Mr. Speaker, I am pleased to add my voice to the debate on Bill C-7, an act to amend the Criminal Code with respect to medical assistance in dying.
I want to start by reminding all members that this is important legislation. We as parliamentarians have a court-imposed deadline of December 18 to pass this legislation. This legislation would help prevent the suffering of Canadians. Even there were no court-imposed deadline, we would have a moral obligation to see it passed.
I am really disappointed, to be frank, to see my colleagues across the aisle delaying the bill, increasing the chances that the government misses the court-imposed deadline and prolongs the suffering of Canadians in denying them the autonomy to choose medical assistance in dying.
I am very disheartened to see members of the Conservative Party of Canada continue their delay tactics to slow this legislation. I saw it at the justice committee and we are seeing it again now. We know that the majority of Canadians believe that MAID is a basic human right. More than 300,000 people participated in consultations earlier this year.
The Quebec Superior Court's deadline is now two weeks away as of today. Conservatives are now trying to undermine the urgency of the situation. They are ignoring the very real consequences that their inaction could have on those who are suffering in this country. I think it is also important to remind members where the content of this legislation came from and the process the government went through in January in developing this legislation.
Bill C-7 was informed by the Truchon decision itself, Canadian and international reports, the experience of existing international regimes, and the government's consultations on MAID held in January and February of this year.
I had the opportunity to participate in some of these round tables that were hosted across the country including in my home of Toronto, where I am speaking from, and in Winnipeg. In these consultations, our team spoke with 125 stakeholders including regulatory bodies, legal experts, doctors, nurse practitioners, representatives of the disability community, and indigenous persons and their representatives. They shared their experiences and insights into MAID and its implementation in Canada over the last four years.
In order to get a broader public perspective, the government also hosted an online public survey. It received over 300,000 responses from people across the country. The summary of the consultations was released in March as a “what we heard” report. Our government did its homework in the creation of this legislation.
I would like to take the time to explain to all hon. colleagues what Bill C-7 proposes to change in our MAID regime so that we all start from the same common understanding of the legislation before us.
There are four main aspects to the bill. The first aspect concerns eligibility criteria and these changes are fairly straightforward. The eligibility criterion requiring a reasonably foreseeable natural death would be repealed. As I have already described, this change would in effect adopt the outcome of the Truchon decision for the whole of Canada.
This eligibility criterion makes Canada's current end-of-life regime available only when a practitioner can determine with confidence that a temporal connection to death exists, with some flexibility. In Truchon, the Quebec Superior Court told us that this criterion violated the charter rights of people whose death was not reasonably foreseeable, people like Mr. Truchon and Ms. Gladu.
To avoid prolonging the suffering of the applicants and other Canadians in similar situations, our government decided to accept the decision and amend the act for all of Canada.
The legislation would continue to require a voluntary request and informed consent from a person with decision-making capacity. These cornerstones of autonomy would ensure that MAID could be safely provided to Canadians who deem it to be the solution to their suffering, while guarding against persons being pressured into seeking MAID. We trust that individuals know best for themselves when they can no longer endure suffering, regardless of whether their natural death is reasonably foreseeable. We are committed to respecting this very personal choice of Canadians.
The second aspect of the bill is the safeguards. The bill would use the criterion of reasonably foreseeable natural death to create a two-track system. Those whose death is reasonably foreseeable would continue to benefit from the current safeguards with two changes. First, the 10-day reflection period would be repealed and a person would only need one independent witness to sign a MAID request instead of two. That independent witness would be someone who is paid to provide health and personal care services to the person requesting MAID. These changes are intended to alleviate barriers to access and to reduce suffering.
We heard from medical practitioners that these did not serve as safeguards, but only unnecessarily prolonged suffering for individuals who had made up their mind. It also created issues of accessing MAID in rural and remote areas.
Those people whose death is not reasonably foreseeable would benefit from an enhanced set of safeguards. In addition to those safeguards required where death is reasonably foreseeable, practitioners would have to assess a person's MAID request over a minimum assessment period of 90 days. If neither of those two MAID assessors has expertise in the condition that is causing the person's suffering, they would have to consult a practitioner who does. That is pursuant to the amendment that was helpfully proposed by the NDP member for Esquimalt—Saanich—Sooke at committee. The person requesting MAID must be informed of the means available to relieve their suffering, including mental health and disability support services, and be offered consultations with professionals who provide those services. Both practitioners have to discuss those means of relieving suffering with the person and be of the view that the person has seriously considered those means.
In terms of the broad approach to the bill, the third aspect of Bill C-7 is that of the limited change around advance consent. This one is unrelated to changes in eligibility criteria, but instead seeks to address an unfair situation that arises when a person is approved for MAID but loses decision-making capacity and cannot consent to the MAID procedure immediately before it would be provided, despite the request having been approved and the procedure already planned. Members probably know the reason for this amendment best through the story of Audrey Parker, the Canadian woman whose case we heard so much about a bit more than a year ago who had to schedule her MAID procedure earlier than she would have wanted, out of fear of losing decision-making capacity before her preferred date to receive MAID.
In my view, Bill C-7 takes the right approach by proposing to allow the waiver of final consent only in cases where the person's death is reasonably foreseeable and only when he or she has already been found eligible for medical assistance in dying and is waiting for the procedure to take place, but risks losing the capacity to provide final consent.
According to practitioners and people like Audrey Parker, this is exactly the kind of situation that forces people to make a cruel choice if they risk losing their capacity to give consent before receiving medical assistance in dying. That is the one, very specific scenario this bill proposes to address, since it presents the least amount of uncertainty in terms of patients' autonomous choices and the least ethical and practical complexity.
