House of Commons Hansard #25 of the 43rd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was medical.

Topics

Criminal CodeGovernment Orders

12:20 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Madam Speaker, I appreciated my Conservative colleague's speech. We do need to focus on the common good. However, I did not understand his position, apart from his plea that we take the time to do things right.

He knows very well that it will not be easy to take that time because, while we are taking our time, there are people who are suffering, people who have no choice, people who want to give their free and enlightened consent about their condition. However, the state that we represent here is not respecting their wishes and giving them the option to relieve their suffering.

What is my colleague's position on giving people like Ms. Gladu and Mr. Truchon access to medical assistance in dying?

Criminal CodeGovernment Orders

12:20 p.m.

Conservative

Gérard Deltell Conservative Louis-Saint-Laurent, QC

Madam Speaker, I agree with the principle behind that. It is important to keep that in mind.

My colleague was a member of the Quebec National Assembly. Four years ago, I worked with him on this bill. My colleague knows full well that we need to take action because there are people who are suffering right now. He also knows very well that, in Quebec, we did things right. It took six years of work to get the job done.

During that six-year period, there were people who were suffering and who would have liked to have access to this sort of care, but we took the time to do things right. Similarly, four years ago, in 2015, when we were just elected, we passed similar legislation under a very tight deadline because the Supreme Court ordered us to do so, but we still did not completely rush the debate.

I agree with my colleague when he says that there are people who are suffering right now. However, there were also people who were suffering in the six years that it took us to do our job properly in the Quebec National Assembly. I do not think that anyone in Quebec or Canada can say that we did not do our job properly in Quebec during the six years that we took to study this extremely delicate subject.

Criminal CodeGovernment Orders

12:20 p.m.

Winnipeg North Manitoba

Liberal

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

Madam Speaker, as a former provincial representative, my friend understands and appreciates the important role that provincial governments play in the administration of health care and in providing services. One of those very critical services is palliative care. We hear a great deal of debate on that particular issue. The federal government also plays a role in ensuring that there is quality palliative care throughout the country, to the extent possible.

I wonder if my colleague could provide his thoughts on how Ottawa needs to work with the other jurisdictions to ensure that the best possible palliative care is available.

Criminal CodeGovernment Orders

12:25 p.m.

Conservative

Gérard Deltell Conservative Louis-Saint-Laurent, QC

Madam Speaker, as I said in my speech, it is important to put an emphasis on palliative care. We are really talking about people's lives. It is not an easy task, but the responsibility of any government is to be sure that those who suffer have access to palliative care.

Obviously this is provincial jurisdiction, and the provinces should do something on this, but on the other hand, it would have been better if the bill had put more emphasis on palliative care, as we did four years ago. It was very important for us on the committee to address this issue, and we hope that the government will take care of palliative care.

Criminal CodeGovernment Orders

12:25 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Madam Speaker, Quebec worked very hard, within its jurisdiction, and chose to include medical assistance in dying as part of a continuum of care, something individuals can request when they are terminally ill. Such care is a provincial responsibility.

Now we are talking about the Criminal Code. Two separate courts have independently asked legislators to intervene regarding assisted suicide in cases where people are suffering but are not terminally ill.

I asked my colleague if he thinks the bill addresses the specific needs of Ms. Gladu and Mr. Truchon, and if he agrees with the two court rulings.

Criminal CodeGovernment Orders

12:25 p.m.

Conservative

Gérard Deltell Conservative Louis-Saint-Laurent, QC

Madam Speaker, yes, I think I already said so. Perhaps he did not hear me.

The fact is, when it comes to issues like this one, the government should have taken its time. There was an initial ruling that came from one court, and there will be others. I think the government has a responsibility to bring this matter before the superior courts to be sure that all legal aspects are assessed by the best legal minds in the country, in other words, the Supreme Court.

That said, personally, I agree.

Criminal CodeGovernment Orders

12:25 p.m.

Conservative

Nelly Shin Conservative Port Moody—Coquitlam, BC

Madam Speaker, Bill C-7, an act to amend the Criminal Code in relation to medical assistance in dying, is one that I believe was written with the intention of providing compassion to those who are suffering through an unfathomable, unbearable degree of pain by allowing a lawful, expedited termination of their suffering and granting access to a dignified death. The intention is kind. I see an urgency from the government to extend this expression of compassion to those who are suffering beyond comprehension.

