Mr. Speaker, in a previous speech at second reading, I noted how, perhaps 50 years from now or even sooner, we may look back on this era and these debates and ask ourselves how we could have been so foolish. History is filled with examples of ideas that were socially acceptable, celebrated or even considered the most moral option, but these ideas and policies were later shown to callously disregard the rights and dignity of individuals and communities.
As the bill went to the justice committee, I held out hope that parliamentarians would listen to the concerns of the disabled and other vulnerable Canadians who were sounding the alarm on the legislation and its implications for their lives. I hoped that the committee members would consider passing amendments to protect the vulnerable, such as extending reflection periods, which are the amendments that we are debating today, so that people would not feel that they are being rushed into medical assistance in dying.
Despite the overwhelming and compelling evidence, the committee majority really chose to ram through the bill with little consideration. There were only five meetings to hear witnesses, and of those five meetings, the majority were with the proponents of medical assistance in dying and there was very little opportunity, relatively, to hear from those who had concerns about the bill. This amounted to a mere hours of debate on an issue that is literally about the life and death of Canadians.
It is just wrong that the government is trying to ram through this important legislation in an expedited manner without taking time to listen and include the concerns of those communities who are vulnerable. It appears that the Liberals do not really want to listen to criticism or work to improve the bill and that they want to implement their agenda, regardless. In doing so, I believe they are ignoring the voices of disabled people, indigenous people, doctors and many others who have raised concerns.
In dealing with the amendments today, I am very pleased that my Conservative colleagues have strongly put forward these amendments related to the 10-day reflection period. I believe that the defeat of this amendment is removing a very basic safeguard for the protection of the vulnerable. The government claims that this would only apply to those with a reasonably foreseeable death and that there should not be a reflection period. However, we have seen the evidence that people who would not be under the existing legislation, individuals who do not have a reasonably foreseeable death, are receiving medical assistance in dying under the current legislation. The government has not strengthened or clarified the definition of what is reasonably foreseeable. The Liberals are actually planning to remove it as a requirement entirely.
I do not believe that the two streams the Liberals are talking about would apply any protections. The reflection period is essential to give Canadians the opportunity to make a decision and then revisit that decision after deep reflection. I understand that no decision to pursue MAID is taken lightly, but by accelerating the timeline between the decision and the receipt of MAID, we are removing an opportunity for reconsideration.
I also do not believe that doctors are always in the best position to consider underlying mental health conditions. If someone comes in and seeks medical assistance in dying with this new expedited timeline, doctors may not be equipped to recognize people with mental health challenges. It could be that those struggling with their mental health will receive medical assistance in dying without their family being informed and without an opportunity to offer treatment or an intervention. This is obviously a very real and dangerous possibility. In fact, it has already happened.
According to testimony from Dr. Trudo Lemmens and in a recent article in Maclean's magazine, people have been seeking and granted MAID because they do not want to live with financial difficulties and loneliness. This is wrong. When did poverty get added to the list of justifications for accessing MAID? I have yet to see it in any legislation, but we are seeing it happen here, right in front of our eyes.
We must also consider that the will to live can fluctuate. Put simply, people who need to make a life-and-death decision must have the opportunity to reflect on that decision over a period of time. Dr. Harvey Chochinov, who gave testimony at committee, reported:
Our research group reported that the will to live can be highly fluctuant over intervals as short as 12 to 24 hours. In fact, 40% of patients who were prescribed lethal drugs in Oregon decided not to take [the drugs].
We also know that people facing chronic conditions may be suffering from suicidal ideation, but if they are given some time, they might choose not to follow through with that. It is clear that when it comes to issues of life and death, it is not black and white. The will to live, to continue on and to overcome can change over time.
Expanding further on the definition and enforcement of “reasonably foreseeable death”, the requirement that a death be reasonably foreseeable was one that a broad group of people could support in 2016, but since 2016, we have seen it abused in ways that people could not have imagined. One recent case comes to mind. Nancy Russell, an elderly woman who was struggling with pandemic-induced isolation, underwent MAID recently in order to, reportedly, avoid another lockdown.
I want to take a moment to say that my thoughts are with her family who recently faced this loss. I know it is not an easy situation. Nevertheless, this is a pertinent example of medical assistance in dying being provided when there was no apparent reasonably foreseeable death. Some have argued that old age in itself is a qualifier for reasonably foreseeable death, although that argument was not made when the original legislation was put forward. It was not the understanding of the public at the time we accepted this.
In this case, however, if COVID-19 had been eradicated and a further lockdown avoided, it is very likely that this woman and maybe several others would not have pursued an assisted death. Therefore, it is clear to me that the reasonably foreseeable requirement has not been respected and is not being enforced or even defined well by the Liberal government.
Let us dive deeper. “Reasonably foreseeable” is not even considered a medical concept. Professor Alain Naud from Laval University stated in his testimony, “The term does not meet any medical concept or definition. It doesn't exist in any medical textbook. Yet it is the responsibility of physicians to assess the eligibility of patients.” The Canadian Bar Association, David E. Roberge, also stated that reasonably foreseeable death has caused “significant uncertainty in practice, and Bill C-7 does not give any guidance on how to apply it.”
Instead of doing the right thing and defining the terminology for the medical community, the government and the committee majority have decided to just remove the safeguard altogether. Clearly, the bill needs further study and clarity, because when it comes to life and death, doctors need a clear set of rules and guidelines, and the bill really fails to provide that.
When I listened to the Minister of Health's committee testimony, she talked about the need to create two streams, one for those with a reasonably foreseeable death and another for those without a reasonably foreseeable death. Since the definition of “reasonably foreseeable” is so ill-defined and subject to abuse, the so-called safeguards for the vulnerable in this case are not worth the paper they are written on. The fact is that there is no desire to intervene to protect the lives of vulnerable people and I firmly believe that once the next parliamentary review is completed, we will see the further removal of any safeguards.
Another point on this feature is that the concerns of the correctional investigator, Dr. Ivan Zinger, were not included in the committee study or in any of the recommendations. Dr. Zinger has raised deep concerns about medical assistance in dying in Canada's prisons and believes that there has been some abuse of process. I agree with his assessment. Prisoners with limited rights being granted medical assistance in dying is a deep, moral and ethical problem, and it is a problem that the committee chose not to deal with. He has even called for a moratorium on MAID in Canada. I did not see his testimony included. His concerns have not been raised or addressed and that is a real failure of the bill.
This brings me to another concern, which is that it seems the government wanted to use the bill as an opportunity to circumvent the will of Parliament. Ironically, it was the will of the last Parliament, when Liberals had a majority government, that we would have a mandated five-year parliamentary review.
The government saw an opportunity with the Truchon decision. Even in the Minister of Justice's own testimony at committee, he said that they saw this as an opportunity to get something done before the five-year review. It kind of undermines the whole point of a review when we need more time. This is a radical departure from where we have been as a country and we need time to experience this and come to a new understanding as a country. We have just short-circuited that review and are pushing forward with the legislation.
In closing, I am pleased that we have brought these amendments forward. I hope we will give them their full consideration so that we can protect the lives of vulnerable people.