Debates of Dec. 2nd, 2020

Questions Passed as Orders for Returns

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I would ask that all remaining questions be allowed to stand at this time.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Is that agreed?

[Some hon. members]

Agreed.

The House resumed from November 30 consideration of Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), as reported (with amendments) from the committee, and of the motions in Group No. 1.

Criminal Code

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I wish to inform the House that because of the deferred recorded division, Government Orders will be extended by 40 minutes.

The hon. member for Battle River—Crowfoot had five minutes of questions and comments remaining.

Questions and comments, the hon. member for Sherwood Park—Fort Saskatchewan.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, I wonder if my colleague can share with this House in particular his concerns about the possibility of same-day death if these amendments are not passed. These amendments include reintroducing a 10-day reflection period. Without this 10-day reflection period, there would be absolutely no time requirements. There is an assessment that would have to take place, but there would be no time limit on that.

There would be no legislated limit on how quickly a person could go through this process without that reflection period, which would create the possibility of a very quick turnaround time and someone not having the opportunity to reflect and really consider what their situation is. I wonder if the member can comment on that.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, I would be happy to comment. Let me first note it is certainly interesting to do a speech one day and then answer questions the next, but it does not diminish the importance of this issue.

The ability to possibly access same-day death is certainly a great concern I have and that I have heard from many of my constituents about. My hon. colleague made a comment in one of his speeches that certainly resonated with me, and it is something I heard from a number of my constituents as well, when he said that one's worst day should not be one's last day.

There are safeguards required to ensure Canada's medical assistance in dying framework is strong and protects the most vulnerable among us. I believe the priority of all members of Parliament needs to be to ensure that is in fact the case.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Madam Speaker, in the speeches we have heard, a number of Conservatives have made the point that living should not be harder than dying. I wonder if that means the Conservatives are ready to support a guaranteed livable income to ensure that no Canadian lives in poverty or has economic disadvantage affecting their ability to make the best of their life.

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, I would simply say this: We are debating a bill that dramatically changes the framework for Canada's medical assistance in dying legislation. This bill was introduced prior to Parliament being prorogued and it is being rushed through. We have heard time and time again from experts. In fact, the Senate just wrapped up hearing from 85 different witnesses about how there is a tremendous amount of concern on this bill from all perspectives. For the justice minister to come and make the declarations he has, saying that somehow they have reached a consensus, is absolutely inappropriate.

Certainly, as we debate this bill, we need to focus on ensuring that Canadians are protected and that Parliament gets this right. This is a question literally of life and death for Canadians. Parliament has to get this right and it has to be fulsomely debated to ensure that we are able to get that balance struck appropriately.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, could the hon. member comment on what he is hearing, in terms of a reaction, from his constituents on this amended bill?

[Damien Kurek, Conservative, Battle River—Crowfoot, AB]

Madam Speaker, I have heard from many constituents on this matter, quite frankly, from all sides of the debate saying two things. The first is that there is a tremendous amount of concern with the bill as it was presented and as it has been presented to this House. The second is that a lot of the very reasonable amendments put forward in committee were not adopted.

Certainly, that has posed a great deal of concern. I have heard from hundreds of constituents who have brought these very serious concerns to my attention. I am proud to stand for their interests in this debate on such an important subject.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, it is a pleasure to be here today because a lot of things need to be said about Bill C-7. For those who are not aware, it is an act to amend the Criminal Code with respect to medical assistance in dying.

Members know I was in Parliament when Bill C-14, the predecessor of this bill, was debated. I heard the debate and discussions about the safeguards that needed to be put in place to make sure we did not go down the slippery slope that many other countries went down when they began to allow assisted suicide and branched further into euthanizing individuals.

Knowing all the discussion and thought that went into the reaction to the Carter case, I am very troubled and disappointed that when the Quebec lower court ruled the reasonably foreseeable death provision was unconstitutional or would not be accepted in Quebec courts, the government did not put this forward to the Supreme Court. I feel as though the Supreme Court was involved in the Carter decision in the first place, as it laid out the provisions it thought would be reasonable. A reasonably foreseeable death was one of them, so this should have gone back to it for commentary before coming to this place.

