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.
The Speaker Liberal Anthony Rota
Pursuant to subsection 79.2(2) of the Parliament of Canada Act, it is my duty to present to the House a report from the Parliamentary Budget Officer entitled “Fiscal Sustainability Report 2020”.
A message from His Excellency the Governor General transmitting estimates for the financial year ending March 31, 2021, was presented by the President of the Treasury Board and read by the Speaker to the House.
Jean-Yves Duclos LiberalPresident of the Treasury Board
Mr. Speaker, I have the honour to table, in both official languages, the Main Estimates, 2020-21.
Jean-Yves Duclos LiberalPresident of the Treasury Board
Mr. Speaker, pursuant to Standing Order 32(2), I have the honour to table, in both official languages, on behalf of the Minister of Finance, the 2020 Report on Federal Tax Expenditures.
Judy Sgro Liberal Humber River—Black Creek, ON
Mr. Speaker, I have the honour to present, in both official languages, the first report of the Standing Committee on International Trade in relation to Bill C-4, an act to implement the agreement between Canada, the United States of America and the United Mexican States.
The committee has studied the bill and has decided to report the bill back to the House without amendment. It has been an honour for all of us as parliamentarians to work on a bill that is going to create thousands of jobs and provide lots of opportunity for growth in our country and to ensure that we continue to work in a very positive way with the United States and Mexico as we move forward.
I want to thank the committee members and all of the staff who worked with us. We had over 102 witnesses. The clerks did a great job. My thanks as well to our deputy prime minister, Ms. Freeland, who did a tremendous amount of work along with our Prime Minister and all of the other witnesses.
It is a great honour to present this report to you, Mr. Speaker.
The Speaker Liberal Anthony Rota
I just want to remind the hon. members not to refer to each other by their names, but by their riding or their position.
Sonia Sidhu Liberal Brampton South, ON
moved for leave to introduce Bill C-237, an act to establish a national framework for diabetes.
Mr. Speaker, I am honoured to rise in the House today to introduce my bill, an act to establish a national framework for diabetes. Today, 11 million Canadians have diabetes or pre-diabetes. Brampton has the highest rate of diabetes. In the birthplace of insulin, how can we not take stronger action toward improving the lives of nearly one-third of Canadians?
Presently, 20 Canadians are diagnosed with diabetes every hour of every day. The national framework seeks to improve access to treatment and prevention of diabetes through education, consultation with the federal and provincial governments and indigenous groups, clinical practice guidelines and, most importantly, a united approach to ensure better health outcomes for Canadians.
Through my bill, I am confident that one day soon we will extinguish the torch outside Banting House. Together, we will find a way to defeat diabetes.
I want to thank the member for Coquitlam—Port Coquitlam for seconding the motion to introduce my bill.
I encourage all members in the House to join in support of improving the lives of millions of Canadians across Canada.
(Motions deemed adopted, bill read the first time and printed)
Bob Saroya Conservative Markham—Unionville, ON
moved for leave to introduce Bill C-238, an act to amend the Criminal Code (possession of unlawfully imported firearms).
Mr. Speaker, people from across the GTA and my riding are scared. Every day the media reports new shootings that are more horrible than the last, and this weekend was no different. In 2018, shootings reached an all-time high. In 2019, the record was broken again. We know that organized crime is behind most of the shootings and innocent people get caught up in the violence. According to the Toronto chief of police, smuggled guns are the weapons of choice for these criminals.
When I spoke with members of law enforcement, they said they were frustrated. Police pick up dangerous offenders and they are back on the streets the next day on bail. When convicted, serious criminals are getting a slap on the wrist.
There is no reason to have smuggled guns. Today, I am proposing a bill that would have the punishment fit the crime for this dangerous offence.
(Motions deemed adopted, bill read the first time and printed)
Candice Bergen Conservative Portage—Lisgar, MB
Mr. Speaker, I think if you seek it you will find unanimous consent for the following motion: That notwithstanding the Standing Orders or usual practices of the House, Bill C-4, an act to implement the agreement between Canada, the United States of America and the United Mexican States, reported back earlier today, be permitted to be considered by the House tomorrow at report stage.