However, from the perspective of a visionary and a lawmaker who cares for the long-term wellness and prosperity of our country, I would like to invite all members of the House to pause and bring into our dialogue the long-term effect of this bill and the impact of this bill on the guiding principles of lawmaking going forward.

I do not stand to speak on this bill with the moral authority of one who has reached a point of suffering equal to those who may be applying for MAID. I do not think most members of the House here have the personal experience to speak on that level. However, I do stand here to speak on this issue because there has been a force in my life that carried me through some very dark nights of the soul when adversity, pain and repeated cycles of injustice were poignant enough to wear down my will to fight and to try, sometimes causing me to question the value of my existence.

I have seen this force raise addicts, cancer patients and those experiencing deep depression from deep pits of psychological paralysis and darkness. This force transcends the distinctions of race, gender, socio-economic background, etc. It is almost as vital as life itself. It is a force that is central to the existence of the human race, and that force is called “hope”. While hope is easier to access for some than others, for others it may be almost impossible, because their painful experience is choking the light from their vision.

As caring individuals, as communities and as a nation that prides itself on compassion, it is our duty to turn over every stone to help others find hope when they can no longer access it themselves. Hope is a journey that demands an unrelenting search until it is found.

We saw it with Terry Fox. He is a national symbol of hope, because despite his painful struggle with cancer, he made the sacrifice he made with his cross-country campaign for cancer research because he was in search of hope and giving that hope to others. The story of his triumph over adversity, though his life was tragically truncated at such a young age, still continues to champion Canadians today, as Canadians respond by revering him as a national hero, because we value hope. We have seen the power of hope that compelled Terry to pass the finish line of his last breath.

We see hope whenever we see Team Canada send our paralympians to the Olympics. Many of them have overcome deep physical, emotional and mental suffering. Their focus, discipline and excellence have helped them to overcome their challenges.

Our nation is built on a foundation that values the sustenance of life and the right to prosper. We invest millions of dollars every year in first responders, medical services, infrastructure and laws to protect the survival, sustenance and prosperity of the people.

However, expediting the administration of death is counterintuitive to the inner reach for hope in the human condition. Our very Constitution is founded on the principles of the value of human life, the prosperity of each human being and each one's access to the opportunity to flourish.

While deep with the intentions of compassion and the appropriation of dignity, intervening with easier access to MAID opens a door to a very complicated path of further suffering, even for those who live on.

I would like to bring to the attention of the House the story of a man named Alan Nichols, from my province of British Columbia. As reported by CTV this past September, his family has stressed that Alan struggled with depression and should not have qualified for assisted death.

Alan's brother Gary told CTV:

He didn't have a life-threatening disease. He was capable of getting around. He was capable of doing almost anything that you had to do to survive.

Like many Canadians, Alan's life was altered dramatically when his father passed away. Especially since his father had been so involved in his life, his father's death made him particularly vulnerable, and he stopped taking antidepressants and became more angry and isolated:

Not going out in public, not seeing anybody, not eating properly.

This is how Gary described it.

Alan's family knows that he rid his home of furniture, apart from a bed and chair, and that he would refuse medication and food because of his depression. Another disturbing aspect to Alan's story is that despite his family's attempts to be involved in his life and an advocate for his life, his family members report that the hospital staff would not share information with them and shut them out from hearing the key facts.

There is more to this story, but I will leave it at that. This is accessible information.

The point I would like to illustrate here is that this is a very complicated issue. It is one that touches something so deep and necessary to our existence and our country, and that is hope. All because of the irreversibility of death, there is little intervention that can be done afterward when hope is terminated because there is no breath to receive the assistance of hope.

Rather than be in a rush to legislate this bill, we should focus on tackling things like the epidemic of suicide among first nations communities and youth. We should also focus on giving Canadians better access to mental health care so Canadians have greater access to hope when faced with situations of suffering, as people who are suffering so much consider MAID. We must do this until there are enough measures to show the flourishing of hope and human prosperity to counter a potential culture of death from capturing our nation, if we are to be too swift and lenient in our decisions surrounding issues of death.

It pains me to watch others suffer, but it also pains me to think that as lawmakers, our focus is on expediting access to death rather than expediting access to hope.