With that in mind, I am also disappointed that the government has not moved forward on the palliative care provisions that were also a clear recommendation from the special committee that studied the Carter decision. It said that without good quality palliative care, we do not have a real choice.

As members know, I brought a private member's bill to the House on this, which was unanimously supported here and in the Senate. I worked with the health minister of the day to put together a framework across Canada to get consistent access to palliative care for all Canadians, because 70% of Canadians have no access to it. As per the Carter decision and the special committee, if we do not have good quality palliative care, we really do not have a choice.

I was disappointed to not even see “palliative care” mentioned in the fall economic update. The words were not even there. The fact the government would prioritize expanding medical assistance in dying without the input of the Supreme Court and without putting provisions of palliative care in place seems to be the wrong priority. Let us let people live as well as they can for as long as they can instead of encouraging them to die. I think that is where we as compassionate Canadians want to go.

Another thing the Liberal government fell down on is the choice not to do the five-year review. When Bill C-14 came through, one of its provisions was about looking at the situation after five years so we would understand whether or not the rules that were put in place were being followed, were adequate and met the intended purpose. That was not done. This was a perfect opportunity for the government to do that work, because we heard anecdotally that in many cases across Canada, the existing rules and safeguards have not been followed. We need to get a quantitative analysis on that and understand how these things could happen and how we can prevent them from happening in the future.

It is disturbing, then, that the government has decided, without doing the five-year review, to make changes to what is happening with respect to medical assistance in dying beyond what was asked for by the Quebec courts. Doing something without reviewing what one already has in place is irresponsible, in my view.

Given that, I have some concerns. The government has removed many of the safeguards put in place in the bill to keep those unfortunate things that we worried about when we were discussing C-14 from happening. For example, there is the 10-day cooling-off period. As anyone who has had relatives suffering through irremediable conditions knows, they have good days and bad days, and on the bad days they can feel like they want to die.

My mother just died in October. At the very end, she was in a lot of pain. I talked to her about medical assistance in dying and it was not something she wanted; she wanted palliative care. I am fortunate that in Sarnia—Lambton we have palliative care. One day she told me she was really thinking about it, but the next day it was not something she wanted, so I really think that 10-day cooling-off period was an important safeguard.

I am sympathetic with one of the changes that was put in, although it should have been put in after the five-year review. It says that once people have signed off on all the documents and the independent witnesses and others who understand the condition have dotted all the i's and crossed the t's, a person perhaps will not be able to give consent immediately before the procedure. I saw this in my mother's situation. At the end, she would not have been able to verbally communicate or even write to indicate her choice, should that have been her choice.

However, removing the 10-day safeguard was a mistake. The Conservatives brought an amendment to try to put it back in and explained why it was important, but it was not received.

The other thing I found troubling was the removal of the independent witnesses. We cannot even get a will without having an independent witness. It seems to me that for something as important as determining one's date of death, it should be a provision.

In Ontario, there is another difficulty, which has to do with conscience rights. There are people who do not want to participate in medical assistance in dying for religious reasons or for personal reasons of conscience, and that is their charter right. This means they do not want to participate in the act and do not want to refer. They do not want to have anything to do with it. In Ontario, medical people are being forced to at least refer. That is still a violation of their conscience rights, and it is troubling that in the debates on Bill C-7, when I asked these questions the Parliamentary Secretary to the Minister of Justice said there are plenty of safeguards in there and it is okay. No, it is not okay. They are still violating rights of conscience and that needs to be addressed as well.

A modified advance consent was opened up to allow people to indicate, 90 days in advance, that they want to have this procedure. Advance consent was studied by one of the committees chartered by Parliament. Its recommendations said that a lot of things need to be considered before we go down the advance consent path. The government has not really done its five-year review, and I remember the member for Vancouver Granville commenting on this very point. There is a lot to be thought out there, and if we do not do it correctly, we will once again have a situation where the intent of the bill is not going to be met. There are going to be new violations in the way we have heard anecdotally, and that will not be a very good situation.