The Speaker Liberal Anthony Rota
Does the hon. member have unanimous consent of the House to move the motion?
Elizabeth May Green Saanich—Gulf Islands, BC
Mr. Speaker, it is an honour to rise today to present a petition from thousands of Canadians who are concerned that six years since the Truth and Reconciliation Commission we have not fulfilled the 94 calls to action. The petitioners call on the House of Commons to immediately undertake to encourage provinces to reform their jury selection systems and other judicial reforms and enact their own reforms, particularly as it relates to the calls to action numbers 25 to 42, to ensure justice for indigenous peoples.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, it is a pleasure for me to table a petition in support of Bill S-204. This bill is in the Senate, and it would make it a criminal offence for someone to go abroad to receive an organ for which there has not been consent by the donor. It seeks to deal with the very serious issue of forced organ harvesting and trafficking.
Paul Manly Green Nanaimo—Ladysmith, BC
Mr. Speaker, it is an honour to put forward two petitions today.
The first petition is from many of my constituents in Nanaimo—Ladysmith. This is a petition that was signed at the The Body Shop at Woodgrove Mall.
The petitioners call upon the House of Commons to ban the sale and manufacturing of animal-tested cosmetics and their ingredients in Canada. This is to get us up to the European Union standards.
Paul Manly Green Nanaimo—Ladysmith, BC
Mr. Speaker, the second petition has been signed by residents up and down Vancouver Island.
The petitioners call upon the House of Commons to establish a permanent ban on crude oil tankers on the west coast of Canada to protect B.C. fisheries, tourism, coastal communities and natural ecosystems forever.
Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons
Mr. Speaker, I would ask that all questions be allowed to stand.
(Bill C-217. On the Order: Private Members’ Bills:)
February 24, 2020—Bill C-217, An Act to amend the Employment Insurance Act (illness, injury or quarantine)—Mrs. Claude DeBellefeuille.
The Speaker Liberal Anthony Rota
I would like to take a few minutes to inform members of an error on the Order Paper. Two private members bills, which are substantially the same, are currently listed under Private Members' Business, items outside the order of precedence. Specifically, Bill C-221 on the Employment Insurance Act, standing in the name of the member for Elmwood—Transcona, was introduced and read the first time on Thursday, February 20, 2020, and Bill C-217, standing in the name of the member for Salaberry—Suroît was introduced and read the first time on Monday, February 24, 2020.
Pursuant to Standing Order 86(4), the Speaker can refuse a notice when he determines that the two items are so similar as to be substantially the same.
In this case, only the first of the two bills should have been put on the Notice Paper. As a result, Bill C-217 is currently before the House in error. I therefore order that the order for the second reading of Bill C-217 be revoked and that the bill be dropped from the Order Paper.
I am sorry for any inconvenience that this error may have caused members. I thank members for their attention.
(Order discharged and bill withdrawn)
Response by Justice Minister to Order Paper Question—Speaker's RulingPrivilegeRoutine Proceedings
Liberal
The Speaker Liberal Anthony Rota
I am ready to rule on a question of privilege raised on February 18, 2020, by the member for Timmins—James Bay concerning the government's response to written Question No. 163.
In his intervention, the member alleged that the Minister of Justice and Attorney General of Canada deliberately misled the House in a response to a written question about the costs incurred in legal proceedings related to Canadian Human Rights Tribunal cases. In short, the member argued that there is a discrepancy between the costs specified in the government's response and the amounts provided to members of the public who obtained the information through access to information requests. In his opinion, the government is in contempt of the House for having deliberately misled it by providing incomplete or inaccurate information in its answer to written Question No. 163.
In response, the parliamentary secretary to the government House leader asserted that the government uses a consistent formula for calculating litigation costs when responding to written questions, while the methodology used for the compilation of the amounts obtained by other people is unknown. He added that this discrepancy in the information by no means suggests that the calculations by the government were done in bad faith or to deliberately mislead the House, and that this matter should not be considered a legitimate question of privilege since it consisted more in a debate as to the facts. In other words, his view is that members disagree on how the final number was arrived at, but that such disagreements are not unusual in debating an issue from different perspectives.