My statement in the House today is to inspire all members of this House to not only consider the dignity of the people suffering seeking release through death, but the dignity of existence and human prosperity for the long term.

Removing the mandatory 10-day waiting period reduces protections for vulnerable members of society. The government's original legislation, Bill C-14, went though extensive consultation. It is scheduled for parliamentary review this summer. I would ask the Liberal government to respect the process and allow the review to proceed rather than rush this very sensitive and complex issue in legislation. Let us give this time because death is irreversible.

I have decided to look at this bill through a filter of hope and preserving a culture of hope, as being a force that guides the laws we make not only today but for decades and centuries to come. Therefore, I stand today in the name of hope and invite my colleagues across all aisles to examine this bill through the lenses of hope and preserving hope in our country.

Criminal CodeGovernment Orders

12:35 p.m.

Liberal

Judy Sgro Liberal Humber River—Black Creek, ON

Madam Speaker, I wanted to applaud my colleague's courage and recognize that every word she spoke today is probably the same words that all of us as parliamentarians have spoken. Hope is eternal. Hope is what gives us all the energy to fight the battles we have in our lives and in our family's lives. We must never eliminate that hope people want to have in various aspects in their lives.

When we dealt with this bill previously, it was amazingly complicated, as my hon. colleague mentioned. It was probably one of the most difficult issues I have had to deal with in my 20-some years as a parliamentarian. By listening to people, like my colleague and others, we try to find the way that reflects the feelings of so many people.

Investing more money makes sure that there are programs that offer hope, whether we are talking about mental health, palliative care or so many other avenues. We are trying to ensure that everybody has hope and that they do not want to give it up and that we have given them every opportunity possible to access that help.

Does my colleague feel there is still a tremendous lack of those services in the areas she represents?

Criminal CodeGovernment Orders

12:35 p.m.

Conservative

Nelly Shin Conservative Port Moody—Coquitlam, BC

Madam Speaker, I appreciate the member's compassionate remarks. I am very emotional right now because it is a very important issue for everyone, and in some way or another we are all impacted by it. I have spent time on the front lines. I believe, whether it is in the area I represent or anywhere else in Canada, there is a lack of access to counselling and mental health care that would, as I mentioned in my speech, give tools to Canadians to work through their struggles, adversity and pains to access more hope before moving in the direction of medical assistance in dying.

I understand fully the implications of compassion that this piece of legislation is wanting to present, but because of the irreversibility of death, I feel time is needed. Preventatively and for the long-term future of our country, we must deal with all those other areas with greater care and time.

Criminal CodeGovernment Orders

12:35 p.m.

NDP

Charlie Angus NDP Timmins—James Bay, ON

Madam Speech, we do not hear the word hope very often in this place and it is something that is very important. I would like to make two comments. One is that death is hard, death is very hard, but it does not mean it is without hope. When my sister died it was brutal, it was unfair, but it was life. We brought her out in the old Celtic way with singing and celebration because that is what we do. There is hope in that and hope has to be about compassion and doing what is right.

Second, I would like to ask my hon. colleague about the lack of action she mentioned on the horrific suicide crisis we are facing. Year in, year out we are losing hundreds of young people. We lose young people in my region all the time and it never seems to be a priority. When I hear the Prime Minister talk about losing patience, I think of the patience that has been lost by children as young as nine years old, 10 years old and 11 years old who do not even believe that this country cares about them enough that their lives are worth living.

What does my hon. colleague think we can do to address the horrific hopelessness in so many young people who are giving up?

Criminal CodeGovernment Orders

12:40 p.m.

Conservative

Nelly Shin Conservative Port Moody—Coquitlam, BC

Madam Speaker, first of all, there needs to be more dialogue and long-term solutions that are thought out, but we need action. We cannot just have good intentions, we need to put them into action. I look forward to the opportunity to working with anyone across the aisle on trying to bring more action in helping to take care of our youth in relation to suicide or mental health issues.

Criminal CodeGovernment Orders

12:40 p.m.

Winnipeg North Manitoba

Liberal

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

Madam Speaker, I rise today to address a very important piece of legislation. Looking at it, I could not help but reflect on the previous debates that we had and the process in the development of Bill C-14, which led us to the point where we are today.