I know this is an important issue for Canadians, and I am committed to working with all parliamentarians to begin the parliamentary review of the medical assistance in dying regime as soon as possible after Bill C-7 has made its way through the parliamentary process. I have no doubt that the issue of advance requests will be an important part of that review.
The fourth and final category of amendments that the bill proposes targets the monitoring regime. The changes would allow the collection of information in a wider range of circumstances, including information about preliminary assessments that might be undertaken before a request is put in writing. Consultations will take place before these regulations are amended. An amendment at committee based on an amendment proposed by the hon. member for Nanaimo—Ladysmith of the Green Party would require that the Minister of Health consult with the minister responsible for the status of persons with disabilities in carrying out their reporting obligations; again, another helpful amendment that was proposed at the committee stage.
Medical assistance in dying has always been a very difficult issue that generates a variety of opinions on all sides of the issue. It strikes deeply to all Canadians' personal morals and sensibilities. We understand this. As such, it requires different interests to be considered. I firmly believe that Bill C-7 does exactly that. The law will continue to require informed consent and a voluntary request made by a person with decision-making capacity, while also creating a more robust set of safeguards where the person's natural death is not reasonably foreseeable. These safeguards require significant attention to be paid to all of the alternatives that might help alleviate suffering on the part of a person whose death is not reasonably foreseeable. We believe such a regime can work safely by guarding against overt and subtle pressures to seek MAID, while providing autonomy to a greater number of Canadians to make this important choice for themselves.
I would like to return for a moment to the topic of safeguards, specifically when it comes to those whose death is not reasonably foreseeable. It is very important to remind members of this House what these safeguards are and why we believe that they are adequate.
This legislation proposes a distinct set of procedural safeguards that are tailored to the risks associated with assistance in dying for persons whose death is not reasonably foreseeable. Ending the lives of those whose suffering is based on their experience of their quality of life is different from offering a peaceful death when the dying process would otherwise be painful or prolonged, or would erode a person's sense of their own dignity. Bill C-7 therefore proposes a more robust set of safeguards where natural death is not reasonably foreseeable. Safeguards for those whose death is not reasonably foreseeable would be built around the existing safeguards, but contain enhancements over the previous Bill C-14, which was passed in the 42nd Parliament. Importantly, the medical assessments of a person's eligibility must span at least 90 days.
I mentioned this earlier, but I want to emphasize, as there appeared to be some confusion around this at the Standing Committee on Justice and Human Rights, and elsewhere. This period of 90 days is not a waiting period or a reflection period. This is not a requirement that the person wait 90 days after they are approved. Rather, it is a stipulation that practitioners must, over at least a period of three full months, fully explore the person's medical condition and the nature and causes of their suffering, and work with them to identify reasonable treatment or other support options they must discuss with the person. The person seeking MAID is not required to undergo any treatments. It would be an intrusion into the individual's autonomy to force them into any sort of treatment, but as we embark on this new expansion of the MAID regime, we believe we can collectively move forward safely, if we can be satisfied that available options have been brought to the person's attention and given serious consideration.
All of these safeguards reflect the irreversible nature of ending someone's life and the very serious nature of medical assistance in dying, which needs to continue to be strictly regulated, especially given the broadening of the regime. As stated by the Canadian Medical Association, which welcomed our government's staged approach, the proposed MAID amendments are “a prudent step forward”. Bill C-7 proposes to further support individual autonomy while also protecting vulnerable persons and ensuring that careful consideration will be given to those challenging issues. For these reasons, among others, I strongly encourage members of this House to support this legislation and to support its passage through this House and Parliament to meet the court deadline of December 18.
I also want to remind members of the upcoming parliamentary review. Through the course of the consultations, and then through the committee process, we did hear of a number of issues that need to be reviewed and addressed, but need more thorough study than could be done in the time required to meet the court-imposed deadline. Parliament will have ample time to review all of these issues, and I think it is important that we do so, but we need to get this legislation passed as well.
Bill C-14, from the previous Parliament, called for Parliament to conduct a review and specifically mentions the state of palliative care. We expect this review will also include important issues such as mature minors, mental illness as the sole underlying condition and advance requests. By no means would I expect this to be a closed list, either. This is a broad issue and we would hope to hear from many Canadians on a wide variety of subjects relating to MAID. Having heard from many witnesses and spoken to many Canadians on Bill C-7, I know there are diverse views on this issue. They are all difficult issues, and I look forward to the parliamentary review and hearing from many more Canadians on the subject and seeing what the review has to say.
As I said at the beginning of my speech, I am very disappointed and concerned by my colleagues across the way and their lack of respect for the court deadline imposed on us by the Superior Court of Quebec to pass this legislation. I believe we have an obligation as parliamentarians to do everything we can to try to meet the deadline of the court. Canadians want this legislation. Quebeckers want this legislation. I am really unclear on why my colleagues across the way are showing disrespect for the will not only of the court, but of all Canadians. They have been slowing and delaying debate unnecessarily, and I am very concerned by what this says about how much they value the rule of law and the will of Canadians.
I want to thank my colleagues who serve with me on the justice committee for their work on helping us in a smooth and efficient committee process on this legislation. I look forward to this House giving the same consideration to the legislation. Again, I want to emphasize to my colleagues the importance of moving quickly. I look forward to continuing the debate on Bill C-7, but also to its ultimate passage in time for Parliament to meet the court-imposed obligation.