I thank the members for their interventions. Essentially, the member for Timmins—James Bay contends that the response was deliberately misleading because, as he mentioned in his remarks, it does not align with the information obtained by an academic and a journalist through other means, while the parliamentary secretary suggests that the methodologies employed by other sources may have differed from the one employed by the government.
Ultimately, this seems to be a dispute as to facts which, as Speaker, it is not my role to assess. Our precedents on this subject are clear and, as stated in House of Commons Procedure and Practice, third edition, at page 529:
There are no provisions in the rules for the Speaker to review government responses to questions.
Furthermore, in the case before us, contrary to the precedents cited by the member for Timmins—James Bay, we do not have a situation where the same individual has presented two different sets of facts to the House, nor is there any evidence to suggest that there was an attempt to deliberately mislead the House. For these reasons, the Chair cannot find that there is a prima facie question of privilege in this case.
It may be that the member for Timmins—James Bay is not satisfied with the response he received. There is however an array of options available for him to pursue this issue, whether it be resubmitting a written question worded differently or by asking questions to the minister directly during Oral Questions or a committee meeting.
The parliamentary secretary, in his intervention on February 25, 2020, also suggested that members could approach a minister or a parliamentary secretary directly to seek clarification when they feel that the information is incomplete or appears to be inconsistent with other sources of information. He contended that, more often than not, these inconsistencies may simply be a mistake, an omission or a misunderstanding instead of a deliberate attempt to mislead the House.
The Chair must admit that perhaps better communication between members, who seek the information, and the government, who provides that information, could be a solution to improve how the information is shared in this process, without escalating any dissatisfaction to a question of privilege. However, the Chair wants to reassure the House that whenever members feel that their privileges have been breached, it is their right to bring the matter to the attention of the Speaker in this way.
In conclusion, as Speakers before me have expressed several times, I would like to reiterate the importance of the accuracy of information from the government on which the members rely to perform their parliamentary duties.
I thank all members for their attention.
The House resumed from February 26, 2020 consideration of the motion that Bill C-7, An Act to amend the Criminal Code (medical assistance in dying), be read the second time and referred to a committee.
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, we are debating a bill today that strips away safeguards from the existing regime for euthanasia and assisted suicide. Debate started yesterday, and I want to continue in the line I was talking about.
Yesterday, I spoke about some of the philosophical problems underlining the government's desire to remove safeguards. Those philosophical ideas are clearly best understood in the realities of life under legal euthanasia and assisted suicide, in the experience of people and families who have been affected by it and in the concerns of people who will be further impacted by the proposed expansion of the practice and removal of safeguards.
The fact is that the expectation at the time of the Carter decision was for a legal regime that would apply narrowly. However, we have seen the alarmingly rapid process of expansion at the level of policy and practice continuing with this legislation. Given that this bill comes ahead of a scheduled statutory review, it looks like the pace of expansion of removal of safeguards and enlarging eligibility will continue apace even after this. Rates of identified euthanasia and assisted suicide have gone up dramatically every year since legalization, from about a thousand in 2016 to over five times that in 2019. Those rate increases show no sign of abating.
More and more horror stories are coming out about how the current regime has already changed the dynamics of our health care system. My grandmother was a Holocaust survivor, so I know about the long-standing traumatic effects that stay with many survivors for the rest of their lives. One instance of euthanasia at the Louis Brier nursing home in Vancouver, a Jewish facility that has Holocaust survivors among its clientele, was particularly traumatic for residents and staff.
Doctor Ellen Wiebe met with Barry Hyman and his family in the spring of 2018 and determined that he met all the criteria. She later went to the nursing home and closed his door without informing or consulting with nursing home staff. Hyman was killed by Dr. Wiebe on the evening of June 29, without any consultation with his primary caregivers at the nursing home. Perhaps Dr. Wiebe had good intentions, but someone sneaking into a nursing home and then asking us to trust her own notes as evidence of consent raises serious concerns.