If members who were not here want to get a good sense of how thorough the debate and discussions were, I recommend they take a look at some of the comments in the standing committees, the many lead-up discussions, different presentations and the pre-study that was conducted.

I enjoyed listening to the debates then, because like the member who just spoke said, we heard a lot of personal stories. When people ask me what I enjoy about being in the chamber, it is the different types of debates that we have. These are the ones, like the debate today, that I learn from. I appreciate the stories that come before the House.

We are all concerned about protecting vulnerable individuals in our society. At the same time, it is important as legislators to have a role to support the eligible person to be able to seek medical assistance in dying. It is a very difficult issue.

A good number of us felt with the passing of Bill C-14 that we had something that would move us forward. Even during the height of that discussion, there was a feeling that in a number of years we should review it and take a look at what has transpired in the previous years. We are quickly getting to that point.

However, last September, a Superior Court in Quebec made a determination. Members of the Conservative Party say maybe we should have appealed that decision. I respect that opinion. I do not necessarily believe that would have been the best direction for the government. The direction we have chosen is to make changes to the legislation now, in the hope that we will better serve Canadians.

Having said that, once we get into the summer months, there is going to be a great deal of discussion because it is mandated. When I think of the Bill C-14 debate, and I will provide some personal thoughts on the issue of palliative care, I would like to see us talk about the issue of mental illness. I am hoping that, when we do that comprehensive review, we incorporate that along with palliative care.

I am sure I am not unique and that all 338 members would concur when we think of health care in Canada, there are a couple of issues at our doors: the issue of mental health care services and palliative care services. I used to be the health care critic 15 years ago in Manitoba. We did not have the same sort of dialogue that we hear in the last number of years on those two critically important issues.

British Columbia many years ago elevated the issue of mental illness and made it a separate ministry. There was a minister of health and a minister of mental health illnesses.

I say that because, more and more, provinces are aware of the issue and the importance of mental illness. The Government of Canada has invested hundreds of millions of dollars over the last number of years, and continues to invest in mental illness and palliative care across the country. We are on a very strong footing when we look at where we are today.

We need to reflect on what brought us here. There were many consultations: literally thousands of people were engaged and many hours of debate and dialogue took place. It could have been in the thousands of hours. I do not know that for a fact, but I am sure that, between the time committees met on second reading of Bill C-14, the amount of consultation with Canadians in all regions of the country and the responses received via all sorts of mediums, hundreds of thousands of Canadians in all regions of our country were able to weigh in on this issue.

If we advance to January of this year, again there were consultations and round tables that took us to the different regions of Canada. There was the survey that has been referenced already today on several occasions. Approximately 300,000 Canadians were engaged in that particular survey at the beginning of the year. I do not know if all of the results have gone public to date, but I trust the individuals who helped formulate the legislation we are debating today did their homework in terms of consultations and incorporating all of the ideas. I know the Department of Justice and the Department of Health are following this debate and listening to what members have to say.

From a personal perspective, based on experiences I have garnered over the years, there are two concerns I want to express. One is with regard to health care services and the other deals with the legislation itself. Let me expand on both points.

If we were to ask Canadians what makes them feel good about being Canadian, we would often hear our health care services. I suspect this is probably number one. I referenced mental illness and palliative care. I have witnessed first-hand the evolution of palliative care.

My grandmother was in the St. Boniface Hospital, and many hospitals in our country have palliative care sections. Many of them panel seniors, in particular, who cannot get the quality care necessary in personal care home facilities or the supports they need in their communities and in their homes, so they end up going into hospitals and are panelled.

Many of them will go into palliative care because there are no designated palliative care units in health care facilities, so they end up in hospitals. My grandmother was one of them. She had terminal cancer, and we watched as the weeks went by. Family members visited and it was very difficult on them.

We had a very special relationship, as we all do with our grandparents. Many of us wondered why she had to be in a hospital. Even though it was kind of sectioned off from the emergency department and other aspects of the hospital, she was still in a hospital. It is a different type of a situation, and not necessarily the most comfortable.

Ultimately, my grandmother passed. Then, a number of years later, I had the personal experience of being there for my father in the days prior to his passing. He had to go from home into a hospital, and we were very fortunate that we were able to get him into the Riverview Health Centre. In that centre, with its large windows and beautiful atmosphere, you get the feeling that the type of care is very different.

