions.
Kevin Lamoureux Liberal Winnipeg North, MB
Mr. Speaker, I suspect if you were to canvass the House, you might find unanimous consent to call it 6:13 p.m. at this time in order to facilitate private members' hour beginning.
The Deputy Speaker Conservative Bruce Stanton
Are there any objections to the House seeing the clock at 6:13 p.m.?
Seeing none, the House will now proceed to the consideration of Private Members' Business as listed on today's Order Paper.