Dr. Keselman, CEO of the Louis Brier nursing home, agrees. He said:
Imagine the implications for our staff and our residents and their families. We have a lot of Holocaust survivors. To have a doctor sneak in and kill someone without telling anyone. They’re going to feel like they’re at risk when you learn someone was sneaking in and killing someone.
Clearly Dr. Wiebe, in this case, was pushing the envelope. I doubt most doctors would behave in such a fashion, but we do see from analyses that have taken place in other countries that a small number of activist, pro-euthanasia physicians are overrepresented in cases with problems. A majority of doctors are trying to do the right thing, but a lot of death can flow from the choices of a small number of envelope-pushers.
In a paper studying cases of euthanasia in Holland between 2012 and 2016, bioethicists David Miller and Scott Kim of the U.S. National Institutes of Health noted significant problems in the application of these laws for vulnerable people, if the screws were not tightened properly.
During that period, Miller and Kim found 33 cases in which doctors had broken at least one rule while killing someone, though apparently none of these justified prosecution. Miller and Kim specifically identified the overrepresentation of certain activist doctors in cases that raised red flags.
I spoke in the House in 2016 about another case in Canada, where a physician declared a depressed person eligible for euthanasia even before examining that person, because the patient “could easily get bed sores and then die of infection”. A person's death was, prior to examination, declared reasonably foreseeable because the person could theoretically die from an as-yet-uncontracted bedsore infection.
It is striking that we have these cases to look to at all in Canada, given the massive data collection gaps. There is no requirement for advance legal review to determine if criteria are being met. There are no national standards on tracking data. In fact, in many cases when a patient dies as a result of euthanasia, their death certificate will not even indicate that as the cause of death.
People who have had bad experiences cannot tell their stories in most cases. The data that the government refers to is severely constrained by these realities. We tried, during the debate on the last euthanasia bill, to push for mechanisms for better data collection and reporting to ensure evaluation and protection was possible, but at the time unfortunately the government did not listen.
Those who have had negative experiences and have lived are understandably reluctant to speak out. However, I want to share one story, with permission, of someone close to me who had a negative interaction with the system after this regime began. This is Taylor's story.
Taylor Hyatt is a twentysomething former member of my staff. She has cerebral palsy. She is vibrant, accomplished and full of life. She went to the hospital a couple of years ago with cold symptoms. She was told that she would probably need some oxygen and was asked if she wanted that. She replied, “Yes, of course”, but then the doctors pressed her on the point by asking if she was sure. Taylor was asked if she was sure she wanted oxygen. She just had pneumonia.
When we look at the government's proposal to further expand euthanasia and assisted suicide, and to expand eligibility criteria and remove the small number of safeguards that exist, we need to ask the same question: Is it sure?
As these cases illustrate, we have particular reason to be concerned about cases in which people receive euthanasia or assisted suicide immediately or alone. If multiple family members and health care staff can see, over a period of time, that a person is clear in the desire to have life end, then there is less risk of vulnerability or abuse.
Imagine a case, though, in which children visit their mother in hospital on a Monday. It seems like she is having a good day and she makes no mention of wanting to die. She is experiencing some pain, but the nurse says she has promising ideas about how to manage that pain. The nurse says she thinks she needs to adjust the levels of a few things that should settle the pain down, and she will work on that as soon as the doctor has a chance to see her. The children leave on Monday feeling reassured.
Then the children are informed on Wednesday that their mother is dead. They are told that when she met with the doctor, she was in extreme pain and expressed the desire to die, so she was killed right away. They did not get a chance to say goodbye and they do not know if the doctor got it right or wrong.
Perhaps their mother really wanted to die, but maybe she was just experiencing a temporary low point from which she would have recovered. Her children will never know the details or the situation. Because of the absence of witnesses and legal review, there is very little evidence left behind. If their mother really wanted to die, she could, but would it be so unreasonable for the doctor to have given it a few days for the children to have been able to talk to her about her wishes?