I reflect on that. I was there at the moment of my father's passing, and we had discussions a number of days prior when he was in fear of what was going to happen, because he witnessed what had taken place with his mother, my grandma, at the St. Boniface Hospital. He did not have that choice, but we talked about having that choice.

I think, knowing my father, he would have been very happy with the way in which he ultimately passed. I really attribute it to his world-class treatment at that particular facility, and I kind of wish that my grandmother had the same sort of atmosphere. Not to take away from the fantastic work that those health care providers and others did at the St. Boniface Hospital, but it was a totally different atmosphere.

During the Bill C-14 debate, we heard many stories like the one we just heard from the member opposite. They are very touching, they are compelling and they make us ask what we can do here in Ottawa to ensure that we have the best quality of health care services we can possibly provide.

It is one of the reasons I am very passionate on the issue of the national framework. It does not have to be a system where we have one thing in British Columbia and another in Atlantic Canada or in the province of Quebec, or in provinces that do not have the same economic means or the same sort of treasury to provide the type of service that they should. This is where the national government has a role to play.

When I listen to comments inside the House with regard to where we might want to go from here, or very serious concerns about the current legislation, I would suggest that we reflect on what we are going to be able to potentially do in the coming months, when we have the opportunity.

Unlike in the Manitoba legislature, our standing committees can be exceptionally effective. It is truly amazing, the type of authority, ability and participation that we can witness if we are prepared to park our partisan hats at the door and try to do what is best for Canadians on this issue. If we can take a look at what took place, with regard to C-14, there is absolutely no doubt in my mind that we can do that.

If members listened to the previous speaker, they would get a sense of what was taking place when we had the debates on C-14. Whether it is in the health standing committee or whatever it is that we come up with collectively, with representation from all the parties, I would encourage them to take into consideration the possibility of going outside of Ottawa.

Maybe we should look at different regions and see what some of these other provinces are doing, and maybe tour some of the palliative care facilities. There is a great variance.

We need to look. If I reflect on the province of Manitoba, we should take a look at what is happening in Winkler, Flin Flon or Winnipeg. We should take a look at the difference between Riverview Health Centre and what takes place in the Seven Oaks hospital.

Where, and what role, can we play as a national government to ensure that we are maximizing the benefits of providing the type of palliative care that Canadians expect and deserve, given the limitations that we actually have? Only the national government can do that. I suggest it is going to be in a very important role.

Earlier today, the standing committee on trade tabled the CUSMA deal, the trade agreement between Canada, the United States and Mexico. Many of the members were taking pictures of that particular committee, feeling very positive in terms of what they had been able to accomplish.

My challenge to the health committee, if that is going to be the standing committee, is to take that role very seriously in terms of the potentially life-changing report it could produce for Canadians.

I truly believe that the will is there to support what that committee is hoping to accomplish. It is just as significant as, and maybe even more important than, the report tabled today by the trade committee, which from what I understand was supported unanimously by all members of the House. If one listens to the speeches thus far, I do not think anyone would dispute what I said in regard to it.

I really encourage the standing committee, in the strongest way I can, to look at the mental illness issue using the same principles I talked about regarding palliative care. It is such a critically important issue, and Ottawa needs to play a stronger national leadership role on that. Hopefully that will happen, but because of time I am only going to highlight a few very brief points.

The proposed amendments would allow for a waiver of final consent for persons whose natural death is reasonably foreseeable, in the sense that they have been assessed and approved to receive medical assistance in dying, and have made arrangements with their practitioners for a waiver of final consent in certain situations because they were at risk of losing decision-making capacity by their chosen date to receive MAID.

I also want to highlight that the government is very aware of the concerns about the increased risks when MAID is provided to persons who are not dying in the short term. The bill, therefore, proposes additional safeguards that would apply when a person's natural death is not reasonably foreseeable.

These new safeguards aim to ensure that sufficient time and expertise are devoted to exploring requests for MAID from persons whose natural death is not reasonably foreseeable and that such people are made aware of, and seriously consider, available means for relieving their suffering.

There is another really important part to me, but maybe I will do it in the question-and-answer period.

Criminal CodeGovernment Orders

1 p.m.