I was happy to see in Bill C-7 the clarification to indicate that if the sole underlying medical condition is mental illness, individuals are not eligible for medical assistance in dying, although there is some controversy there. I have heard from groups across Canada that are calling on the government to allow individuals whose underlying suffering condition is mental illness to receive medical assistance in dying. I think it is not a good idea, and I believe this is in line with what was said by the committee that studied this part of medical assistance in dying. It said many of the mental illness conditions, such as depression, could be treated. These are treatable conditions, not irremediable conditions, and some are glad to see this loophole closed.

The bill intends to:

permit medical assistance in dying to be provided to a person who has lost the capacity to consent to it as a result of the self-administration of a substance

We talked about this when Bill C-14 was in this place. At that time, we were not sure about the method of application of medical assistance in dying, whether it could be done with a prescription or not, and there was a concern: What if the procedure went wrong and a person cannot give consent? What do we do then? I am glad to see that situation was addressed in the bill.

Overall, those are my concerns with Bill C-7, and I think the government needs to go back to the drawing board on it. As 50% of the Canadian public seem to be concerned about the existing bill, such as people with disabilities and mental illness, let us go back to the drawing board.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Madam Speaker, in 2016, the Alberta Court of Appeal unanimously granted a 58-year-old woman, known as E.F., access to medical assistance in dying. She suffered from severe conversion disorder, which meant involuntary muscle spasms that radiated from her face causing her severe, constant pain and migraines. Her eyelid muscles spasmed shut, rendering her effectively blind. Her digestive system was ineffective and she went without eating for up to two days. She had trouble sleeping, and because of digestive problems she lost significant weight and muscle mass. She was not ambulatory a needed to be carried or use a wheelchair. Her quality of life, on the court's record, was non-existent. The court also noted that the applicant's husband and adult children were supportive of her decision.

Does the member agree that E.F. should have had access to medical assistance in dying?

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I am not a lawyer, and I think these issues are best decided in the courts.

The Supreme Court, which studied the Carter decision originally, said there had to be an irremediable condition with a reasonably foreseeable death. Although there is definitely suffering in the situation described by the member, it does not seem like death was reasonably foreseeable, so it would not have met the Supreme Court's decision.

Until the Supreme Court has a chance to weigh-in on the Quebec court's decision, it would be unrealistic for a person who is not a lawyer to weigh-in.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, I congratulate my colleague on her speech and I thank her for that. I want to express my sincere condolences on the loss of her mother. I know how that feels.

The member did raise some interesting issues. The act is slated for a comprehensive review in June. It will also prevent intense suffering.

This is certainly an emotional debate, but I would like to hear the member's thoughts on what happened with Nicole Gladu and Jean Truchon in Quebec.

I would like to know what she thinks of the court deadline. If this law is not passed, we will have inconsistent legislation.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I thank the member for his question.

The courts in Quebec made a decision, and until it is overruled, it is clear that the practice in Quebec is going to be to allow people whose death is not reasonably foreseeable to have medical assistance in dying. That means there is a different practice in Quebec from the rest of the country, until the courts can determined whether or not that is constitutional. That is the step that was missing: finding out if the Supreme Court agreed with the Quebec court's decision. I think that should have proceeded before the bill came forward here.

[Gerald Soroka, Conservative, Yellowhead, AB]

Madam Speaker, first, I want to tell the member how sorry I am for her mother's passing this fall.

One of the things you spoke about was how important palliative care is and that it was available to her. However, there are other places in the country where palliative care is not as available or the quality is not as good.

Do you feel that if we had a better palliative care system, maybe people would not be looking at assisted suicide as much?

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I remind the member that he is to address his questions and comments through the Chair.

The hon. member for Sarnia—Lambton.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I thank my colleague for an excellent question, because, in fact, countries have studied this. About 95% of people who have good quality palliative care choose to live as well as they can for as long as they can.