This particular case is exactly where we should focus our concerns as we look at this legislation. The current legal system requires at least two independent witnesses who are not paid personnel, and there is a 10-day reflection period. I would underline, as members have said and as the government has generally failed to acknowledge, that there is already a mechanism by which the 10-day reflection period can be waived.
However, the 10-day period sets out a rule of general practice that is open to variation. It establishes the general and important principle that people should not have their lives taken as a result of a fleeting sense of hopelessness or because their medication levels are off for a period of time.
It makes no sense, as the government is proposing to do, to reduce the number of witnesses and remove the reflection period when there are already provisions for waiving it and managing that effectively in different situations.
Other members may have had these same experiences. I can tell them I had a close friend dealing with depression a few years ago and his state of mind would fluctuate dramatically from day to day. On certain days, he could not imagine going on, while on other days he would feel, in his words, like himself again.
Recognizing the realities of fluctuations and the development of people's experiences, it is horrifying to me that someone could opt for, and receive, euthanasia or assisted suicide within a few hours without independent witnesses or any reflection period. Therefore, the government must remove the clauses of this bill that reduce witnesses and eliminate that reflection period.
The government has included a clause in this bill dealing with so-called advance consent. The mechanism is that I, as a patient meeting the criteria, might ask to die on June 1, even if I had lost capacity. My consent right now would suffice for the taking of my life on June 1. However, the legislation contains no requirement that I be asked how I feel on June 1.
Suppose that I am facing a loss of capacity and I am afraid of the implications of that loss of capacity, not knowing what it would be like to mentally regress in the way that doctors have predicted that I will. Suppose that, in light of this fear, I sign on to advance consent but then, on June 1, while I have indeed lost substantial capacity, I actually have a much higher quality of life than I expected to have.
Should the advance consent that I have provided, in ignorance of my future circumstances, overrule my feelings in that moment? This is not just idle speculation.
Let me read from an article in the The Washington Post about a Dutch case involving an advance directive. It states:
The patient, referred to in official documents only as “2016-85”, had made an advanced directive requesting euthanasia in case of dementia. But the directive was ambiguously worded, and she was no longer able to clarify her wishes by the time she was placed in a nursing home—though her husband did request euthanasia for her.
Despite the lack of a clear expression from the patient, a physician concluded her suffering was unbearable and incurable—though there was no terminal physical illness—and prepared a lethal injection.
To ensure the patient's compliance, the doctor gave her coffee spiked with a sedative, and, when the woman still recoiled from the needle, asked family members to hold her down. After 15 minutes were spent by the doctor trying to find a vein, the lethal infusion flowed.
The government has tried in this legislation to avoid this most extreme case by saying that advanced consent would only apply to a particular date and that the procedure should not proceed if the patient was clearly refusing euthanasia. Unfortunately, the space left for abuse is still massive.
In the case just given, suppose the patient was given stronger sedatives so she was completely unaware of what was happening, and therefore offered no resistance. That would be allowed under the framework established by this legislation. It does not require that patients be informed or consulted at the time of their death. If they have provided advanced consent, that is considered sufficient.
In virtually every case, the requirement for contemporaneous consent is important in our law and is a necessary part of autonomy. If I am to be truly free, then I must be free from the directives of my past self. My past self should not irrevocably be able to bind my future actions.
Even so, it may be possible to still allow advanced consent, but to have some mechanism through an amendment to ensure that a patient, even with limited capacity, is informed and consulted at the time when his or her life is to be taken. I would encourage the government to consider that.
The government should be open to considering these problems and these fixes, taking out sections of the bill that dangerously remove safeguards and strengthening the section on advanced consent to ensure a patient is informed and consulted contemporaneously.
Finally, on the point of safeguards, let us go back and reflect on what the purposes of safeguards are.
Some members will feel that meaningful safeguards are not necessary because we should trust medical professionals and patients to get it right. The parliamentary secretary has used general data about trends in this area to suggest that there are no problems with abuse.