Conservative

David Sweet Conservative Flamborough—Glanbrook, ON

Madam Speaker, I do not often take the chance to speak for my colleagues on this side of the House, but I will right now with regard to the strategy the government is taking on this important issue of medical assistance in dying.

In 2015, in the last election, the Liberals made a commitment that they would invest $3 billion in palliative care to make sure that palliative care across the country was as available as medical assistance in dying. To date, they have not fulfilled that commitment.

The problem we have with modifying the medical assistance in dying legislation is that those who would like to have palliative and hospice care, to feel loved all the way through to the end of their life with the assistance of medicines that would relieve their pain, do not have the capability to experience that. They should have equal rights to those who want medical assistance in dying.

Why have the Liberals not delivered on their promise and why will they not commit to that today?

Criminal CodeGovernment Orders

1 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, I have a couple of quick points on that matter.

First, I do not necessarily concede to the member in terms of the commitment he has referenced. Record amounts of money have been transferred to the provinces to deal with health care. A historic number of dollars has flowed to the provinces. A significant amount of that has been allocated to palliative care, although I really do not know the actual dollar figure.

For the second point, I will pick up on the first point to try to alleviate the concerns the member has. I talked about the importance of having the committee go forward into the summer, and part of its discussion and study should take into consideration what sort of financial role Ottawa could be playing to support this. As I said, we want to make sure there is a sense of equity among the provinces. I think part of that study, which we will be having in the coming months, also needs to take into consideration the issue of the costs of palliative care.

Criminal CodeGovernment Orders

1 p.m.

NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, the NDP is, in general, fairly happy with this new legislation because it would fix some of the real problems we saw in the original legislation, which we debated and passed in the last Parliament in reaction to the Supreme Court ruling. The Liberal government at that time ignored some very important parts of that Supreme Court ruling and just forged ahead with its own version of what it thought was best, and here we are, four years later, redoing everything.

I wonder if the member could comment on that. Should we not have done it right the first time and not put all of these people, who are suffering so much, through additional duress for these past years?

Criminal CodeGovernment Orders

1:05 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, as the member knows, there was a debate process, and the passage of Bill C-14 ultimately received, I believe, unanimous support from the House. However, there is no doubt that during that dialogue there were some differing opinions. The government at the time genuinely felt that this was the best way to proceed. Some wanted the government to go a little further. It is one of the reasons why we recognized back then that this was the type of issue, given the nature of the legislation, we wanted to come back to. Even if the Superior Court in Quebec had not made the ruling it did back in September of last year, the House would have reviewed the process.

The decision by the Superior Court of Quebec allows us to speed up on this very important issue, and that is why the government has chosen to bring forward the bill. It might change to a certain degree, and we will wait and see what happens once it gets to committee, but even at the conclusion of the bill, we will still have this future study, which is a good thing.

Criminal CodeGovernment Orders

1:05 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Madam Speaker, the Parliamentary Secretary to the Leader of the Government in the House of Commons gave a very interesting speech.

As lawmakers, we must focus on what we are responsible for and the object of the court's ruling. We must amend the Criminal Code. Although I share my colleague's concerns about good palliative care and its accessibility, palliative care is not in the Criminal Code and does not fall within the federal government's jurisdiction.

Does he not agree that one way to increase the availability and accessibility of palliative care for those who need it, but who would not benefit from it, would be to provide access to MAID?

First and foremost, the solution would be for the government to respond favourably to the request from the premiers of all provinces and Quebec that it increase health transfers to 5.2%.

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1:05 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, I believe it is important that the Government of Canada, no matter its political partisanship into the future, should always provide financial support for health care across Canada. A part of that also includes recognizing that the national government has a role to play in ensuring that the Canada Health Act is implemented and that we look at areas of health care, like mental health and palliative care. I think there is an expectation among Canadians that the national government is doing that.

I am glad to say that we have a government that is working with the provinces to support, where it can, the delivery of good-quality health care services from coast to coast to coast.

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1:05 p.m.

Conservative

Damien Kurek Conservative Battle River—Crowfoot, AB

Madam Speaker, it seems that the bill goes far beyond the scope of the court decision. That is a big concern, but my question is about the consultation period.