The Liberal government pledged $3 billion over five years, which was changed to be over 10 years, and now that the framework is in place, we are looking for a whole bunch of fixes, such as infrastructure to do virtual palliative care, training for paramedics to be in rural and remote places, training for medical professionals and research. I really think it is the right plan, but we just need to get going on it. The sooner the better.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I appreciate the opportunity to speak at report stage of Bill C-7, an act to amend the Criminal Code, medical assistance in dying, with which the government is seeking to dramatically expand the existing euthanasia regime in Canada.

The government claimed to want to protect vulnerable Canadians. It claimed to be open to our amendments. I see no evidence whatsoever for either of these claims.

Despite knowing full well the concerns that numerous groups had, including those disability rights groups, with the pre-prorogation version of the bill, the minister reintroduced the exact same legislation word for word. In fact, the bill even has the same number. The minister refused to pre-emptively adopt any of the proposed amendments, and has hidden behind the Truchon decision throughout this debate.

What of the Truchon decision? First, it is beyond unacceptable that the Liberal government did not appeal the Truchon decision to the Supreme Court. Truchon struck down vital protections for vulnerable Canadians, protections that this very government put in less than five years ago. Not only would appealing this decision have brought necessary clarity to the legal status of federal euthanasia legislation, it was also the right thing to do.

Instead, the minister used the Truchon decision, which struck down the reasonably foreseeable death requirement in the province of Quebec, to justify a wholesale abandonment of euthanasia safeguards put in place by the previous minister, the member for Vancouver Granville, and the creation of an advanced consent framework, open to any number of abuses.

That member for Vancouver Granville raised these concerns in this place. She said:

Nothing in the Truchon decision...and the Supreme Court of Canada, in Carter, insisted on the requirement of clear consent. Palliative care physicians, disability advocates and other experts insist that this is an important safeguard, and, like other legislated MAID reports on mature minors and mental disorder, advance requests also raise significant challenges.

However, the minister refuses to listen. A statutory review of the impacts of Bill C-14, required by law, has not been undertaken. That review is mandatory to ensure that the safeguards in place are effectively protecting the elderly and infirm Canadians from manipulation and abuse. Instead of waiting to make these changes until the mandatory review was completed, the Minister of Justice pushed forward his own ideological stamps. He blindly pushed Canadians into the dark instead of the light. Sadly, I am not surprised the minister would push this ideology on vulnerable Canadians. When Bill C-14 was introduced, after all, he opposed his own government's legislation. Now, as the minister, he is refusing to listen.

It has always been my priority and that of my colleagues to ensure that any legislation on euthanasia and assisted suicide includes strong safeguards for the most vulnerable in our society as well as for the conscience rights of health professionals. This is clearly not the minister's priority. Instead, by allowing advanced directives for assisted suicide without any legal assurance that individuals will have the opportunity to change their minds and with Liberal members voting down an amendment that would have required those seeking euthanasia to be given an opportunity to refuse it on the day in question, could mean that people could be legally euthanized in their sleep without any opportunity for them to change their mind. This is horrifying. How can the Liberals possibly justify this?

Inclusion Canada, a disability rights organization, has stated that the legislation is its worst nightmare and that it is a moral affront to equate euthanasia to an equality right. The minister still refuses to listen.

The most egregious, in my view, is the removal of the 10-day waiting period and the need for two independent witnesses. The Liberals also voted against a seven-day-waiting period amendment proposed at committee. They made a deliberate choice to strike down one of the most important safeguards for vulnerable people facing uncertain medical prognosis and have opened Pandora's box to same-day death.

Each of us can think of someone in our lives, perhaps a friend, a grandparent or even a spouse, who has received a serious medical diagnosis. The emotional impact of hearing that news can be overwhelming for both the patients and their families. It can cause depression, anxiety and a great fear of the unknown, especially now in the face of the ongoing pandemic.

Many of us can also think of loved ones who have received terminal diagnoses, only to beat their illness and live for years afterward. However, with the safeguards of two independent witnesses and a 10-day waiting period gone, such stories will be fewer and further between. Without a mandated length of time to collect themselves, to receive support from their families and to learn about treatment options or get second opinions, some people will make emotional decisions based on fear.