Let us be very clear that the reason we have safeguards is not to deal with general cases, but is precisely to deal with exceptional cases. Even if there are not problems in the vast majority of cases, we try to introduce reasonable verification mechanisms, because those verification mechanisms will catch instances of abuse and cases where vulnerable people might be pushed toward a death they do not want.
The reason we need law enforcement is not because most people are lawbreakers, but because some people are lawbreakers. The reason we have fire departments and expansive rules and protocols around fire prevention is not because most houses are on fire, but it is because some houses could catch fire.
I hope we will see through this debate that the safeguards in the current legal region really are a minimum and that we can provide reasonable safeguards like a short reflection period that can be waived and a requirement for independent witnesses which, like sprinkler systems in this room and security guards watching over us, insulate us against the possibility of something going very wrong.
For the sake of the vulnerable, let us not fire the security and rip the sprinklers out of our system just to make an ideological point.
Arif Virani LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada
Mr. Speaker, I want to point out four matters and lower the tone a bit. We need to talk about facts as opposed to emotional arguments.
My first point is to clarify that depressed individuals are not subject to this regime. We have specifically included a carve out for mental illness as a sole condition.
My second point is that the data collection the member seeks is being beefed up by this very bill.
My third point is that hyperbole has entered into this debate about people being “killed right away”. The notion of having a written consent witnessed by an independent witness and then the eligibility being verified by two independent practitioners, and that occurring in a matter of minutes or hours, is categorically false. That is not the way the system currently operates.
My fourth point is that it is an absolute red herring to raise a case based in Holland, which as has advanced directives for ailments such as dementia. We do not have dementia within the penumbra of ailments subject to this regime. We are also not proposing advanced directives; we are proposing advanced consent.
The member has raised, in some instances, concerns about what he perceives to be patients who are suffering or doctors who are acting aggressively. Those are important cases. If the member has cases, he should have those cases brought to the attention of either disciplinary bodies, regulated physicians or to law enforcement, because those should be enforced.
In fact, what we have is evidence to the contrary, that doctors are not practising this overly aggressively. In fact, there is a small of pool of doctors that—
Garnett Genuis Conservative Sherwood Park—Fort Saskatchewan, AB
Mr. Speaker, the member should know that the last legislation included a good faith exception, that a doctor who did not follow all the rules, but still acted in “good faith” would escape prosecution. Cases have been referred to disciplinary bodies, but there is a limited capacity to actually prosecute people who are, in the case, described as going into a nursing home and taking someone's life, without any consultation with the surrounding staff. These cases raise significant concern.
The member says that we should lower the tone and avoid hyperbole and then criticizes me for bringing up specific cases in Canada and in other countries that have similar legal regimes. The government should look at these cases and consider them before moving forward.
It is right to bring up the Dutch case, and I acknowledge the differences in the proposed regime in Canada from the Dutch regime. However, I pointed out very specifically that there was no requirement in the existing legislation for the person to be asked in the moment. I would beg the government to introduce that additional requirement for some contemporaneous consultation with the patients. After all, what does it have to lose? There very much is the possibility of someone being killed right away under the proposed legislation.
If the parliamentary secretary is so opposed to that characterization of the legislation, then why not leave in some waiting period? If he says that because of all the administrative requirements, inevitably there would be some delay, then leave the waiting period to consider—
The Deputy Speaker Conservative Bruce Stanton
Order, please. Questions and comments, the hon. member for Thérèse-De Blainville.
Louise Chabot Bloc Thérèse-De Blainville, QC
Mr. Speaker, I listened carefully to the member's remarks.
I have some important questions for him. I felt like his remarks were unrelated to the bill before us.
In my former life, I was a nurse. As I listened to the member, I got the sense that his stories were designed to appeal to our emotions. They seemed to suggest that health professionals are malicious rather than benevolent, but that is not true. I heard the member talk about doctors sneaking into care facilities to kill people. That seems a bit far-fetched to me. If something that terrible really happened, I hope my colleagues brought it to the attention of the appropriate authorities.
That is not at all what this bill sets out to do. The bill was improved thanks to two people who went to court. We are looking at how we can broaden the scope of the bill to include people who are suffering but are not necessarily at the end of their lives.