There was a tremendous amount of response. I had dozens of constituents who wished to get involved but, for one reason or another, were unable to participate in the consultation process. Why was the consultation process so limited in terms of time and only online? Many challenges have resulted from what I think was an inadequate consultation period on such a serious issue.

Criminal CodeGovernment Orders

1:05 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, I can assure the member that there were thousands of people. Factoring in the surveying and the questionnaires that went out, I believe well over 300,000 Canadians participated in one way or another directly.

There were round tables and consultations in every region of the country, which included provincial governments, disability groups, doctors and nurses. Of course, there is the feedback MPs are bringing back. We also have the standing committee. I can assure the member that there will be good, healthy discussions there. I am being approached by constituents, so I am sure we are all being approached by constituents. At the end of the day, we still have another consultation coming up to do an overall review of everything.

Criminal CodeGovernment Orders

1:10 p.m.

Waterloo Ontario

Liberal

Bardish Chagger LiberalMinister of Diversity and Inclusion and Youth

Madam Speaker, I appreciate the great work the member for Winnipeg North does in the House. I also appreciate his referring to the previous debate. I know his time often feels limited in this chamber. He had one more point to make, and I would be pleased to hear that point.

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1:10 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, I thank the minister very much for that.

The point I want to make is with regard to permitting a waiver for the requirement to give final consent, in specific circumstances. Persons whose natural death is reasonably foreseeable who have been assessed as eligible for MAID and are at risk of losing capacity can make an arrangement with their practitioner in which they provide their consent in advance. This allows the practitioner to administer MAID on a specified day, even if the person has lost decision-making capacity.

There are some other issues related to that, but I thought it was a very important thing to get on the record.

Criminal CodeGovernment Orders

1:10 p.m.

Bloc

Yves Perron Bloc Berthier—Maskinongé, QC

Madam Speaker, I will be sharing my time with my very esteemed colleague from Shefford.

The debate we are having today must be handled with restraint, dignity and composure. Partisanship has no place here. This is a serious matter, and our decision will have significant repercussions on the lives of many, and perhaps even on our own lives one day, because we all have to leave this world sometime. It is inevitable.

The sad thing in all this is that, through decisions made in this very Parliament, our society has forced people who are suffering to suffer even more. People with severe medical conditions were forced to appeal to the justice system to have their most basic rights upheld. Worse yet, some had to go on a hunger strike to get access to medical assistance in dying by meeting the reasonably foreseeable death requirement. Do hon. members have any idea what we have asked these suffering patients to endure?

These long-suffering people coping with illness, trying to get through the day in unspeakable physical and psychological agony, were forced to go to court or put themselves in a position where their death was reasonably foreseeable. Everyone knows that the justice system is backed up. The costs and delays are typically unreasonable. These people had to endure a veritable ordeal because we made a decision for them.

We failed to make informed decisions that upheld individual liberty. It is a huge privilege to sit in this House, and with that privilege come serious responsibilities. We must honour our position. I want all members of the House to know that this time, we cannot fail. Courageous patients have had to fight the system to get us to make a wise, informed decision. The Superior Court of Quebec gave very clear directives. We must have the courage and vision to apply these directives and support this bill in principle, because it deserves to be improved in committee.

The Beaudoin decision in favour of Nicole Gladu and Jean Truchon is very clear: “The Court has no hesitation in concluding that the reasonably foreseeable natural death requirement infringes Mr. Truchon and Ms. Gladu's rights to liberty and security, protected by section 7 of the Charter.”

We must read those last few lines carefully. They refer to the rights to life and freedom of choice. Which of us can presume to choose for someone else? I want to warn my colleagues against the temptation to think about themselves. I want to warn them against voting according to their own beliefs, philosophies or religion. Freedom to choose must be upheld, and in order to choose, we need options. The basis of the decision, which came after a very long wait and constant anguish, makes it very clear that this is about rights and freedoms. No one can choose for another person. We must remove the barriers so that everyone can live out their last moments in their own way, freely and without constraint. Of course, we must not fail to protect the most vulnerable, in accordance with the well-established rule, in medical practice, of free and informed consent. That means informed by exposure to all possible options, and free from any undue pressure.