Taylor Hyatt, a young woman with a visible disability, shared her experience while suffering from pneumonia and in need of oxygen to help her to breathe. She said:

After taking a cab to the nearest hospital, I was immediately admitted. A couple hours – and many tests – later, the doctor was no closer to finding out what caused my illness. When she finally came to see me, at about 11pm, she said: “The only thing we know is that this infection affects your breathing. You may need oxygen. Is that something you’d want?” My answer was: “Well, of course!” She seemed surprised maybe, or unconvinced, so she asked again: “Are you sure?” I replied, “Well, of course!

Any non-disabled person would have received oxygen immediately, but instead the doctor asked her twice, leaving Taylor to believe that the doctor assumed that because she was disabled she may not want to live. What if Taylor had felt overwhelmed that day and requested euthanasia in a moment of weakness? At the time, she would have had 10 days to reconsider this choice. If this bill passes, she could have died that day and the world would have lost a great warrior for the rights of disabled Canadians. How can we allow for the legal possibility of such a tragedy?

Every Canadian should feel great shame for these failures. We are and we must be better than this. Every great or good society is judged by how it treats those deemed to be the least among them. How can we claim to be either great or good if we treat the Taylor Hyatts of our nation as if their lives are less valuable than our own. We must protect the innate dignity of every human life, knowing that nothing, not time, not illness, not disability, can ever take that dignity away.

Still, the minister refuses to listen. He is ignoring the statutory review but only to weaken protections, not to strengthen them. Not only has he torn down protections for vulnerable Canadians, he has placed medical professionals into an even more precarious position than the current regime by expanding the eligibility and thereby the number of medical professionals who are impacted. The Liberal members voted down an amendment that would have protected the charter rights of medical professionals, trampling their rights in the rush to a predetermined ideological end goal.

Tens of thousands of doctors believe, truly and wholeheartedly, that taking part in an assisted suicide breaches their calling to do no harm. Those beliefs are protected in our charter, but not in this, nor in any other federal legislation regarding euthanasia. Such a glaring omission makes it clear that this minister's priority is not to protect the rights of Canadian citizens but to push his ideology as far as possible. That is something I cannot and will not support.

I would plead with the other place to take the time needed for a sober second thought, removed as they are from the minister's ideological fixation, because the minister is refusing to listen.

[Nathaniel Erskine-Smith, Liberal, Beaches—East York, ON]

Madam Speaker, in answer to my last question, the member for Sarnia—Lambton suggested that the Supreme Court in Carter had indicated that one's death needed to be reasonably foreseeable. Of course that is patently untrue. The criteria, established by our Supreme Court unanimously, are that one needs to have a sound mind, be of capacity, be suffering an irremediable illness and be suffering intolerably. I recognize that safeguards are required, but does the member agree that if those conditions are satisfied, the unanimous decision of the Supreme Court should be respected?

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, what we are debating today in Bill C-7 are the changes that would be made as a result of the Truchon decision in Quebec. Nobody is questioning that Canadians have the right to choose MAID. Nobody is questioning that they should have access to that. We are questioning why the minister and the government are bent on removing all the safeguards that were put in place back in 2015 to protect the vulnerable.

[Louise Charbonneau, Bloc, Trois-Rivières, QC]

Madam Speaker, first off, I want to say that Quebec already has legislation on this matter.

What is the plan for harmonizing the provincial and federal laws?

I would also like to talk about my sister, who has had multiple sclerosis for several years. She has never considered medical assistance in dying, even though she suffers every day.

I think that people who choose to ask for medical assistance in dying have thought long and hard about that decision, on top of going through all of the steps involved, such as making a written request, signing the request, getting witnesses, and going through the 90-day, or three-month, assessment period. When someone is suffering greatly, three months is a long time.

In her speech, my hon. colleague said that she—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I must interrupt the hon. member for Trois-Rivières because the hon. member for Carlton Trail—Eagle Creek is rising on a point of order.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I am hearing the French and the English at the same time and I cannot hear the interpretation of the member's question.