This bill is a step in the right direction. It includes important precautionary measures and provides for the study of other important issues that need to be considered. Among other things, it would exclude people suffering solely from mental illness. I think that is a wise decision. This is an extremely complex issue that should be studied further. We cannot decide on this issue right now, hence the need to study it properly without skipping any steps.

We must also look at the issue of advance requests for persons newly diagnosed with a condition that may have an impact on their decision-making ability in the future. These are extremely sensitive issues that we must study with great care and a great deal of precaution. It is therefore wise not to include them for now.

Generally speaking, the purpose of this bill is to allow those suffering from degenerative, incurable diseases to have access to medical assistance in dying, whether natural death is reasonably foreseeable or not, except in cases of degenerative cognitive disease, as I was just saying.

For people whose death is reasonably foreseeable, this is about relaxing the rules by eliminating the 10-day waiting period between the written request and the administration of MAID. The 10-day waiting period may be waived if a person has been assessed and their request for MAID has been approved and arrangements have been made with their practitioner to obtain a waiver of final consent because the patient is at risk of losing their capacity to make a decision as the disease progresses or with the administration of pain-relief medication. That way, when making the request for MAID, the patient can agree to waive consent the second time if their pain is beyond treatment, even with care.

This last measure allows the person to live longer with a reasonable quality of life. The person therefore does not have to feel like they have to rush to request MAID out of fear of losing their capacity to do so.

For people whose death is not reasonably foreseeable, there is a 90-day delay between the request and the provision of the MAID service, unless assessments have been made and the loss of capacity is imminent. This time period must therefore be applied in a reasonable and reasoned manner. Who among us can guarantee that 90 days will be enough for some? Who among us can say whether 90 days will be too long a hell to endure for others? We are entitled to question the application of this delay. No one can say. That is why this clause and this entire bill will have to be implemented in a sensible, flexible and intelligent way. Practitioners are in the best position to determine what is valid and what is not when they work together with their patients, listen to them and, of course, treat them humanely. Ultimately, the priority must be the patients themselves, their well-being and their dignity.

I remind all members that although we are talking about dignity, this is above all about rights and freedoms. Every person at end of life must have options, and that individual is the only one who should be able to make that choice. We must not impose our own values and opinions. We must simply ensure that we provide a suitable framework regulating the practice of and the right to medical assistance in dying. We must respect the freedom of the individual. That is fundamental.

I urge all parliamentarians in the House to consider the huge responsibility we must shoulder. We hold in our hands the fate of hundreds of thousands of people. Not only is the end-of-life suffering of these people in our hands, but the suffering and anguish of their family members is as well. It is horrific to watch a loved one suffer at end of life and to feel helpless. Some members of the House may be thinking about personal choices. As I mentioned earlier, we need to figure out a reasonable framework for this very complex act and, through all of this, maintain freedom of choice for these individuals.

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Parkdale—High Park Ontario

Liberal

Arif Virani LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Madam Speaker, I thank the hon. member for his comments. I have some questions for him.

During the debates today and yesterday, a lot was said about some MAID practitioners. I would like to know whether the member heard the same concerns raised by the Conservatives about doctors who pressure patients too aggressively.

My second question has to do with the fact that mental illness is not included in the bill and that we will be studying it, as the member mentioned. I would like to hear his thoughts on the fact that the Government of Quebec also decided to study whether mental illness should be an underlying condition.

I would like to hear his thoughts on those two questions.

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Bloc

Yves Perron Bloc Berthier—Maskinongé, QC

Madam Speaker, I thank my hon. colleague. His questions are valid.

I will start by answering his second question.

With respect to mental illness, the Government of Quebec chose to study the issue more thoroughly before including it in the law. If two separate lawmaking bodies are making the same choices, that strongly suggests we are on the right path. I think it is a reasonable decision. Laws as impactful as MAID legislation must be drafted very carefully.

With respect to doctors' policies, I heard the horror stories some of our colleagues shared with the House. It is important to note that the medical profession is extremely well regulated. We need to make sure this bill provides a solid framework.

Some MPs shared examples of real cases with us, and I would encourage them to report those cases. I believe such cases are rare exceptions.

By far, most health professionals, including doctors, nurses and attendants, are dedicated to and care deeply about the well-being of their patients. They will take every possible precaution to ensure that the patient's choice is free and informed. As I said, for patients to make free and informed choices, they must be made aware of their options.